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Monday, December 19, 2022

What Are the Most Common Issues Discussed in Sex Therapy?

Many people who have sexual problems feel too ashamed to get help in sex therapy or they don't know what sex therapy is (see my article: What is Sex Therapy?).

Common Issues in Sex Therapy

To shed light on some of the most common issues clients discuss in sex therapy, I'm writing this article to help reduce the stigma related to sexual problems and encourage people to seek help.

What Are the Most Common Issues Discussed in Sex Therapy?
The following are just some of the most common issues discussed in sex therapy in no particular order:
  • Mismatched Libidos/Discrepant Sexual Desire Between Partners: The initial stage of a relationship is the limerence stage when people experience that heady in love feeling and sex tends to be passionate and exciting.  But it's a common occurrence that the limerence stage only lasts for a relatively short time and then the relationship develops into a more mature phase of love, which is often less exciting. This is normal, but many people think there's something wrong with their relationship when the excitement wanes. When this happens and one person desires sex more often than the other, there is a mismatch in sexual desire, which is called discrepant sexual desire. The mismatch can involve any type of difference. This mismatch can involve sexual frequency or the type of sex each person wants to have. Sex therapy can help couples to reignite the spark in their relationship (see my article: Relationships and Mismatched Sex Drives: What is Discrepant Sexual Desire?).
Common Issues in Sex Therapy: Sexual Desire Discrepancy

  • Differences in Sexual Responsiveness in a Relationship: Related to discrepant sexual desire is a difference in sexual responsiveness.  This can occur at any stage in a relationship.  This means that each person in the relationship experiences sexual arousal in a different way.  One person experiences spontaneous desire and the other person needs more time to get turned on, which is called responsive desire.  Again, this is common and normal. Neither type of desire--spontaneous nor responsive--is better than the other. They're just different. Sex therapy can help people struggling with this issue, especially if both people are willing to work on getting to know their turn-ons and turn-offs, which are often referred to as sexual accelerators and sexual brakes (see my articles: Spontaneous Sexual Arousal and Responsive Sexual Arousal Are Both Normal and Understanding Your Sexual Accelerators and Brakes).
  • Frustration About a Sexless Relationship: There are relationships where neither partner is bothered by the fact that they're not having sex because sex isn't important to them. If both people feel the same way, there's no problem. But in most relationships sex is important and if sexual frequency has dwindled down to several times a year or to nothing, one or both partners are often dissatisfied.  Sex therapy can help people to get to the root of their sexless relationship so they can enjoy sex (see my article: Have You and Your Partner Stopped Having Sex?).


Common Issues in Sex Therapy: Frustration About a Sexless Relationship

  • Loss of Trust and Sexual Desire After Infidelity: After one or both people in a relationship discover infidelity, they often find it difficult to reestablish trust so that they can enjoy emotional and sexual intimacy.  Even if the person who cheated is genuinely remorseful, the person who feels betrayed often associates sex with anger, resentment, sadness, betrayal and suspicion.  This can make having sex challenging. Sex therapy can help these individuals to work on regaining trust and intimacy (see my article: Learning to Trust Again After an Affair).
  • Erectile Unpredictability: When medical issues have been ruled out, most cases of erectile unpredictability, including erectile dysfunction, premature ejaculation, delayed ejaculation, an inability to sustain an erection, are psychological in nature.  The man who experiences erectile unpredictability often experiences shame and guilt, and the significant other sometimes blames themselves or believes their partner doesn't find them sexually desirable.  However, sexual desirability usually isn't the problem.  The problem often involves anxiety about maintaining an erection or a self consciousness about sexual performance. Sexual anxiety often leads to spectatoring. Spectatoring, which can happen to a man or a woman, means they get stuck in their head and they lose focus of their own and their partner's sexual pleasure (see my article: Are Negative Thoughts About Yourself During Sex Distracting You?).

