6 things a sex therapist wishes you knew

22 05 2018

Here’s an article I did for Prima magazine a couple of years ago, but omitted to post on here at the time:

6 Things A Sex Therapist Wishes You Knew

My 6 tips were as follows:

1. It’s good to talk about sex!
Lots of clients still feel like opening up about their sex lives is a real taboo, and that sexual thoughts should be kept private and hidden away. But the truth is that sex is a huge part of who we are – it plays a vital role in determining our identities, and in shaping the relationships we choose throughout our lives – so it’s good to talk about it, and there’s nothing shameful or degrading about doing so.

You might not think that your sexual thoughts are relevant to certain other issues in your life, but sometimes sharing these inner desires can really shine a light on something else that’s seemingly unconnected.

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2. …but don’t JUST talk about sex
Sex is often the symptom, not the cause. Lots of people come to therapy looking to resolve a sexual issue, and often there’s a temptation to focus on that issue and not talk about anything else. But as you explore around the problem, you tend to find that what’s being played out in the bedroom is often related to other thoughts and feelings.

Even something as innocuous as moving house or changing job can have an unexpected impact on libido, as attention and energy levels are focused elsewhere. So it’s really important to get the full picture of what’s going on.

3. There’s nothing you could say that would surprise your therapist
People go to therapy for all kinds of sexual issues. This might be a question of their own orientation, making sense of a certain fetish, or exploring some kind of dysfunction, which they feel is preventing them from having the sex life they truly desire.

No matter how embarrassed you might feel about a certain sex-related issue, your therapist won’t judge you for it, and will remain calm and impartial as you explore the problem. Sexual issues are very common reasons for people to seek therapy, so your therapist has most likely heard it all before; and however filthy or unusual you might think your kink is, someone else has probably already shared it.

4. The biggest sexual organ is the brain
People spend so much time focusing on genitals, but often forget about the brain. Sex is a deeply psychological process, and one person’s turn ons can be another’s turn offs. This is because we all get aroused by different sensory stimuli, and have a different set of positive and negative associations for all kinds of situations and events; often relating back to previous experiences.

You can have a lot of fun with your body, but truly great sex needs to involve the brain as well. After all, it’s the brain that gets flooded with a magical cocktail of chemicals – dopamine, serotonin, oxytocin and endorphins – at the point of orgasm, to produce an almost trance-like experience.

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5. Sex means different things to different people, at different times
There’s no single definition of a good sex life. Sexuality is fluid, and needs and desires can change drastically from person to person, and even day to day. For example, at the start of a relationship sex is usually about pleasure and passion, but over time it can become more about intimacy and connection, and then if a couple decide to have children it can suddenly become quite outcome-focused.

Sometimes people struggle to cope with these transitions, or may find that their own needs don’t match with their partners’, and this is why talking about sex is so important in relationships.

6. Don’t put it off
If you do have a sex-related worry or concern, it’s best to talk about it as soon as possible. If you don’t feel comfortable discussing it with a family member or a friend or partner, then seek out a good therapist to explore the issue with you. The longer you wait, the more it becomes likely that you build the issue up in your head, or start to complicate it even further.

It’s always best to tackle issues, rather than to let them fester or be ignored. More than ever, people are talking openly about their sexual orientations and desires, so there’s no need to deal with your worries alone. Everyone deserves to feel sexually fulfilled, and that includes you.

I specialise in sex and relationship issues, so if you would like to discuss any of these in a safe and secure environment, either individually or as part of a couple of family, then please contact me and I will schedule a session for you.

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Fertility treatments and counselling

18 03 2015

Last Sunday, the 15th March 2015, the Sun published an article about IVF treatments and the stress – both psychological and financial – that these can place on a family. They contacted me and asked me to say a little bit about the systemic, wider-reaching impact that such a process can have on all the family members. and how therapy can often be a way for everyone to come together and process these issues.

You can see some clips of the article  as it appeared in the paper, below.

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If you, or any family members, might be interested in counselling for fertility issues or any related problems, then please do contact me to arrange an individual, couples, or family session as soon as possible. I look forward to hearing from you.





Wishing everyone a restful end to the year.

20 12 2014

As we’re coming to the end of the year I just want to wish everyone a restful time over the next few weeks. It’s often a time where families get to come together, but that doesn’t mean it’s any less manic or stressful than the rest of the year; in fact it can often be a time of conflict and anxiety.

I work with a lot of my clients to raise awareness of their feelings at times of conflict or anxiety, and then to manage them using techniques such as mindfulness. I see mindfulness as a means of remaining focused on the here and now, and being completely in touch with the present moment; thus removing ourselves from the constant ‘noise’ of past-oriented or future-focused thoughts buzzing around our brain. Imagine your mind as one of those Christmas snowglobes, shaken up and swirling all over the place; and mindfulness helping all the snowflakes become settled and calm, so that the globe is clear again.

