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Diane Gleim, LMFT, CST, CST-S - Guest
LMFT is a Licensed Marriage and Family Therapist and AASECT Certified Sex Therapist and Supervisor practicing online throughout California and in-person in Santa Rosa, California. As the first Certified Sex Therapist in Sonoma County, Diane treats the many diverse issues related to sexual identity, sexual expression, sexual behavior, and sexual relationships. Her clients include everyone with a sexual concern: individuals and couples ages 18-85, and the LGBTQ+, kinky, and poly populations. In addition to her private practice, Diane’s work also includes providing trainings and consultations on sex therapy; writing the blog "Underneath the Sheets" on Psychology Today’s website; and supervising sex-therapists-in-training. She has been quoted in various press and a guest on podcasts. Diane has been voted Sonoma County’s Best Sex Therapist by the readers of the North Bay Bohemian five times. |
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W. Keith Sutton, Psy.D. - Host
Dr. Sutton has always had an interest in learning from multiple theoretical perspectives, and keeping up to date on innovations and integrations. He is interested in the development of ideas, and using research to show effectiveness in treatment and refine treatments. In 2009 he started the Institute for the Advancement of Psychotherapy, providing a one-way mirror training in family therapy with James Keim, LCSW. Next, he added a trainer and one-way mirror training in Cognitive Behavioral Therapy, and an additional trainer and mirror in Emotionally Focused Couples Therapy. The participants enjoyed analyzing cases, keeping each other up to date on research, and discussing what they were learning. This focus on integrating and evolving their approaches to helping children, adolescents, families, couples, and individuals lead to the Institute for the Advancement of Psychotherapy's training program for therapists, and its group practice of like-minded clinicians who were dedicated to learning, innovating, and advancing the field of psychotherapy. Our podcast, Therapy on the Cutting Edge, is an extension of this wish to learn, integrate, stay up to date, and share this passion for the advancement of the field with other practitioners. |
Keith Sutton, PsyD: (00:24)
Welcome to Therapy on the Cutting Edge, a podcast for therapists who want to be up to date on the latest advancements in the field of psychotherapy. I'm your host, Dr. Keith Sutton, a psychologist in the San Francisco Bay Area, and the Director of the Institute for the Advancement of Psychotherapy at the Institute, the Advancement of Psychotherapy. We provide training in evidence-based models, including family systems, cognitive behavioral therapy, emotionally focused couples therapy, eye movement desensitization reprocessing, motivational interviewing, and other approaches through live in-person and online trainings on-demand trainings, consultation groups, and one-way mirror trainings. We also have therapists throughout the Bay Area and California providing treatment through our six specialty centers, which are each grounded in evidence-based approaches with our lifespan centers, our center for children, center for adolescents, where all the therapists are working systemically, our center for couples, where all the therapists are using emotionally focused couples therapy.
Keith Sutton, PsyD: (01:19)
And our specialty issue centers, our Center for Anxiety, where all the therapists are using CBT and EMDR for trauma, and our Center for ADHD and our Oppositional and Conduct Disorder Clinic, where we're integrating those four approaches. Additionally, we have our associated nonprofit, Bay Area Community Counseling, where we provide treatment for those in financial need who cannot afford the licensed, experienced therapists in the Institute but can work with associates and clinicians developing their expertise through our nonprofit. Additionally, as part of our nonprofit, we also have the Family Institute of Berkeley, where we provide treatment, training, and one-way mirror trainings in family systems. To learn more about training, treatment, or employment opportunities, please go to sfiap.com, and to support our nonprofit, you can go to sf-bacc.org to donate today to support access to therapy for those in financial need, as well as training and evidence-based treatment. BACC is a 501(c)(3) nonprofit, so all donations are tax-deductible.
Keith Sutton, PsyD: (02:21)
Today, I'll be speaking with Diane Glim, who is a licensed marriage and family therapist and a certified sex therapist and supervisor. She practices online throughout California and in-person in Santa Rosa as the first certified sex therapist in Sonoma County. Diane treats many diverse issues related to sexual identity, sexual expression, sexual behavior, and sexual relationships. Her clients include anyone with a sexual concern, individuals and couples aged 18 to 85, and the LGBTQ+ and poly populations. In addition to her private practice, Diane's work also includes providing trainings and consultations on sex therapy, writing the blog Underneath the Sheets on Psychology Today’s website, and supervising sex therapists in training. She has been quoted in various press and has been a guest on several podcasts. Diane has been voted Sonoma County's best sex therapist by the readers of the North Bay Bohemian five times. Let's listen to the interview.
Keith Sutton, PsyD: (03:21)
Well, hi, Diane. Welcome. Thanks for joining today.
Diane Gleim, LMFT, CST, CST-S: (03:24)
Hi, Keith. Thanks for having me.
Keith Sutton, PsyD: (03:26)
Yeah, so this is great. I know of your work — gosh, I think you did a training for the Redwood Empire chapter of the California Association of Marriage and Family Therapy on pornography and relationships, taking a sex-positive approach, a couple of years ago. I got to see some of that training and really liked your work. I’ve been very slowly working on a sex certification with the American Association of Sex Educators, Therapists, and Counselors. Yes, Counselors and Therapists. I’ve done some consultation from you on cases, and I’ve really enjoyed hearing about your work and the ideas you’ve been talking about in the background. So, I thought it would be great to have you in for an interview. I’d love to hear about your work, but before we get to that, I always like to ask people about the evolution of their thinking. How did they get to doing kind of work they're doing and the way they're thinking about their work?
Diane Gleim, LMFT, CST, CST-S: (04:27)
Sure. Yeah. Well, when I was an intern psychotherapist many years ago, I got licensed in 2007, so I’ve been doing this for a while. I quickly realized, when I was working at a community mental health clinic as an intern, two things: one, I was not prepared to work with couples — graduate school did not prepare me enough. And two, graduate school did not prepare me at all for working with couples around sexual issues. After speaking to a few other folks in the field and in my community, I decided that I’d get licensed first and then immediately start pursuing a specialty in sex therapy. At first, I was quite ambivalent, to be honest, about pursuing the AASECT certification. It’s a lot of time, a lot of money.
Keith Sutton, PsyD: (05:36)
That's why I'm doing it so slowly.
Diane Gleim, LMFT, CST, CST-S: (05:38)
Yes, exactly. I wasn’t sure I necessarily needed it, to be quite honest. If I got the training, did I really need the certification? So, I pursued the training first. Then, after I left a group practice and went into solo private practice, I said, you know what? I’m going to go for that certification. At the time, there was no one in our community who was a certified sex therapist, so I thought, that’s a great way to market myself, get my name out there, and really pursue that specialty. In terms of my work with porn and porn-related issues, that also evolved over time. The pandemic really accelerated people’s relationship with technology.
Diane Gleim, LMFT, CST, CST-S: (06:40)
You know, we did Zoom therapy, people did Zoom school, Zoom exercise classes, Zoom church, synagogue, and so on. In my mind, that meant people were consuming porn of all kinds on the internet long before the pandemic, of course, but the pandemic was like an accelerator. I realized two things: one, there was all this talk in the field of sex therapy about the need for porn literacy—that porn consumers need a better understanding of what they’re watching and its effect and impact on them. And yet, no one was creating such content or literacy, either for therapists or for the general public.
Diane Gleim, LMFT, CST, CST-S: (07:42)
And so what started as a training for mental health professionals, which you attended—wow, that was like three years ago now! Early 2021, I created a training for therapists. It was a three-hour training, I think. The first half was on porn literacy, and the second half focused on working with individuals and/or couples who were in conflict over porn. The porn literacy part was always viewed as foundational. With that foundation, you can work more effectively with individuals and couples who have issues with porn. I created that training, and I’ve given it 6, 7, maybe 8 times now over the last three years at various places—from the CAMP Annual Conference last year to various sex therapy institutes.
Diane Gleim, LMFT, CST, CST-S: (08:44)
I get universally positive feedback, with people saying they’ve learned something either about themselves or gained a clinical nugget to take into their practice. The second piece of feedback I received was from a friend who said, “Gee, Diane, everyone needs to see the porn literacy piece, not just therapists.” So, that planted the idea in my head to create a course that would take the porn literacy portion of the program and make it available to the general public. It was a lot of work to figure out what platform to use, how to get it out there, and whether to do a straight translation of all the clinical information for the general public or to adjust parts of it.
Diane Gleim, LMFT, CST, CST-S: (09:44)
There were lots of decisions, all these micro-decisions to make. Last summer, I finally launched it on my website: Porn Literacy 101. It’s an on-demand course, and I say it’s beneficial for both therapists and the general public. I’m getting really great feedback from both the general public and therapists, with people finding it excellent and useful. My hope is that it helps to neutralize some of the angst about porn that’s out there.
Keith Sutton, PsyD: (10:26)
There's a lot of controversy. A lot of people have very strong feelings in different directions,
Diane Gleim, LMFT, CST, CST-S: (10:30)
Yes. Yes. Right. Right. My view is that porn is neutral. Of course, there’s some icky, illegal stuff out there, but the vast majority of people consuming online porn are not going to those places or pursuing the icky, illegal stuff. It’s about getting a better understanding of what’s drawing you to it and why, and what you can learn about yourself, your partner, and your relationship.
Keith Sutton, PsyD: (11:08)
Great. Wonderful. Perfect. Well, can I ask you to start by discussing your conceptualization of sex therapy, especially given your AASECT certification? I know a lot of people who do couples therapy either don’t address the sexual aspects of the relationship much or only address them briefly, without much experience in sex therapy. On the other hand, there are those who focus primarily on sex therapy and don’t do much couples work, or where the couples aspect is secondary. Since the AASECT certification process is so in-depth, I’m interested in hearing your perspective on sex therapy as it relates to couples therapy. Specifically, how do you view sex therapy separately from couples therapy, and how do you see the combination of being a sex therapist who also works with couples?