Common Issues in Sex Therapy: Erectile Unpredictability
  • Sexual Performance Anxiety: People who are preoccupied with performance anxiety during partnered sex often have problems with sexual self esteem.  Their preoccupation with their performance, body image issues, and other inhibitory factors often bring about the problems they fear in terms of erectile unpredictability (as mentioned above), problems with orgasms (for both men and women), and other sex-related problems. Rather than focusing on pleasure, they're focused on performance. Sex therapy can help these individuals to reorient their focus to sexual pleasure rather than on performing in a certain way (see my article: What is Performative Sex?).
  • Unresolved Sexual Abuse That Has a Negative Impact on Solo and Partnered Sex: Unresolved sexual abuse trauma can get triggered during solo or partnered sex. Individuals with a history of sexual abuse, which include women and men, can experience anything from flashbacks to overall feelings of revulsion when they have sex. Some people are aware of their history of sexual abuse. Others might have fleeting memories or fragments of memories.  Others might have no conscious memories of it, but they have a sense of it. These individuals can be helped in sex therapy with a therapist who also specializes in psychological trauma (see my article: Overcoming the Trauma of Sexual Abuse).
Common Issues in Sex Therapy: Sexual Abuse
  • Painful Sex For Women: Even though as many as 1 in 5 women suffer with some form of pain during sexual intercourse (penis in vagina sex), many of these women don't know that this is a common problem. They suffer in silence or they avoid sex altogether.  They also don't know that sex therapy can help them (see my article: Getting Help For Painful Sex in Sex Therapy).
  • An Orgasm Gap Between Heterosexual Women and Men:  The orgasm gap refers to differences experienced by heterosexual women as compared to heterosexual men in terms of having an orgasm during partnered sex.  Many women are able to have an orgasm during solo sex (masturbation), but they're unable to have an orgasm during partnered sex with men.  This is usually due to the fact that many women don't have an orgasm from sexual intercourse alone.  They need clitoral stimulation, and many men and some women are unaware of this. Unfortunately, there's also still a double standard when it comes to sexual satisfaction: Some men don't value a woman's sexual pleasure as much as much as they value their own. In addition, some women are also focused more on their male partner's sexual satisfaction.  Or, sex is so unsatisfying for some women that they just want to get it over with as quickly as possible. Often poor sexual communication between the man and the woman having sex is an issue.  In addition, poor sex education in the United States is a contributing factor (see my articles: Closing the Orgasm Gap Between Men and Women - Part 1 and Part 2).
  • Compulsive and Out of Control Sexual Behavior:  Sexually compulsive behavior includes an excessive preoccupation with sexual thoughts, urges or behavior. These compulsive thoughts, urges or behavior are disruptive. They often have a significant negative impact on a person's health, relationships, work and other important areas of their life. Compulsive or out of control sexual behavior is not the same as feeling ashamed or guilty about sex in general.  Sexually compulsive behavior can be treated in individual sex therapy or in couples sex therapy (see my article: Treating Sexually Compulsive Behavior in Sex Therapy).
  • Lack of Sexual Experience: There are men and women who, for a variety of reasons, have either limited sexual experience or no sexual experience as adults. Shame and guilt are often at the root of this problem, including poor body image.  There might also be cultural factors. Sex therapy can help adults overcome shame and guilt so they can have a healthy sex life (see my article: (see my article: Is a Negative Body Image Ruining Your Sex Life?).
Common Issues in Sex Therapy: Lack of Sexual Experience
  • Unrealistic Expectations About Partnered Sex: Due to the inadequacy of sex education in the United States, many people, especially those in their 20s and 30s, get their so-called "sex education" from mainstream pornography. Unfortunately, mainstream pornography gives false and misleading information about sex. People, who rely on mainstream pornography to learn about sex, forget they are watching actors in scripts. They forget that these sexual portrays aren't real.  Not only are these portrayals unrealistic, but the scripts are often very misogynistic in terms of how women are portrayed. Sometimes porn uses women as well as children who have been coerced into working on these films due to sex trafficking.  Pornography also has misleading information about what gets a woman turned on.  This is especially unfortunate because there are sources of ethical pornography that don't have these problems.  Sex therapy can help people, who have false and misleading information about sex and unrealistic expectations, to learn how to have healthier solo and partnered sex.
Common Issues in Sex Therapy: Exploring Kink or BDSM 

