Dr. Goschi's Blog

Seeking Sex Therapy in Chicago

Posted on January 28, 2019 at 1:53 pm in Addiction Counseling Chicago, Chicago Sex Addiction Counseling, Divorce and Infidelity Chicago

Couples don’t know what to expect when they seek sex therapy. Many couples fear talking about their intimate feelings about their sexual life. They worry that their partner may scorn or reject them. Fears about addressing sexual issues mount when the couple also exhibits communication problems. After all, it takes good communication skills and risk taking to enjoy a fulfilling sexual relationship.

So, what happens in sex therapy? First, the therapist gathers a thorough history of your sexual experiences. The couple offers their sex history together and as individuals. The couple also writes down their sexual preferences and style to be shared later in a session. This method helps ease the couple into talking about their sexual life. The therapist also addresses any fears and anxieties which stand in the way of honest reporting.

Some individuals fear talking about sex will take the mystery out of their sexual relationship. Not so. Understanding what turns your partner on only enhances the sexual relationship. Therapy strives to convert “mystery” into understanding. Let’s not conflate mystery with romance. Romance does not die when you know what excites your partner – you can think of creative ways of incorporating their desires into your sexual repertoire. Think of sex therapy as exploring ideas and wishes about sex and then exploring new ways of sexually interacting at home.

The couples’ expanded sexual knowledge of each other helps move the therapy forward. Sex therapy can augment any couples work you have completed. Sex therapy helps the individual/couple learn more about themselves and their partners in a safe environment. Yes, I said individual as some clients wish to work on dysfunctional sexual behaviors that interfere with establishing a more fulfilling intimate relationship. You and Dr. Goschi talk about sexual issues at your own pace. Dr. Goschi’s treatment style is nonjudgmental.

If you live in the Chicago area and find that you have sexual issues in your relationship Dr. Goschi can help you explore better ways of expressing yourselves. Sex therapy can help couples better their intimate relationships. Sex therapy can also help individual’s who struggle to form sexual bonds while dating. Don’t hesitate to call today I’m here to help and you can reach me by email barbara@drgoschi.com or phone at (312)595-1787.

Compulsion versus Addiction

Posted on December 5, 2018 at 3:16 pm in Addiction Counseling Chicago, Wilmette Sex Addiction Counseling

The debate between professionals today relates to how we identify process addictions.  Many professionals view sexual acting out as part of a broader symptomatology of mental illness or compulsive behaviors.   As we learn more about the processes involved with sexual acting it better fits within the addictions model.

Anxiety, depression, and compulsive thoughts apply to sexual acting out.  The sequence with which the individual experiences these emotions seems relevant to making the distinction between an addiction and a compulsion.  Process addictions such as gambling addictions, sex addictions, and binge eating disorders share a lot of common features.

One clear distinction relates to the onset of the anxiety.   Some individuals feel compelled to engage in an action to diminish their anxiety and nothing else will suffice until they have completed the act.  For these individual’s relief follows the action. Even though they realize the disruptive quality of the action on their lives. For example, if you feel the need to drive back home to make sure you locked the door, even though you did, you will not feel relief until you check.  Perhaps you feel like your preoccupation dictates your life.

Sexual addiction has similar qualities.  The preoccupation controls one’s thoughts and sometimes actions.  Just thinking and planning to engage in the action often lifts the person out of their anxiety or depression.  The mere thought of the act results in elation. However, once the addict engages in the act shame, guilt, anxiety, and depression soon set in.  The addict does not experience relief. Rather, and intense downward spiral occurs.

Once the individual completes the action, they feel worse.  The shame, guilt, and anxiety lead the addict to feel out of control and vulnerable.  Therapy is most likely sought during this part of the addiction process. The addict experiences great highs followed by very low lows.  Compulsive behaviors don’t always fit as nicely into this scenario.

The therapist misses the bigger picture by treating all process addictions as compulsive behaviors.  The addict’s treatment approach must involve family members, especially wives or significant others. Therapists describe addiction as a family disease because it has such a profound effect on individuals within the family.  When working with individuals who have children it isn’t wise to include young children in the treatment. Rather, the kids can learn new ways of interacting with their depressed or anxious parent. The children should understand they did not cause the problems.

I’m not criticizing clinicians who treat sexual addiction as a compulsion.  I simply think the two exhibit adequate differences that warrant a different look at treatment goals. In conjunction with individual treatment, marital therapy and meetings are recommended.