Diane Gleim, LMFT, CST, CST-S: (12:16)
Yeah, right. Your comments immediately make me think about the PLISSIT model, which is a foundational idea in sex therapy. PLISSIT outlines a path that sex therapy generally follows. It starts with the P, which stands for Permission—giving permission to have a problem with sex, to talk about sex, and to express oneself about sex. It’s all okay. There’s a place in sex therapy where we can explore these issues and seek healing. The LI refers to the next step, which is Limited Information. This can include everything from sex education to information about sexual health, statistics, or anything relevant to the client’s presenting problem. SS stands for Specific Suggestions. In general therapy, we often say that we don’t give suggestions or advice. However, in sex therapy, we provide specific suggestions. This is often because clients may not be aware of these options or may have so much sexual shame that they can only see the problem and struggle to envision a solution. If the PLISS part of sex therapy doesn’t resolve the issue, we then move into intensive therapy, IT, which is more long-term. Specifically, couples seeking out sex therapy that falls into this intensive category are often high-conflict or frequently avoidant couples. These couples typically need longer-term, more intensive work.
Keith Sutton, PsyD: (15:30)
How do you think about that? Or how does someone doing sex therapy think about that?
Diane Gleim, LMFT, CST, CST-S: (15:35)
Ideally, for someone like myself, I prefer clients to come to me after they’ve done some amount of general couples therapy. This allows them to learn things like, though I find this term a bit vague, “good communication skills,” which means avoiding blaming language, using “I” statements, owning their projections, working on active listening, and empathetic listening. With these tools, when they come to me with a sexual issue, we can dive right into the sex part without needing to teach them these basics or work through those other issues. However, that doesn’t always happen, and so we often start with those foundational skills, such as managing projections, using non-blaming language, “I” statements, empathy, and differentiation skills.
Diane Gleim, LMFT, CST, CST-S: (16:47)
We can disagree, and I can empathize with your position, but that doesn’t mean I endorse it or agree with it. It's important to hold one's bone in a conflict while staying connected. Many people, when conflict happens, each go to their respective corners. Learning how to stay connected and repair the relationship are important relationship skills. If there’s a conflict about sex, they need those skills. Whether they learn them from me or from previous couples therapy treatment, it's what they need.
Keith Sutton, PsyD: (17:32)
Yes. And so there’s a foundation needed because these are often the hottest topics. It’s hard enough to talk about things around the house, but even harder to talk about sex. Particularly, the vulnerability is often significantly heightened.
Diane Gleim, LMFT, CST, CST-S: (17:51)
So much more. Yep. Yep.
Keith Sutton, PsyD: (17:52)
There’s all this stuff around it. Do you have a particular orientation that you come from in your work with couples? I heard about individuation and wasn’t sure if it’s more in line with Ian or Betty Perel, or Esther Perel, or something else.
Diane Gleim, LMFT, CST, CST-S: (18:10)
Yes. So I use a combination of psychodynamic approaches. I’m pretty eclectic, incorporating psychodynamic work, Ellen Bader’s developmental model, and a lot of systems work with couples, especially around sex. I find it particularly helpful for maintaining the symptoms and understanding the secondary gains in maintaining the problem. Some CBT is used as well, depending on the presenting problem. And a lot of humanistic approaches. At my core, I am a humanistic therapist, which is what initially drew me to sex therapy. It’s about affirming that you are okay and that you’ll be okay.
Keith Sutton, PsyD: (19:10)
Yes. Helping people accept themselves and be open to different possibilities, rather than feeling they must be a certain way, not to mention that.
Diane Gleim, LMFT, CST, CST-S: (19:19)
Right. And that really flies in the face of the ideas people pick up from social media, friends, family, and other sources. These messages often tell people that their sex life should be this way, not that way, and that they should be this way and not that way.
Keith Sutton, PsyD: (19:44)
Yes. There are so many contradictions that come from culture. For example, there are strong opinions against pornography, yet there is widespread use of it. This creates a contradiction between what is being taught and what is happening behind closed doors.
Diane Gleim, LMFT, CST, CST-S: (20:04)
Exactly. One of the things you said earlier made me think about how I often tell couples, particularly those who have been together for around ten years or longer, that a common reason they come to a sex therapist is what we call a desire discrepancy. In this scenario, one partner has a "higher" libido or desire, while the other has a "lower" libido or desire. I remind them that most of the time, they have never been in this position before. Even if they have been previously married, they might not have reached ten years or longer in a relationship and experienced all that they have with their current partner, including all the added layers of feelings, disappointments, resentments, and fulfilled hopes and dreams.
Diane Gleim, LMFT, CST, CST-S: (21:07)
Right. Not just the negative, but the positive. It's a much more emotionally complex relationship. The emotional landscape is totally different from the beginning of the relationship when sex was easy, required no effort, and libido was high. We have to work through all those layers. There’s often a minimization of this fact. You've been together a long time and likely faced many stressors: kids, mortgages, careers, saving for college and retirement, taking care of older parents, whatever all the stressors are,
Keith Sutton, PsyD: (22:05)
Body and all the right pieces. It reminds me of a couple I'm working with. The guy, an engineer, asked, "Just tell me what to do. What's the problem statement and the solution?" I explained that it’s more complex than just A, B, C. It’s not as simple as doing this and fixing the issue.
Diane Gleim, LMFT, CST, CST-S: (22:27)
Yeah. He's right.
Keith Sutton, PsyD: (22:28)
That one, uh, right.
Diane Gleim, LMFT, CST, CST-S: (22:30)
Yeah. He's wanting behavioral interventions and this is an emotional landscape.
Keith Sutton, PsyD: (22:35)
Yeah. I come from an emotionally focused couples therapy background. I often assess the level of safety, not just in terms of violence but in emotional safety. For example, with one heterosexual couple, the woman felt like her partner was always ready to pounce, which led to higher anxiety and a need to fend off. This dynamic created a lack of emotional safety.
Diane Gleim, LMFT, CST, CST-S: (23:03)
Really Right.
Keith Sutton, PsyD: (23:05)
Helping with the desire. As you’re discussing the difference in desire, I recall some of David Snarch’s work, where he mentions that in every couple, there is always a high desire and low desire partner. Whether one wants it once a week and the other once a month, or one wants it three times a week and the other four times a week, it’s common for desires to not be perfectly matched.
Diane Gleim, LMFT, CST, CST-S: (23:26)
Right. And so
Keith Sutton, PsyD: (23:26)
That's actually very common. And like you're saying too, after the kinda honeymoon phase of the first year or so, or however long the, the person phase is when they get into that long term relationship and being able to maintain desire, connection, sexual relationship, it's a, it's a lot, lot of work. And it's very complex.
Diane Gleim, LMFT, CST, CST-S: (23:46)
I'm often reminded of, I believe it was Yalom in one of his books, said that he does not, or will not work with any client who is currently in love.
Diane Gleim, LMFT, CST, CST-S: (24:05)
And that idea, that the psychological process of being in love is all projection-based, meaning they’re not seeing their partner or themselves clearly, can be a hindrance. It distorts psychological growth. Meanwhile, experiencing that feeling of being in love is one of the best feelings, and when it fades, it can feel like a thump, a fall from that pedestal, and it's painful. This is when people often say things like, "You've changed," "You're not the person I married," or "I didn't sign up for this." These statements reflect the pain of seeing both their partner and themselves more clearly.
Keith Sutton, PsyD: (25:12)
Yeah.
Diane Gleim, LMFT, CST, CST-S: (25:13)
Yep. Mm-Hmm. And it's really the time to do the work.
Keith Sutton, PsyD: (25:17)
Yeah. Yeah. Definitely. Because there is a lot of work that can be done. I heard someone say that oftentimes, many couples don’t communicate about sex. They used the analogy of never talking about food preferences but only getting subtle cues from meals. For instance, if one person turns their nose up at a dish, the other might decide never to serve it again.
Diane Gleim, LMFT, CST, CST-S: (25:41)
Right, right.
Keith Sutton, PsyD: (25:42)
They end up with a very bland, routine sex life that's not enjoyable for either person, because they've had to pick up on subtle cues rather than discussing their likes and dislikes directly. And for many couples, just starting to talk about it can make their sex life begin to blossom, as they often realize what their partner is interested in, or liked or didn't like, or so on.
Diane Gleim, LMFT, CST, CST-S: (26:10)
Right. I love that example about dinner and food preferences because, similarly in sex, one look or sigh, not necessarily of pleasure but of frustration, can lead the other partner to draw huge conclusions or universal ideas. This often happens without any curiosity about what the sigh was really about or what's going on with the partner. Breaking through that and fostering open communication is a key part of sex therapy.
Keith Sutton, PsyD: (26:49)
It actually made me think of something. I was listening to a podcast, I sometimes tune into Sex with Emily, a sex therapist, and she was talking, or maybe it was someone else, but anyway, they were discussing how people often treat sex like a race to orgasm. Oh, yeah. If there's even one bump or trip-up along the way, it's like, boom, the whole thing's over. So, if there’s a sigh or something, they’re like, oh, forget it, and they just call it quits.
Diane Gleim, LMFT, CST, CST-S: (27:15)
Right.
Keith Sutton, PsyD: (27:16)
It ends as if it had failed, rather than seeing it as something to actually talk about and explore. Like, oh, just breathe through it and tune in to those moments.
