Transforming Sexual Narratives A Relational Approach to Sex Therapy

Introduction Part 1: The Foundations of Narrative Relational Sex Therapy (NRST) 1. Sex is Possible without Desire 2. Expanding the Healthy Sex Narrative 3. The Sexual History: Identifying Conscious and Unconscious Narratives 4. Deconstructing Sex with the Sexual Menu 5. Moving from Mind to Body: A Narrative Approach to Mindful Touch Part 2: Applying NRST to Challenging Sexual Issues 6. Embracing The Complexity of Sexuality 7. When Three or More is Not a Crowd: Non-monogamy and Polyamory 8. We’re All a Little Bit Kinky 9. George and Martha Try to Have Sex: Listening to Emotional Sadism 10. Sexual Resilience: Maintaining an Erotic Connection to Self and Other(s) References

Biography

Suzanne Iasenza is a psychologist and sex therapist based in New York City. She is a faculty member at the Institute for Contemporary Psychotherapy and Psychoanalysis, the Ackerman Institute for the Family, and the Adelphi University Post-Graduate Program in Psychoanalysis.

"This is simply a wonderfully written book that acknowledges the unruly multidimensionality of sex and offers a rich, deep understanding of sexual issues and the stories that shape our sex lives; a clear way forward to eroticism that is about pleasure, not just performance; and intimate connection rather than recipes for endless novelty. Note this as essential reading for every sex therapist and couple counsellor!" — Sue Johnson, author of Hold Me Tight: Seven Conversations for a Lifetime of Love, Canada

"Suzanne Iasenza has written a unique and challenging book which should be on every clinician’s shelf, especially those working with non-traditional individuals and couples. Her relational approach to sex therapy, focused on transforming sexual narratives, is a comprehensive approach combining psychodynamic, couple, and queer perspectives. The emphasis on willingness as the key to desire, creating a sexual menu, mindfulness narrative touch, kink, and sexual resilience provides an empathic, respectful perspective on individual and couple sex therapy. Particularly important is confronting simplistic understandings and the pathologizing of sexual variations. Dr. Iasenza confronts secrecy and shame as she encourages clients to make meaning of the complex themes from childhood and create a meaningful narrative about themselves, and their relational and sexual lives. Sexuality enhances mastery and satisfaction." — Barry McCarthy, Professor of Psychology, American University, USA

"On the topic of sex therapy, there is no one I trust more than Dr. Suzanne Iasenza. She is at home with patients who are lesbian, gay, queer, straight, non-binary, cisgender and trans. Wherever someone lands in what we might call the sexual diaspora, Iasenza is able to meet them with a capacious clinical wisdom. Relying on notions from narrative therapy, family systems, and psychoanalysis, she offers case examples that help couples and therapists move past outdated, normative goals　to a model focused on willingness and pleasure. This is no less than a step towards the cultural redefinition of Eros." — Deborah Anna Luepnitz, PhD, Psychoanalyst and author of Schopenhauer's Porcupines, USA

"Never before has the realm of the practice of sex therapy been explored in such depth, breadth and sensitivity. Suzanne Iasenza demonstrates the wide range of therapeutic interventions that can be called up in the process of healing and integration. She provides the reader with a lucid conceptual base and a detailed account of practical ways of doing sex therapy using her innovative model. She helps us rethink what is healthy sex, doing so with exquisite sensitivity to the cultural and socio-political issues that impact us all. This is essential reading for every couple therapist." — Lois Braverman, MSW, President Emeritus, Ackerman Institute for the Family, USA

"With Transforming Sexual Narratives, Suzanne Iasenza has written an instant classic - a book that should be read by every clinician, not just those who consider themselves sex therapists. Weaving together the most current psychoanalytic theories, family systems theory, and a genuine understanding of the intersubjective nature of human experience, she builds a compelling narrative that builds to her own, very unique Relational Theory of Sex Therapy. Finally, we have an answer to that often-asked question "what is it that sex therapists actually do?" Iasenza not only tells us, but tells us how to do it effectively. The book is devoid of jargon, written with empathy and a directness accessible to all, and filled with meaningful clinical examples that bring her concepts alive. Debunking prevalent sexual myths like sex with strangers always lacks intimacy, Iasenza critiques the ubiquitous Desire-Arousal-Orgasm Model of sexual experience, that imposes a rigid linear scheme on what’s actually a complex multidimensional process. Most clients, she asserts, unknowingly internalize this model as the only model of "healthy" sexuality. The party line, she suggests, kills the party, and she offers a new model that includes each individual’s lived experience. I cannot recommend Transforming Sexual Narratives more highly. It will change how we all work." — Sandra Kiersky, PhD, Co-Editor Sexualities lost and Found. International Universities Press or Institute for the Psychoanalytic Study of Subjectivity, USA