  • Individuals or Couples Who Want to Explore Kink or BDSM: There are individuals and couples who want to explore kink or BDSM (Bondage, Dominance, Sadism, Masochism), but they might not know where to start. Or, one person in a relationship wants to explore kink and the other is hesitant. Sex therapy can help individuals and couples to start with their sexual fantasies as a way to explore their sexual turn-ons. From there, they can decide if they want to act on their fantasies or if the fantasies are enough without engaging in the behavior (see my articles: Destigmatizing Fantasies About BDSM and What is Power Play?)
  • Disagreements About Opening Up a Relationship: Many people who are currently in monogamous relationships would like to have an open relationship, but their partner doesn't want it.  Couples who have a conflict around this issue could benefit from sex therapy where this issue can be negotiated. Other couples both want to open up the relationship, but they don't know how. There are many forms of consensual nonmonogamy. A couple can work out an agreement that suits both of them or they can acknowledge they're not compatible and end the relationship amicably. Sex therapy can help with all of these issues (see my article: What is Consensual Nonmonogamy?)

Common Issues in Sex Therapy: Disagreements About Consensual Nonmonogamy

The categories listed above are just some of the most common reasons why people seek help in sex therapy.  There are many other sexual issues that bring individuals and couples to sex therapy.

Why Couples Therapy is Often Not the Right Therapy for Sexual Problems
Many couples therapists aren't trained sex therapists.  

Worse still, many couples therapists, who were trained in more traditional or outdated forms of couples therapy, don't know how to talk about sex with their clients. Many others collude with couples by avoiding the topic of sex altogether. In cases like this, a couple can go through an entire couples therapy with neither the couple nor the therapist bringing up anything about sex.

Couples therapists who weren't trained in sex therapy believe that if they help the couple to fix romantic problems, sex will naturally improve.  And while this might be true for many couples, it's definitely not true for all couples.  

In fact, there are lots of couples, who love each other and get along well, but there are problems in their sex life.  If a couples therapist doesn't know this, the sexual problems either never get addressed or the couples therapist unintentionally gives misleading or false information.  

In short, many couples therapists, who have no additional training in sex therapy, don't know how to help individuals with contemporary sexual issues.  This often leads to more harm than good.

When to Seek Help in Sex Therapy
Sex therapy is a form of psychotherapy, also known as talk therapy. 

There are no physical exams, no touching and no nudity in sex therapy (see my article: Common Misconceptions About Sex Therapy).

If you have attempted to resolve sexual problems on your own without success, you could benefit from working with a sex therapist.

Rather than allowing hurt, shame and resentment to grow, seek help in sex therapy so you can have a more fulfilling sex life.

About Me
I am a licensed New York City psychotherapist, hypnotherapist, EMDR, AEDP, EFT, Somatic Experiencing and Sex Therapist.

I am also a trauma therapist who has helped clients to overcome problems related to sexual abuse (see my article: What is a Trauma Therapist?).

I am a sex positive therapist who works with individual adults and couples.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.














    Friday, December 16, 2022

    What is Sexual Self Esteem?

    Most people are familiar with the concept of self esteem, which is how you see yourself in terms of deserving love and being capable of handling life's many challenges.

    Sexual Self Esteem

    As it turns out, self esteem affects every area of your life:
    • How you feel about yourself
    • What you feel you deserve
    • How lovable/unlovable you feel
    • Whether you get into healthy or unhealthy relationships
    • What career choices you make
    • How you feel about yourself sexually
    What is Sexual Self Esteem?
    We are all sexual beings.