Diane Gleim, LMFT, CST, CST-S: (27:25)
And it's, so this is what I was gonna say, it's so much easier to, for people in general, to speak from a place of hurt and blaming and complaining, as opposed to, cause there's almost no vulnerability in that, as opposed to, this really hurt my feelings, or I'm feeling really judged by you. That's an, that's an entirely different statement than you did this, you did that, you know, shaking a finger, wagging a finger kind of a thing.
Keith Sutton, PsyD: (27:56)
Yeah. Judged or rejected.
Diane Gleim, LMFT, CST, CST-S: (27:59)
Yep.
Keith Sutton, PsyD: (28:00)
Oftentimes, for some people, it's difficult to talk about and be vulnerable with their partner. They often seek affirmation through sex. Whether it's about feeling desirable or something else, there's a common belief that sex should be easy and natural. In the beginning of a relationship, with all the passion and intensity, there's often uncertainty about whether the other person likes them. Later on, the focus shifts to maintaining a good sex life.
Keith Sutton, PsyD: (28:34)
There's a lot of work.
Diane Gleim, LMFT, CST, CST-S: (28:35)
Because we change, right. We're not the same people. We were, you know, however, long ago at the be beginning of the relationship, we too have changed over the course of those life experiences that I referenced about children and mortgages and careers and retirement plans and college savings, you know, all of those things. Right. They change us. And who are we right at, at each of those different phases or stages of a relationship? And, um, you know, and we age, right? The effects of aging play a huge role on people's sexuality, huge role.
Keith Sutton, PsyD: (29:17)
And psychological.
Diane Gleim, LMFT, CST, CST-S: (29:18)
Yes, absolutely. And there isn’t much out there in terms of helpful resources for learning about the aging process. As my mother says, it beats the alternative. We can either adapt to it or resist it, and resisting creates its own set of consequences.
Keith Sutton, PsyD: (29:52)
Well, as you mention resources, this is a good segue into pornography. This is one of the main "resources" people often turn to, comparing their own sex life to what they see in pornography. This can lead to feelings of disappointment or frustration, as they may feel unable to match what they see in the movies. Can you talk about pornography and your perspective on it? I know you have a sex-positive view.
Diane Gleim, LMFT, CST, CST-S: (30:24)
Yes. So first, let me mention for your listeners that in addition to my clinical work, I also write a blog for Psychology Today. One of my most viewed blogs is titled "To the Wife Upset About Her Husband's Porn Viewing: An Open Letter from His Sex Therapist."
Keith Sutton, PsyD: (30:49)
Oh.
Diane Gleim, LMFT, CST, CST-S: (30:50)
Where I discuss some of these issues. In my porn literacy online course, I explain that porn is full of symbolism that the average viewer may not recognize or understand. For example, porn never shows a man losing his erection.
Keith Sutton, PsyD: (31:21)
Mm-Hmm.
Diane Gleim, LMFT, CST, CST-S: (31:21)
Yes, porn never shows a woman saying, "Ouch, that hurts." These are just a couple of examples. And, you know, what's that?
Keith Sutton, PsyD: (31:31)
Yeah, I agree.
Diane Gleim, LMFT, CST, CST-S: (31:33)
Right. There’s a reason porn doesn’t show those things—it represents fantasy, sex without roadblocks or everyday obstacles. Those everyday obstacles are what people seek sex therapists for.
Keith Sutton, PsyD: (31:57)
Yeah. Yeah.
Diane Gleim, LMFT, CST, CST-S: (31:57)
Right. Erectile dysfunction is unsexy, and painful intercourse is unsexy, both physically and psychologically. Porn creates a world on screen that is completely absent of real-life problems and stressors. Everything is green-lighted—there are no red or yellow lights in porn, and that’s intentional. When people understand this, they realize it's not real life. And those actors, depending on what you’re watching, may or may not be having "real" sex, depending on camera angles and various aids—let’s put it that way.
Keith Sutton, PsyD: (33:00)
It reminds me too of, um, you know, sometimes when talking to, you know, teenagers, uh, about sex or things like that kind of bringing up and, and liking it to, you know, like an action movie
Diane Gleim, LMFT, CST, CST-S: (33:10)
Yes.
Keith Sutton, PsyD: (33:11)
It’s similar to an action movie, where you see dramatic fight scenes and battles. All the laws of reality are thrown out, and it’s designed to be exciting. Understanding that pornography is curated in a similar way—that it leaves out the real-life aspects and focuses on creating an exciting scene
Diane Gleim, LMFT, CST, CST-S: (33:35)
Right.
Keith Sutton, PsyD: (33:36)
A couple having conversations or a couple having moments of like, oh, hold on.
Diane Gleim, LMFT, CST, CST-S: (33:40)
Right. You don’t see any of the negotiation, like discussing what you want to do tonight or expressing what you're in the mood for. You know, “I’m into this, but not that—what do you think?” That’s never shown.
Keith Sutton, PsyD: (33:51)
Yes, maybe reference this article. What does the open letter discuss? It seems to address heterosexual couples, specifically the female partner.
Diane Gleim, LMFT, CST, CST-S: (34:04)
Right. So the classic presentation, I think, is that of clients in my practice. If it’s not a couple coming in to talk about one partner’s problematic porn viewing, it’s often the man in a heterosexual couple saying, “My wife caught me again watching porn, even though I told her three times before I would stop. Now she’s caught me for the third time, or she checked the history on my internet browser and told me I have to come to therapy. So, I found you." That’s a classic pattern presentation. Meanwhile, there is something going on with him and his relationship to pornography, but there’s also a couple’s issue.
Diane Gleim, LMFT, CST, CST-S: (35:10)
Mm-Hmm. And that goes unaddressed when he’s only getting individual therapy. She quickly labels him as the identified patient—the one with the problem—so he goes to therapy. But there’s also some disagreement about the role of pornography in the relationship, and that’s not being discussed. That’s one reason I wrote the blog article: to communicate some things to that partner, as his individual therapist, to say that he understands he has broken a promise. Mm-Hmm. And that’s an issue of his integrity.
Keith Sutton, PsyD: (36:01)
Yeah.
Diane Gleim, LMFT, CST, CST-S: (36:01)
Right. That isn't porn's fault, that's his fault.
Keith Sutton, PsyD: (36:06)
Sure.
Diane Gleim, LMFT, CST, CST-S: (36:06)
Right. And we’re working on that. In heterosexual relationships, she often says things like, “I don’t look like the women he’s watching. I don’t have the size, shape, or youth.” Yeah. Many times, those men have told me—and I’m sure they’ve told their partners—that they don’t compare her. Yeah. They love her body, love her, and she’s their beloved. I’m not comparing. And yet, many women in that situation don’t believe him if he says that.
Keith Sutton, PsyD: (36:56)
Mm-Hmm. Yes.
Diane Gleim, LMFT, CST, CST-S: (36:58)
Why is that? Is it her own low sexual self-esteem, or has he lied to her so many times that she doesn’t believe him? That’s an issue of integrity. When only one partner goes to therapy—in this case, the one with the problem with porn—the couple’s dynamic goes unaddressed. Yeah. Then it becomes about me trying to fix him. Yeah but that often puts some pressure on him because the suggestions I offer sometimes he says, well, that's not gonna fly with my wife.
Keith Sutton, PsyD: (37:45)
Yeah.
Diane Gleim, LMFT, CST, CST-S: (37:46)
Again, missing an opportunity, of couple's work.
Keith Sutton, PsyD: (37:50)
Uhhuh, or something like that.
Diane Gleim, LMFT, CST, CST-S: (37:51)
Or he might just say, “Please believe me when I tell you I’m not comparing your body to theirs.” You know, there’s this couple’s dynamic that’s going unaddressed. So it becomes about how he can make her happy.
Keith Sutton, PsyD: (38:08)
Yes.
Diane Gleim, LMFT, CST, CST-S: (38:09)
Which is problematic. Yeah. Right. There needs to be space for him and, you know, and who he is too, not just people pleasing to her.
Keith Sutton, PsyD: (38:16)
Yeah. This reminds me of the EFT dynamic, specifically the pursuer-withdrawer cycle. Yes. Many times, the men are the withdrawers. Yes. They want to keep the peace and avoid distance, so they don’t speak up about what’s important to them or their feelings. Instead, they might just focus on keeping their partner happy, thinking, “Happy wife, happy life,” rather than having a conversation to reach a place where both feel fulfilled and have their needs met.
Diane Gleim, LMFT, CST, CST-S: (38:58)
Right. That whole ideology—"happy wife, happy life" or "happy house, happy spouse"—is problematic to me. When I hear that, I think about how much of himself he’s sacrificing.
Keith Sutton, PsyD: (39:14)
Mm-Hmm.
Diane Gleim, LMFT, CST, CST-S: (39:15)
Right. In order to people please.
Keith Sutton, PsyD: (39:17)
Yeah.
Diane Gleim, LMFT, CST, CST-S: (39:18)
And, and what are the long-term consequences of that?
Keith Sutton, PsyD: (39:20)
Mm-Hmm.
Diane Gleim, LMFT, CST, CST-S: (39:21)
Yeah.
Keith Sutton, PsyD: (39:22)
Well, and I imagine it’s also a different perspective for each person. The wife might think, “If I were in that situation, I’d be attracted to the person physically,” or whatever it might be. Whereas, for some men, it’s more anonymous or something else.
Diane Gleim, LMFT, CST, CST-S: (39:39)
Sure. Right.
