Therapy Resource Guide
Therapy is amazing. I’m a big fan and proponent of therapy. True, there are a lot of bad therapists out there, and a lot of others that are good in general but just not a good fit for you in particular. But please don’t let that stop you from seeking the support you need. Most of us will need some professional support at some point in our lives, and that’s totally OK.
Below is a list of different types of therapy, along with links to some places to begin looking for each type of therapist. While this course centers on CNM, many different types of issues can arise on your journey in this course. Attachment difficulties, relationship conflict, childhood traumas, sexual dysfunction, behavioral issues and more can all come up. We offer multiple modalities so that you can choose the best type of therapy for your unique issues.
If you’re going in to work on more general personality and mental health issues, you don’t need a CNM-experienced or sex therapist necessarily. However, you do want someone who is sex-positive and CNM-friendly and won’t judge you for it. Some will specifically advertise this on their websites; though there are sex-positive therapists who don’t advertise as such.
That said, many of the general therapeutical approaches are pretty conservative in their views on sex. They often treat casual sex, nonmonogamy (consensual or nonconsensual), sex work, pornography, kink/fetishes, high levels of sexual desire or behavior, and other less common expressions of human sexuality as unhealthy or problematic. Even some sex therapists are actually quite sex-negative when it comes to anything but vanilla sex with one partner in a long-term relationships – this is especially true of therapists who specialize in “sex addiction.” Working with someone like this can cause more harm than good – it’s the CNM equivalent of “gay conversion” therapy.
Please do your research on the person you’ll be working with before you do it. See the section below on “Finding a CNM-Friendly Therapist” for more advice.
- Cognitive Behavioral Therapy (CBT). CBT is a type of psychotherapy that helps people learn to identify and change destructive or disturbing thought patterns that have a negative influence on behavior and emotions, and create new ways of thinking and processing information that are more effective. CBT has been demonstrated to be effective for a range of problems including depression, anxiety disorders, alcohol and drug use problems, relationship problems, and eating disorders. However, it often tends to be short-term and symptom-oriented (rather than in-depth and cause-oriented.)
- Dialectical Behavioral Therapy (DBT). DBT is a type of cognitive-behavioral therapy. DBT is specifically focused on teaching people how to develop healthy ways to cope with stress, regulate their emotions, live in the moment, and improve their relationships with others. In other words, DBT is kind of the perfect type of therapy for someone looking to improve their emotional regulation. One important caveat about DBT (similar to many other therapy approaches) is that they often have a sex-negative approach when it comes to CNM relationships or casual sex, so take those aspects with a grain of salt.
- Emotionally Focused Therapy (EFT). EFT is a therapeutic approach that’s deeply rooted in adult attachment theory, and the belief that emotion and emotional regulation are the key factors underlying many if not most mental health and relationship issues. This is a great option for people looking to work on their attachment anxiety or avoidance, and also for couples struggling with relationship problems.
- Psychoanalysis and psychodynamic therapies. These approaches focus on changing problematic behaviors, feelings, and thoughts by discovering their unconscious meanings and motivations. Psychodynamically oriented therapies are characterized by a close working partnership between therapist and patient over long periods of time. Patients learn about themselves by exploring their interactions in the therapeutic relationship. While psychoanalysis is closely identified with Sigmund Freud, it has been extended and modified since his early formulations.
- Humanistic therapy. This approach emphasizes people’s capacity to make rational choices and develop to their maximum potential. Concern and respect for others are also important themes. Humanistic philosophers like Jean-Paul Sartre, Martin Buber and Soren Kierkegaard influenced this type of therapy. Three types of humanistic therapy are especially influential.
- Client-centered therapy. This type of therapy rejects the idea of therapists as authorities on their clients’ inner experiences. Instead, therapists help clients change by emphasizing their concern, care and interest.
- Gestalt therapy. This type of therapy emphasizes what it calls “organismic holism,” the importance of being aware of the here and now and accepting responsibility for yourself.
- Existential therapy. This type of therapy focuses on free will, self-determination and the search for meaning.
- Trauma therapy. In order for someone to qualify as a trauma therapist, they need to have specific training in helping clients with trauma, in addition to being a licensed therapist, and also have substantial experience in this realm. If you have gone through serious trauma, finding someone who is qualified is of the utmost importance.
