Relationship Therapy for LGBTQ+

by: Dr. Dino Zuccarini, C.Psych.

Living and loving in the social margins of a heteronormative world can create complexity in the relationships of individuals from the LGBTQ+ community.  In our early years, recognition of being different than members of your family of origin and peers can create significant attachment and self fears. We all need a sense of acceptance, emotional validation, approval, and admiration if we are to develop a strong sense of self and connection to others. Individuals from LGBTQ+, in many instances, may face abandonment, rejection, punishment, and abuse just for being different. These types of traumatic experiences create fears and distrust in others, mainly when early attachment figures are the individuals who are the source of rejection, punishment, and abandonment. Rejection also fills individuals with a deep sense of shame that comes with deep feelings of unlovability, insignificance, and worthlessness.  

The internalization of these experiences can create difficulties when fears, shame, and past hurts limit the capacity to trust and connect others. The clinicians at CFIR work to build more secure, resilient identities and strengthen interpersonal relationships in the LGBTQ+.  They support you to unpack the emotional residue of early distress in attachment and/or with pears and the impact of this residue on your attachments.

Attachment Style and Couple Sexual Issues

According to attachment theory, as a result of early year interactions with caregivers, we either become securely attached or insecurely attached—either anxiously or avoidantly attached.  Attachment style then influences sexuality in complex ways. Anxiously attached partners in the bedroom might be seeking out sex for reassurance of self or attachment fears.  For example, they may feel less positive about themselves (e.g., undesirable or unattractive), and/or have worries about the availability, accessibility, and responsiveness of their partner.  Strong sexual desire is fuelled by the need for self and attachment reassurance. Avoidantly attached partners are not motivated sexually in the same way.  These partners are more likely to focus on the pleasure-oriented aspects of sex only and have difficulties with feelings of closeness.  Some avoidantly attached partners will have sex for duty's sake. Arousal and desire problems arise when anxiously or avoidantly attached partners are unable to fulfill these goals.  

The clinicians at CFIR support couple partners to discover the multiple ways in which securely attached partners experience and explore sexuality. The couple and sex therapy clinicians at CFIR use a wide variety of strategies to support couple partners to build more confidence in their sexuality, greater eroticism, and desire.

Forgiveness and Reconciliation for Couples Post Affairs

Forgiveness and reconciliation after an extramarital affair is a complex process. Forgiveness occurs when there is an experiential shift in the injured partner toward the betraying partner— a movement toward softer feelings. This experiential shift requires an unpacking of different types of emotional reactions associated with these types of relationship traumas. The shattering of one’s sense of self, the other, and one’s sense of future identity in the aftermath of an affair can create instability and insecurity in one’s self and the relationship. These types of injuries result in complex emotional reactions that require resolution. Reconciliation, the next step in recovery, occurs when steps are taken to rebuild trust and restore the relationship after a forgiveness process. These steps are essential for the restoration of security.

The team of psychologists, psychotherapists, and counsellors at CFIR employ evidence-based interventions to support relationship partners beleaguered by emotional injuries in the aftermath of an affair. Steps to forgiveness and reconciliation and the interventions required for successful resolution of an extramarital affair have been delineated in research conducted by Dr. Zuccarini, C.Psych., co-founder of the Centre for Interpersonal Relationships. (Zuccarini et al., 2013). Clinicians at CFIR are prepared to support you in promoting healing in your relationship.

7 Signs Your Relationship May Need Help

Relationships have never been easy and now it seems we’re in a space and time where technology and the way we connect are continuously growing and changing. The intimacy we have with someone can mean so much, yet it seems we consistently struggle to maintain the bond. How can we know if we are “getting it right” in our partnerships?

In speaking about the complexity of our relationships, famed relationship expert, Esther Perel notes that “companionship, family, children, economic support, a best friend, a passionate lover, a trusted confidante, an intellectual equal [...] we are asking from one person what an entire village once provided.” In this paradigm, it can be hard to understand when our partners and our relationships maybe failing us. 

Here are some signs that indicate your relationship may need some work:

1. Lack of Communication 

In a world bursting with ways to communicate, it may be surprising to learn that ineffective communication remains a common issue in relationships. It’s impossible for your partner to know all your needs, feelings, and thoughts without talking about them. Communication is essential in overcoming relationship wounds, and very few relationships can survive without it.

2. Arguing with No Repair

Though constant arguing can sometimes be indicative of relationship distress – unrepaired conflict may be the real culprit. Arguments, when done sympathetically, are an essential part of relationship satisfaction. Repairing from a dispute allows partners to accept each ones’ differences and re-establish their love for one another. 

3. Loss of Curiosity

We are continually growing and changing as individuals and it crucial we remember to remain curious about our partners as they grow. The experience of curiosity and surprise is one of the essential processes in maintaining long-term desire. Partners in healthy relationships are happy to explore their partner’s unique perspective of the world.