Keith Sutton, PsyD: (39:41)
Actually, one of the big challenges with pornography is the conflict between basic sexual impulses and interests, which can be exciting, and the objectification involved. Particularly in this case, where there are also women who watch pornography, but the majority of the content involves seeing women as sex objects. So, it's about reconciling the respect and value we hold for women—partners, mothers, sisters—with the enjoyment of watching sex and viewing pornography and how to reconcile those at the same time.
Diane Gleim, LMFT, CST, CST-S: (40:34)
Yeah. So my response to that is, particularly with film-based pornography, as opposed to erotica or literature, when I watch a movie with, I don’t know, Brad Pitt in it, I might know a few things about his personal life, unfortunately.
Keith Sutton, PsyD: (41:05)
Sure, sure.
Diane Gleim, LMFT, CST, CST-S: (41:05)
But I also recognize he's acting. Knowing a few things about his personal life, I understand he’s acting on screen. When we watch porn, the average viewer doesn’t know anything about the performers or their personal lives, and that’s intentional. It makes the imagery more believable. We’re not distracted by what we might know about their personal lives. Objectification has a negative connotation these days. But there is such a thing as healthy objectification, and it does exist. We understand that porn performers are doing what they do on camera for their own reasons. I don’t need to be curious about their deepest hopes and dreams. They’re presumably consenting to what they’re doing. We don’t know who they are, and they’re okay with that.
Diane Gleim, LMFT, CST, CST-S: (42:31)
And keep in mind that, you know, not just women are objectified in porn, men are too
Keith Sutton, PsyD: (42:36)
Sure. And I guess as we're talking about this, it makes me think that women have often been more the victims of objectification when it's not in the context of wanting that objectification from a respectful partner. So, that’s often a big aspect of it. It’s almost fueling some men's idea that this is how you can treat or see women without considering the relationship. I know some couples where the wives love to be objectified by their husbands if there’s a mutual respect and supportive relationship.
Diane Gleim, LMFT, CST, CST-S: (43:31)
Well, and I think you're addressing something about like, uh, we can, like objectification has an on/off switch, right. We can turn it on and we can turn it off.
Keith Sutton, PsyD: (43:40)
Yeah.
Diane Gleim, LMFT, CST, CST-S: (43:41)
Right. And, you know, and you know, for couples like the ones you were describing, um, they turn it on at certain points, but then they also turn it off.
Keith Sutton, PsyD: (43:51)
Yes.
Diane Gleim, LMFT, CST, CST-S: (43:51)
Right. I'm not completely dismissing my partner's personhood and humanity, you know for entirety. You know, it's for this specific period of time, I'm gonna focus on this or that.
Keith Sutton, PsyD: (44:08)
Yeah. It’s about having the flexibility to move in and out of that space, within alignment with a partner—like a dance.
Diane Gleim, LMFT, CST, CST-S: (44:15)
Yes.
Keith Sutton, PsyD: (44:16)
In tune and synced together. Right. And I think we had a conversation about a client I was working with, where this dynamic comes up in a number of couples. Sometimes, I work with one person with trauma who pairs with someone very even-keeled—stable and dependable. But later on, it can feel boring. They often wish for more emotional engagement or intensity in their sex life. They wish the partner weren’t so passive, although this passivity was initially attractive. It’s a double-edged sword: the stability and easygoing nature that attracted them can sometimes translate into a less dynamic sex life.
Keith Sutton, PsyD: (45:14)
In one couple I was working with, she wanted him to take charge more and be more assertive sexually. However, this was difficult for him. He was a very nice, meek, and passive guy, so it was outside his comfort zone. He also had a conflict about objectifying his wife or acting in ways he associated with "bad guys." We discussed this conflict and the juxtaposition involved.
Diane Gleim, LMFT, CST, CST-S: (45:54)
I remember that consultation, Keith. The Me Too movement emerged in the fall of 2017, and soon after, I noticed a fascinating phenomenon in my practice. I started receiving many calls from individual men who wanted to process past sexual encounters, whether from 23 years ago or two years ago. They were anxious about whether their behavior had been appropriate or inappropriate. There was real anxiety among men about their sexual behavior. Mm-Hmm. There’s an idea called perpetrator fear, which many men, particularly heterosexual men, have. This fear of being perceived or accused became much more pronounced after Me Too.
Diane Gleim, LMFT, CST, CST-S: (47:09)
Yeah. In the case of the Me Too movement, perceived or accused of being a sexual perpetrator. And, I don't wanna, like you said, I don't wanna be a bad guy. I don't wanna be that kind of guy. Yeah, yeah. And that's where things like consent, learning consent, all the nuances of consent can happen. That's where focusing more on relational sex, which I define as a back and forth, dynamic happening between partners where there's this sort of checking in ongoing, it's not like, do you wanna have sex? You know, yes or no? And then it's, consent is done for the remainder of the encounter. No, it's, um, do you, you know, how about, can I touch you here? Yeah. Can you touch me there? Can we do this next? Right. That there's this back and forth negotiation that is based in the relationship, not just in what I want or what I think I need.
Keith Sutton, PsyD: (48:22)
Yeah. Well, this is a good point that I went to a workshop with Dossie Houston on cultural competency with BDSM couples.
Diane Gleim, LMFT, CST, CST-S: (48:31)
Yeah.
Keith Sutton, PsyD: (48:32)
She talked about, which I thought was really well put, that in a domination, sadomasochistic relationship, when there's a dominant and a submissive, the dominant can only really be dominant if they can trust that the submissive will tell them if something does not feel right. If they can actually trust that the other person is going to say something doesn't feel good or is uncomfortable, then they can be even more dominant or aggressive or whatever it might be in the sexual relationship because ultimately the submissive has the power.
Diane Gleim, LMFT, CST, CST-S: (49:14)
And it's predicated on the submissive knowing themselves, number one, knowing their limits. Number two, feeling comfortable enough and having the skills to communicate
Keith Sutton, PsyD: (49:24)
Exactly. I think back to that aspect of the safety, feeling safe to say, Ugh, this didn't feel or you know, doesn't matter. I'm in the mood for that right now. Or something. In those ways. And that really oftentimes
Diane Gleim, LMFT, CST, CST-S: (49:38)
Right. People often confuse consent as like this carte blanche Green light.
Keith Sutton, PsyD: (49:49)
This is kinda what we're doing tonight versus like, is going all,
Diane Gleim, LMFT, CST, CST-S: (49:53)
What, what are we, what am I consenting to? Yeah. A step one, step two steps, three, you know.
Keith Sutton, PsyD: (50:01)
And as couples get to know each other better and better, that, you know, it is a bit awkward, like learning to dance and stepping on each other's toes. Oh, you're going that way. I'm going this way. Yeah. You know, not just kind of in the mechanics of sex, but also kind of what they're wanting and how they're wanting to encounter.
Diane Gleim, LMFT, CST, CST-S: (50:18)
Couples often develop what we call a sexual script, where each couple has a sequence they follow during sex: first they do A, then B, then C, then D. That's their definition of sex. When a partner consents to sex, it's often assumed to be this A, B, C, D sequence. But what if one partner wants just A and nothing else, or B and nothing else, or A and B? Couples make many assumptions about sex. In sex therapy, we try to slow that process down and clarify what's happening, why, and what each person wants. Just because someone wants something tonight doesn't mean they will want it again tomorrow. They might want something different. We also talk about the internalized image of our partner, which is based on assumptions and conclusions. We stop being curious about who they really are.
Keith Sutton, PsyD: (51:44)
Yeah. Rather than taking a moment to understand why someone likes something, it's important to explore what they like about it. This applies to sex and pornography as well. Understanding what kind of pornography a person is watching and what they like about it is crucial. People in pornography often play roles, and there’s no backstory provided. Even in erotica, there might be roles like the submissive person or someone who is just available for sex without complications, such as whether they got enough sleep. Sometimes, this is a fantasy of simplicity. Understanding what excites couples about what they’re watching helps because they don’t need to act out every fantasy, like group sex, if one person isn’t interested. It’s about understanding what is exciting to them.
Keith Sutton, PsyD: (52:44)
What’s important is being able to talk and bring some of those things into the relationship, whether it’s from the novels people are reading or other sources.
Diane Gleim, LMFT, CST, CST-S: (52:54)
One question I like to ask my clients, especially when they reveal that they view porn, is: Who do you identify with in the porn you're watching? They often respond with a bit of confusion, and I explain that I’m asking if they identify with the doer or if they are more of an observer.
Keith Sutton, PsyD: (53:23)
Yeah.
Diane Gleim, LMFT, CST, CST-S: (53:25)
And the answers are fascinating.
Keith Sutton, PsyD: (53:28)
Yeah.
Diane Gleim, LMFT, CST, CST-S: (53:29)
And I, and then I followed up with, well, why do you think that is? Why do you think that you are identifying with, with whatever role you are
Keith Sutton, PsyD: (53:36)
The receiver of the get? Yeah, yeah. Well, I think it's also important to ask what they like about it. For example, I had one couple where the wife was curious about what it was like for her husband. He mentioned that he enjoyed seeing the women enjoying themselves and acting like they were enjoying it. She was surprised because she assumed he would be imagining himself as the man in the porn, similar to how she imagines herself as the woman when she watches.
Diane Gleim, LMFT, CST, CST-S: (54:04)
Right. Great point. Yeah.
Keith Sutton, PsyD: (54:06)
That’s happening to her. So again, very different perspectives on that. Yes. This is such a huge topic, and we could go on and on, but we’re out of time. Thank you so much. This is so important, and I really encourage therapists to dig deeper into this area of sex therapy. Many couples therapists don’t have this extra kind of training, which leaves out a crucial piece. What you’re doing around pornography is really great, and things are changing with each generation. Couples in their twenties have very different feelings about pornography compared to couples in their fifties or sixties.
