Men’s Sex Therapy Intensive

Who this is for

This intensive may be a good fit if you have struggled with:

• erectile difficulty
• performance anxiety
• desire that has gone quiet or conflicted
• desire or fantasy that concerns you
• ejaculating sooner or later than you want
• avoiding sex inside a relationship that is otherwise good
• pornography use you feel badly about
• sexual behavior that feels out of control

You don’t need a partner. Single men do this, divorced men do this, and so do men whose marriage is the whole reason they’re here.

What most men coming to me have in common is that the explanation they’ve landed on for what’s wrong has not brought relief, and it may have even left them feeling more stuck or disconnected from themselves. A good part of this work is getting to a better explanation — not a kinder story, an accurate one — and exploring what changes when you are no longer organizing your sexuality around an explanation that has kept you stuck.

And who it isn’t for

This is the wrong format if you’re in untreated substance dependence, if you’re actively suicidal or recently attempted, if there’s violence or sexual coercion in your relationship, if you’re managing untreated psychosis or mania, or if you’re carrying trauma that needs slower pacing than ten compressed hours can give it. It’s also wrong if all you want is technique instruction, or if the goal is getting a partner to tolerate sex they don’t want.

A different way of understanding your sexual symptoms

This isn’t true of every man, but it’s true of most of the men who reach me, so I’ll say it plainly:

Men usually arrive with an “accelerator” theory. Not enough desire or libido. Low testosterone. Getting older. A body that’s started failing. The assumption underneath is that something which should be running has run down.

Months or years go into that assumption without much changing, because arousal isn’t only an accelerator. There’s also a brake — and the accelerator was rarely the problem. You’re pressing a brake you can’t feel.

The brake is anxiety. Not anxiety as nervousness, but the body’s response to pressure, exposure, evaluation, and fear — the same response that has to be quiet for arousal to happen at all. That’s why the symptom shows up on some occasions and not others, and why simply trying harder to get rid of the symptom doesn’t help. Trying harder is pressure, and pressure is what it’s responding to.

Which makes the symptom useful, once you can read it. It’s a fairly honest account of what you’re braking for. Fear of exposure. A sense of obligation. A resentment you haven’t been able to say out loud. Or how genuinely dangerous it can feel to want something openly from someone and let them see you want it.

So we don’t focus only on the symptom itself. Many men who come here have already spent years trying to solve the symptom directly. We explore whether the symptom has been helping you manage something more difficult to experience: shame, fear, alienation, loss, or vulnerability. The structure of the intensive allows you to truly experience what is underneath the symptom with your protection down rather than simply learning to describe it in an intellectual way. Working differently with the feelings underneath the symptom is what makes a different kind of sex life possible.

Desire, shame, and labels

Most of what men bring into this room has shame in it, and shame is often a poor explainer. It works by handing you a label — addict, broken, deviant, too much, not enough — and a label feels like understanding while actually collapsing you into a category. Then the category itself can become the thing you manage, and the deeper question can get lost.

My approach starts somewhere different. This is sex-positive work. I’m interested in what your desire is actually made of, what it’s organized around, what it needs in order to show up, and what it’s been trying to tell you. That’s a longer conversation than a diagnosis and a considerably more useful one.

If, for example, you use pornography and feel badly about it, we’ll look at what it does for you and what it costs you, and I’ll take your values seriously — without assuming a framework that reduces your sexuality to a disease process before understanding your actual experience.

Why an intensive instead of weekly therapy

Many men who come to see me are ready to work on themselves but aren’t sure about committing to weekly therapy indefinitely. Maybe for cost and budgeting reasons. Or schedule constraints. Or skepticism about whether ongoing therapy is right for them. I designed the intensive with these concerns in mind as a defined treatment with a beginning and an end, with clear objectives and deliverables.

The other thing about working intensively is that it allows for something more experiential, an opportunity to actually feel and experience what’s been hiding under the sexual symptom. A man who is good at managing himself can manage fifty-minute sessions indefinitely. You arrive, you give a good account of your week, you leave. Do that weekly for a year and you can have a real relationship with your therapist and never once get near the thing you came in for. An intensive behaves differently.