4. Mind Reading

This familiar refrain, “Look, I know you're angry…” exposes a common misstep in many relationships. Often experienced in conjunction with a loss of curiosity, partners start assuming they are always in each other’s “bad books” even before a problem is revealed. Stay tentative about your perceived experience of your partner, especially in times of distress. You might be surprised by the difference between how they feel and how you thought the feel!

5. Loss of Priority

It can be hard to find a balance between work, children, friends, and family in today’s busy world. How you prioritize your relationship may look different to you, so it’s crucial that you discuss this with your partner. Failure to explore this in a discussion could leave your partner feeling unloved and unimportant. 

6. No Hurt – Only Anger

When we’re most distressed it may feel instinctive to get angry. Though anger is an important emotion in that it tells us something isn’t working, it isn’t usually helpful in resolving conflict. Instead, opting to express our more vulnerable and hurt emotions allows our partner to understand and ultimately care for us when necessary. 

7. Blaming your partner

It takes two to tango! Though one partner may sometimes be experiencing more distress, it’s beneficial to recognize that your relationship is co-created by both of you. Take note of how you may be contributing to the dynamic between you and your partner.

Couples experiencing any of these relationship difficulties at heightened levels may feel like they are insurmountable problems. However, exploring these issues can provide a needed check-in for your relationship. Moreover, what you discover can inspire you and your partner to reimage what your relationship could become. Couples therapy offers an excellent opportunity to explore these struggles and move towards growth. The skilled clinicians at CFIR can help you and your partner better understands your current distress and support you to build a more resilient and healthy relationship.

A Look at Hypersexuality: Treatment and Assessment

by: Dr. Ainslie Heasman, C.Psych.

The classified advertising site, Backpages.com, was recently shut down by the United States government, thereby making it inaccessible in Canada as well.  The website, which hosted everything from child care to real estate ads, was recently suspended by U.S. law enforcement due to activity stemming from the “adult” sections on the site.

Many essential political and societal discussions have transpired following the decision to close the site, including debates about whether the intention to prevent sex trafficking will benefit from this action. 

Amid these discussions, some of my clients who use the internet to access sex services, and who identify as having problems regulating their sexual behaviour feel a sense of relief.  Some are experiencing an unexpected external control over their response, albeit temporary, now that Backpages.com is no longer accessible.

What is hypersexuality?

Problematic sexual behavior is referred to using a variety of labels – from sex addiction to compulsive or impulsive sexual behaviour to hypersexuality.  Societally, this is commonly labeled as sex addiction, but there remains little scientific evidence to support sex as an addiction.  There is also some suggestion that perceived addiction to pornography can contribute more to psychological distress than pornography use itself (Grubbs, Volk, Exline, & Pargament, 2013). 

Many of my clients seek out therapy for problems managing their sexual behaviours, sexual interests or both. Regardless of the label, many men (and it is mostly men that seek treatment for this in my practice) are struggling with a variety of sexual behaviours, from anonymous sexual encounters to frequent masturbation and pornography use.  Some men also experience distress related to the content of their sexual thoughts, or pornography use (versus the frequency of their sexual behavior).  In other words, they experience a sexual interest that is atypical or less common; the inclination could turn illegal if acted upon and/or it contributes to significant moral distress. 

Assessment

Research has been conducted to identify the characteristics of individuals who seek out help for hypersexuality, along with related treatment targets (Cantor et al., 2013; Sutton, Stratton, Pytyck, Kolla, & Cantor, 2014). The paths leading people to engage in hypersexual behaviour are varied and beyond the scope of this current blog, but there are more common ones I see in my clients.  Clients often use sexual behaviour as a way of procrastinating, avoiding, and escaping stressors.  Many of my clients struggle with identifying, labeling, and expressing their emotional experiences (preferring instead to ignore and suppress). This is even more common with emotions experienced as being more challenging to manage (i.e., frustration, anxiety, anger, disappointment), and they seek out a distraction, and a way of temporary escape, through sexual behaviour. 

Other clients have varied sexual interests that are explored through pornography or sexual activity with another, that they may not feel comfortable talking about or exploring in their partnered relationship.  At times there is a mismatch in sexual drive or interests in a relationship, but what is often apparent is a lack of healthy communication between partners about their needs and experiences in their sexual relationship.

What is essential when seeking support is finding a mental health clinician who will engage in a detailed assessment to understand the nature of the problem and the contributing factors.  It is also essential to determine if there are other mental health concerns (i.e., depression, anxiety, bipolar disorder to name a few) that are influencing the behaviour and also require intervention.  There is no ‘one size fits all’ approach to treating individuals who struggle with sexual behaviour. As a result, an assessment helps to determine the most relevant treatment targets to assist those seeking help to achieve their goals.

Treatment

A therapist assists clients in understanding the origins and development of their behaviour.  Clients are offered support through their journey to develop and refine skills to live a life that is more in line with their values.  This path is often challenging and filled with a range of emotions, and mistakes and a return to old patterns may occur.  With the guidance of a therapist, these challenges can be navigated and explored in a safe and supportive environment. The client can take steps they feel are necessary to define and live a more fulfilling and value driven life.