- Somatic therapies. These types of therapy tend to focus on the body as an integral aspect of both holding onto and releasing emotions and trauma. Thus, they offer body- and emotion-based techniques to help the client become aware of and process issues. While there is not as much academic research on them and I don’t have personal experience with any of them, many people (including several of my close friends) swear by them and they are increasing in popularity. They can be done individually or as an add-on to traditional therapeutic approaches. Some therapists also have traditional training in addition to somatic education, which can be the best of both worlds. Here are a few of the most well-known ones:
- Peter Levine
- Holotropic Breathwork
- Besel VanDerKolk
- Polyvagal Theory https://www.amazon.com/Polyvagal-Theory-Therapy-Interpersonal-Neurobiology/dp/0393712370
- Psychedelic therapies. Although both classical psychedelics (LSD, mushrooms, DMT, ayahuasca) and MDMA (“ecstasy”) remain illegal for recreational use in most of the country, they’re slowly becoming legalized for use in psychotherapy (and in some places also decriminalized for recreational use). Growing academic research shows that they are highly effective in treating depression, anxiety, addiction, PTSD, and eating disorders (in fact, significantly more effective than traditional psychotherapy and pharmacotherapy). They also have this powerful ability to increase empathy and compassion, and foster a sense of connection with others, which can do wonders for communication skills and enthusiasm. Please keep in mind that these are powerful substances that have known negative interactions with certain medications or genetic predispositions, so please do not go down this path on your own or without professional supervision. If this is of interest, I’d suggest starting by reading the following:
- How to Change Your Mind by Michael Pollan
- Acid Test by Tom Shroder. Read this if you want to understand why MDMA therapy is important, and the history of MAPS (the Multidisciplinary Association for Psychedelic Research).
- Trust Surrender Receive: How MDMA Can Release Us From Trauma and PTSD by Anne Other. Read this if you want to understand how many of our challenges, like anxiety, relationship issues, anger, addiction, are related to trauma, and the benefits of MDMA therapy.
- Ecstasy: The Complete Guide by Julie Holland, MD. Read this if you want to get a good overview of MDMA edited by a practicing psychiatrist.
If you’d like to work with these “medicines”, look for a certified therapist through the MAPS institute who’s trained to administer these substances in a therapeutic setting. https://maps.org/research
- Integrative or Holistic Therapy. Many therapists don’t tie themselves to any one approach. Instead, they blend elements from different approaches and tailor their treatment according to each client’s needs. Here are a few:
- Sex therapy. Sex therapists have specific training in human sexuality in addition to being licensed therapists. They can work with your practical concerns as well as doing in-depth work to understand the roots of your issues, where necessary.
- American Association of Sexuality Educators, Counselors, and Therapists
- Sex surrogacy. Sexual surrogates work with the person on a physical, hands-on level to resolve sexual issues and build sexual skills. This is only legal in a couple of states in the US, so please look into the legal issues if looking to hire one.
- Sexological bodyworkers. Sexological bodyworkers also work on a hands-on level with clients, helping them resolve sexual issues and improve sexual functioning.
- Shameless, by Pamela Madsen, is a first person account of how transformative relationships with sexological bodyworkers can be.
Coaching is a somewhat ambiguous umbrella term for a lot of different modalities of working with clients to optimize or improve your life and relationship quality. Unlike therapists, coaches are not licenced by the American Psychological Association and they are not trained at accredited schools, so it’s very difficult to assess the expertise of a coach. It’s important to know that while therapists are trained extensively in how to do in-depth work with trauma and developmental issues, coaches are generally not. So if you’re generally doing OK and would like to optimize some aspects of your life, feel free to try coaching. If you’re facing more serious issues, I highly recommend a qualified therapist. What’s the difference between a therapist and a life coach?
Here are some types of coaching you might look for:
- Life Coaching. Life coaching encompasses a huge variety of different modalities and skills, but generally involves the coach being an active participant in guiding the client towards a more ideal life. They often take a much stronger approach than therapists in helping clients develop specific habits, forming strategies, and achieving goals.
- Sex coaching. Sex coaching or counseling generally involves addressing current concerns though education, skill acquisition, and practical suggestions. It can also involve learning specific sexual skills or optimizing an already healthy sex life.