    Sexual Self Esteem


    Sexual self esteem includes: 
    • How sexually attuned you are to your body
    • Whether your relationship to your body is positive, negative or a mix
    • Whether you see yourself as a sexually appealing individual
    • Whether you believe you deserve a satisfying and enjoyable sex life
    • Whether you feel sexually confident
    • How capable you feel about giving yourself sexual pleasure during solo sex/masturbation
    • How much sexual confidence you feel when you're having sex with your sexual partner(s)
    • Whether you make healthy sexual choices, which is part of high sexual self esteem, or poor sexual choices, which is part of low sexual self esteem.  
    What Factors Affect Your Sexual Self Esteem?
    Your sexual self esteem can be affected by:
    • What your psychological and emotional history in your family of origin
    • Whether you were taught that you are a lovable, capable person who deserves to be happy
    • What your sexual developmental history was including, among other things:
      • How you learned about sex and what you were taught
      • What you were taught about your sexuality and your body
      • Whether sexual boundaries in your family and with others were healthy or unhealthy
      • Whether you were sexually, physically or emotionally abused
      • What you experienced in your prior sexual and romantic relationships
    • Whether or not you had positive experiences in your first romantic and sexual relationships 

    • Other related issues
    How Does Your Self Esteem Affect Your Sexuality?
    • Your Sexual Choices: People with high sexual esteem usually make positive choices, and people with low sexual self esteem often make poor choices. An example of a poor choice might be going along with a sexual partner's wish not to practice safe sex when you really wanted to be safe.
    • Self Confidence: You're more likely to have a satisfying sex life when your self confidence is high.  This includes both solo sex and partner sex.
    • Body Image: Whereas having high sexual self esteem allows you to generally have a positive regard for your body, having low sexual self esteem can make you feel self conscious about your body image.
    Sexual Self Esteem Can Change Over the Course of Your Life
    Sexual self esteem can change over time--from negative to positive as well as from positive to negative.

    Most of us are bombarded by images and concepts on social media, magazines, television and other outside sources about what is considered beautiful or sexy, which leads to unhealthy comparisons.

    Sexual Self Esteem and the Aging Process

    The aging process can be a positive or a negative factor in terms of sexual self esteem.  If a person derives their sexual self confidence based on sources outside him or herself, their sexual self confidence can suffer, especially if they allow negative concepts about aging and attractiveness to affect them.

    Sexual Self Esteem and the Aging Process


    Being able to maintain a positive self regard for your inner qualities as well as cherishing your body and overall sexuality will help you to develop and maintain a high degree of sexual self esteem.

    Developing Healthy Sexual Self Esteem
    There are steps you can take on your own to bolster your sexual self esteem, including
    • Keeping a journal to express how you feel about yourself sexually
    • Educating yourself about sexuality through books, podcasts or other forms of healthy sex education
    • Being aware of what you're willing and unwilling to do sexually and being able to communicate that to sexual partners
    When to Seek Help in Sex Therapy
    If you have been unable to increase your sexual confidence on your own with self help techniques, you could benefit from help in sex therapy.

    Sex therapy is a form of psychotherapy, also known as talk therapy, where the sex therapist focuses on the sexual issues of individuals and people in relationships. 

    There is no physical exam, nudity or physical touch involved in sex therapy (see my articles: What is Sex Therapy? and Common Misconceptions About Sex Therapy).

    You deserve to have a fulfilling sex life.

    You can free yourself of the obstacles that are keeping you from having a fulfilling sex life when you work with a skilled sex therapist.

    About Me
    I am a licensed New York City psychotherapist, hypnotherapist, EMDR, AEDP, EFT, Somatic Experiencing and Sex Therapist.

    I am a sex positive therapist who works with individual adults and couples.

    To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

    To set up a consultation, call me at (917) 742-2624 during business hours or email me.



























    Getting Help in Sex Therapy For Painful Sex

    Painful sex is a lot more common than most people think: Approximately 1 in 5 women experience pain during sex.  

    Even though it's a common problem, many general practitioners and gynecologists fail to ask women about it during regularly exams.  This is especially problematic when women feel too ashamed to mention it during medical exams.

    Get Help in Sex Therapy For Painful Sex


    Experiencing painful sex can be confusing, emotionally traumatic and create problems in intimate relationships, especially when the cause of the pain isn't understood.

    Sex therapy can help (see my article: What is Sex Therapy?).  More about this later.