"Suzanne Iasenza is a master clinician, an inspiring teacher, and an excellent writer. In Transforming Sexual Narratives, she builds upon earlier theoretical and clinical approaches to develop a comprehensive, practical, and effective methodology for achieving transformation. Iasenza offers a framework for Narrative Relational Therapy and a guide to practice with practical examples to share her professional experience with individuals and couples. She shows how to do work that gets to root of the problem and enables therapists and clients to examine the long-hidden core aspects of individual experience and the sexual persona. Her approach embraces the full complexity of a person and recognizes the depth of sexuality developed over a lifetime. She demonstrates how to clear obstacles and break patterns. This book provides therapists and patients with a clear vision that the change they seek is perfectly possible by stressing difference between desire and willingness, between history and fate, between limiting beliefs and real possibilities. Transforming Sexual Narratives is a genuinely helpful book that will transform clinical practice with people of all genders and sexual orientations, solo and partnered. It challenges assumptions, increases clinical competence, elevates our approach to human sexuality, and can truly transform clinical practice. As a sex therapist who works with individuals and couples I am energized and eager to get to work with these transformational tools." — Katherine Rachlin, PhD, Clinical Psychologist, AASECT diplomate of sex therapy, USA

"Suzanne Iasenza's Transforming Sexual Narratives beautifully details an approach to sexual difficulty that has both far-reaching breadth and stunning depth. She creatively combines elements from a range of important contributors from behavioral therapy, psychodynamic approaches, sexology and mindfulness, to name a few. She applies the resulting tools to today's broad variety of sexualities -- to partnered and unpartnered sex, to gay and straight sex, and polyamory and single sex in order to enable the clinician reader to develop an informed, flexible and tensile capacity to face the many issues that are the staple of modern work with sexual difficulty. Iasenza's widely informed and integrated approach will enhance the work of clinicians of all stripes who dedicate themselves to working with sex and relationships." — David Scharff, MD, is Co-Founder and Former Director, the International Psychotherapy Institute; Former President, The American Association of Sex Educators, Counselors and Therapists; and Chair of the International Psychoanalytic Association's Committee on Couple and Family Psychoanalysis, USA

"Sex therapy has evolved since the pioneering work of William Masters and Virginia Johnson. Their research was heavily focused on the physiological process that occurred in the body during intercourse and at the point of orgasm. But as someone once said, sex is not what you have between your legs but what you have between your ears. How do our thoughts, the narratives we tell ourselves and others, promote or interfere with healthy sexual functioning? Given the state of sexuality education in the United States, it is not surprising that many people believe that they are the only ones who feel or think the way they do. In Transforming Sexual Narratives: A Relational Approach to Sex Therapy, Dr. Iasenza demonstrates through the use of case histories, how a client’s mistaken sexual narratives can be transformed ‘to reclaim intimacy and satisfaction in their erotic lives.’ Dr. Iasenza’s approach to sex therapy offers a valuable guide for any psychotherapist who has clients with sexual problems." — Herb Samuels, PhD, Past President Society for the Scientific Study of Sexuality, USA

"Suzanne Iasenza’s new book, Transforming Sexual Narratives: A Relational Approach to Sex Therapy, builds upon her extraordinary body of previous clinically informed work on sexually conflicted, low desire, and otherwise struggling varieties of couples that are seeking an appropriate holding environment for sorting out and improving their intimate relationships. Her relational approach (NRST) embodies the best of scientific contributions from sexology, and sexual disorders literature and practice, but her contemporary psychoanalytic, clinical-technical wisdom captures the essential narratives of lived couple experience, past and present. What is truly transformative in these pages, for the beginning and experienced couple’s therapist, is how her chapters weave the sexual and interpersonal histories of each partnership into a therapeutic potential; opening a space for new emotional experience that both informs and improves empathic understanding, for couple use, enriching their relational mosaic. While readers of this book can learn about skills when working with sexual difficulties of couples, the strength of her work is in its humble translation of the internal and external worlds of her treatment couples. Dr. Iasenza embraces and expects a psychological-emotional exposure to occur and utilizes transferences and countertransference to cull the necessary underbelly of neglected, traumatized, and repressive elements so interpretive and technical measures can be applied. This book adds a necessary component of relationally sound clinical material for use in working with troubled couples presenting disorders of desire, and other symptoms of disappointment and dissatisfying interpersonal relations. I recommend it without hesitation. In fact, I recommend reading it twice." — Carl Bagnini, LCSW, BCD, Senior and Founding Faculty, The International Psychotherapy Institute, and faculty, The Adelphi Derner Institute Post-graduate and Doctoral Programs in Psychoanalysis and Couple Therapy, USA. Author of Keeping Couples in Treatment: Working from Surface to Depth