Dr. Goschi's Blog

What the heck‘s a Sexologist?

Well, I’m not exactly sure.  I discovered this word while using google analytics.  People looking for sex therapy search for a “sexologist.”  According to Wikipedia, “Sexology is the study of human sexuality, including human sexual interests, behaviors and functions.   Topics of study include sexual development, sexual orientation, gender identity, sexual relationships, sexual activities, paraphilias, and atypical sexual interests.”  Many of these topics comprise what I treat in my practice. However, people searching under this term may be looking for how they might enjoy better sexual lives rather than the most recent research on human sexuality.

I do believe that in couples counseling talking about your marital sexual interactions should be addressed.  Very often, clients who have previously worked on their marriages have neglected to work on their sexual relationship.   If your marital communication is poor it follows that your sexual life may also suffer.

In general, we view our sexual relationship as separate from other aspects of our marriage.  However, they are intrinsically tied to each other. If, for example, we are always fighting with each other this most likely has a profound impact on the frequency of your sexual expression.  Some couples have great makeup sex while others simply stop having sex when there is too much conflict. Maintaining a healthy sexual life enhances the strength of any marriage.

What does a healthy sexual life look like?  Each partner defines what they believe a healthy sex life would include.  For example, feeling gratified, expressing your needs and desires, talking about what you enjoy and what you don’t enjoy.  These topics define what couples say they require to feel sexually complete. Also, being honest with your partner if there’s something that they do sexually that bothers you tell them, instead,  share with them how they can sexually please you.

If you are looking for a “Sexologist” or more importantly someone who can help you with your sexual relationship don’t hesitate to call Dr. Barbara Goschi.  She’s here to help. You can reach her by phone at (312) 595-1787 or email her at barbara@drgoschi.com.

To Touch or Not to Touch

Sex Addiction Therapy, Chicago and Wilmette. Il.

Individuals no longer seem to understand healthy parameters of a loving, consensual sexual relationship. Someone told me about a disturbing episode on Vice news. The couple on the show discussed sexual interactions between husband and wife. According to this couple, an individual must “always” ask permission to touch their partner. This meant that if a wife wanted to grab her husband’s butt she needed explicit permission from him first. The conversation went from confusing to more confusing.

Common sense has flown out the window when it comes to rules of sexual interaction. Therapists encourage couples to engage in playful, spontaneous sexual expression during sex therapy. In the above-mentioned conversation, the couple described sexual playfulness and spontaneity as bordering on abusive. This commentary is completely ridiculous.

Your sexual intimacies as a couple should not be dictated by what reporters, television shows, or what culture defines as politically correct. Your sexual relationship with your partner should include mutually agreed upon loving interactions between the two of you. Romantic exchanges between the two of you may include spontaneous, erotic, and romantic sexual expressions.

What makes good sex? Good sex results from shutting off our big brains, while engaging in good communication, and focusing on pleasure. When a couple feels comfortable and safe with each other they can ask for what turns them on without fear of scorn or rejection. When you communicate well with your partner it’s very difficult for either one or the other to feel misunderstood or threatened by touching. If you don’t like it if your husband grabs your breasts while you’re doing some chore tell him. Most often couples want to please each other.

If you find that you are struggling with communication or sexual issues either as an individual or in your marriage don’t hesitate to call Dr. Goschi to schedule your appointment. Dr. Goschi can be reached at (312)595-1787 or by email at barbara@drgoschi.com

Addiction and Defenses

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

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!