    What Are the Different Types of Sexual Pain Experienced By Women?
    Women can experience different types of sexual pain, including but not limited to:
    • Anxiety during sex which makes it difficult to relax and causes pelvic muscles to tighten
    • Lack of lubrication due to insufficient sexual foreplay
    • Lack of estrogen
    • Vaginal dryness
    • Vaginal atrophy
    • Pelvic pain due to weak core muscles
    • Vulva pain when the vulva is touched  (the vulva is the outer part of female genitals, including labia majora, labia minora and the clitoris)
    • Pain during sexual penetration (penis in vagina or PIV sex)
    • Painful orgasms
    • Vulvodynia (chronic vulvar pain without an identifiable cause)
    • Vaginismus (the involuntary contraction of the pelvic floor muscles in response to vaginal penetration, including inserting a tampon, toy or penis)
    • Dyspareunia (pain before, during or after sex)
    • Chronic yeast infections
    • Postpartum
    • Deep vaginal pain around the cervix
    • Endometriosis
    • Interstitial cystitis (chronic bladder condition with recurring pain in the bladder and pelvic area)
    • Lack of sex education
    • Other pelvic floor problems
    • Other medical and/or psychological issues
    Medical Treatment
    If you are experiencing painful sex, you shouldn't ignore it.  Over time, it can get worse.

    The first place to start is getting medical help.

    Seek help from a medical doctor who is knowledgeable about painful sex.  You can see a primary care physician, a gynecologist or a urologist.  Just make sure the doctor you choose deals with women's painful sex.

    Pelvic Floor Treatment
    Many women who experience painful sex benefit from seeking help from a physical therapist who specializes in pelvic floor issues.  

    Since not all physical therapists are trained to deal with pelvic floor problems, it's important that you ask beforehand to make sure you get appropriate help.

    How Can Sex Therapy Help?
    Women who experience anxiety or other psychological issues before, during or after sex can benefit from working with a sex therapist who can help them to overcome emotions that interfere with sex.

    Women in sex therapy can also learn to incorporate the exercises they learned in physical therapy into their routine at home (see my article: What Are the Most Common Misconceptions About Sex Therapy?).

    A sex therapist can help clients to have better sex by learning to use mindfulness.

    Partners of women who have pain during sex often don't understand the problem. A skilled sex therapist can also work with a woman and her partner so that the partner understands the problems involved with painful sex, how to overcome these problems, and how to improve their sex life overall.

    About Me
    I am a licensed New York City psychotherapist, hypnotherapist, EMDR, AEDP, EFT, Somatic Experiencing and a Sex Therapist.

    I work with individual adults and couples.

    To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

    To set up a consultation, call me at (917) 742-2624 during business hours or email me.






    Sunday, December 11, 2022

    What Are the Most Common Misconceptions About Sex Therapy?

    This is the first article in a series of articles about sex therapy where I'll begin addressing the most common fears and misconceptions that people have about sex therapy and some of the most common issues addressed by sex therapists (see my article: What is Sex Therapy?)

    Sex Therapy For People in Relationships

    There are many misconceptions about sex therapy which, as a sex therapist, I would like to address in this article.  These misconceptions and their related fears often keep people from seeking much-needed help in sex therapy.

    Common Problems and Misconceptions That Keep People From Seeking Help in Sex Therapy
    Some of the most common problems and misconceptions include (but are not limited to):
    • Shame: Shame is a big reason why people, who could benefit from sex therapy, don't go.  Many individuals and couples who are having sexual problems don't know that their sexual problems are common, so they feel too ashamed to see a sex therapist. However, whether the problem is lack of sexual experience, low libido, problems with sexual desire discrepancy in a relationship, premature ejaculation, erectile unpredictability, painful intercourse, a desire to explore consensual non-monogamy or BDSM or kink, or a variety of other issues, these issues and other sexually related issues are common in sex therapy.  
    Sex Therapy For Individual Adults

    • Fear of Being Asked to Do Things They Don't Want to Do: Many people who have misconceptions about sex therapy fear that the sex therapist will ask them to engage in sexual acts they would be uncomfortable doing (group sex, threesomes, and so on).  But sex therapists focus on what the clients want.  They don't have their own agendas.  
    • Fear of Being Judged or Criticized: Many people fear the sex therapist will judge them for their problems or their desire to explore certain areas of sexuality, like kink or BDSM (Bondage, Discipline, Dominance, Submission and Sadism and Masochism) as one example.  The reality is that most sex therapists are trained to discuss these issues in a sex positive and nonjudgmental way. 
    Sex Therapy For All Genders and Sexual Orientations