What happens in the four sessions

Saturday, week one. We build a map out of one specific episode — not what usually happens, but that particular Tuesday. Where you were, what you noticed first, what went through your mind, what you concluded about yourself afterward. By the end there’s a description of the pattern in plain language that you either recognize or correct.

Sunday, week one. Your history. How relationships, family, masculinity, and early experiences shaped what closeness, vulnerability, and desire came to mean. I’ll often interrupt when the story starts flowing. When a story becomes familiar or well-rehearsed, I’ll slow things down and pay attention not only to what you’re telling me, but to what happens inside you as you tell it.

The week between. One experiment drawn from what we found, a short daily practice, and a written plan for reaching me if you need to.

Saturday, week two. Processing what the week produced, and then the relationship itself (if partnered). One question sits at the center of this whole format: what does a partner become to you when sex becomes possible? Judge, examiner, someone whose disappointment you can’t survive. The answer often reveals something important about how intimacy, vulnerability, and sexuality have come to be linked for you. If a partner segment makes sense, it’s the back half of this session, and I say plainly to both of you that I’m your clinician and this isn’t couples therapy.

Sunday, week two. You put it together, not me — what role the symptom has been playing, what experiences have been difficult to approach, what changed and what didn’t. Saying it yourself is what makes it portable. Then we decide what comes next.

Every session has built-in time to slow down and let things settle. You shouldn’t leave flooded, and I build each day around that.

What happens at the end

Some men finish this and don’t need anything further for a good while. Others find it opened something that warrants ongoing work — with me, or with someone else. Both are real outcomes, and I’d rather you know that going in than hear at the end that of course there’s more.

I won’t know at the start which one you’ll be. Finding out is part of what the ten hours are for.

Either way, you leave with a written formulation: what the symptom was doing, what it was protecting, how your anxiety behaves in your body, what happens when someone gets direct with you, the family and attachment picture we built, and what I’d work on next. It’s written so another therapist can use it. If you continue elsewhere, you hand them ten hours of work instead of a blank intake form.

If ongoing therapy work is indicated after the intensive, continuing with me is one option (pending availability) and a referral is another. I’ll make the referral gladly.

What I’m offering is a defined arc, a process for developing an understanding of what is happening that you have tested against your own experience rather than simply accepted intellectually. What I cannot promise is an erection. No responsible clinician can promise that. What I can offer is a serious process for understanding what is happening and what may help.

How I work

I’m an AASECT-certified sex therapist, trained in Emotionally Focused Therapy, psychodynamic in orientation, with a long background in mindfulness and Buddhist psychology. In practice that means I work from attachment — what happens in your body has something to do with the people whose regard you need — and I pay close attention to what gets repeated between us in the room, because the way you handle me is usually the way you handle anyone you’re trying not to disappoint.

Warm, fairly direct, and not another examiner. You’ve spent a lot of your life being evaluated, and you’ll probably try to get me to score you. I’d rather point that out than do it.

The medical part

Sexual symptoms deserve a real medical evaluation, and this isn’t one. Erectile difficulty can be vascular, endocrine, or neurological, and it’s frequently a medication side effect — SSRIs, finasteride, blood pressure medication, stimulants. Delayed ejaculation, low desire, and pain each have their own differential.

So either you’ve had an evaluation or you agree to get one, and we document which. It can happen alongside the intensive rather than delaying it, and I’ll ask for a release so I can talk to your physician when that’s useful. Applying insight to a vascular problem wastes your money and misses your medicine.

What this isn’t

Not couples therapy. If the real problem turns out to be the two of you, I’ll say so and point you toward couples work — mine or a colleague’s.

Not coaching. I’m a licensed clinical social worker practicing psychotherapy, with the records, confidentiality obligations, and accountability that come with a license.

Not medical treatment, and no substitute for it.

Not a technique course. There’s real behavioral technique in sex therapy and I use it where it belongs, but sold as the whole answer it fails — and most men who reach me have already bought it once.

If you want to know when this runs

Four two-and-a-half-hour sessions across two consecutive weekends, in person in Pittsburgh. $3,450. No dates are set yet. Join the interest list and you’ll be the first to know when the next intensive is scheduled.

Leave your name and email and I’ll write when the dates exist. If a weekend works for you then, the next step is a written intake packet and a free twenty-minute call. Nothing here commits you to any of it.