Couples Sex and Intimacy Therapy

Intimacy doesn't collapse all at once. It erodes slowly, through unspoken frustrations, avoided conversations, and the quiet accumulation of distance. By the time most couples reach out for help, they've been navigating this alone for months or years, unsure how to talk about what's not working without making it worse.

If you're here, you've likely recognized that something fundamental in your intimate connection needs attention. Maybe sex has become infrequent or mechanical. Maybe one of you wants it and the other doesn't, and that difference has become a source of tension neither of you knows how to address. Maybe there's been a breach of trust, or life circumstances have shifted everything, and you're trying to find your way back to each other.

I work specifically with couples navigating sexual and intimacy challenges, not as a generalist who occasionally sees couples, but as a specialist who understands the complex dynamics between desire, communication, emotional safety, and physical connection. Whether you're in San Francisco, Palo Alto, Los Angeles, or San Diego, my practice provides structured, confidential space to address what's been difficult to name.

Rebuilding Emotional and Physical Connection

Physical intimacy doesn't exist in isolation. The quality of your sexual connection reflects what's happening emotionally, how safe you feel with each other, how seen you feel, and how much unspoken hurt or resentment has quietly accumulated.

The work we do together addresses both dimensions. We'll examine the emotional patterns that have undermined closeness: cycles of pursuit and withdrawal, communication breakdowns around desire, the ways performance pressure or shame have created distance. We'll work on rebuilding trust if it's been damaged, developing the skills to talk about sex without defensiveness, and creating the conditions where genuine intimacy becomes possible again.

This isn't just about having more sex. It's about building a relationship where both of you feel connected, understood, and safe enough to be fully present with each other, emotionally and physically.

What Couples Work on in Intimacy Therapy:

• Emotional disconnection and growing distance

• Desire discrepancy and mismatched libidos

• Rebuilding closeness after infidelity or broken trust

• Intimacy avoidance and physical withdrawal

• Navigating changes after pregnancy, illness, or major life transitions

• Shame or anxiety around sexual needs and desires

• Learning to initiate and communicate about sex without conflict

• Addressing patterns where sex has become obligatory rather than connecting

Addressing Sexual Dysfunction Together

Sexual dysfunction, erectile difficulties, low desire, painful sex, difficulty with orgasm, premature ejaculation affects couples, not just individuals. Yet these concerns often go unaddressed for years because of the shame one or both partners carries.

I approach these issues without judgment and with the understanding that they're rarely just physical problems. Sexual dysfunction has medical, psychological, relational, and behavioral dimensions. Effective treatment addresses all of them.

For couples, this means working on both the individual experience and the relational dynamic simultaneously. How you respond to dysfunction together matters as much as the dysfunction itself. The criticism, withdrawal, or pressure that develops around sexual difficulties can become more damaging than the original problem.

We'll work to understand what's contributing, stress, anxiety, relationship dynamics, past experiences, medical factors, and develop approaches that address the actual causes rather than just the symptoms. When medical consultation is needed, I work collaboratively with physicians to ensure you're getting comprehensive care.

What Sex Therapy Actually Involves

Sex therapy is talk therapy. We meet in my office or via secure video, fully clothed, and have conversations you probably can't have anywhere else.

Your first sessions include a comprehensive assessment: your sexual health history, current concerns, relationship dynamics, communication patterns, and what you're hoping to change. From there, we develop a treatment plan tailored to your specific situation.

This might include:

• Psychoeducation about sexual response, desire, and arousal

• Communication skills specific to talking about sex and intimacy

• Cognitive-behavioral approaches for anxiety or performance pressure

• Mindfulness and nervous system regulation techniques

• Guided exercises you do together between sessions to rebuild connection

• Processing past experiences or trauma affecting current intimacy

• Exploring beliefs and narratives about sex that may be creating barriers

The goal is helping you experience more pleasure, emotional safety, and genuine connection—not performing intimacy for each other, but actually feeling it.

Individual Sex Therapy

Sex therapy isn't only for couples. Many people come to my practice individually to address specific concerns, process past experiences, or develop a healthier relationship with their own sexuality.

For Men: Performance Anxiety and Erectile Dysfunction

Erectile dysfunction is one of the most common concerns men bring to therapy and one of the least discussed. The shame around ED often compounds the problem—the more you worry about it, the more likely it becomes.

I work with men on both the psychological and physiological dimensions of ED. This includes addressing performance anxiety, stress, relationship dynamics, and the emotional weight that accompanies sexual difficulties. When there's a medical component, I collaborate with physicians to ensure comprehensive treatment.

Beyond erectile dysfunction, I work with men on:

• Premature ejaculation

• Performance pressure and anxiety

• Compulsive sexual behavior and pornography concerns

• Sexual shame and difficulty communicating desires

• The disconnect between professional success and intimate struggles

• Desire changes and loss of interest in sex

Beyond Specific Dysfunction

Individual sex therapy also addresses:

• Developing a healthier relationship with your sexuality

• Processing sexual trauma or negative past experiences

• Exploring sexual identity, orientation, or desires

• Navigating the intersection of culture, faith, and sexuality

• Building confidence and reducing shame

• Understanding your own arousal and desire patterns

Affirming Care for All Identities

My practice is affirming of all sexual orientations, gender identities, and relationship structures. Whether you're LGBTQ+, exploring aspects of your identity, navigating non-monogamy, interested in kink, or simply need a therapist who won't make assumptions about who you are or what you want: I provide that space.

You shouldn't have to educate your therapist or manage their discomfort. You deserve care that meets you where you actually are.

Getting Started

The hardest part is often just reaching out. The shame, the uncertainty about whether therapy can actually help, the vulnerability of admitting you're struggling, all of it makes that first contact difficult.

But intimacy challenges don't typically resolve on their own. The patterns that create distance tend to deepen over time. The sooner you address what's not working, the more options you have for repair.

If you're in the San Francisco Bay Area, Los Angeles area, or San Diego region and recognizing yourself in any of this, I encourage you to reach out for a consultation. We'll talk about what's bringing you in, what you're hoping to change, and whether working together makes sense.

You deserve an intimate life that feels fulfilling, connected, and free from shame. That's what we'll work toward together.

I work with all types of clients, including:

✓ Individuals seeking clarity and meaning around their
sexual health and needs
✓ Monogamous and non-monogamous partnerships
✓ LGBTQIA+ and queer couples navigating relationships
✓ Long-term and newly committed relationships
✓ Couples exploring kink, polyamory, or open relationships/ENM
✓ Partners navigating parenting, neurodiversity, or life transitions
✓ Individuals and couples in alternative lifestyles or cultures
✓ Individuals who feel they are dealing with “sex addiction,” “porn
addiction,” and out of control sexual behavior

Common Challenges Include:

• Communication breakdowns and conflict cycles

• Mismatched desire and sexual disconnection

• Infidelity, betrayal trauma, and ruptured trust

• Performance anxiety, shame, or body-based barriers, men’s sexual health

• Negotiating non-monogamy or new relationship agreements

• Emotional distance, resentment, or loss of passion

• Rebuilding intimacy after a rupture

• Building better boundaries in your relationship