Intimacy & Sexual Wellness Counseling nYC, NY 

Effective NYC Therapy For Intimacy & Sexual Wellness

As a sex-positive therapist, this practice supports all forms of sexual expression that are mutual and consenual. Sex and intimacy Are healthy and even necessary for physical and emotional well-being, and are shown to lead to more satisfying relationships. This practice offers experienced NYC Counseling for Sexual Intimacy and Relationship Concerns for traditional and non-traditional relationships, including, Marital/Pre-Marital, Non-Monogamy (CNM & ENM), Polyamory, BDSM/Kink/fetish, Sex Therapy, Infidelity, Sex and Intimacy Coaching

As a sex-positive licensed clinician with training in human sexuality and intimacy, I provide a safe and supportive space for individuals and couples to explore their attachment and relationship dynamics, identity of self, intimacy, and sexuality. Everyone can and deserves to experience joy and pleasure and have an overall sense of freedom throughout their lives, especially when honoring their authentic self and desires. As your therapist, I offer a judgment-free space to examine your lifestyle. Issues we explore may include family systems and religion, intimacy, attachment styles, boundaries, pleasure, sexual dysfunction, kink and BDSM, reproductive health and hormones, mood, and alternative lifestyles.

Learning To Inhabit The Body and Co-regulation practices

Talking about sex from an educational perspective is helpful, but only briefly. Successful sex therapy requires a deeper mind-body connection. As an EMDR Therapist and a clinician trained in somatic experiencing, I am skilled at helping clients integrate both thoughts and beliefs, as well as developing a profound sense of body awareness and partner connection. Somatic therapy includes a technique called resourcing, which helps clients experience a deeper sense of embodiment and comfort, as well as a fuller range of emotions. Resourcing is an important aspect of somatic therapy, which involves helping identify the places in your body where you feel safe, grounded, and at ease, as well as noticing where you may feel numb, tense, and experience distress. Somatic psychotherapy can provide deep healing for clients who struggle with sex and intimacy. Clients generally experience this integration of mind and body as extremely helpful and healing. 

Common Reasons Individuals And Couples Seek Sexual Counseling:

• Low sexual desire

• Exploration of sexual interests such as kink, fetish, and BDSM

• Exploration of sexual orientation

• Infidelity and its impact on sexual relationships

• Desire to improve communication, satisfaction, and sexual intimacy

• Sexual difficulties after chronic medical problems, pain, disabilities, and medications

• Sexual challenges following surgery or post-cancer treatment

• Pain during intercourse (vaginismus/dyspareunia)

• Difficulties with orgasm

• Erectile dysfunction/rapid ejaculation

• Hormone changes in women (perimenopause, menopause, post-menopause, estrogen, progesterone & testosterone deficiency)

• Hormone changes in men (testosterone deficiency)

When To Consider Sex Therapy As A Couple:

• You are craving more passion, exploration, novelty, mystery, surprise and desire

• You would like to reclaim your sexuality following sexual abuse, rape, or exploitation

• You have concerns that you are inexperienced or have difficulty pleasing your partner

• You are experiencing aging concerns, health and pain complaints, and phase-of-life issues

• You have problems related to medication or a medical diagnosis that is impacting your relationship

• Your sexual identity and gender concerns are interfering with your relationship

• You were raised in a religion or culture that was not sex-positive and has left you feeling conflicted or with states of guilt or shame

Relationships Take Many Forms, ranging from traditional to alternative lifestyle…

Some couple therapists choose to work only with traditional couples, while other relationship therapists are comfortable working with non-traditional couples, which can take various forms, challenging the conventional norms of romantic partnerships. These relationships might involve unique dynamics, structures, or expectations that deviate from what society traditionally deems as the "standard" couple model. The following examples show how diverse and fluid relationships can be, with each type emphasizing communication, consent, and mutual respect as core elements. Here are some examples:

Traditional Relationships

• A traditional relationship, especially in the context of romantic partnerships, typically refers to a relationship structure that aligns with societal norms or expectations about love, commitment, and gender roles. While traditional relationships can vary depending on cultural, social, and historical context, they often share some common elements. Traditional relationships typically include monogamy, conservative views on sexuality, clearly defined gender roles, and a focus on family and children. However, over time, the concept of traditional relationships has evolved to encompass a wider range of dynamics and greater flexibility.