    • Fear of What Will Happen in the Sex Therapist's Office: There are people who fear they will have to take off their clothes or engage in sex in front of the sex therapist. However, there are no physical exams in sex therapy, no nudity and no touching.  In fact, a sex therapist's office is just like any other therapist's office.  Sex therapy is a form of psychotherapy which is also known as talk therapy.
    Sex Therapy Online

    • Fear of Sexual Boundary Violations: As mentioned above, there is no nudity or sexual acts in a sex therapist's office.  You and the sex therapist talk about your problems and there might be assignments for you and your partner(s) to try at home and come back to discuss the following week, depending upon the issue and how the sex therapist works.  Sex therapists don't have sex with their clients.  That would be a serious ethical and legal breach.  Also, a sex therapist doesn't talk about her own sexual experiences.  In other words, sex therapists are licensed therapists who must maintain legal and ethical boundaries with their clients.  

    What Are Some of the Most Common Issues Addressed in Sex Therapy?
    Most sex therapy begins with the clients discussing what they want to work on in sex therapy.  As previously mentioned, these issues include but are not limited to:
    • Lack of Sexual Experience (for all genders/sexual orientations)
    • Sexual Anxiety
    • Sexual Shame
    • Lack of Sexual Confidence or Sexual Self Esteem
    • Problems With Body Image That Interferes With Sex
    • Problems with Having an Orgasm For Both Men and Women
    • Painful Sex
    • Erectile Dysfunction
    • Premature Ejaculation
    • A History of Sexual Abuse That Negatively Impacts Current Sexual Pleasure
    • Problems With Sexual Intimacy After Having Children
    • Other Emotional or Mental Issues Interfering With Sex

    What Happens in Sex Therapy?
    Now that I've addressed some of the most common fears and misconceptions people have about sex therapy and some of the most common issues addressed, let's begin a discussion about what actually happens in sex therapy.  I'll go into further detail about this in my next article.

    What Happens in Sex Therapy?

    Both individual adults and people in relationships, including monogamous and non-monogamous relationships, attend sex therapy.  

    As previously mentioned, sex therapy is a form of psychotherapy, which is also known as talk therapy.

    Sessions can be in person or online.

    The initial session is for clients to discuss why they are seeking help in sex therapy.  

    For a variety of reasons, many people feel ashamed to talk about sex, so part of the sex therapist's role is to help clients get more comfortable talking about sex without experiencing shame.  

    Sex Therapy Online

    It's also common for clients to want to get comfortable with a sex therapist before they really open up to talk about their sexual problems in detail, and skilled sex therapists know how to facilitate this.

    Other clients might feel more open and comfortable talking about sex right away.  So, the sex therapist can begin getting a sexual history from the client(s).

    Getting a comprehensive sexual history taking is an important part of the initial stage of sex therapy.

    When Should You See a Sex Therapist?
    If you have tried on your own to resolve sexually related problems without success, you're not alone.  

    Many people seek help in sex therapy, and you could also benefit from seeing a sex therapist.

    A sex therapist can help you with practical steps to resolve the underlying issues related to your sexual problems.

    Rather than struggling on your own, if you're having sexual problems, seek help with a licensed psychotherapist who is a sex therapist.

    You deserve to have a fulfilling sexual life.

    About Me
    I am a licensed New York psychotherapist, hypnotherapist, EMDR, AEDP, EFT, Couples and Sex Therapist.

    I am a sex positive therapist who works with individual adults and couples.

    I provide in-person and online therapy.

    To find out more about me, visit my website where I have many articles about sex therapy as well as other topics: Josephine Ferraro, LCSW - NYC Psychotherapist.

    To set up a consultation, call me at (917) 742-2624 during business hours or email me.









    Thursday, December 8, 2022

    How to Maintain a Happy Relationship

    Developing and maintaining a happy relationship is more challenging these days than ever.  Whereas in former times people had the emotional support of an extended family, people in relationships now tend to rely much more on each other, which often places a strain on the relationship (see my articles: Nurturing Your Relationship and Creating a Safe Haven For Each Other.

