Intensive Outpatient Program


The Counseling Center for Sexual Health is pleased to introduce our Intensive Outpatient Program (IOP) for adult males struggling with sexually related issues. This program provides ten hours of therapy a week for each client; including both individual and group therapy. Group sessions will be offered Tuesday and Thursday from 6-9pm, and Saturday from 9-12pm. Individual therapy will be scheduled per client.

There are many benefits for participating in an IOP. Perhaps the largest benefit is the continued support and treatment while individuals integrate life events (work, school, socialization) into a sober lifestyle.

CCSH professionals are sex therapists certified through the American Association of Sexuality Educators, Counselors and Therapists (AASECT) trained and skilled in ways to assist people in gaining a deeper understanding of their own sexuality and how it affects their lives in relationships.

If you believe you or someone you know would benefit from our Intensive Outpatient Program or Psychological services, please call the Counseling Center for Sexual Health intake department (805)308-9800 Ext. 3.

-Darilyn Shano, M.S., MFTI

Ashley Madison Scandal

ashley madison pic

First ask yourself, “What is Ashley Madison?” If you can confidently answer the question with anything but, “I do not know,” then you may have been affected by this site.

Ashley Madison is the second largest online dating website, second only to, with the slogan, “Life is Short. Have an Affair.” Recently a hacker group called, “The Impact Team,” threatened to release the “confidential” information for dating websites: Ashley Madison, Cougar Life, and Established Men. The goal behind the threat was to have these websites permanently shut down because the “cheating dirtbags,” according to the Impact team, were not worthy of discretion or confidentiality.

“Cheating dirtbags,” does not exactly insinuate the Impact Team is composed of men; and coincidently Christian Mingle did not get hacked. Does this information shed some light on who orchestrated the attack? Maybe, maybe not.

The more important questions are: What lead up to the affair?; Is there a history of similar sexually acting out behavior?;  What happens to the relationship now?; How do you cope with the onslaught of emotions ranging from fear to shame?

Millions of relationships and families have been affected by this threat of exposure. You are not the only one and you do not need to deal with this alone.

If you have been affected by the recent events involving Ashley Madison and other sites, the Counseling Center for Sexual Health can help. We work with individuals, couples, and partners of individuals affected. Contact us today (805)308-9800.

-Darilyn Shano, M.S., MFTI

The Imperfections of Sex

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We all know that SEX sells and no one is perfect. Except that guy that just read this and said, “I’m perfect!” He may be right, but we have veered from the point. If no one is perfect and sex is everywhere, what happens when our imperfections and sex collide? …Trouble in paradise; which begs the next question, “Now what?” The options are vast and often break down into stages including, but not limited to: sheer panic, the blame game “it’s not me; it’s you,” abandonment, denial, grief, shame, anxiety, depression, etc. None of these emotions or stages sound appealing or paint a picture of health and it certainly is not what Hollywood is selling. Dang “fine print” can get you every time.

Wherever you may be in this cycle, the Counseling Center for Sexual Health is here to help. We treat a variety of sex related problems ranging from erectile dysfunction to addiction, infidelity, prostitution, compulsive masturbation, and online hookups.

It is a new day in the world of sex. The internet has made pornography more accessible than ever and having sex the easiest it has ever been to get. You do not even need to leave the comfort of your own home in order to have sex. But, even though we know that sex sells, there is another fun fact that “too much of a good thing is not a good thing.”

Suddenly a ritual has formed and before you know it, a routine ensues. For example, you come home from a stressful day at work. You need to unwind so you go through the paces of a hot meal or a couple drinks and some television. Next step, take a shower and get into some relaxed clothes. The computer sits at the desk, waiting for you to come join. The sound of the box fires up and the fan kicks in. A bright screen welcomes you to continue, invites you to begin the internet search. Your computer knows you so well, Google auto populates your search after a couple of letters entered. An abundance of images appear begging you to choose each one, but you skillfully and precisely select the perfect link for you and let the unwinding begin.

Night after night this continues, until it is no longer enough and the frequency increases. The location is no longer only the comfort of your own home, but it is the car, office and bathroom stall. The ritual has progressed, and not only has the frequency and location changed, but your physical health is changing as well with sores and chaffing from excessive friction.