If you or someone you love is struggling with a sexual addiction, please don’t hesitate to call or email Dr. Goschi at (312)595-1787 or barbara@drgoschi.com.  I look forward to hearing from you in order to begin the healing process.

 

 

Sex Addiction not just for Men

Posted on October 23, 2018 at 8:14 pm in Addiction Counseling Chicago, Addiction Therapy Chicago, Chicago Sex Addiction Counseling

Dr Goschi Sexual Addiction CounsellingWhen we talk about sex addiction pictures arise in our mind of men, especially, with the #me too movement. However, women also struggle with sexual addiction. We do not think of the female sexual addict because cultural stereotypes portray women as not liking sex. Sexual issues in women tend to present as related to other conflicts. Therapists traditionally view female’s sexual acting out as a symptom of their diagnosis rather than a problem itself.

While a diagnosis of Bipolar will include inappropriate sexual behavior, the disorder can mask
the sexual addiction. Women often deny sexual addiction issues. They frame their conflict
exclusively as related to relationship problems. Thus, as a group female sexual addicts tend to
be more difficult to recognize and treat. Not many women seek individual therapy for “sexual
addictions.”

While female sexual addicts seek treatment for other issues it is only during individual therapy
that the sexual addiction becomes apparent. Comorbid issues such as; eating disorders,
alcoholism, drug addiction, depression or anxiety also mask the sex addiction. However, the
above mentions problems intricately connect to the woman’s sex addiction.

Females don’t admit their sexual addictions also because of the societal shame associated with
sexual acting out in women. These individuals are described by others as “whores,” “sluts,” or
“nymphomaniacs” who then hide their behavior rather than dealing with the negative labels.

Both married and single women exhibit sexual addictions. The two groups demonstrate some
similar reasons for engaging in sexual addictive behaviors but also some divergent ones. Single
women may long for a relationship while simultaneously being relationship avoidant. They may
find themselves unable to tolerate being alone instead always seeking a partner. Lastly, some
single women use sex as a means of self-medication to help with their intense emotional
turmoil.

Married women at risk for acting out sexually complain about feeling underappreciated,
rejected, or ignored by their partners. They exhibit terrible relationships with their husbands
and search outside the marriage for intimacy and sexual fulfillment. Both groups of female
addicts use sex to remedy their loneliness, boredom or sense of emptiness.

The reasons single or married women become addicted to sex are very complicated. Individual
treatment can help you find your way back to a more fulfilling existence with true intimacy and
better self-esteem. If you think you may be a sexual addict, please call to schedule your
individual therapy appointment today. Dr. Goschi can be reached at (312)595-1787 or by email
at barbara@drgoschi.com

Sex Addiction and Pornography

Posted on October 13, 2018 at 2:06 pm in Addiction Counseling Chicago, Addiction Therapy Chicago

The authors Ogas and Gaddam of the 2011 book, “A Billion Wicked Thoughts,” outline some alarming facts. This book highlights not only the explosion of pornography sites but an alarming rise in pornography addiction. The sharp increase in sexual addiction/pornography addiction interferes with healthy sexual functioning. According to the authors, only 90 porn magazines were available for purchase in 1991. By 1997 the web introduced some 900 porn sites. Today, the number of porn sites has exploded to over 2.5 million. This disturbing trend has profound implications for children, adults of every age, relationships, and marriages.

Couples of all ages often seek therapy due to a sexless relationship/marriage. It’s alarming to have a couple in their 30’s complain they haven’t had sex in 2 years. When the therapist digs a little deeper they find out that one of the partners obsessively uses pornography while masturbating each time (even several times a day). The partner simply doesn’t understand, instead, he or she perceives the excessive porn usage as infidelity.

Women are not exempt from engaging in on line pornography. They may be sexually acting out on line by hooking up with someone they meet on a virtual site. However, it seems more common for women to be “addicted” to the online sex chat rooms or the gaming sights including sexually explicit avatars. These women seek romance or to express an alternate self.

Overall, men and women have become susceptible to the seductive nature of online pornography. The implications for their lives is profound. Young men spend hours surfing the web for the perfect sexual fantasy isolating themselves from friends and family. Some men lose their jobs as they cannot stop themselves from engaging in pornographic searches at the office. Women run off with men that they’ve met online only to be disappointed and disenfranchised from their families afterward. They sometimes find themselves in dangerous situations from which they find it impossible to escape. Their family and friends disown them making it impossible to “get their old life back.” We tend to judge women more harshly than their male counterparts.