Often when a man is in a partnered relationship, couples therapy is recommended, mainly when the sexual behaviour of concern involved infidelity.  In these situations, the sexual behaviour that occurred happened in the context, and with all the relevant dynamics, of a relationship.  If the couple desires to remain together, at the very least, the rebuilding of trust occurs again in the context of the couple.  With that in mind, many men still seek out therapy on their own, either at the insistence of their partner or without their partners’ knowledge that there is a problem. 

If you can identify with these struggles, there is help and support.  Individual and couples therapy is available at the Centre for Interpersonal Relationships (CFIR).

References

Cantor, J., Klein, C., Lykins, A., Rullo, J., Thaler, L., & Walling, B. (2013). A treatment-oriented typology of self-identified hypersexuality referrals. Archives of Sexual Behavior. 42. 10.1007/s10508-013-0085-1.

Grubbs, J., Volk, F., & Exline, J., & Pargament, K. (2013). Internet pornography use: Perceived addiction, psychological distress, and the validation of a brief measure. Journal of Sex & Marital Therapy. 41. 10.1080/0092623X.2013.842192.

Sutton, K., Stratton, N., Pytyck, J., Kolla, N., & Cantor, J. (2014). Patient characteristics by type of hypersexuality referral: A quantitative chart review of 115 consecutive male cases. Journal of Sex & Marital Therapy. 41. 10.1080/0092623X.2014.935539.

Can Social Media Impact Your Romantic Relationship? Here are Five Ways to Get Connected

A restaurant in the U.K. recently announced it will be banning the use of mobile devices in their establishment on February 14 in an effort “to refocus diners on the food and experience”. This move has generated a bit of online buzz and has turned attention to how preoccupied society is becoming with the world-wide-web and more specifically, social media. In the spirit of Valentine’s Day, we recently asked CFIR Psychologist, Dr. Tracy Dalgliesh C. Psych. "Can social media outlets have an impact on our romantic relationships? What are some positive ways to use them (or not) on Valentine’s Day?". 

Here's her response: 

Social media becomes problematic when we use it to turn away from our partner, resulting in decreased connection and communication. Instead of working through an argument and engaging in a difficult conversation, you turn to scrolling through social media. This is an avoidance strategy, and we know from couples research that shutting down (i.e., stonewalling) is a type of communication that can result in long-term couple distress.² (For more on the four communication styles that predict the dissolution of a relationship, see https://www.gottman.com/blog/the-four-horsemen-recognizing-criticism-contempt-defensiveness-and-stonewalling/. Recent research suggests that excessive use of devices leads to lower relationship satisfaction.¹ This is even truer for partners with anxious attachment (i.e., they fear that they are unlovable or unworthy). Other examples may include messaging friends over talking to your partner, checking your phone in the middle of a conversation with your partner, or sharing fun and exciting information with others online and not your lover.

Individuals fall into the trap of the comparing themselves and their relationships to what they see on social media. Profiles often portray the happiest moments – and these are often posed images. They do not display the challenges that couples all face. Frequently seeing these stylized and selected images can impact how you view your own relationship. Thoughts of “why aren’t we that happy?” or “we never do anything exciting” may arise and create negative feelings towards your relationship and partner. This negative filter may then lead to thoughts of “I could be happier with someone else,” further contributing to dissatisfaction.

Social media can also impact one’s feelings of jealousy and insecurity. All of the platforms for social media offer easy ways to connect with others privately. This becomes a problem when it is done in secret, or when connecting with someone else feels good and you are putting more energy into that connection than with your partner. A negative feedback loop can also start, where jealousy leads to snooping, which further exacerbates feelings of jealousy. In some situations, social media can lead to infidelity.

While social media can present with its challenges for couples, I do believe that it can be used in a healthy manner – where couples can build and enhance their connection. Here are some tips on how to use social media this Valentine’s Day to enhance your relationship:

• Set limits on the time that you are on your devices. Agree to put the phones on silent in another room (e.g., from 7pm-9pm) on Valentine’s Day (and maybe every day!).
• Send a message letting your partner know you are thinking of them or excited to see them at the end of the day. We long to know that we matter to the ones we love, so let your partner in on your feelings.
• Send a good morning or good night love meme.
• Share a memory or article with your partner that you found on your social media outlet and use it to get to know the other person’s opinions and desires.
• If scrolling and connecting is part of your time together, take a break and talk about what you each found interesting. Ask open-ended questions, like “What did you find most surprising to read today?” or “What emotions did you feel while seeing X.”

1. James A. Roberts, J. A., & David, M. E. (2016). My life has become a major distraction from my cell phone: Partner phubbing and relationship satisfaction among romantic partners. Computers in Human Behavior, 54, 134-141. https://doi.org/10.1016/j.chb.2015.07.058.

2. Gottman, J. M., & Krokoff, L. J. (1989). Marital interaction and satisfaction: A longitudinal view. Journal of Consulting and Clinical Psychology, 57, 47-52.

Read more about our Relationship & Sex Therapy Service.