Individuals Marriage and Relationship Families Sex Therapy Compulsive Sexual Behavior
I am available to see individuals, couples and families for counseling and psychotherapy. I am also available to provide interpersonal and organizational consultation to enhance communication, problem-solving and team building.
What is Counseling and Psychotherapy?
The decision to seek help for yourself may be one of the most important decisions you will ever make. Sometimes this decision goes against the notion that we should be able to solve our problems, concerns, or issues by ourselves—without professional help. To seek help for oneself is an act of courage, and is often the first step toward mental, emotional, and spiritual health and wholeness. This kind of self-care may be the most important investment one can make.
The quest for meaning and fulfillment is universal and this is especially significant for mental, emotional, and relational health.
The words “counseling” and “psychotherapy” are often used to refer to the same process. However, some find it useful to think of these terms in slightly different ways. Counseling may be seen as more structured, solution focused, and short term while psychotherapy may involve a more in-depth exploration of the inner world of self, life experiences, the search for meaning and fulfillment, and the resolution of chronic or traumatic distress. Understood this way, counseling may be seen as relatively short journey and psychotherapy may be a longer journey. Whether short or long, the most important decision is to begin the journey.
Individual Counseling and Psychotherapy
Individuals enter counseling or psychotherapy for a variety of reasons including depression, anxiety, emotional distress, behavioral issues, spiritual concerns, difficulty in management of stressful situations, desire for personal growth, fulfillment, or meaning, sex disorders, compulsive sexual behavior, relationship difficulties, professional pressures, or any concern that keeps them from having a meaningful and fulfilling life.
Individual counseling sessions are usually scheduled on a weekly basis. Time during your first session will be devoted to helping me understand your concerns and your goal(s) for therapy. We will then conjointly decide whether we will continue. Because this is such an important and personal experience, we must be comfortable with each other. This is to say that both of us must believe that I can be of help to you and that you are ready to do the sometimes difficult work of personal therapy. To put this another way, there must be a “personality fit” if we are to do our best work together.
Attention is given to the way you think (cognition), the way you feel (emotions), and to your behavior (what you do). These three things are happening with each one of us at all times, although we may have a preference for one more than the others. We will examine each of these and work to achieve changes that will make your life better.
Your spirituality or value system, however you define it, is inherent in the way you think, feel, and act. True spirituality/value system is never separated from the life experience but is expressed in all that we think, feel, and do. Furthermore, life is always defined in some way by our relationships with others. This understanding is the foundation of my clinical work and informs how I work with individuals.
Medication is often a very important part of the treatment plan for individuals who have a mood disorder or depression. This is also true for persons with severe anxiety and other mental health concerns. Often the treatment of choice is a combination of talk therapy and medication. While either talk therapy only or medication only may be helpful, the choice treatment is often a combination of the two. I may request that you get an evaluation by your physician (or a psychiatrist) concerning your need for medication. I will be happy to work with you and your physician to provide the care that you need.
Marriage and Relationship Counseling
Marriages or committed relationships, like individuals, can become distressed for a variety of reasons. When either or both partners become unhappy or unfulfilled in marriage, this is a clear signal that marital therapy or relationship therapy may be appropriate. There may be no loneliness or emptiness that compares to that of a marriage that has become dysfunctional.
Often couples enter therapy only after a rather severe crisis in their relationship—a very commendable thing to do and hopefully something that will help them recover. Other couples realize that their marriage/relationship is not working although both are trying to make the marriage successful. Although not in a crisis, such couples often realize the limitations of their efforts to improve their marriage and they enter marital/relationship therapy. Again, this is a very commendable thing for them to do.
Most couples are curious about what happens in marital therapy—before they make an appointment. Although every couple are unique and have issues that are particular to them, there are a few things that can be said about most marital/relationship therapy.
One the first tasks that many couples have as they enter therapy is that of disengaging from fault-finding and blaming each other. Over a period of time each partner has come to see and understand the other in particular ways based on limited perception and that perception seems like reality even the presence of evidence to the contrary. To step away from one’s perceptions and opinions long enough to consider other possibilities can be a very real challenge.
As couples disengage from their customary ways of understanding each other and from their unsuccessful ways of trying to manage their relationship, the rebuilding process can be enhanced. Typically, couples will be encouraged to examine what caused them to be attracted to each other initially and how that attraction has played an important role in the way they function. They are encouraged to examine their beliefs, assumptions, and expectations about marriage, especially as they learned from their families of origin.