    Developing and Maintaining a Happy Relationship

    While no relationship is without occasional problems, more relationships these days are failing because of the greater emotional burden placed on the relationship.  Also, people often enter into a relationship with unrealistic expectations of their partners and unaware of the work it takes to develop and maintain a happy relationship.

    How to Develop and Maintain a Happy Relationship
    Developing a Happy Relationship: Spend Quality Time Together Without Distractions
    • Be Loving and Kind to Each Other:  Many couples are loving and kind to each other at the beginning of the relationship but, as time goes on, they forget to do the things that endeared them to each other (see my articles:  Practicing Tolerance and Compassion in Your Relationship).
    • Talk About What You Need Emotionally From Your Romantic Partner:  Talking about emotional needs is often difficult for people who are afraid to make themselves emotionally vulnerable, especially if one or both partners grew up in a family where people didn't talk about their feelings. Many couples don't know how to communicate their needs and come across as blaming or complaining, which makes the other partner shut down.  Other people seem to feel that their partner "should know" what they want without their communicating their needs (see my article:  Relationships: Are You Too Afraid to Talk to Your Spouse About What's Bothering and Are You Feeling Lonely in Your Relationship?).
    • Respect One Another:  Respecting one another is often related to being able to talk about emotional needs.  For example, if, instead of focusing on what she needs emotionally from her husband, a woman blames her husband for not being more attentive, her husband might shut down and not hear her underlying message, which is: "I need you to show that you care about me."  That message gets lost because it's not getting communicated directly.  The husband will feel criticized and might stonewall.  This often leads to the wife becoming more strident, which leads to even further withdrawal by the husband.  Aside from the obvious forms of disrespect, like name calling, other less obvious forms of disrespect, like eye rolling, show contempt for the other partner and often lead to the demise of the relationship (see my articles:  Emotional Intimacy: The One Who Loves You the Most is Often the One Who Hurts You the Most, and Relationships: When Expressing Your Feelings Turns Into Verbal Abuse).
    • Develop Realistic Expectations of Your Relationship:  You're partner can't be everything to you.  You need to have friends and other forms of emotional support in order not to put too heavy a burden on the relationship (see my article: Relationships: Your Spouse Can't Meet All Your Expectations).
    • Let Go of the Small Stuff:  When you're in a relationship, you need to know what's most important to you.  Do you really want to argue about the socks that never made it from the floor to the hamper?  If you do, you'll be arguing a lot and this can erode a relationship quickly (see my article: Are You Overreacting to Small Disappointments? and Letting Go of Resentment).
    Developing and Maintaining a Happy Relationship:  Be Playful With One Another
    Getting Help For Your Relationship in Couples Counseling
    There are many couples who have lost their way in their relationship and they're unable to find their way back to the loving relationship that they once had.

    A skilled psychotherapist, who works with couples, can help a couple to understand what went wrong and provide them with tools to get back on track (see my article: What is Emotionally Focused Couples Therapy?).

    If you've tried on your own to work out your relationship, but you keep coming up short, you could benefit from seeing a couples therapist who can help you to have the loving relationship that you once had.

    About Me
    I am a licensed New York City psychotherapist, hypnotherapist, EMDR, AEDP, EFT, Somatic Experiencing and Sex Therapist 

    I am a sex positive therapist who works with individuals and couples.

    To find out more about me, visit my website:  Josephine Ferraro, LCSW - NYC Psychotherapist.

    To set up a consultation, call me at (917) 742-2624 during business hours or email me.





    Tuesday, December 6, 2022

    Feeling Lonely in a Relationship

    Everyone feels lonely sometimes.  It's not unusual.  There are different kinds of experiences of feeling lonely.  

    Usually we associate feeling lonely with being alone. But it's not unusual to feel lonely from time to time while you're in a relationship.  You and your partner or spouse aren't always going to feel emotionally attuned.  