Diane Gleim, LMFT, CST, CST-S: (54:50)
Completely. Well, thanks Keith. This was fun.
Keith Sutton, PsyD: (54:53)
Yeah. Appreciate it. Okay, great. Thanks a lot. Take care.
Diane Gleim, LMFT, CST, CST-S: (54:58)
Yeah, thanks.
Keith Sutton, PsyD: (54:59)
Thank you for joining us today. If you'd like to receive continuing education credits for the podcast you just listened to, please visit therapyonthecuttingedge.com and click on the link for CE. Our podcast is brought to you by the Institute for the Advancement of Psychotherapy, where we offer training for therapists in evidence-based models through live and online workshops, on-demand workshops, consultation groups, and online one-way mirror trainings. To learn more about our trainings and treatment for children, adolescents, families, couples, and individual adults with our licensed and experienced therapists, in-person in the Bay Area or throughout California online, and about our employment opportunities, visit SFIAP.com. For information on our associateships, psych assistantships, and low-fee treatment through our nonprofit, Bay Area Community Counseling and Family Institute of Berkeley, go to SFBCC.org and FamilyInstituteofBerkeley.com. If you'd like to support therapy for those in financial need and evidence-based treatments, you can donate at SFBCC.org. BCC is a 501(c)(3) nonprofit, so all donations are tax-deductible. We also appreciate your feedback. If you have something of interest or cutting-edge in psychotherapy that therapists should know about, send us an email. We're always looking for advancements to create lasting change for our clients.
Welcome to Therapy on the Cutting Edge, a podcast for therapists who want to be up to date on the latest advancements in the field of psychotherapy. I'm your host, Dr. Keith Sutton, a psychologist in the San Francisco Bay Area, and the Director of the Institute for the Advancement of Psychotherapy at the Institute, the Advancement of Psychotherapy. We provide training in evidence-based models, including family systems, cognitive behavioral therapy, emotionally focused couples therapy, eye movement desensitization reprocessing, motivational interviewing, and other approaches through live in-person and online trainings on-demand trainings, consultation groups, and one-way mirror trainings. We also have therapists throughout the Bay Area and California providing treatment through our six specialty centers, which are each grounded in evidence-based approaches with our lifespan centers, our center for children, center for adolescents, where all the therapists are working systemically, our center for couples, where all the therapists are using emotionally focused couples therapy.
Keith Sutton, PsyD: (01:19)
And our specialty issue centers, our Center for Anxiety, where all the therapists are using CBT and EMDR for trauma, and our Center for ADHD and our Oppositional and Conduct Disorder Clinic, where we're integrating those four approaches. Additionally, we have our associated nonprofit, Bay Area Community Counseling, where we provide treatment for those in financial need who cannot afford the licensed, experienced therapists in the Institute but can work with associates and clinicians developing their expertise through our nonprofit. Additionally, as part of our nonprofit, we also have the Family Institute of Berkeley, where we provide treatment, training, and one-way mirror trainings in family systems. To learn more about training, treatment, or employment opportunities, please go to sfiap.com, and to support our nonprofit, you can go to sf-bacc.org to donate today to support access to therapy for those in financial need, as well as training and evidence-based treatment. BACC is a 501(c)(3) nonprofit, so all donations are tax-deductible.
Keith Sutton, PsyD: (02:21)
Today, I'll be speaking with Diane Glim, who is a licensed marriage and family therapist and a certified sex therapist and supervisor. She practices online throughout California and in-person in Santa Rosa as the first certified sex therapist in Sonoma County. Diane treats many diverse issues related to sexual identity, sexual expression, sexual behavior, and sexual relationships. Her clients include anyone with a sexual concern, individuals and couples aged 18 to 85, and the LGBTQ+ and poly populations. In addition to her private practice, Diane's work also includes providing trainings and consultations on sex therapy, writing the blog Underneath the Sheets on Psychology Today’s website, and supervising sex therapists in training. She has been quoted in various press and has been a guest on several podcasts. Diane has been voted Sonoma County's best sex therapist by the readers of the North Bay Bohemian five times. Let's listen to the interview.
Keith Sutton, PsyD: (03:21)
Well, hi, Diane. Welcome. Thanks for joining today.
Diane Gleim, LMFT, CST, CST-S: (03:24)
Hi, Keith. Thanks for having me.
Keith Sutton, PsyD: (03:26)
Yeah, so this is great. I know of your work — gosh, I think you did a training for the Redwood Empire chapter of the California Association of Marriage and Family Therapy on pornography and relationships, taking a sex-positive approach, a couple of years ago. I got to see some of that training and really liked your work. I’ve been very slowly working on a sex certification with the American Association of Sex Educators, Therapists, and Counselors. Yes, Counselors and Therapists. I’ve done some consultation from you on cases, and I’ve really enjoyed hearing about your work and the ideas you’ve been talking about in the background. So, I thought it would be great to have you in for an interview. I’d love to hear about your work, but before we get to that, I always like to ask people about the evolution of their thinking. How did they get to doing kind of work they're doing and the way they're thinking about their work?
Diane Gleim, LMFT, CST, CST-S: (04:27)
Sure. Yeah. Well, when I was an intern psychotherapist many years ago, I got licensed in 2007, so I’ve been doing this for a while. I quickly realized, when I was working at a community mental health clinic as an intern, two things: one, I was not prepared to work with couples — graduate school did not prepare me enough. And two, graduate school did not prepare me at all for working with couples around sexual issues. After speaking to a few other folks in the field and in my community, I decided that I’d get licensed first and then immediately start pursuing a specialty in sex therapy. At first, I was quite ambivalent, to be honest, about pursuing the AASECT certification. It’s a lot of time, a lot of money.
Keith Sutton, PsyD: (05:36)
That's why I'm doing it so slowly.
Diane Gleim, LMFT, CST, CST-S: (05:38)
Yes, exactly. I wasn’t sure I necessarily needed it, to be quite honest. If I got the training, did I really need the certification? So, I pursued the training first. Then, after I left a group practice and went into solo private practice, I said, you know what? I’m going to go for that certification. At the time, there was no one in our community who was a certified sex therapist, so I thought, that’s a great way to market myself, get my name out there, and really pursue that specialty. In terms of my work with porn and porn-related issues, that also evolved over time. The pandemic really accelerated people’s relationship with technology.
Diane Gleim, LMFT, CST, CST-S: (06:40)
You know, we did Zoom therapy, people did Zoom school, Zoom exercise classes, Zoom church, synagogue, and so on. In my mind, that meant people were consuming porn of all kinds on the internet long before the pandemic, of course, but the pandemic was like an accelerator. I realized two things: one, there was all this talk in the field of sex therapy about the need for porn literacy—that porn consumers need a better understanding of what they’re watching and its effect and impact on them. And yet, no one was creating such content or literacy, either for therapists or for the general public.
Diane Gleim, LMFT, CST, CST-S: (07:42)
And so what started as a training for mental health professionals, which you attended—wow, that was like three years ago now! Early 2021, I created a training for therapists. It was a three-hour training, I think. The first half was on porn literacy, and the second half focused on working with individuals and/or couples who were in conflict over porn. The porn literacy part was always viewed as foundational. With that foundation, you can work more effectively with individuals and couples who have issues with porn. I created that training, and I’ve given it 6, 7, maybe 8 times now over the last three years at various places—from the CAMP Annual Conference last year to various sex therapy institutes.
Diane Gleim, LMFT, CST, CST-S: (08:44)
I get universally positive feedback, with people saying they’ve learned something either about themselves or gained a clinical nugget to take into their practice. The second piece of feedback I received was from a friend who said, “Gee, Diane, everyone needs to see the porn literacy piece, not just therapists.” So, that planted the idea in my head to create a course that would take the porn literacy portion of the program and make it available to the general public. It was a lot of work to figure out what platform to use, how to get it out there, and whether to do a straight translation of all the clinical information for the general public or to adjust parts of it.
Diane Gleim, LMFT, CST, CST-S: (09:44)
There were lots of decisions, all these micro-decisions to make. Last summer, I finally launched it on my website: Porn Literacy 101. It’s an on-demand course, and I say it’s beneficial for both therapists and the general public. I’m getting really great feedback from both the general public and therapists, with people finding it excellent and useful. My hope is that it helps to neutralize some of the angst about porn that’s out there.
Keith Sutton, PsyD: (10:26)
There's a lot of controversy. A lot of people have very strong feelings in different directions,
Diane Gleim, LMFT, CST, CST-S: (10:30)
Yes. Yes. Right. Right. My view is that porn is neutral. Of course, there’s some icky, illegal stuff out there, but the vast majority of people consuming online porn are not going to those places or pursuing the icky, illegal stuff. It’s about getting a better understanding of what’s drawing you to it and why, and what you can learn about yourself, your partner, and your relationship.
Keith Sutton, PsyD: (11:08)
Great. Wonderful. Perfect. Well, can I ask you to start by discussing your conceptualization of sex therapy, especially given your AASECT certification? I know a lot of people who do couples therapy either don’t address the sexual aspects of the relationship much or only address them briefly, without much experience in sex therapy. On the other hand, there are those who focus primarily on sex therapy and don’t do much couples work, or where the couples aspect is secondary. Since the AASECT certification process is so in-depth, I’m interested in hearing your perspective on sex therapy as it relates to couples therapy. Specifically, how do you view sex therapy separately from couples therapy, and how do you see the combination of being a sex therapist who also works with couples?
