Finding a Therapist Q What is the difference between a psychologist and a psychiatrist? A psychiatrist has attended medical school and completed a residency in psychiatry. A psychologist, on the other hand, has usually completed 4 years of graduate school and an internship in psychology. Although both are experts in emotional and behavioral issues, they approach problems from different viewpoints.
The psychiatrist, being a medical doctor, often sees emotional difficulties from a physiological perspective and typically prescribes medications for problems such as depression and anxiety. For certain problems, the two individuals may work together using both counseling and medications.
Q How do I find a counselor or therapist to work with? Word of mouth or a referral from a friend are often the best places to start. If you have an HMO or insurance that will pay for therapy, you can obtain a list of therapists who are covered under your plan. Other ways to find a therapist include calling a local hospital or mental health center, contacting your state psychological association, using the yellow pages or the internet.
Be a cautious consumer! Ask about credentials, experience, specialties and professional activities. If you feel uncomfortable with the therapist, continue looking elsewhere until you find someone that you feel comfortable with. Q How do I find a sex therapist? Some psychologists and other therapists may specialize in sex therapy or couples counseling. This association provides a referral service by calling 1 or by connecting to their web site at www.
You might also get information and a referral from your primary care doctor, urologist or gynecologist. Q How do I know where is the best place to get help? Often, finding the right professional for you or a partner is a trial and error process. A professional who works in isolation from other colleagues can ultimately be a disadvantage for the patient. Today, sexual concerns are often seen as multi-faceted and require an expertise beyond that of a single individual.
For example, before undergoing extensive sex therapy, insist on a medical evaluation. Q Is there a charge for the first consultation with a psychologist or therapist? Most often psychologists and other mental health professionals do charge for the initial meeting. There are exceptions to this practice in different countries, different states and among various practitioners. If money is a concern, ask about this courtesy when calling to set up the first appointment.
A clinical practice is a small business however, and economics usually dictate that it is necessary to charge for professional time. Q How do I know that information discussed with my therapist will be kept confidential? There are very strict laws in all states that regulate what information can be released to other people or to insurance companies and attorneys.
In general, a signed release of information is necessary before any information can be shared with other people. The exceptions to this law include the reported abuse of a minor or when there is sufficient concern about the safety of the patient or another person.
Your state psychological association can provide you with specific information for your state. It is always recommended to discuss this issue with your psychologist at the beginning of treatment. Sexual Addictions Q Do sexual addictions really exist? Yes, sexual addictions do exist and can create chaos in the lives of an individual and their family. Moreover, sexual addictions can also put the individual in danger of legal action, potential violence or sexually transmitted disease.
Whether specific behaviors can be considered sexual addictions may vary from person to person. However, an addiction may exist if an individual is unable to control certain sexual behaviors; the sexual behavior is self-destructive and it interferes with the normal daily functioning of the individual.
Q What type of sexual addictions are seen by psychologists? There is a tremendous range of sexual addictions that people experience and seek treatment for. Over the last several years, addictions to internet pornography are very common. This type of addiction may be accompanied by excessive masturbation lasting long periods of time or by the use of prostitution.
Other forms of sexual addiction may involve exhibitionism, public masturbation, uncontrolled sexual contact with strangers and a wide variation of activity designed to elicit sexual pleasure. Q What types of treatments are available for a person with a sexual addiction? There is no one form of treatment that has been proven most effective. Often, a combination of treatments are used in working with the person who has a sexual addiction.
For example, some of the psychiatric medications can be helpful in reducing sexual drive or in decreasing sexually intrusive thoughts. These medications may also allow an individual to consider consequences before acting on a sexual urge or impulse.
In addition to medications, treatment almost always involves therapy or counseling on a regular basis. In the United States there are also self-help programs for people with sexual addictions. These are modeled after the AA 12 step programs and are found in most major cities in the US. Q What can I do if I think my partner has a sexual addiction?
Clearly, the first step is to speak with your partner and discuss your observations and concerns. Like all addictions, denial is common. In some cases, the individual may not realize that a problem exist or that certain behaviors have become out of control.
Encouraging psychological treatment and providing strong emotional support are critical if changes are expected. Expressing emotional support is often difficult at this time because of personal distress and feelings of anger.
Q How can someone I love do this to our relationship? In trying to grasp a situation such as this, it is important to remember that the sexual behavior is an addiction. Like all addictions, they serve a purpose. Often, the behavior is an attempt to cope with feelings such as depression, stress or other emotionally painful material.
Typically, the reasons behind addictive behavior are complex and multi-faceted. Like any addiction, maintaining control and avoiding future problems is a difficult, life long process. Maintaining sobriety over sexual addictions requires strong motivation and a constant vigilance over times of potential danger.
With good emotional support however, it is possible to make the necessary changes. For most people, a sense of over-confidence and a premature termination of psychological treatment and support are the biggest mistakes that can lead to future problems. Sex Therapy Q How do I know if my sexual difficulty is from a psychological or physical problem? The answer to this question may depend on whom you ask. A mental health professional may believe that your problem comes from a psychological issue and a medical doctor may feel that there are physical concerns.
The reality is that most sexual difficulties have both psychological and physical components that can contribute to the problem. Today, because of recent medical advances, physical causes are often discovered in the majority of cases. The psychological or emotional component thus may be a result of the sexual problem rather than causing the sexual difficulty. Also, relationship issues often emerge after any form of sexual difficulty.
Because there is no simple answer to this question, a good sex therapist should refer you to a medical doctor for an evaluation while a medical doctor may also suggest that you address the emotional issues with a therapist.
Q If my sexual difficulty is because of psychological causes what can I do? There are new effective treatments for people who have sexual problems due to either physical or psychological reasons.
Almost everyone who has a sexual difficulty hopes that a physical reason can be discovered. We all want a quick fix and hope that a pill can solve our problem. This is why Viagra has become so popular. Psychological causes for a problem are much more vague, difficult to understand and sometimes more difficult to treat.
If there are psychological difficulties, we tend to blame ourselves and self-esteem is affected. Unfortunately, even in this age, many people feel a sense of shame and inadequacy about psychological problems. We all believe we should be able to fix the problem ourselves without seeing a professional!
With sex being such a personal matter, most people do wait considerable time before seeking professional assistance. The embarrassment surrounding sexual difficulties often prevents people from getting early help.
Some problems do clear up on their own especially if they are related to factors such as excessive alcohol consumption or stress. However, if a problem persist over a period of weeks or months there is a good chance that the situation will not improve without some professional intervention.
Once a sexual problem has occurred, even once, we tend to anticipate difficulties every time in the future. This loss of sexual confidence and fear of failure can easily intensify an already existing sexual difficulty.
Q I am unable to ejaculate during intercourse although I have no difficulty during masturbation. What should I do? This problem is often seen in clinics and can be either from medical or psychological issues. For example, a decrease in the sensitivity of the penis may be caused by a nerve injury thus making ejaculation difficult with the friction of intercourse.
On the other hand, anxiety about reaching orgasm may be another factor. A good medical evaluation is an essential first step and would be recommended by most therapists. Q What causes pre-mature ejaculation? No one is quite sure how men develop problems with rapid ejaculation. Often, masturbation is considered a method in which this response is learned and mastered. Although the problem is more common among young men it can persist throughout the life span of an individual.