Individual or couples therapy as well as a 12 step support group is very helpful in pulling these individuals out of their addictive behavior. If you or a loved one struggles with pornography addiction call for help today. You can reach Dr. Goschi at (312) 595-1787 or barbara@drgoschi.com

 

Addiction and Defenses

Posted on August 24, 2018 at 1:55 pm in Addiction Counseling Chicago, Addiction Therapy Chicago, Cyber-sex addiction Counseling Chicago, Licensed clinical psychologist Chicago

Many sex addict’s actions confuse those around them. It seems that at times they completely deny that they have a problem instead blaming others for their actions. The addicted individual often places responsibility for his/her behaviors on their spouse, bad marriage, negative feelings, or bad job. Overall, the person finds it difficult to take responsibility for their actions.

It seems obvious to other’s that the sex addict experiences severe problems. In individual therapy a spouse or significant other often discloses their confusion. “Why does it mean so much to them?” or “How can they allow the sex addiction to take priority over me and the kids?” Some sex addicts lose everything to maintain their addictive behavior.

Most sexual addicts have been exposed to early life trauma . Dr. Christine Courtois defines trauma as “… any event or experience that is physically and/or psychologically overwhelming to the exposed individual.” These varied traumatic events set the stage for resorting to destructive behavior later in life. The addict learns poor coping mechanisms and often repeats the trauma by acting out as an adult. However, it is during these very difficult times in their childhood that the addict learns to use primitive defense mechanisms. Sex addict’s use primitive defensive structures to “protect” them from seeing or acknowledging their addictive behavior. The defenses that protected them as a child now are considered destructive.

What are these defense mechanisms? Perhaps the most primitive of all is denial. The sex addict acts as if the painful event (memory or emotion) does not exist. “I’m not feeling anxious because of my addiction rather it’s because my job sucks.” Twelve step programs often deal with breaking through the denial to help the addict take ownership of one’s own behavior. Individual therapy also helps the addict acknowledge their use of denial to continue the destructive life style.

Regression is another primitive defense used by addicts. The regressive behaviors of the addict resemble actions of a much younger person. They become clingy or dependent on others rather than relying on themselves to solve the problem. In contrast, adults rely on themselves and view others as equals. Addicts sometimes find this process difficult as they need so much themselves.

Most of us familiar with addictions understand the defensive acting-out that constantly occurs. The sexual acting out temporarily ends the painful emotions associated with the underlying addiction. However, when the acting out ends the guilt and shame associated with the sexual behavior overwhelm the individual. Individual therapy helps address the underlying issues and the triggers associated with these acting out behaviors.

Individuals who exhibit the strongest history of childhood trauma survive the memories by acting as if they are someone else. As adults they have a disconnected view of themselves. The addict’s “created self” does not suffer from the same problems. This defense mechanism is known as dissociation. The defensive behavior provides them with a temporary escape.

Individual treatment along with a 12 step sex addiction group helps the individual confront their behavior. Rather than engaging in the above mentioned primitive defense mechanisms the individual learns new means of coping with their strong emotions. Ideally, the individual will learn how to identify their feelings and tolerate them while acquiring new ways of expressing themselves. For example, clients learn to become more assertive and replace their negative behaviors with healthier more gratifying means of coping with the complexities of their lives.

If you or someone you love struggles with sex addiction don’t hesitate to call Dr. Goschi for an individual therapy appointment. She can be reached directly at (312)595-1787 or by email at barbara@drgoschi.com

Stages of Sex Addiction

Posted on August 13, 2018 at 3:45 pm in Addiction Counseling Chicago, Addiction Therapy Chicago, Cyber-sex addiction Counseling Chicago, Individual Coaching & Counseling

Process addictions, in particular sex addiction, causes much confusion.  People tend to lump those individuals who act out sexually as “sex addicts.”  Or, even put sex offenders and the paraphillias in the same category as sex addicts.  There is a huge difference. Sexual addiction is defined as a loss of control, having a negative impact on your life, developing a tolerance for the behavior, denying it’s a problem, and blaming others for your acting out.  Individual therapy helps define whether the person is struggling with an addiction and if they require the help of therapy to recapture their lives.

According to many expert’s sex addiction/process addictions can be broken down into discrete stages.  The individual struggling with an addiction moves through these various stages one after the other often feeling trapped.  One stage feeds into the next causing a negative spiral of emotions and inappropriate behaviors often leading to self-loathing.