Polyamorous Relationships

• Involves consensual, ethical, and informed romantic or sexual relationships with more than one person at a time.

• Hierarchical - Partners may have primary, secondary, or tertiary status.

• Non-hierarchical - All partners are considered equally significant.

• Solo Poly - Individuals prioritize independence and may not seek a primary partner.

Open Relationships

• A relationship where both partners agree to engage in sexual or romantic encounters with others while maintaining the core of their primary partnership.

• Difference from Polyamory - Polyamory often involves deeper romantic connections with multiple partners, whereas open relationships tend to focus more on sexual openness.

Long-Distance Relationships (LDRs)

• Couples who live far apart and maintain their romantic connection through communication, often over the phone, video chats, or visits.

• Characteristics - These relationships can range from traditional monogamy to polyamory, but the defining feature is physical separation.

Co-Parenting Relationships

• People who come together primarily for the purpose of raising children, without necessarily having a romantic or sexual relationship.

• Platonic Co-Parenting: Sharing parenting duties without romantic involvement.

• Intentional Parenting: Two or more individuals may form a family unit without being romantically or sexually involved.

Relationship Anarchy

• A philosophy that rejects traditional norms about relationships, including expectations about romantic or sexual exclusivity.

• Characteristics - Relationships are treated as individual and fluid, with no predefined rules about hierarchy or expectations. Consent and communication are central.

Monogamish Relationships

• A relationship where the primary partners mostly practice monogamy but allow for occasional exceptions.

• Example - A couple who may have sexual experiences with others, but maintain their emotional commitment and primary connection.

Swinging

• A practice where committed couples consensually engage in sexual activities with other couples or individuals.

• Characteristics - Typically focused on sexual exploration, rather than emotional or romantic connections with others.

Queerplatonic Relationships

• A term often used by those in the asexual and aromantic communities to describe a deeply committed, emotionally intimate relationship that isn’t necessarily sexual or romantic in nature.

• Characteristics - A "queerplatonic" partner may share a home, family responsibilities, and close emotional bonds without conventional romantic or sexual expectations.

Solo Relationships

• Individuals who choose to prioritize their own autonomy and well-being without being in a romantic or sexual partnership.

• Characteristics - They may still form close, emotionally supportive relationships but without the expectation of traditional coupledom.

Non-Monogamous Friendships

• While not strictly a "couple" relationship, some non-monogamous individuals may have deep emotional, supportive, and even sexual relationships with friends, redefining what a "relationship" can be outside of romantic norms.

Arranged Or Semi-Arranged Marriages

• A relationship structure where partners may not initially choose each other for romantic reasons, but are introduced or brought together by families or other third parties.

• Characteristics - The relationships may evolve over time into deep romantic or platonic bonds, with varying levels of independence or emotional connection.

Virtual Relationships

• Romantic or sexual relationships conducted entirely online, where partners may never meet in person or have limited physical interaction.

• Characteristics - These relationships can be monogamous, open, polyamorous, or even based on shared hobbies and interests.

Transitional Or Situational Relationships

• Relationships that form temporarily due to life circumstances, such as during a period of geographic transition, academic focus, or major life changes.

• Characteristics - These relationships might not have long-term expectations and can often be more flexible.

Asexual Relationships

• Relationships where one or both partners do not experience sexual attraction.

• Characteristics - They may be romantic or non-romantic and focus on emotional intimacy and companionship, but without sexual involvement.

Companionship-Based Relationships

• Partnerships focused on companionship, where emotional connection and support are prioritized over physical intimacy or traditional romantic expectations.

• Characteristics - May be deeply satisfying for people who value emotional closeness without a desire for sexual activity.

Are you struggling with sexual dysfunction?