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Scientific evidence has shown the effectiveness of regular mindfulness, and you can read the recent experiences of the American news anchor Anderson Cooper here, as he describes how mindful practice has changed his life; enabling him to be more calm, present, and efficient.

However you spend the next few weeks, why not try out some mindfulness techniques to simply catch your breath and gather your thoughts? For example, you might want to just focus on your breathing for a couple of minutes, or try some progressive muscle relaxation, or sit through a brief guided imagery exercise. These techniques should help you feel far less stressed and anxious, and much less overwhelmed.

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I would also like to briefly thank everyone at the ACPNL, as they kindly invited me to present a workshop for them last Sunday. I have to admit I didn’t expect many people to be present – considering it was a cold and frosty Sunday morning at the end of the year – so I was delighted to have almost 50 people in attendance. I presented for 3 hours, on the topic of Social Emotion Regulation, and talked about the difference between attachment and attunement, how to create lasting and secure connections in therapy, and the basics of Emotionally Focused Therapy (as a reminder, EFT is an evidence based modality with a proven ‘total recovery’ rate of 75%, and 90% of clients showing improvements; no other modality even comes close!). The workshop was such a success that the ACPNL have requested that I go back and do another one, so I will keep you posted once dates are confirmed.

Once again, I would like to wish you all a happy and healthy end to the year, and all the best for 2015.





How To Change Your Drinking: A Harm Reduction Guide to Alcohol

16 12 2011

My review of “How To Change Your Drinking: A Harm Reduction Guide to Alcohol” by Kenneth Anderson:

How to change your drinking front cover

Substance misuse is one of the most common and widely discussed topics within the mental health community, as both clients and professionals debate the most effective ways to deal with addictions and their causes.

In the past, treatment might typically have involved a focus on abstinence as the ultimate goal, through zero-tolerance groups such as Alcoholics Anonymous, or a 12-step program, where clients would be rewarded only for complete sobriety and nothing less.

This has slowly changed over the past decade, though, through the realization that complete abstinence simply wasn’t a realistic or achievable goal for some, and that such a harsh insistence on withdrawal simply wasn’t working. In fact, it is estimated that 60 to 95 percent of clients who enter 12-step programs either drop out or otherwise fail to maintain abstinence from alcohol, and the NIAAA’s statistics suggest that only 7 percent of people who suffer from an alcohol use disorder will typically seek treatment within any given year.

As a result the treatment focus has shifted from simple cold turkey toward an overall emphasis on healthier and safer habits, and lowering risks. This has seen an emerging popularity for modalities such as motivational interviewing, where both the pros and cons of sustaining the negative behaviors are acknowledged. The client is then free to decide how, and at what pace, to proceed.

The HAMS group takes a similar “baby steps” approach. HAMS — the acronym stands for Harm reduction, Alcohol abstinence, and Moderation Support — describes itself as “a free of charge, lay-led support and informational group for people who want to change their drinking for the better.” Founder and CEO Kenneth Anderson is himself a former problem drinker.

In this book, How To Change Your Drinking: A Harm Reduction Guide To Alcohol, Anderson presents a comprehensive summary of the harm reduction approach to drug and alcohol problems, suggesting it could “either be used as a self-help manual for people working on their own or by people who are participating in a harm reduction support group.”

The book begins by introducing the underlying theories of harm reduction, and is written in a nonjudgmental tone that will be reassuring to most readers:

Some folks today want to say that everything fun is an addiction and that everyone had better spend their lives in 12 step meetings talking about their ‘Higher Power’ and holding hands and saying the Lord’s Prayer instead of ever doing anything fun. We beg to differ with these people. Prohibition does not work because there is nothing essentially evil, sinful, or diseased about having fun. There is nothing evil, sinful or diseased about drinking alcohol moderately, and for that matter there is nothing sinful, evil or diseased about engaging in recreational intoxication either.

There is not some specific magical quantity which we can say is too much alcohol – free individuals have the right to make up their own minds about how much they believe is too much for them personally. Occasional intoxication is not a symptom of a disease; it is a choice.

It is this focus on individual choice and empowerment which personifies this book and differentiates it from much of the rest of the substance misuse canon. Instead of focusing on problematic labels or clinical diagnosis as a means of demanding perfect abstinence, the author leads the reader on a step-by-step journey toward deciding what their own goals should be, and offers advice and support on the healthiest ways to achieve and maintain them. There is even a short section titled “Ken’s Story,” where Anderson talks about his own previous drinking problems and near-death experiences in AA. Those led to his resolution to “find a better way” and start the HAMS network.