- CNM-related coaching. These are coaches who specialize in helping you work through issues or navigate challenges specifically related to consensual non-monogamy. This can involve helping you make choices about the format of your relationship, navigating emotions that arise, or developing communication skills between nonmonogamous partners. There are a number of such coaches around the country, I suggest googling some of them and see which one you connect with most.
Below are a few resources for finding therapists, counselors, and other mental health professionals who are specifically knowledgeable and open-minded when it comes to sex, kink, CNM and other nonnormative expressions of sexuality and relationships.
- The Open List http://openingup.net/open-list/
- Poly-Friendly Professionals http://polyfriendly.org/index.php
- Manhattan Alternative https://www.manhattanalternative.com/
- Kink Aware Professionals – The Kink And Poly Aware Professionals Directory (KAP) is a service offered by the National Coalition for Sexual Freedom dedicated to providing the community with a listing of psychotherapeutic, medical, legal and other professionals who have stated that they are knowledgeable about and sensitive to diverse expressions of sexuality – https://www.kapprofessionals.org/
Of course, just because someone identifies as sex-positive on a directory, doesn’t mean they actually are. Or that they would make a good fit for you in general. Fit with your therapist is key. The way to figure this out is to trust yourself, and whether you feel connected, at ease, or trusting with this person.
Finding a CNM-Friendly Therapist
(or Health-Care Providers More Generally)
Coming out to a new therapist about your journey with CNM can be awkward and anxiety-provoking, but I think it’s really important, so that you can get competent care from a respectful and open-minded person. Whether or not you and your partners are struggling with something related to your CNM dynamic, relationship and sexuality factors always play a role in our mental health and functioning, and you need to be able to discuss these issues openly and honestly with your therapist. Most mental health providers — including marriage and family therapists — receive very little training in sexuality specifically, and even many sex therapists receive little training in alternative sexualities. And many are prejudiced against nonmonogamy, something that surprised me when I first started educating sex and relationship therapists on the topic. In one study of poly people who’ve been in counseling or therapy, 40% said they had not revealed their polyamory to their providers, and 10% of those who did reveal it experienced a negative response (Weber, 2002). It’s really important to find health care providers who are CNM-competent and nonjudgmental. CNM-friendliness is less important for your physical care providers, but it still makes a difference, especially around sexual and reproductive health issues.
Here’s some tips and tricks for how to come out to your therapist/health care provider:
- Treat the first appointment with a potential mental health provider as a job interview, because it literally is. You should like your therapist, feel respected by them, feel respect for them, and feel like they have the appropriate knowledge and expertise to deal with your issues and lifestyle. We often don’t think we’re allowed to question mental health care providers (they’re the ones questioning us, right?) but we’re absolutely allowed. Some questions you might want to ask:
- What do you know about polyamory/open relationships? What are your thoughts on it?
- Do you believe someone can be both promiscuous/poly and healthy?
- Do you have experience working with CNM, promiscuous, or queer clients? Do you feel competent addressing issues specific to those lifestyles?
- If they judge you, find someone else. Most people have options for a therapist, so exercise that choice. You might also want to find someone else if they don’t judge you, but they’re simply not very knowledgeable about your lifestyle; you won’t get optimal care that way. I’ve always made sure I’ve had poly- and promiscuity-friendly providers from the get-go. If you really like that particular provider for other reasons, or if you don’t have other options, you can decide to educate them and give them some resources. The National Coalition for Sexual Freedom is a good place to start. https://ncsfreedom.org/
- Volunteer the info about your CNM. Most providers will almost certainly not ask about it directly. Most operate on the assumption that people are monogamous. Especially if you’re married or in a long-term relationship, they will almost certainly assume you’re monogamous and not ask any further questions about it. Often during intake interviews, they’ll ask if you’re in a relationship or married. This is a good opportunity to volunteer the info that you’re CNM, and briefly explain what that relationship structure entails.
- When coming out to anyone, your tone matters. Own your nonmonogamy and present it as normal, don’t act ashamed or guilty about it. The more you approach the issue as unproblematic, the more others will too.
- Trust your gut. There have been several times in my life when, based on my first experience with a health care provider, I’ve said, “I don’t think we’re a good fit. Thank you for your time, but I won’t be coming back.” If you don’t feel comfortable, don’t second guess yourself or try to make it work. Find someone with whom you feel at ease and like they get you.