There Are Many Reasons Partners Experience Intimacy And Sexual Difficulties When The Relationship Is Solid And Good. Sexual Problems Can Be Influenced By Various Other Factors, Including Physical Health, Hormonal Imbalances, Psychological Factors, And Relationship Dynamics. Hormones Play A Significant Role In Regulating Sexual Function And Desire,

It’s not uncommon for people to experience sexual problems at some point in their lives. I believe that sexuality is an important component of human happiness and connection. Sex therapy is still therapy. We talk about concerns, past and present experiences, desires, anxiety, traumas, relationships, the desire for change, and more. The difference is, we focus on sexual matters, and your relationships. As a sex-positive therapist, you should not feel judged about any aspect of your consensual sexual experiences or your fantasy life. Many have never had the permission or opportunity to explore their sexuality. All too often, aspects of sexuality and desire may be coupled with feelings of shame and guilt. Sometimes experiences stemming from negative childhood or adult experiences will interfere with creating and sustaining healthy sexual experiences. This creates shame and confusion, as well as fear and avoidance. We can explore obstacles and inhibitions together.

I provide sex therapy to individuals and couples, helping clients restore sexual health, intimacy, and pleasure. Together, we will work to help you discover the psychological, emotional, and physical factors contributing to your sexual concerns and lack of fulfillment, as well as create a plan to help you overcome them. We will not only explore the specific problem(s) you present in treatment, but we will also help you develop greater ease when communicating about sensitive, difficult-to-discuss topics. This is important when working together, as I’d like you to develop self-empowerment, self-compassion, and self-awareness as they all relate to human sexuality.

Any Imbalance Can Lead To Sexual Problems. Here's An Overview Of How Health And Hormonal Issues Can Affect Sexuality:

Hormonal Imbalances And Their Impact

Hormones are chemical messengers that help regulate various bodily functions, including sexual desire, arousal, and response. Changes or imbalances in certain hormones can affect sexual health, and this is the case for men and women.

Common Hormones Involved In Sexual Health:

• Testosterone - This hormone is crucial for libido (sexual desire) and sexual arousal in both men and women. Low levels of testosterone can lead to a reduced interest in sex, erectile dysfunction in men, and vaginal dryness in women.

• Estrogen - This is the primary female sex hormone and is important for sexual function in women. Low estrogen levels (which can occur during menopause) can lead to vaginal dryness, pain during intercourse, and a decrease in sexual desire.

• Progesterone - This hormone works alongside estrogen in regulating menstrual cycles and pregnancy. Low levels can lead to irregular menstrual cycles, and, in some cases, low libido.

• Prolactin - Elevated levels of prolactin (often due to conditions like pituitary tumors) can interfere with sexual desire and arousal by inhibiting the effects of estrogen and testosterone.

• Oxytocin - Often referred to as the "love hormone," oxytocin is involved in bonding, orgasm, and sexual pleasure. Low levels of oxytocin may affect sexual satisfaction and emotional connection.

Causes Of Hormonal Imbalances:

• Menopause (for women) - As women approach menopause, estrogen and progesterone levels decline, which can lead to changes in sexual desire, vaginal dryness, and discomfort during sex.

• Testosterone deficiency (for men and women) - A decline in testosterone levels can reduce sexual desire and energy levels.

• Thyroid issues - Both hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid) can lead to sexual dysfunction, including low libido and erectile issues.

• Adrenal insufficiency - Conditions like Addison’s disease or chronic stress can affect cortisol and adrenaline, leading to fatigue, depression, and decreased sexual desire.

Common Sexual Problems Related To Hormonal Imbalances

• Low Libido (Sexual Desire) - Low levels of testosterone in men and estrogen in women can decrease sexual interest and desire. This can be influenced by hormonal changes due to aging, medical conditions, or medications.

• Erectile Dysfunction (ED) - While ED is often linked to physical factors like cardiovascular health, hormonal issues (especially low testosterone) can contribute. ED can also be associated with stress, anxiety, or depression, which can disrupt hormone balance.

• Vaginal Dryness - This is commonly caused by low estrogen levels, particularly during menopause or after childbirth. Dryness can make intercourse painful and reduce sexual pleasure.

• Painful Intercourse (Dyspareunia) - Hormonal imbalances can contribute to vaginal atrophy (thinning and drying of the vaginal walls), which can make sex painful. This is common during menopause when estrogen levels decrease.

• Orgasmic Dysfunction - Hormonal changes, especially in estrogen and testosterone, can affect a person's ability to achieve orgasm. This can be linked to physical and psychological factors.

