Counseling

Head_ladderBoth men and women seek therapy from Peter at Capital Counseling Services, LLC – women typically seek help dealing with infidelity or lack of intimacy and desire from their partner.  Men typically seek counseling because of poor sexual performance, relational concerns, a lack of a romantic affiliation, infidelity, sexual addiction or current or history of trauma (sexual, physical or emotional).

Peter also provides couples therapy to address a variety of needs such as sexual dysfunction, intimacy needs, and infidelity. Peter has worked with many couples who have seen numerous other therapists without great success. Please see the “Couples” tab for additional information regarding this therapeutic intervention.

SPECIALTIES

Specialty counseling services focus on the treatment of a wide range of topics associated with couple or partnered relationships and human sexuality.

Men

Capital Counseling Services, LLC provides a wide range of services to address men’s health needs.

Many men seeking therapy for poor sexual performance, relationship concerns, lack of romantic affiliation, infidelity, sexual addiction or unresolved/unidentified sexual/emotional trauma.  Others are confused about their sexual, gender identity or orientation.

Most often, shame, guilt and embarrassment have prevented men from seeking therapy or couples counseling until sexual secrets are discovered.  Men tend to hyper-focus on work as a distraction from resolving problematic issues related to men’s health.

Frequently, it is the spouse who encourages a man to begin therapy and, typically, as a last resort before a divorce or separation.  One performance issues that may be addressed is an inability to obtain or consistently maintain an erection sufficient for satisfying sexual activity.  Premature ejaculation may also be a singular or co-occurring problem as well.  Some men experience erectile dysfunction because of prostate cancer surgery, psychological (relationship) or physical trauma, or insufficient endocrine functioning (low or fluctuating hormone levels).malesymbol_cropped

Others experience a lack of sexual desire for their partner or complete lack of or declined interest in any sexual activity. Many male clients who come for treatment have questions regarding sexual orientation, gender variant behavior, alternative or non-mainstream (atypical) sexual interests or arousal patterns. These concerns may occur with or without a partner.

Sexual compulsive behaviors, both thoughts and feelings (sex addiction) are other major concerns for men and their partner.  Additionally, Peter has worked extensively with many men with these concerns as well as those who have been victims of sexual assault or physical and psychological trauma (PTSD), either as a child or an adult. Other areas of specialty focus include the assessment and treatment of an ongoing lack of healthy emotional attachment with a partner or generalized anger which connecting with others. Treatment with Peter Chirinos addresses how trauma impacts their sexuality, masculinity and relationships. All of these concerns are treatable. Therapy moves men beyond the shame, guilt and humiliation that imprison their lives.

Couple therapy

Couple therapy and sex therapy services include the treatment of:

  • Infidelity (commitment related concerns)

  • Sex addiction (out of control compulsive sexual behavior)

  • Communication difficulties

  • Life transitions

When a couple comes in for their first session they are provided with an overview of the three (3) part evaluation process that is specific for this particular modality. The three phases include 1-the initial couple session in which both partners are present; 2-meeting with each partner, individually, to gain an understanding of the issues from their subjective perspective and experience and occurs in two separate individual evaluative sessions; and 3-a couple session to provide feedback and a recommendation for ongoing treatment. These phases of evaluation are general guidelines and are flexible depending upon clinical issues presented, the structure of the relationship and/or alternative relationship structures.

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To maximize focus of the time during your first session, I ask that each couple please fill out the intake forms prior to the scheduled session. Please email me now to schedule an appointment and have these forms sent to you. If you choose to read and fill out these forms when you arrive for your first session, then please be sure to arrive early.  In this case, the forms will be waiting for you in the waiting room.

SEX THERAPY

What is Sex Therapy

Sex therapy is a sub-specialty of couple therapy. It is a dynamic process that encompasses the assessment and treatment of a broad range of topics associated with human sexuality. It is a process by which the client and therapist explore the meaning as well as an applied definition of healthy sexuality. Healthy sexuality is an integral part of sex therapy and is unique to each person. Sex therapy also focuses on understanding and treating sexual dysfunction and problems with intimacy within the context of and, respect for, the client’s specific preferences, personal experiences, morals and ethics, as well as their religious and cultural beliefs.

Other than a handshake, treatment sessions do not involve touching in any way. Professional sex therapists (psychotherapists) and counselors adhere to ethical guidelines set forth by certifying associations. Referrals to and supervision of specialty (ancillary) sex therapy interventions involving sexual and sensual touch are an option for appropriate clients. These services may include:

Sex therapy is used to treat the following problems and concerns in individual therapy and/or couple therapy:

  • Sexual Dysfunction

    • Premature, delayed or inhibited ejaculation

    • Erectile dysfunction

    • Vaginal pain disorders

    • Lack of sexual intimacy (Inhibited sexual desire)

    • Ejaculatory Disorders (Premature, Absent or Retrograde Ejaculation)

    • Erectile dysfunction

  • Internet porn addiction & sex addiction (compulsive sexual behavior)

  • Sexual trauma & abuse

  • Sexual orientation & identity

  • Transgender & gender fluid identities (Gender-Queer,

  • Mixed orientation relationships including

    • Straight spouses with gay, bisexual, Queer, transgender, cross-dressing partners

    • Partners with atypical sexual interests (BDSM, D/s, M/s, kink, etc.)