This is no longer a coping mechanism for stress, but an impairment on your life. Masturbation is healthy, but history will repeatedly prove that too much of a good thing is not a good thing. The Counseling Center for Sexual Health can help you develop healthy coping strategies and remove the impairment. Call today and together we can work to build a healthier lifestyle.

-Darilyn Shano, M.S., MFTI

An Introduction: Partners of Sex & Love Addicts


We’ve touched upon sex and love addiction, discussing etiology, symptoms, and treatment.  We would now like to provide support for partners who are impacted by sex or love addiction.

Partners of sex addicts or any significant other who is close with the patient will also need support with the discovery of sex addiction. The discovery itself is traumatizing. The pain of betrayal can feel overwhelming . The relationship is exposed to sexually transmitted diseases, financial consequences, and social embarrassment.

Is is crucial to recovery for partners to be connected with support.  Partners can often feel isolated, use avoidance to cope, and engage in self-blame (Manning & Watson, 2007).

Do you think your boyfriend, girlfriend, husband, or wife may be a sex or love addict? Please visit our previous posts if your partner repeatedly lies about his or her sexual activity or online behavior.

Next week, we’ll discuss the Stages of Recovery for partners of sex & love addicts.

-Katie McGrath, M.S.

Treatment of Love Addiction


Last week we discussed the etiology of Love Addiction and how it involves brain neurotransmission processes similar to the effects of drug misuse. This week, we would like to discuss potential treatment option for love addiction.

Self-help books 

  • Gaining awareness and cognitive restructuring of love addiction-related disturbances.
  • Means of insight include learning to be aware of and discriminate between current love relationships and childhood love relationship inadequacies.
  • Discerning between passion, tenderness (caring), and commitment aspects of love may be essential to understanding the degree of health in one’s love relationships one may have.

Sex Love Addicts Anonymous (SLAA)

  • 12-Step group that most closely pertains to the romantic/emotional aspects, though other groups include Codependents of Sex Addicts (COSA), Sex Addicts Anonymous (SAA), and Sexaholics Anonymous.
  • In SLAA, members learn to surrender, one day at a time, their whole life strategy of, and their obsession with, the pursuit of romantic and sexual intrigue and emotional dependency; they learn to take care of their own needs before involvement with others; become willing to ask for help, be vulnerable, and learn to trust and accept others; work through the pain of low self-esteem and fears of abandonment and responsibility; and learn to feel comfortable in solitude.

Individual Therapy

  • Various individual-level therapy options might be considered. Motivational interviewing may help love addicts understand maladaptive functions of love objects. For example, one may learn through motivational interviewing techniques that their romantic relationships involve an ongoing pattern of issues surrounding trust and intimacy. One may then try to reduce the discrepant feelings by deciding to enter relationships more slowly.
  • Through therapy, one may learn that it may be most prudent to avoid all contact with the objects of the love addiction, particularly rejecting partners, and for one to become exposed to novel environments to facilitate new more healthy experiences.
  • The love addict should learn how to construct a self-support system through the use of guided healthy selftalk.This self-talk might guide one toward getting used to less intense, more constructive feelings toward self and others.
  • Self-management training should be considered to help one redirect one’s behavior. The therapist may establish short-term goals with a love addict that could include signing up for community courses (e.g., photography), participation in meditation or exercise, and making same sex non-sexual, non-romantic friends.

Group therapy

  • Group therapy techniques (e.g., use of psychodrama) may help one decrease illusions toward romantic partners, and help one understand one’s feelings toward long-term significant others such as one’s nuclear family. One may also learn through group interaction how to better participate in healthy romantic relationships, which may be less exciting but more rewarding in the long run.

-Katie McGrath, M.S.

Relapse Prevention

Anticipating and Preventing Relapse

What Is Emotional Buildup?
Feelings that don’t seem to go away and just keep getting
stronger cause emotional buildup. Sometimes the feelings seem
unbearable. Some feelings that can build are boredom, anxiety,
sexual frustration, irritability, and depression.

Have you experienced a buildup of any of these emotions?

The important step is to take action as soon as you recognize the danger signs.

Which actions might help you prevent relapse?

Consider the actions below the may help prevent relapse:

Calling a counselor
Calling a friend
Taking a day off
Talking to your family
Going to a 12-Step or outside
mutual-help support meeting

-Katie McGrath, M.S.