Robert Weiss in his “Sex Addiction 101” book outlines the various stages of sex addiction.  Many addicts share these six stages. The first stage is the triggers. Triggers are those actions, thoughts, places, visual cues, even smells which act as catalysts for the inappropriate behavior.  Emotions, such as anger, sadness, shame, anxiety and loneliness can also be powerful triggers.

The second stage involves fantasizing about past encounters and the enjoyable memories.  These thoughts become obsessional over time growing in strength. Individual therapy helps the person explore the reasons for the fantasies while coming up with strategies to stop them.

Stage three involves ritualizing the sexual acting out.  Fantasy begins to dictate behavior. The addict goes to their favorite bar or begins looking at postings on Craig’s list.  The addict describes this experience as lost in a bubble without concerns for the real world or their action’s consequences.

Acting out occurs in stage four.  The addict perceives this stage as the most desired aspect of the addiction.   The individual consummates the sexual act. But, the addict really desires escape and dissociation.  The sexual enactment ends the fantasy abruptly.

This sudden end leads directly to stage five.  During this phase the addict feels numb attempting to distance themselves from what has just taken place.  Justification or even blame enters the addict’s language. Individual therapy helps the addict stop blaming others or justifying their behavior rather than taking full responsibility for their actions.

The last stage of sex addiction results in self-loathing and other terrible emotions including shame, guilt, anxiety and depression.  At this point they may seek individual treatment given the hopelessness they feel. Or, it may simple foster a repeat of the process all over again.  Individual therapy can help break the cycle for the addict, so they can gain some true insight and alternative ways of coping with the disruptive triggers that begin the cycle.

If you or a loved one are struggling with a sex addiction don’t hesitate to call or email Dr. Goschi at (312)595-1787 or barbara@drgoschi.com.  Your healing can begin today!

Addiction and Motivation

Posted on August 1, 2018 at 6:32 pm in Addiction Counseling Chicago, Addiction Therapy Chicago, Sex Therapy Counseling

Some clinicians question whether “process addictions,” such as sex addictions, qualify instead as compulsions. The person struggling with sex addiction, for example, needs to find the appropriate motivation to change their compulsive behavior. The individual eventually acknowledges the extreme consequences of their actions. At this point the person wants to change. Individual therapy helps one successfully master these life changes.

Roman Gelperin in his 2017 book, “Addiction Procrastination and Laziness,” states the desire to engage in an inappropriate behavior outweighs the behavior’s negative outcome. The positive outcome of resisting the behavior does not provide enough incentive to stop. Resisting the behavior often leads to mounting sadness, anxiety or anger causing extreme discomfort. The distressed person may choose a new behavior or resort to their “tried and true” maladaptive behavior. Damn the consequences at least for one more time!

Gelperin links the “fundamental human compulsion to an increase in pleasure and decrease in displeasure.” In my opinion this seems a bit simplistic. Soothing a severe negative emotion requires more than increasing pleasure. Perhaps people prone to compulsive behaviors exhibit an inability to tolerate bad feelings for any length of time.

According to the author, appealing to a person’s logical self helps unlock their ability to change behavior. Guilt and remorse often becomes a strong motivating force for change. However, the intensity of the guilt must be large enough to stop the individual from engaging in the negative behavior. Compulsive sexual actions are particularly vulnerable to this process as the pleasure may outweigh the guilt.

What must a person do to change their compulsive behavior? The author outlines various approaches. Each approach provides the individual opportunity for change. A patient must actively engage the following actions to make lasting changes. Each action involves a conscious choice by the individual.

Form new habits by replacing the inappropriate action with a healthier behavior. The new behavior provides a similar outcome with positive consequences. For example, if you suffer from anxiety, engage in physical activity rather than viewing pornography.

Control your environment by making changes. If your compulsive behavior begins with hanging out with coworkers after work, then go directly home or straight to the gym. Look for proactive ways to make sure you avoid those surroundings which increase the likelihood of engaging in your temptations.

Employ social motivation to improve the likelihood of change. Individual therapy can assist by holding you accountable to another person. Maintaining an open and honest demeanor helps you examine what triggers and motivates your inappropriate actions.

Using guided imagery in individual therapy helps practice new behaviors. The power of imagination can help you visualize engaging in more appropriate behaviors while resisting negative ones. It also gives you the opportunity to deal with any powerful emotions which arise during the exercise while in the safety of an individual session.

Struggling with compulsive/addictive behaviors greatly interferes with achieving your potential. If you suffer with addictive behaviors please don’t hesitate to call for help. Individual therapy helps begin the process of change. Call or email Dr. Goschi today at (312)595-1787 or barbara@drgoschi.com.