  • Atypical sexual interests

    • BDSM, kink, fetishistic behaviors

    • Dominant/submissive dynamics

    • Fetish interests

    • Sexual orientation (Bisexuality, Queer, Pansexual, homo- or hetero-flexibility)

The most common concerns couples seek to address in sex therapy are for the treatment of erectile dysfunction (ED), decreased or absent sexual desire (libido), or sexual pain disorders. Regardless of the issue it is greatly encouraged to have both partners present during their first session. It is highly encouraged that both partners work in collaboration with the therapist as well as each other for the most effective treatment in the shortest time frame possible. When both partners are able to create and maintain a strong sense of collaborative effort toward a common goal in the early phases of couple sex therapy, their ability to resolve the sex therapy issue and grow in intimacy increases. Sex therapy with one partner is possible; however, is more complicated and requires different clinical and therapeutic strategies.

Healthy sexuality

Very few professionals provide clear a definition(s) of what it means to have and express a healthy sexuality. This lack of clarity along with an over emphasis on sex addiction and other negative aspects of human sexuality leads clients to referring to their sexuality and expression as abnormal at best and, more often, as clinically pathological. Here people are welcomed to explore how these notions become engrained, are encouraged to become more self accepting and, with accurate education and deep insight, reclaim their sexuality through a process that involves redefining their sexuality that is free of shame and guilt. The first step in sexually affirming therapy and coaching is to establish clear parameters of health that are based on one’s morals, ethics, religious and personal experiences. These aspects are also put within context of their socio-political and ethnic community.

The World Health Organization provides a general definition of healthy sexuality. However, this working definition primarily focuses on very broad, overarching topics, which are relevant to public health, sexual freedom and social justice issues across cultures around the world. The McKinley Health Center at the University of Illinois also provides a definition. Although these statements are helpful it lacks pragmatic applicability to currently emerging sexual identities, that do not conform to cultural norms.

Some obvious examples of healthy sexuality include:

    1. Getting HIV and other STI testing and treatment;

    2. Communicating your sexual needs and wants to your partner;

    3. Obtaining overt verbal and/or nonverbal consent for sexual behaviors;

    4. Expressing your sexuality without shame, guilt or fear of persecution by people who are closest to you;

    5. Understanding your expressed and unexpressed sexual drives and urges

    6. Having your sexual thoughts, behaviors and drives reflect your personal values, morals, religious and ethics; and

    7. Expressing sex (partnered & solo/masturbation) as a life affirming event

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Porn & Sex Addiction

Pornography addiction is an example of sex addiction and involves the compulsive and uncontrolled viewing of sexually explicit content in written or graphic forms for the purpose of sexual arousal with the intent for gratification. Porn addiction, like sex addiction, is almost always aimed at male sexuality. The general public is now ‘formally’ diagnosing themselves or their partners as having a sex addiction, roughly defined as self-destructive sexual behavior. Unfortunately, many professional counselors and psychotherapists, among others, lacking rigorous formal training and experience in sexology are also doing the same. Sex addiction is a loosely held theoretical construct which has yet to be proven using unbiased primary research and is based on a medical model of addiction where the brain is exposed to an intoxicating substance. Sex addiction advocates’ argument is flawed, in part, in that in lieu of the introduction of an external chemical substance into the brain, the brain itself is presumably ‘addicted’ to the biochemical rewards associated with the compulsive sexual behavior (sex addiction) in spite of negative consequences. There are a number of reasons why sex addiction is attempting to be used as a formal diagnosis when in in fact it does not exist in the Diagnostic Statistical Manual of Mental Disorders, the diagnostic tool used to determine, among other things, insurance reimbursement. Porn addiction, like sex addiction, is a socio-political construct used to demonize male sexuality.

GROUP THERAPY

Group psychotherapy is a unique therapeutic intervention facilitated by professional counselors and is used to learn about yourself, as the client, and improve inter- and intra-personal relationships by creating a better understanding of yourself and others. Among other things, it can address feelings of depression, isolation or anxiety, for example. Research indicates that group therapy is highly transformative and often more effective than individual therapy.

Some of the issues typically addressed include:

  • Difficulties with interpersonal relationships

  • Chronic and emotionally painful loneliness

  • Aging

  • Medical illness

  • Depression and anxiety

  • Loss of a meaningful relationship, family or friend, or employment

  • Traumatic experiences (work, relationships, violence, etc.)

  • Lifestyle issues within a traditional culture

  • Personality disorders

  • Addictive disorders

Men’s Sexual Health Group

This 10-session process group will incorporate fact-based psychoeducation, coaching principles and facilitated discussions of currently relevant issues that translate definitions of men’s sexual health into practice with the goal of letting go of shame and guilt. Sharing challenges and successes related to personal experiences are the foundational elements of learning from others who struggle with obtaining a more fulfilling relationship with themselves and those they love. Some of the discussion topics will include sex addiction (out of control compulsive sexual behavior), infidelity, sexual function/dysfunction, and atypical sexual expressions and relationships. Group sessions are limited to six participants and will last 90 minutes. Contact me directly for additional information about psychotherapy groups currently being offered.

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!Confidentiality Notice: Please be advised that Capital Counseling Services, LLC (CCS) is not able to ensure confidentiality via the internet or standard e mail. To send a confidential e mail message and to access confidential video counseling services click here and you will be directed to the Secure Client Area. New clients click here to complete registration that will, in turn, enable you to access the Secure Client Area. Confidentiality is assured when calls are made directly to CCS at (571)344-5926. You may also leave a confidential voice mail message at this number.