Diane Gleim, LMFT, CST, CST-S: (12:16)
Yeah, right. Your comments immediately make me think about the PLISSIT model, which is a foundational idea in sex therapy. PLISSIT outlines a path that sex therapy generally follows. It starts with the P, which stands for Permission—giving permission to have a problem with sex, to talk about sex, and to express oneself about sex. It’s all okay. There’s a place in sex therapy where we can explore these issues and seek healing. The LI refers to the next step, which is Limited Information. This can include everything from sex education to information about sexual health, statistics, or anything relevant to the client’s presenting problem. SS stands for Specific Suggestions. In general therapy, we often say that we don’t give suggestions or advice. However, in sex therapy, we provide specific suggestions. This is often because clients may not be aware of these options or may have so much sexual shame that they can only see the problem and struggle to envision a solution. If the PLISS part of sex therapy doesn’t resolve the issue, we then move into intensive therapy, IT, which is more long-term. Specifically, couples seeking out sex therapy that falls into this intensive category are often high-conflict or frequently avoidant couples. These couples typically need longer-term, more intensive work.
Keith Sutton, PsyD: (15:30)
How do you think about that? Or how does someone doing sex therapy think about that?
Diane Gleim, LMFT, CST, CST-S: (15:35)
Ideally, for someone like myself, I prefer clients to come to me after they’ve done some amount of general couples therapy. This allows them to learn things like, though I find this term a bit vague, “good communication skills,” which means avoiding blaming language, using “I” statements, owning their projections, working on active listening, and empathetic listening. With these tools, when they come to me with a sexual issue, we can dive right into the sex part without needing to teach them these basics or work through those other issues. However, that doesn’t always happen, and so we often start with those foundational skills, such as managing projections, using non-blaming language, “I” statements, empathy, and differentiation skills.
Diane Gleim, LMFT, CST, CST-S: (16:47)
We can disagree, and I can empathize with your position, but that doesn’t mean I endorse it or agree with it. It's important to hold one's bone in a conflict while staying connected. Many people, when conflict happens, each go to their respective corners. Learning how to stay connected and repair the relationship are important relationship skills. If there’s a conflict about sex, they need those skills. Whether they learn them from me or from previous couples therapy treatment, it's what they need.
Keith Sutton, PsyD: (17:32)
Yes. And so there’s a foundation needed because these are often the hottest topics. It’s hard enough to talk about things around the house, but even harder to talk about sex. Particularly, the vulnerability is often significantly heightened.
Diane Gleim, LMFT, CST, CST-S: (17:51)
So much more. Yep. Yep.
Keith Sutton, PsyD: (17:52)
There’s all this stuff around it. Do you have a particular orientation that you come from in your work with couples? I heard about individuation and wasn’t sure if it’s more in line with Ian or Betty Perel, or Esther Perel, or something else.
Diane Gleim, LMFT, CST, CST-S: (18:10)
Yes. So I use a combination of psychodynamic approaches. I’m pretty eclectic, incorporating psychodynamic work, Ellen Bader’s developmental model, and a lot of systems work with couples, especially around sex. I find it particularly helpful for maintaining the symptoms and understanding the secondary gains in maintaining the problem. Some CBT is used as well, depending on the presenting problem. And a lot of humanistic approaches. At my core, I am a humanistic therapist, which is what initially drew me to sex therapy. It’s about affirming that you are okay and that you’ll be okay.
Keith Sutton, PsyD: (19:10)
Yes. Helping people accept themselves and be open to different possibilities, rather than feeling they must be a certain way, not to mention that.
Diane Gleim, LMFT, CST, CST-S: (19:19)
Right. And that really flies in the face of the ideas people pick up from social media, friends, family, and other sources. These messages often tell people that their sex life should be this way, not that way, and that they should be this way and not that way.
Keith Sutton, PsyD: (19:44)
Yes. There are so many contradictions that come from culture. For example, there are strong opinions against pornography, yet there is widespread use of it. This creates a contradiction between what is being taught and what is happening behind closed doors.
Diane Gleim, LMFT, CST, CST-S: (20:04)
Exactly. One of the things you said earlier made me think about how I often tell couples, particularly those who have been together for around ten years or longer, that a common reason they come to a sex therapist is what we call a desire discrepancy. In this scenario, one partner has a "higher" libido or desire, while the other has a "lower" libido or desire. I remind them that most of the time, they have never been in this position before. Even if they have been previously married, they might not have reached ten years or longer in a relationship and experienced all that they have with their current partner, including all the added layers of feelings, disappointments, resentments, and fulfilled hopes and dreams.
Diane Gleim, LMFT, CST, CST-S: (21:07)
Right. Not just the negative, but the positive. It's a much more emotionally complex relationship. The emotional landscape is totally different from the beginning of the relationship when sex was easy, required no effort, and libido was high. We have to work through all those layers. There’s often a minimization of this fact. You've been together a long time and likely faced many stressors: kids, mortgages, careers, saving for college and retirement, taking care of older parents, whatever all the stressors are,
Keith Sutton, PsyD: (22:05)
Body and all the right pieces. It reminds me of a couple I'm working with. The guy, an engineer, asked, "Just tell me what to do. What's the problem statement and the solution?" I explained that it’s more complex than just A, B, C. It’s not as simple as doing this and fixing the issue.
Diane Gleim, LMFT, CST, CST-S: (22:27)
Yeah. He's right.
Keith Sutton, PsyD: (22:28)
That one, uh, right.
Diane Gleim, LMFT, CST, CST-S: (22:30)
Yeah. He's wanting behavioral interventions and this is an emotional landscape.
Keith Sutton, PsyD: (22:35)
Yeah. I come from an emotionally focused couples therapy background. I often assess the level of safety, not just in terms of violence but in emotional safety. For example, with one heterosexual couple, the woman felt like her partner was always ready to pounce, which led to higher anxiety and a need to fend off. This dynamic created a lack of emotional safety.
Diane Gleim, LMFT, CST, CST-S: (23:03)
Really Right.
Keith Sutton, PsyD: (23:05)
Helping with the desire. As you’re discussing the difference in desire, I recall some of David Snarch’s work, where he mentions that in every couple, there is always a high desire and low desire partner. Whether one wants it once a week and the other once a month, or one wants it three times a week and the other four times a week, it’s common for desires to not be perfectly matched.
Diane Gleim, LMFT, CST, CST-S: (23:26)
Right. And so
Keith Sutton, PsyD: (23:26)
That's actually very common. And like you're saying too, after the kinda honeymoon phase of the first year or so, or however long the, the person phase is when they get into that long term relationship and being able to maintain desire, connection, sexual relationship, it's a, it's a lot, lot of work. And it's very complex.
Diane Gleim, LMFT, CST, CST-S: (23:46)
I'm often reminded of, I believe it was Yalom in one of his books, said that he does not, or will not work with any client who is currently in love.
Diane Gleim, LMFT, CST, CST-S: (24:05)
And that idea, that the psychological process of being in love is all projection-based, meaning they’re not seeing their partner or themselves clearly, can be a hindrance. It distorts psychological growth. Meanwhile, experiencing that feeling of being in love is one of the best feelings, and when it fades, it can feel like a thump, a fall from that pedestal, and it's painful. This is when people often say things like, "You've changed," "You're not the person I married," or "I didn't sign up for this." These statements reflect the pain of seeing both their partner and themselves more clearly.
Keith Sutton, PsyD: (25:12)
Yeah.
Diane Gleim, LMFT, CST, CST-S: (25:13)
Yep. Mm-Hmm. And it's really the time to do the work.
Keith Sutton, PsyD: (25:17)
Yeah. Yeah. Definitely. Because there is a lot of work that can be done. I heard someone say that oftentimes, many couples don’t communicate about sex. They used the analogy of never talking about food preferences but only getting subtle cues from meals. For instance, if one person turns their nose up at a dish, the other might decide never to serve it again.
Diane Gleim, LMFT, CST, CST-S: (25:41)
Right, right.
Keith Sutton, PsyD: (25:42)
They end up with a very bland, routine sex life that's not enjoyable for either person, because they've had to pick up on subtle cues rather than discussing their likes and dislikes directly. And for many couples, just starting to talk about it can make their sex life begin to blossom, as they often realize what their partner is interested in, or liked or didn't like, or so on.
Diane Gleim, LMFT, CST, CST-S: (26:10)
Right. I love that example about dinner and food preferences because, similarly in sex, one look or sigh, not necessarily of pleasure but of frustration, can lead the other partner to draw huge conclusions or universal ideas. This often happens without any curiosity about what the sigh was really about or what's going on with the partner. Breaking through that and fostering open communication is a key part of sex therapy.
Keith Sutton, PsyD: (26:49)
It actually made me think of something. I was listening to a podcast, I sometimes tune into Sex with Emily, a sex therapist, and she was talking, or maybe it was someone else, but anyway, they were discussing how people often treat sex like a race to orgasm. Oh, yeah. If there's even one bump or trip-up along the way, it's like, boom, the whole thing's over. So, if there’s a sigh or something, they’re like, oh, forget it, and they just call it quits.
Diane Gleim, LMFT, CST, CST-S: (27:15)
Right.
Keith Sutton, PsyD: (27:16)
It ends as if it had failed, rather than seeing it as something to actually talk about and explore. Like, oh, just breathe through it and tune in to those moments.
Diane Gleim, LMFT, CST, CST-S: (27:25)
And it's, so this is what I was gonna say, it's so much easier to, for people in general, to speak from a place of hurt and blaming and complaining, as opposed to, cause there's almost no vulnerability in that, as opposed to, this really hurt my feelings, or I'm feeling really judged by you. That's an, that's an entirely different statement than you did this, you did that, you know, shaking a finger, wagging a finger kind of a thing.