• Anorgasmia (Inability to Reach Orgasm) - This may be associated with hormonal fluctuations, particularly in cases of thyroid issues, menopause, or the use of birth control pills.

Health Conditions That Affect Sexual Function

Several health conditions can disrupt sexual function, often through their effect on hormones or overall health:

• Diabetes - Poor blood sugar control can damage blood vessels and nerves, leading to erectile dysfunction, vaginal dryness, and reduced sexual sensitivity.

• Heart Disease - Cardiovascular health is closely related to sexual function, particularly for men. Poor circulation can hinder blood flow to sexual organs, causing erectile dysfunction.

• Obesity - Excess weight can lead to hormonal imbalances (e.g., increased estrogen levels in men) and is often linked to low libido and erectile dysfunction.

• Chronic Stress and Anxiety - Stress can lead to elevated cortisol levels, which can interfere with normal sexual function, causing reduced libido, erectile dysfunction, and difficulty reaching orgasm.

Medications That Affect Sexual Health

Certain medications can interfere with sexual desire, arousal, and performance, often by altering hormone levels or by having side effects that affect sexual health:

• Antidepressants - Selective serotonin reuptake inhibitors (SSRIs) can cause sexual side effects, including reduced libido, delayed orgasm, or anorgasmia.

• Birth Control Pills - Hormonal contraceptives that contain synthetic estrogen and progesterone can sometimes lead to reduced libido and vaginal dryness.

• Blood Pressure Medications - Some antihypertensive drugs, especially beta-blockers and diuretics, may contribute to sexual dysfunction.

• Anti-androgens - Medications used to treat prostate cancer or to manage gender transition (e.g., spironolactone, finasteride) may reduce testosterone levels, leading to reduced sexual desire and function.

Psychological And Emotional Factors

While hormonal and health factors are important, psychological factors also play a significant role in sexual health. Conditions like stress, depression, anxiety, or relationship issues can affect sexual desire and performance. Psychological factors may also affect the way hormones are produced or used by the body, creating a feedback loop that compounds sexual difficulties.

Treatment And Solutions

If hormonal imbalances are suspected to be causing sexual problems, it’s important to consult a healthcare provider who can help identify the underlying cause. Treatment options may include:

• Hormone Replacement Therapy (HRT) - For women experiencing menopause, HRT can help restore estrogen and progesterone levels, alleviating symptoms like vaginal dryness and low libido.

• Testosterone Replacement Therapy - In cases of low testosterone, either in men or women, testosterone replacement therapy (TRT) may help restore libido and sexual function.

• Medications for Erectile Dysfunction - Drugs like sildenafil (Viagra) or tadalafil (Cialis) can help improve blood flow to the penis, aiding in the management of erectile dysfunction.

• Psychotherapy or Counseling - Therapy can help address the psychological factors affecting sexual health, including anxiety, stress, depression, and relationship issues.

• Lifestyle Changes - Improving diet, exercise, stress management, and sleep can have a positive impact on hormone levels and sexual health.

• Fertility Treatments - If hormonal imbalances are affecting fertility, treatments like in vitro fertilization (IVF) or medication to regulate ovulation may be necessary.

Helpful information about Polyamory and Ethical non-monogamy

Are people experiencing greater freedom to be more transparent, or is it on the rise? Polyamorous and ethical non-monogamous relationships emphasize consent, communication, and mutual respect. While there is no singular “look” for these relationships, certain key principles and dynamics tend to define them. Ethical non-monogamy (ENM) is an umbrella term that includes polyamory, open relationships, swinging, and other forms of consensual non-monogamous arrangements. Below is an overview of what these relationships typically involve, with an emphasis on ethics and healthy dynamics.

Key Principles of Ethical Non-Monogamy

Consent

• Informed Consent - Ethical non-monogamy is always based on the informed consent of all parties involved. Everyone in the relationship (or relationships) knows and agrees to the arrangements, boundaries, and terms. There is no manipulation or deceit.

• Ongoing Consent - Consent is not a one-time thing. People in ethical non-monogamous relationships continually check in with each other to ensure that everyone’s needs, desires, and boundaries are still being respected.

Communication

• Clear and Honest Communication - Communication is a cornerstone of ethical non-monogamy. Partners are open about their feelings, desires, and needs, and they engage in regular conversations to make sure that everyone is comfortable.