The opening chapters might seem familiar to many mental health professionals, as Anderson suggests that each reader completes a Cost Benefit Analysis exercise, similar to those used in motivational interviewing techniques:

Miller and Rollnick (2002) say, ‘Often individuals considering changing a problem behavior will concentrate on all the negative aspects of the behavior. ‘I know how bad my drinking is for me,’ they say. In fact, they can often produce a litany of reasons why what they are doing is bad for them. Clinician and client are often baffled by the fact that even with all these negatives, change does not occur. The reality is that if the behavior were not in some way beneficial to the client, he or she would not be doing it. Until the client acknowledges the ‘good things’ about the behavior, they cannot prepare to combat temptation once they make an attempt to change. The decisional balance helps facilitate this process.

It is clear that Anderson has done his research in this field, and even though much of the book features personal stories and experiences, these are all presented within a scientifically supported framework, using clinically proven techniques and offering further resources where appropriate. Later in the book, Anderson explains Prochaska’s “stages of change” model, leading the reader through each stage and explaining the range of thoughts and behaviors that might accompany this process. He offers readers a large quantity of materials to help them along this journey, too, ranging from goal-setting and risk-ranking worksheets, to consumption charts and graphs, to the chemical breakdown of different alcoholic beverages and how they are processed within the body.

The book also addresses the addict’s friends and family. Anderson features chapters on specific topics such as spousal goals, alcoholism’s effects on children, and a study of drinking patterns as affected by ethnic identity and religious affiliation.

There is a wealth of knowledge in this book, but the clear, concise and easy-to-read style ensures that it never becomes overwhelming or difficult to follow. Anderson describes things in layman’s terms and it is doubtless this open, reassuring style which attracts so many of the HAMSters to the harm reduction approach.

As a comprehensive manual to changing drinking behaviors, readers will be hard-pressed to find a better book than this. If you’re looking for support, advice, scientific facts, or recovery tools, you’ll find them all here, clearly laid out for both mental health professionals and clients alike.

4 out of 5 stars.

It is worth noting that alcohol misuse has been a major issue in the British media since I wrote this review; with suggestions of major changes in government policy and the introduction of ‘drunk tanks’ and ‘booze buses’. I have a lot more to say on this topic, and it is one that is close to my heart as I do a lot of work for a substance misuse agency within the NHS in North London; but that’ll have to wait for another time.





Stop Suffering Needlessly: How to Quickly Recover from Depression

18 07 2011

Another book review: “Stop Suffering Needlessly: How to Quickly Recover from Depression”, by Kathy Reagan.

Stop Suffering Needlessly cover

Almost everyone reading this review – particularly those in the mental health field – will have had first-hand experience of dealing with depression at one time or another, whether the sufferer was a client, a relative, a friend, or themselves. The World Health Organization predicts that by 2020, depression will be the second largest cause of suffering in the world, second only to heart disease. Depression affects over 15 million Americans alone, and is one of the most prevalent and debilitating mental illnesses in the world today, often going undiagnosed and untreated. So there is no doubt that this is a topic which deserves to be written about, and which requires serious attention.

With her new book ‘Stop Suffering Needlessly’, Kathy Reagan joins the host of other self-help authors who all proclaim to be able to offer their readers the secret cure to depression. The back cover of Reagan’s book suggests that “If you’re one of the majority of people who aren’t receiving any treatment for your depression, this book will teach you everything that you need to know to recover quickly.” The cover also promises that “Stop Suffering Needlessly will benefit you, whatever your age, gender, ethnicity, geography, socioeconomic status, sexual orientation, or religious beliefs.” Bold statements indeed.

Unfortunately, on just the second page of the book, these promises begin to come undone, when Reagan says:

Whether we suffer as a result of things we can or cannot control, I believe that there is value in suffering. I believe that God gives all of us at least one opportunity, if not many opportunities (especially for those of us who don’t get it the first time), to fall to our knees, acknowledge our weaknesses, and ask for help. Maybe that’s the lesson to be learned when we suffer. Maybe learning to finally ‘let go and let God,’ and rely on a Power greater than ourselves, is the true value of suffering.

Reagan goes on to explain that:

I believe that there is a Divine plan, which calls each of us to heal from whatever suffering we may experience, to learn and choose to be happy, to pay it forward, and to grow toward our Maker. This is why I wrote Stop Suffering Needlessly.

It quickly becomes clear that this is not a book which would appeal to the general populace. In fact, Reagan seems to be writing exclusively for a very specific audience here: those who share only her own religious beliefs. One of Reagan’s concluding remarks tells us to “Learn to give up control, rely on God or your Higher Power,” and to say the Serenity Prayer daily. The book will also be of most relevance to American readers, as Reagan quotes only from American television shows throughout, and all of her statistics are taken from the American Psychological Association (APA).