Keith Sutton, PsyD: (27:56)
Yeah. Judged or rejected.
Diane Gleim, LMFT, CST, CST-S: (27:59)
Yep.
Keith Sutton, PsyD: (28:00)
Oftentimes, for some people, it's difficult to talk about and be vulnerable with their partner. They often seek affirmation through sex. Whether it's about feeling desirable or something else, there's a common belief that sex should be easy and natural. In the beginning of a relationship, with all the passion and intensity, there's often uncertainty about whether the other person likes them. Later on, the focus shifts to maintaining a good sex life.
Keith Sutton, PsyD: (28:34)
There's a lot of work.
Diane Gleim, LMFT, CST, CST-S: (28:35)
Because we change, right. We're not the same people. We were, you know, however, long ago at the be beginning of the relationship, we too have changed over the course of those life experiences that I referenced about children and mortgages and careers and retirement plans and college savings, you know, all of those things. Right. They change us. And who are we right at, at each of those different phases or stages of a relationship? And, um, you know, and we age, right? The effects of aging play a huge role on people's sexuality, huge role.
Keith Sutton, PsyD: (29:17)
And psychological.
Diane Gleim, LMFT, CST, CST-S: (29:18)
Yes, absolutely. And there isn’t much out there in terms of helpful resources for learning about the aging process. As my mother says, it beats the alternative. We can either adapt to it or resist it, and resisting creates its own set of consequences.
Keith Sutton, PsyD: (29:52)
Well, as you mention resources, this is a good segue into pornography. This is one of the main "resources" people often turn to, comparing their own sex life to what they see in pornography. This can lead to feelings of disappointment or frustration, as they may feel unable to match what they see in the movies. Can you talk about pornography and your perspective on it? I know you have a sex-positive view.
Diane Gleim, LMFT, CST, CST-S: (30:24)
Yes. So first, let me mention for your listeners that in addition to my clinical work, I also write a blog for Psychology Today. One of my most viewed blogs is titled "To the Wife Upset About Her Husband's Porn Viewing: An Open Letter from His Sex Therapist."
Keith Sutton, PsyD: (30:49)
Oh.
Diane Gleim, LMFT, CST, CST-S: (30:50)
Where I discuss some of these issues. In my porn literacy online course, I explain that porn is full of symbolism that the average viewer may not recognize or understand. For example, porn never shows a man losing his erection.
Keith Sutton, PsyD: (31:21)
Mm-Hmm.
Diane Gleim, LMFT, CST, CST-S: (31:21)
Yes, porn never shows a woman saying, "Ouch, that hurts." These are just a couple of examples. And, you know, what's that?
Keith Sutton, PsyD: (31:31)
Yeah, I agree.
Diane Gleim, LMFT, CST, CST-S: (31:33)
Right. There’s a reason porn doesn’t show those things—it represents fantasy, sex without roadblocks or everyday obstacles. Those everyday obstacles are what people seek sex therapists for.
Keith Sutton, PsyD: (31:57)
Yeah. Yeah.
Diane Gleim, LMFT, CST, CST-S: (31:57)
Right. Erectile dysfunction is unsexy, and painful intercourse is unsexy, both physically and psychologically. Porn creates a world on screen that is completely absent of real-life problems and stressors. Everything is green-lighted—there are no red or yellow lights in porn, and that’s intentional. When people understand this, they realize it's not real life. And those actors, depending on what you’re watching, may or may not be having "real" sex, depending on camera angles and various aids—let’s put it that way.
Keith Sutton, PsyD: (33:00)
It reminds me too of, um, you know, sometimes when talking to, you know, teenagers, uh, about sex or things like that kind of bringing up and, and liking it to, you know, like an action movie
Diane Gleim, LMFT, CST, CST-S: (33:10)
Yes.
Keith Sutton, PsyD: (33:11)
It’s similar to an action movie, where you see dramatic fight scenes and battles. All the laws of reality are thrown out, and it’s designed to be exciting. Understanding that pornography is curated in a similar way—that it leaves out the real-life aspects and focuses on creating an exciting scene
Diane Gleim, LMFT, CST, CST-S: (33:35)
Right.
Keith Sutton, PsyD: (33:36)
A couple having conversations or a couple having moments of like, oh, hold on.
Diane Gleim, LMFT, CST, CST-S: (33:40)
Right. You don’t see any of the negotiation, like discussing what you want to do tonight or expressing what you're in the mood for. You know, “I’m into this, but not that—what do you think?” That’s never shown.
Keith Sutton, PsyD: (33:51)
Yes, maybe reference this article. What does the open letter discuss? It seems to address heterosexual couples, specifically the female partner.
Diane Gleim, LMFT, CST, CST-S: (34:04)
Right. So the classic presentation, I think, is that of clients in my practice. If it’s not a couple coming in to talk about one partner’s problematic porn viewing, it’s often the man in a heterosexual couple saying, “My wife caught me again watching porn, even though I told her three times before I would stop. Now she’s caught me for the third time, or she checked the history on my internet browser and told me I have to come to therapy. So, I found you." That’s a classic pattern presentation. Meanwhile, there is something going on with him and his relationship to pornography, but there’s also a couple’s issue.
Diane Gleim, LMFT, CST, CST-S: (35:10)
Mm-Hmm. And that goes unaddressed when he’s only getting individual therapy. She quickly labels him as the identified patient—the one with the problem—so he goes to therapy. But there’s also some disagreement about the role of pornography in the relationship, and that’s not being discussed. That’s one reason I wrote the blog article: to communicate some things to that partner, as his individual therapist, to say that he understands he has broken a promise. Mm-Hmm. And that’s an issue of his integrity.
Keith Sutton, PsyD: (36:01)
Yeah.
Diane Gleim, LMFT, CST, CST-S: (36:01)
Right. That isn't porn's fault, that's his fault.
Keith Sutton, PsyD: (36:06)
Sure.
Diane Gleim, LMFT, CST, CST-S: (36:06)
Right. And we’re working on that. In heterosexual relationships, she often says things like, “I don’t look like the women he’s watching. I don’t have the size, shape, or youth.” Yeah. Many times, those men have told me—and I’m sure they’ve told their partners—that they don’t compare her. Yeah. They love her body, love her, and she’s their beloved. I’m not comparing. And yet, many women in that situation don’t believe him if he says that.
Keith Sutton, PsyD: (36:56)
Mm-Hmm. Yes.
Diane Gleim, LMFT, CST, CST-S: (36:58)
Why is that? Is it her own low sexual self-esteem, or has he lied to her so many times that she doesn’t believe him? That’s an issue of integrity. When only one partner goes to therapy—in this case, the one with the problem with porn—the couple’s dynamic goes unaddressed. Yeah. Then it becomes about me trying to fix him. Yeah but that often puts some pressure on him because the suggestions I offer sometimes he says, well, that's not gonna fly with my wife.
Keith Sutton, PsyD: (37:45)
Yeah.
Diane Gleim, LMFT, CST, CST-S: (37:46)
Again, missing an opportunity, of couple's work.
Keith Sutton, PsyD: (37:50)
Uhhuh, or something like that.
Diane Gleim, LMFT, CST, CST-S: (37:51)
Or he might just say, “Please believe me when I tell you I’m not comparing your body to theirs.” You know, there’s this couple’s dynamic that’s going unaddressed. So it becomes about how he can make her happy.
Keith Sutton, PsyD: (38:08)
Yes.
Diane Gleim, LMFT, CST, CST-S: (38:09)
Which is problematic. Yeah. Right. There needs to be space for him and, you know, and who he is too, not just people pleasing to her.
Keith Sutton, PsyD: (38:16)
Yeah. This reminds me of the EFT dynamic, specifically the pursuer-withdrawer cycle. Yes. Many times, the men are the withdrawers. Yes. They want to keep the peace and avoid distance, so they don’t speak up about what’s important to them or their feelings. Instead, they might just focus on keeping their partner happy, thinking, “Happy wife, happy life,” rather than having a conversation to reach a place where both feel fulfilled and have their needs met.
Diane Gleim, LMFT, CST, CST-S: (38:58)
Right. That whole ideology—"happy wife, happy life" or "happy house, happy spouse"—is problematic to me. When I hear that, I think about how much of himself he’s sacrificing.
Keith Sutton, PsyD: (39:14)
Mm-Hmm.
Diane Gleim, LMFT, CST, CST-S: (39:15)
Right. In order to people please.
Keith Sutton, PsyD: (39:17)
Yeah.
Diane Gleim, LMFT, CST, CST-S: (39:18)
And, and what are the long-term consequences of that?
Keith Sutton, PsyD: (39:20)
Mm-Hmm.
Diane Gleim, LMFT, CST, CST-S: (39:21)
Yeah.
Keith Sutton, PsyD: (39:22)
Well, and I imagine it’s also a different perspective for each person. The wife might think, “If I were in that situation, I’d be attracted to the person physically,” or whatever it might be. Whereas, for some men, it’s more anonymous or something else.
Diane Gleim, LMFT, CST, CST-S: (39:39)
Sure. Right.
Keith Sutton, PsyD: (39:41)
Actually, one of the big challenges with pornography is the conflict between basic sexual impulses and interests, which can be exciting, and the objectification involved. Particularly in this case, where there are also women who watch pornography, but the majority of the content involves seeing women as sex objects. So, it's about reconciling the respect and value we hold for women—partners, mothers, sisters—with the enjoyment of watching sex and viewing pornography and how to reconcile those at the same time.
Diane Gleim, LMFT, CST, CST-S: (40:34)
Yeah. So my response to that is, particularly with film-based pornography, as opposed to erotica or literature, when I watch a movie with, I don’t know, Brad Pitt in it, I might know a few things about his personal life, unfortunately.