Addiction and the Other

Posted on July 23, 2018 at 2:57 pm in Addiction Counseling Chicago, Addiction Therapy Chicago

We seem to exclusively talk about the addict when addressing any addiction, whether it is alcohol, sex, opioids or even social media addictions. In our conversations about the sex addict or alcoholic we forget about “the other.” I’m referring to the family member, wife, child, sibling, or significant other, who often silently deals with the antics of the addict.

“The other” often suffers the most from the addiction. Siblings of an addict witness countless tumultuous events in their lives. Many times the family member’s home life was turned upside down by the addict. These individuals replay stories over and over in their heads. They talk about Holidays during which the day was going well until the addict “ruined” everything. Their memories of the Holiday remain filled with conflict rather than fond recollections and laughter.

The wife, husband, sibling, girlfriend or boyfriend never know what to expect. This makes life so very difficult for all of those around the addict. Their lives are never predictable. They cannot bring friends home because you never know who you are going to get. Thus, the stress levels for everyone else are so very high that home is no longer a soothing environment. Instead, “the other” may prefer to be outside of the home as much as possible.

Fighting is only one part of it. It also involves blame and icy cold relationships as well. Whether sex addiction, alcohol addiction, the addict initially refuses to take responsibility for his or her own actions. Rather, everyone else is the reason why the addict over indulges. On the other hand, apologies might happen and then “the other” feels guilty for having been so hard on the addict.

However we look at this it’s never about “the other.” The addict sucks up all of the oxygen in the room. Either it’s through their outrageous antics, their incredible moodiness, or when they begin recovery it’s all about them. The meetings, the individual therapy, the extreme changes to their life style which again can have a huge impact on the other. You may ask yourself when does this personal hell end? Attending Al Anon meetings helps. Working the 12 steps can be very helpful as well.

“The other” has lived in isolation for so long that reaching out for Individual therapy yourself in conjunction with Alanon can be extremely beneficial. Therapy is a place where it is finally about you not the sex addict or alcoholic. You can say or feel whatever you want and someone will listen to you. You can talk about how crazy your life has felt and receive validation rather than scorn. You can talk about why you’ve stayed and why you still want to stay rather than having someone question you and constantly tell you that you should leave. Individual therapy is finally that place where you can grow as an individual, become the person you have long desired to be without judgment.

If you are finding yourself in the grips of an addictive relationship call to schedule your individual therapy appointment today. Dr. Goschi is there to help. You can reach her at (312)595-1787 or by email at barbara@drgoschi.com.

Opioid Crisis and Children

Posted on January 22, 2018 at 7:55 pm in Addiction Counseling Chicago, Depression Counseling Chicago, Family Counseling Chicago, Licensed clinical psychologist Chicago

The Opioid Crisis and Children

This month’s American Psychological Association’s journal “Monitor on Psychology” has an interesting article written by Lorna Collier on the population that is perhaps most profoundly affected by the opioid addiction in our country. Very often kids who grow up in families with one or both parents addicted to opioids often end up in foster homes. “Parental substance use was cited as a factor in about 32% of all foster placements, a rise of 10% from 2005” (Monitor on Psychology, January 2018).

Foster homes although sounding like a safe place for kids lead to further problems for children. These children often move through the system for years. Going from one home to another. The children in foster care may also be separated from their siblings. The “lucky” children stay in one home with foster parents who actually look after their interests and are willing to keep siblings together.

“Lucky” children from addicted households end up with families that grow to love them and eventually want to adopt the child(ren) if parents don’t recover. However, foster homes are not created equal. Some foster homes provide excellent care while others offer the bare minimum. I’ve heard and witnessed so many incidents with foster care children where they feel lost, abandoned and even abused setting them up for life long struggles.

How do we change this problem? Of course, we have to have better treatment for the opioid epidemic in our country. The article in “Monitor on Psychology” has some good ideas. They talk about how a child does far better when they stay with their parents even when those situations are highly dysfunctional. Instead, we should look for ways to provide the families counseling. Perhaps more active participation in the home through home visits and expecting parents to be engaged in active treatment. Children always do better when they stay with their family. Kids advance in life if they learn how to cope with the difficulties facing them at an early age through individual and family counseling. We should be providing them with empathy and warm, nurturing place to talk about their issues while teaching them how to self-advocate. Individual therapy can help these children grow into successful adults.

If you or a loved one is dealing with an opioid crisis please call Dr. Goschi for addictions counseling, individual counseling or family therapy at (312)595-1787. I’m here to help!