This is a disappointing approach to the topic, as it will immediately alienate a huge part of Reagan’s potential audience from her book and limit it to a niche market; rendering many of her suggestions invalid and not applicable to other people. It is also a surprising one, as one would not expect to find such a polarizing opinion in the field of mental health advice or self-help, especially coming from someone who has worked as a professional therapist for almost 20 years. Far from the unbiased, open-minded and nonjudgmental approach we might expect, Reagan makes no hesitation in stating her own beliefs, and repeats them again and again throughout her book, seemingly imposing them on her readers:

I believe that guilt and shame are gifts to help us become better human beings. Following the Ten Commandments for example, is a wonderful guide for our conscience and behavior, and feeling and experiencing some guilt for breaking a commandment can help us do better.

At best this makes Reagan’s book come across as one which should only be read by a select readership, but at worst it comes across as patronizing, insulting, or downright irresponsible. I can only hope that Reagan has adopted this tone for her writing alone, and does not voice her personal beliefs so openly in session, with her clients.

Sadly, the problems with this book do not end at Reagan’s insistence on expressing her beliefs, but continue to emerge as she gives her advice on the topic of depression and its cures. Reagan’s suggestions are purely anecdotal; drawn from her own memories and personal experiences, rather than from any kind of professional research or actual facts. She scatters the phrases “in my experience” and “in my opinion” frequently throughout her book, but fails to back up her theories with any proof or further evidence, instead supplying the reader with occasional quotes from TV shows:

Rejection is God’s protection is a line from a recent episode of ‘Law and Order.’ If you’ve experienced rejection (who hasn’t at one time or another?), consider the possibility that this statement is true. If you’re suffering from the loss of a relationship, is it possible that God is protecting you from some future danger or sorrow that you can’t see? Or that God has something better planned for you in the future?

As if this wasn’t bad enough, Reagan consistently makes sweeping statements, offering vague generalizations and clichés:

It’s common for people who experience depression, and women in particular, to lose a sense of themselves, especially if they have been trained to be care-givers for their partners, children, or others. Do you know who you are and what you need? Do you even have a clue what you need? Many women do not.

As seen here, Reagan has a tendency to pepper her prose with incessant questions, one after the other, presumably aimed at her imaginary readers. Unfortunately these have the effect of making it seem like the author herself is not sure of the answers, and at times make the book completely unreadable, as the text dissolves into entire paragraphs of theoretical questioning and rhetoric.

I do not wish to be overly critical here, as there are a few snippets of worthwhile information hidden among the text. Some of Reagan’s stories do contain interesting suggestions and techniques, and she supplies a useful collection of links and resources in her Appendix. Her nine steps toward taking control of depression may also be of use to some readers:

1. Recognize and acknowledge your depression.
2. Ask for help. Expect to recover.
3. Take medication if you need it.
4. Take care of your body.
5. Seek therapy.
6. Practice Cognitive Behavioral Therapy (CBT).
7. Learn other important skills.
8. Increase your social support.
9. Develop a relapse prevention plan: Take responsibility for your depression and your recovery.

However, whenever Reagan seems to latch on to something of interest, or to present a promising theme, she just as quickly goes on to contradict herself, or undo her sentiments entirely. In an early chapter Reagan writes:

Have you ever heard the phrase’ Just pull yourself up by your bootstraps?’ Or ‘Just think positively!’ These old simplistic and cavalier responses to people with depression now sound ridiculous, knowing that depression is a medical illness. As if depressed people could do just that and recover easily… Effective treatment for the medical illness of depression involves more than trite solutions.

Then, just a few pages later she says:

Even if you currently don’t have health insurance, that doesn’t mean that you cannot receive recommended treatment if you want it. You are likely still eligible for some kind of assistance or program, so if you want help, ask for it.

And again, in another chapter, Reagan repeats this sentiment:

Do what you need to do to obtain care. Some health care providers also provide pro bono (free) care. Some retail and drug stores offer free walk-in services too. If you need treatment, you can find it.

These simplistic and cavalier suggestions do indeed come across as ridiculous, particularly as Reagan herself dismissed them earlier, and they seem to lack the sensitivity or understanding one would expect from an author in this field. One can only wonder how a seriously depressed reader might feel, if they turned to this book during a time of utter desperation and exhaustion, only to find such unsympathetic, matter-of-fact advice. Even the book’s title, Stop Suffering Needlessly, seems accusatory and blunt when taken in this context.

Even though I operate from a strengths-based perspective and believe in carrying this approach across to all aspects of my life — including book reviews — it is hard to find many positives in this self-published text. It may conceivably be helpful to the few readers who happen to share Reagan’s exact outlook on life and her religious beliefs, but otherwise it would be best avoided. There are numerous other books on offer which cover this same topic, and do so far better, without any sense of discrimination or prejudice against their readers, and with a grounding in reputable clinical experience and scientific fact, all of which are lacking here.

Reagan is right about one thing: the effective treatment of depression definitely does involve more than trite solutions. Unfortunately, those are all you’ll find in this book.

1 out of 5 stars.