Is Sex Addiction Real?


Is Sex Addiction Real?

We’ve all seen it on the news. “Celebrity cheats on wife: So and so is a sex addict.” But is sex addiction real?

In the mental health field, we use DSM (Diagnostic and Statistical Manual of Mental Disorders) criteria to categorize different disorders. Currently, there is no diagnosis for sex addiction. However, I have included a case study outlining how sex addiction can mirror alcohol abuse and dependence. Simply, replace “sex” with “alcohol” using the criteria listed at the bottom of the page and decide for yourself whether you think sex addiction should be a recognized disorder.

The Case of Caveh Zahedi
Caveh Zahedi shares his struggle with sex addiction in his courageous documentary, “I am a Sex Addict.” Watch it HERE: I am a Sex Addict

Caveh’s addiction began with a chance encounter with a prostitute in Paris. He was walking along a street and saw a beautiful prostitute scantily dressed, leaning up against a wall. Caveh noticed that she bore a striking resemblance to his wife which triggered an atavistic response. He asked the prostitute, “Will you suck me?” and then walked away. Caveh remembers he felt a “rush” and felt “free” speaking to the prostitute in such a manner. He went home and immediately masturbated.

In the beginning, Caveh’s strategy was to speak with various prostitutes and then go home and masturbate. His next strategy was to be honest with his wife, Caroline, about his prostitute fetish. However, she eventually became upset and so he turned to dishonesty. Each time Caveh developed a new strategy his plan escalated. In almost all addictions, an addict will slowly engage in a behavior but then need to increase and intensify their actions to achieve the desired effect.

So how is Caveh’s “sex addiction” similar to alcohol abuse and dependence?

Escalation to Achieve Desired Effect

A chance encounter with a prostitute turned into Caveh masturbating in every cathedral in Paris. Masturbating at home was no longer exciting enough and Caveh had to intensify the behavior and frequency to acquire the same “rush.” Caveh began to experience characteristic psychophysiological withdrawal symptoms such as feeling “euphoric” during and immediately after the sexual activity but then feeling empty and sad hours later.

Large Amounts of Time Devoted to the Addiction

Caveh spent a great deal of time planning and engaging in sexual behavior, much more so than was intended. Caveh was continually trying to “quit his prostitute fetish” and would exclaim “just one more time” but his efforts to cut back were never successful. Caveh spent less time with his significant others while feeding his sexual addition.

Despite the Consequences

Caveh continued having sex with prostitutes despite the knowledge of having a persistent or recurrent psychological problem that was likely to have been caused or exacerbated by the behavior. Caveh knew that he would feel depressed and empty after having sex with a prostitute but he could not stop himself.

DSM-IV Criteria
Alcohol Abuse

  • Recurrent use of alcohol resulting in a failure to fulfill major role obligations at work, school, or home (e.g., repeated absences or poor work performance related to alcohol use; alcohol-related absences, suspensions, or expulsions from school; neglect of children or household)
  • Recurrent alcohol use in situations in which it is physically hazardous (e.g., driving an automobile or operating a machine when impaired by alcohol use)
  • Recurrent alcohol-related legal problems (e.g., arrests for alcohol-related disorderly conduct)
  • Continued alcohol use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of alcohol (e.g., arguments with spouse about consequences of intoxication).

Alcohol Dependence
A maladaptive pattern of drinking, leading to clinically significant impairment or distress, as manifested by three or more of the following occurring at any time in the same 12-month period:

  • Need for markedly increased amounts of alcohol to achieve intoxication or desired effect; or markedly diminished effect with continued use of the same amount of alcohol
  • The characteristic withdrawal syndrome for alcohol; or drinking (or using a closely related substance) to relieve or avoid withdrawal symptoms
  • Drinking in larger amounts or over a longer period than intended.
  • Persistent desire or one or more unsuccessful efforts to cut down or control drinking
  • Important social, occupational, or recreational activities given up or reduced because of drinking
  • A great deal of time spent in activities necessary to obtain, to use, or to recover from the effects of drinking
  • Continued drinking despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to be caused or exacerbated by drinking.

-Katie McGrath, M.S.

© 2016 Counseling Center for Sexual Health. All Rights Reserved