Self-awareness, self-understanding, and openness to one’s partner are helpful couples explore their hopes for marriage and learn new relationship skills. Marital/relationship therapy is not easy and sometimes couples will experience unanticipated emotional distress as they work together for marital health. The potential for positive marital transformation is very real as couples come to a renewed commitment to each other, learn to communicate effectively, learn how to share in the power of decision making and problem solving, and learn to manage differences and conflict in non-threatening and non-destructive ways. The process requires commitment, effort and often hard work of each individual.
Healthy families, like healthy marriages and healthy individuals, demand time and effort. When our best efforts do not produce the family satisfaction and health that we anticipate, it may be appropriate to make an appointment for family therapy.
Family therapy is a systems way of doing counseling. This means that the family functions as a system that cannot be explained simply by looking at characteristics and traits of individual family members. The family functions as a unit and there are various roles and functions filled by various members. This gives the family its unique personality that observers might identify. The family, not the individuals in the family, becomes the client.
There is no one way of understanding family systems and there is no one way for helping families move from being dysfunctional to optimal functioning. There are indeed numerous schools of thought about family therapy, focusing on various aspects of what it means to have healthy family life and on what it takes to get there.
Primary in family therapy is belief that the family strives to survive and perpetuate itself, dysfunctional or not. Today’s families are shaped by the families of the past and the cultural environment of both the past and the present. Knowledge of one’s family of origin and of one’s local culture can help families break away from dysfunctional behaviors and move toward healthy family functioning. This process often involves understanding roles and influence in the family, developing new understanding of how the behavior of one family member influences others and implementing change. Focus is placed on developing effective communication skills in the family—including assertiveness, listening, respectfulness of others, decision making communication, problem solving communication, communication of feelings and emotional states, and how to ask for help. Emphasis is also placed on the uses of power and control in the family interaction.
Although sexuality is one of God’s/Nature’s most marvelous gifts to us, it is also an aspect of life that can cause great distress for individuals and couples. When sexual problems develop, it is not uncommon for relationship problems to develop as well. Sometimes it is the other way around—relationship problems may lead to sexual problems. Traumatic experiences, misinformation, or negative religious/cultural teachings about sexuality may also lead to sexual problems. Unhealthy marital interaction, such as unresolved anger, poor communication, or power/control issues can adversely affect healthy sexual functioning. Medical causes for sexual problems must also be considered. Whatever the cause for sexual problems, help is available.
Sexual problems are classified as desire, arousal, orgasmic, and pain disorders. In treating individuals with such disorders, Dr. Calhoun usually works closely with physicians, especially gynecologists and urologists. Medical conditions that affect sexual function are given careful consideration in the assessment phase of therapy and appropriate medical referrals are made.
Although there have been significant advances in the medical management of sexual dysfunctions, medication may not address psychological, psychosocial, spiritual, or interpersonal factors that may have contributed to the development and maintenance of a sexual problem. These factors are often the focus of sexual therapy before specific behavioral strategies are developed for the treatment of sexual problems.
Because sexuality is a very private and personal matter, it is often difficult for individuals and couples to reach out for help. For those who do have the courage to seek help, there are often life-changing results.
Compulsive Sexual Behavior
Out of control compulsive sexual behavior, sometimes referred to as sex addition, has become a major source of distress for many individuals and couples. With the publication of Out of the Shadows (1983, Dr. Patrick Carnes) and subsequent research, this problem has become widely recognized. According to the International Classification of Diseases (ICD):
“Compulsive sexual behaviour disorder is characterized by persistent and repetitive sexual impulses or urges that are experienced as irresistible or uncontrollable, leading to repetitive sexual behaviours, along with additional indicators such as sexual activities becoming a central focus of the person's life to the point of neglecting health and personal care or other activities, unsuccessful efforts to control or reduce sexual behaviours, or continuing to engage in repetitive sexual behaviour despite adverse consequences (e.g., relationship disruption, occupational consequences, negative impact on health). The individual experiences increased tension or affective arousal immediately before the sexual activity, and relief or dissipation of tension afterwards. The pattern of sexual impulses and behaviour causes marked distress or significant impairment in personal, family, social, educational, occupational, or other important areas of functioning.”
Such individual have often made valiant attempts to stop their behavior without success. While often very successful in other areas of life, they are unable to stop acting out sexually. Asking for help can very difficult and embarrassing. Sometimes a crisis at home or work, either of which may have severe consequences, may necessitate getting help and making changes. The good news is that there is help for those who have the courage to seek it. The first step in getting help is to recognize that you have a problem—and then make the phone call you have dreaded to make.
Dr. Calhoun does not provide therapy for pedophiles or persons convicted of serious criminal sexual crimes such as sexual assault.