    But when you feel lonely most of the time while you're with your partner, this is a different kind of loneliness and can be indicative of problems in the relationship (see my article:  What's the Difference Between Solitude and Loneliness?).

    Feeling Lonely in a Relationship

    There are many reasons why you could be feeling lonely or emotionally estranged from your partner.  Assuming that you and your partner spend time together and that you're not away from each other for significant periods, it's important to determine what's causing you to feel lonely and if your partner is feeling the same way.

    Are one or both of you withdrawing emotionally when you're together so that you're in the same room but you're not connecting with each other on an emotional level?  Are you bored?  Has your sex life waned?  Have you grown apart?

    The following vignette is a fictionalized composite that illustrates a particular cause of loneliness in a relationship:

    Alice and Peter:
    Alice and Peter were married for 15 years.  They had two sons, who were 11 and 12.  They both had successful careers.  When they first got married, they had a very passionate relationship.  But in the last few years, they focused most of their free time on their sons' various activities, including sports events.  Their once passionate sex life had waned to nearly nothing (see my article: Reviving Your Sex Life).

    Feeling Lonely in a Relationship


    After their children went away to sleep away camp for the first time, they found themselves together and alone for the first time in a long time.  Before their sons left, they each thought they would enjoy having time to themselves for a change.

    But after their sons were gone, they both felt awkward around each other and somewhat at a loss as to how to spend their time together.  Both of them felt too uncomfortable talking about it, so they each dealt with the awkwardness and loneliness they felt on their own.  They each found individual projects to work on in their spare time, and they tried to avoid the emotional awkwardness by spending their time apart.

    As the weeks passed, they each felt more emotionally estranged from each other.  Finally, when it became too uncomfortable for her, Alice broached the topic with Peter, feeling embarrassed and shy, but  deciding that it was better to talk about it than to keep sweeping it under the rug.

    So, over breakfast, before they went off to their separate projects, Alice told Peter that she was feeling lonely.  There was an awkward silence, which increased Alice's embarrassment and feelings of awkwardness.  Then, Peter looked away and said he was feeling the same way.

    They talked about how they never realized, while the children were around, that they had lost sight of their relationship.

    They acknowledged to each other that they still loved one another, but their sex life had waned to nothing.  This was a difficult conversation to have, but it was a relief for both of them to stop avoiding each other and the so-called "elephant in the room" of the loneliness that they each felt around each other.

    Peter and Alice realized that they needed to get to know each other again.  They loved their sons very much, but they realized that they needed to spend more quality time with each to rekindle their relationship.

    But they didn't know how after all this time, so they sought the help of a marriage counselor. In marriage counseling, they learned to re-engage in the activities that they used to enjoy--going out dancing, going to the theatre, and reading aloud to each other.

    To rekindle their sex life, they rediscovered how to be sensual with each other and, eventually, becoming sexually intimate again after years of not being sexual at all.  When their sons returned, they made sure to continue to find time for each other by going out on a "date" at least 3-4 times per month to maintain the emotional and sexual intimacy they discovered with each other while their sons were away.

    Loneliness and Estrangement Can Develop Over Time in a Relationship
    The scenario above is only one example of how loneliness and emotional estrangement can develop in a relationship over time without the couple even realizing it.

    There are many other examples, too many to discuss in one blog post.  

    One common complaint I hear from couples in my New York City private practice is that one or both people are continually preoccupied with their cellphone.  This could be a topic unto itself.  Another common complaint is that one or both people have outgrown each other.

    Getting Help in Therapy
    The main point of this blog post is that if you're feeling lonely in your relationship, you owe it to yourself and your partner to communicate this before it's too late.

    You're not alone.  There are many individuals and couples that experience this problem.

    If you're unable to work on it on your own by rekindling your relationship, you can seek the help of a licensed mental health professional who  specializes in working with couples.

    About Me
    I am a licensed New York psychotherapist, hypnotherapist, EMDR, AEDP, EFT, Somatic Experiencing and Sex Therapist.

    I work with individual adults and couples.

    To find out more about me, visit my website:  Josephine Ferraro, LCSW - NYC Psychotherapist.

    To set up a consultation, call me at (917) 742-2624 during business hours or email me.