Keith Sutton, PsyD: (41:05)
Sure, sure.
Diane Gleim, LMFT, CST, CST-S: (41:05)
But I also recognize he's acting. Knowing a few things about his personal life, I understand he’s acting on screen. When we watch porn, the average viewer doesn’t know anything about the performers or their personal lives, and that’s intentional. It makes the imagery more believable. We’re not distracted by what we might know about their personal lives. Objectification has a negative connotation these days. But there is such a thing as healthy objectification, and it does exist. We understand that porn performers are doing what they do on camera for their own reasons. I don’t need to be curious about their deepest hopes and dreams. They’re presumably consenting to what they’re doing. We don’t know who they are, and they’re okay with that.
Diane Gleim, LMFT, CST, CST-S: (42:31)
And keep in mind that, you know, not just women are objectified in porn, men are too
Keith Sutton, PsyD: (42:36)
Sure. And I guess as we're talking about this, it makes me think that women have often been more the victims of objectification when it's not in the context of wanting that objectification from a respectful partner. So, that’s often a big aspect of it. It’s almost fueling some men's idea that this is how you can treat or see women without considering the relationship. I know some couples where the wives love to be objectified by their husbands if there’s a mutual respect and supportive relationship.
Diane Gleim, LMFT, CST, CST-S: (43:31)
Well, and I think you're addressing something about like, uh, we can, like objectification has an on/off switch, right. We can turn it on and we can turn it off.
Keith Sutton, PsyD: (43:40)
Yeah.
Diane Gleim, LMFT, CST, CST-S: (43:41)
Right. And, you know, and you know, for couples like the ones you were describing, um, they turn it on at certain points, but then they also turn it off.
Keith Sutton, PsyD: (43:51)
Yes.
Diane Gleim, LMFT, CST, CST-S: (43:51)
Right. I'm not completely dismissing my partner's personhood and humanity, you know for entirety. You know, it's for this specific period of time, I'm gonna focus on this or that.
Keith Sutton, PsyD: (44:08)
Yeah. It’s about having the flexibility to move in and out of that space, within alignment with a partner—like a dance.
Diane Gleim, LMFT, CST, CST-S: (44:15)
Yes.
Keith Sutton, PsyD: (44:16)
In tune and synced together. Right. And I think we had a conversation about a client I was working with, where this dynamic comes up in a number of couples. Sometimes, I work with one person with trauma who pairs with someone very even-keeled—stable and dependable. But later on, it can feel boring. They often wish for more emotional engagement or intensity in their sex life. They wish the partner weren’t so passive, although this passivity was initially attractive. It’s a double-edged sword: the stability and easygoing nature that attracted them can sometimes translate into a less dynamic sex life.
Keith Sutton, PsyD: (45:14)
In one couple I was working with, she wanted him to take charge more and be more assertive sexually. However, this was difficult for him. He was a very nice, meek, and passive guy, so it was outside his comfort zone. He also had a conflict about objectifying his wife or acting in ways he associated with "bad guys." We discussed this conflict and the juxtaposition involved.
Diane Gleim, LMFT, CST, CST-S: (45:54)
I remember that consultation, Keith. The Me Too movement emerged in the fall of 2017, and soon after, I noticed a fascinating phenomenon in my practice. I started receiving many calls from individual men who wanted to process past sexual encounters, whether from 23 years ago or two years ago. They were anxious about whether their behavior had been appropriate or inappropriate. There was real anxiety among men about their sexual behavior. Mm-Hmm. There’s an idea called perpetrator fear, which many men, particularly heterosexual men, have. This fear of being perceived or accused became much more pronounced after Me Too.
Diane Gleim, LMFT, CST, CST-S: (47:09)
Yeah. In the case of the Me Too movement, perceived or accused of being a sexual perpetrator. And, I don't wanna, like you said, I don't wanna be a bad guy. I don't wanna be that kind of guy. Yeah, yeah. And that's where things like consent, learning consent, all the nuances of consent can happen. That's where focusing more on relational sex, which I define as a back and forth, dynamic happening between partners where there's this sort of checking in ongoing, it's not like, do you wanna have sex? You know, yes or no? And then it's, consent is done for the remainder of the encounter. No, it's, um, do you, you know, how about, can I touch you here? Yeah. Can you touch me there? Can we do this next? Right. That there's this back and forth negotiation that is based in the relationship, not just in what I want or what I think I need.
Keith Sutton, PsyD: (48:22)
Yeah. Well, this is a good point that I went to a workshop with Dossie Houston on cultural competency with BDSM couples.
Diane Gleim, LMFT, CST, CST-S: (48:31)
Yeah.
Keith Sutton, PsyD: (48:32)
She talked about, which I thought was really well put, that in a domination, sadomasochistic relationship, when there's a dominant and a submissive, the dominant can only really be dominant if they can trust that the submissive will tell them if something does not feel right. If they can actually trust that the other person is going to say something doesn't feel good or is uncomfortable, then they can be even more dominant or aggressive or whatever it might be in the sexual relationship because ultimately the submissive has the power.
Diane Gleim, LMFT, CST, CST-S: (49:14)
And it's predicated on the submissive knowing themselves, number one, knowing their limits. Number two, feeling comfortable enough and having the skills to communicate
Keith Sutton, PsyD: (49:24)
Exactly. I think back to that aspect of the safety, feeling safe to say, Ugh, this didn't feel or you know, doesn't matter. I'm in the mood for that right now. Or something. In those ways. And that really oftentimes
Diane Gleim, LMFT, CST, CST-S: (49:38)
Right. People often confuse consent as like this carte blanche Green light.
Keith Sutton, PsyD: (49:49)
This is kinda what we're doing tonight versus like, is going all,
Diane Gleim, LMFT, CST, CST-S: (49:53)
What, what are we, what am I consenting to? Yeah. A step one, step two steps, three, you know.
Keith Sutton, PsyD: (50:01)
And as couples get to know each other better and better, that, you know, it is a bit awkward, like learning to dance and stepping on each other's toes. Oh, you're going that way. I'm going this way. Yeah. You know, not just kind of in the mechanics of sex, but also kind of what they're wanting and how they're wanting to encounter.
Diane Gleim, LMFT, CST, CST-S: (50:18)
Couples often develop what we call a sexual script, where each couple has a sequence they follow during sex: first they do A, then B, then C, then D. That's their definition of sex. When a partner consents to sex, it's often assumed to be this A, B, C, D sequence. But what if one partner wants just A and nothing else, or B and nothing else, or A and B? Couples make many assumptions about sex. In sex therapy, we try to slow that process down and clarify what's happening, why, and what each person wants. Just because someone wants something tonight doesn't mean they will want it again tomorrow. They might want something different. We also talk about the internalized image of our partner, which is based on assumptions and conclusions. We stop being curious about who they really are.
Keith Sutton, PsyD: (51:44)
Yeah. Rather than taking a moment to understand why someone likes something, it's important to explore what they like about it. This applies to sex and pornography as well. Understanding what kind of pornography a person is watching and what they like about it is crucial. People in pornography often play roles, and there’s no backstory provided. Even in erotica, there might be roles like the submissive person or someone who is just available for sex without complications, such as whether they got enough sleep. Sometimes, this is a fantasy of simplicity. Understanding what excites couples about what they’re watching helps because they don’t need to act out every fantasy, like group sex, if one person isn’t interested. It’s about understanding what is exciting to them.
Keith Sutton, PsyD: (52:44)
What’s important is being able to talk and bring some of those things into the relationship, whether it’s from the novels people are reading or other sources.
Diane Gleim, LMFT, CST, CST-S: (52:54)
One question I like to ask my clients, especially when they reveal that they view porn, is: Who do you identify with in the porn you're watching? They often respond with a bit of confusion, and I explain that I’m asking if they identify with the doer or if they are more of an observer.
Keith Sutton, PsyD: (53:23)
Yeah.
Diane Gleim, LMFT, CST, CST-S: (53:25)
And the answers are fascinating.
Keith Sutton, PsyD: (53:28)
Yeah.
Diane Gleim, LMFT, CST, CST-S: (53:29)
And I, and then I followed up with, well, why do you think that is? Why do you think that you are identifying with, with whatever role you are
Keith Sutton, PsyD: (53:36)
The receiver of the get? Yeah, yeah. Well, I think it's also important to ask what they like about it. For example, I had one couple where the wife was curious about what it was like for her husband. He mentioned that he enjoyed seeing the women enjoying themselves and acting like they were enjoying it. She was surprised because she assumed he would be imagining himself as the man in the porn, similar to how she imagines herself as the woman when she watches.
Diane Gleim, LMFT, CST, CST-S: (54:04)
Right. Great point. Yeah.
Keith Sutton, PsyD: (54:06)
That’s happening to her. So again, very different perspectives on that. Yes. This is such a huge topic, and we could go on and on, but we’re out of time. Thank you so much. This is so important, and I really encourage therapists to dig deeper into this area of sex therapy. Many couples therapists don’t have this extra kind of training, which leaves out a crucial piece. What you’re doing around pornography is really great, and things are changing with each generation. Couples in their twenties have very different feelings about pornography compared to couples in their fifties or sixties.
Diane Gleim, LMFT, CST, CST-S: (54:50)
Completely. Well, thanks Keith. This was fun.
Keith Sutton, PsyD: (54:53)
Yeah. Appreciate it. Okay, great. Thanks a lot. Take care.
Diane Gleim, LMFT, CST, CST-S: (54:58)
Yeah, thanks.
Keith Sutton, PsyD: (54:59)
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