"A lot happened to me growing up...some of it was really bad. I can't relax around people, things I'm supposed to understand confuse and overwhelm me, and everything stresses me out. I'm exhausted! Is this PTSD? Am I just broken? Can I ever get to just feel 'normal'?"

He had a laundry list of diagnoses--and was on medications that had been just piled on top of each other. He couldn't focus, couldn't hold a job. We found a psychiatrist who really listened, and we worked together to dump all the wrong diagnoses and change to medications that let him feel like himself.

With a combination of trauma treatments, we removed trauma from many memories and helped him to 'befriend' his nervous system, increasing his comfort and confidence in relationships and social situations. He is now an outstanding employee in a demanding job and is planning his next career move.

"Our relationship is great, but when it comes to sex, we are so different that we fight every time we try to talk about it. Now we don't have sex at all! Help!"

Together, we built on their trust and ease with each other to create safety with vulnerable issues--disappointment, performance anxiety, lack of desire--and explore solutions as a team. With a deeper understanding of each other, they felt they now "were on each other's side" and "found their sexual groove" again--this time with deeper intimacy and a confidence that they could meet any issues together.

"We fight about everything--and even about nothing! We're both bitter about 'the affair' and can't get past it. It's so bad, we're talking about divorce: we don't even know each other anymore!"

In therapy, we created a safe space to understand the pain each partner was feeling -- to help them to hear each other and feel truly heard. Understanding the cycle they were falling into became a roadmap to learn to interrupt it and stop the escalating conflicts. They discovered a new vulnerability with each other, and it brought them close again. They were able to heal their sexual relationship to a deeper connection than ever before, and they are excited to keep on growing together.

"Every time I think about sex, I worry it will be the same problem. I've been avoiding it. Now I don't have any desire! I don't have a partner--and now I'm afraid I never will!"

We approached his dilemma on multiple levels: what's 'working?'/what's not, his past experiences leading to now, and a close look at what happens with a partner. We looked at his expectations and his "self talk." Together we designed experiments to manage anxious thoughts and stay present and in his body. Then we worked on how to interact with a new partner to connect with them and take the "performance" out of intimacy and sex. His confidence has returned, and he has met a new person he is excited to ask out.

"I guess I've always known I'm trans, but when I met my partner, I thought we were so good together we could just go on the way we were. But something changed, and now we're struggling. Body dysphoria comes up for me, then I get overwhelmed and I shut down. My partner feels bad--and I feel even worse! What can we do?"

Talking about intimacy and sex can be difficult! But it works much better when you have a 'coach/referee'/therapist to keep things calm and on track. They keep things safe, keep it focused--even "translate" when it's not quite coming through. It's a learning process: learning how to work toward understanding and manage the big feelings that come up. Partners grow to understand themselves better, and hear each other more deeply. With practice, partners gain confidence that they can create solutions that don't compromise on their needs and that respect each other: "We can get there together!"

"Sex was good, then we agreed to explore more things. But now my partner wants to try more and more things...and I don't. I get resentful when I feel 'pushed'--But I hate disappointing him! Now he doesn't even want to ask me...and I'm afraid I'll lose him!"

In relationships, we get stuck when we believe important things can't be talked about. When we believe what we have to say would hurt our partner, it's a dilemma, and it feels vulnerable and risky. In therapy, we practiced how to "keep the guardrails on" so they could be honest and share what was real. They discovered that when they really understood each other, neither felt alone or defensive. And that's when they could find a new path together. Learning to have these conversations takes work (it really does!), but these are the skills to keep your relationship for a lifetime!

"I have a secret. I finally told my partner, and at first it seemed ok, but now they say it isn't sexy to them and they're not attracted to me when I want to be 'little.' Maybe not attracted to me at all?! But I just want them to accept it and support me. I'm so sad! It seems hopeless. Is this going to end our relationship?"

And their partner said: "I love them--but I didn't sign up for this! I said I'd try it, but I'm getting more uncomfortable, and I'm not sure I can stay in this. I don't want to hurt them--I don't know what to do!"

We talked together, first individually with me, and then all together. They learned to listen deeply and be curious about each other's experiences--without feeling defensive, arguing, or shutting down. With time and effort, they learned to "hold steady" (as Dr. Martha Kauppi says) and slow down to give each other the 'gift' of feeling heard and understood. They realized that certain thoughts and beliefs escalated the way they felt. They discovered they could stay connected, even when it was hard and they had to really work to understand. They began to see new spaces of possibility, where they could be themselves and care about each other.

One partner said: "this doesn't solve all the problems--but it's so different when we know we've got each other and we can keep facing this together."