• Emotional Literacy - Those practicing ENM often become more emotionally aware, learning how to express their feelings, deal with jealousy, and resolve conflicts in healthy ways.

Respect for Boundaries

• Personal Boundaries - Ethical non-monogamous relationships are built on respect for personal boundaries, whether physical, emotional, or sexual. Partners agree to certain rules about how they engage with others (e.g., use of protection, time limits, or types of intimacy) and respect these boundaries at all times.

• Negotiating Boundaries - Boundaries are not fixed and can evolve. In ethical non-monogamous relationships, individuals check in regularly with their partners to discuss whether boundaries are still being met or if new boundaries need to be set.

Transparency

• No Secrecy - Ethical non-monogamy values openness. Partners often share details of their other relationships with each other, depending on the level of intimacy or agreement in place. This fosters trust and ensures that no one is kept in the dark.

• Avoiding Deception - Ethical non-monogamous relationships require transparency to avoid betrayal or hurt feelings. For example, a partner will typically inform their primary partner when they’re planning to meet a new lover or engage in sexual activities with someone else.

Emotional Responsibility

• Self-Awareness and Emotional Growth - People in ethical non-monogamous relationships are expected to take responsibility for their own emotional needs and reactions. This includes acknowledging feelings of jealousy, insecurity, or discomfort and addressing them through communication or self-reflection rather than projecting them onto others.

• Compersion - Compersion is an important aspect of non-monogamy and refers to the feeling of joy or happiness when a partner is happy with someone else. While not everyone feels compersion, ethical non-monogamy encourages people to explore these feelings, or at least be open to them, as a way to reduce jealousy and encourage emotional growth.

Emotional and Relational Dynamics in Ethical Non-Monogamy

Sometimes, problems arise in ethical non-monogamy relationships, which often leads to different relational dynamics compared to monogamous relationships. These include:

Handling Jealousy
Jealousy is a common emotion in non-monogamous relationships. However, ethical non-monogamy encourages people to address jealousy in healthy ways. This might involve:

• Self-reflection - Understanding the root of jealousy and whether it stems from insecurity, fear of abandonment, or unmet needs.

• Open Communication - Talking about jealousy with partners and finding ways to address feelings without shutting down or creating conflict.

• Reassurance and Support - Providing emotional reassurance and support when jealousy arises, and reminding each other of the love, care, and respect in the relationship.

Time Management

• With multiple partners, time management becomes important. Ethical non-monogamous people often create schedules or systems to make sure they are spending enough quality time with each partner and meeting their emotional and logistical needs.

Nurturing Multiple Connections

• Maintaining multiple relationships can be deeply fulfilling but also requires emotional and logistical energy. People in ethical non-monogamous relationships often have to nurture their connections through regular communication, acts of care, and emotional investment. This can lead to deeper emotional intimacy and growth, both within each individual relationship and in one's self-awareness.

Ethical Considerations in Non-Monogamy

Sexual Health and Safety

• Ethical non-monogamy emphasizes mutual responsibility for sexual

About Relationship Therapy NYC

This practice provides a range of psychological & sexual wellness services in NYC and throughout NY state. The goal is to individualize treatment to your unique physical, emotional, cognitive, and spiritual needs. I have experience working with a broad range of symptoms and approaches in psychotherapy, including but not limited to EMDR Therapy, Psychodynamic Psychotherapy, Cognitive Behavioral Therapy (CBT), Dialectical Behavioral Therapy (DBT), Solution-Focused Therapy, Internal Family Systems, and Holistic Mind-Body Medicine. Therapy begins with a therapeutic consultation, where you will gain a wealth of information about your difficulties. Many people feel better after the first session. The initial consultation also lays the groundwork for future treatment as we determine the best modalities to help you heal.

Relationship Therapist With Nearly 20 Years Of Experience

This practice offers supportive, compassionate and comprehensive care and also stays current on research related to mental health. My goal for you is to use my expertise and extensive training to get you back to living your life as quickly as possible.

Book An Appointment For Sex & Intimacy Counseling Today

To get started, book an appointment or text at 212-529-8292. Integrative Psychotherapy & Wellness Manhattan can help you in your healing journey toward optimal mental health.