Working with Sexuality: Bodies, Desires and Imagination

With Module Speakers:
Professor Brett KahrDr Ronald DoctorDany NobusChristiane SandersonDr Thaddeus BirchardJanice HillerProfessor Stephen PorgesDr Meg John BarkerDr Anton HartJoyce SlochowerCabby LaffyChris OakleyDr Andrea CelenzaDr Christopher ClulowDr Galit AtlasDr Jessica BenjaminDr Estela Welldon,

This package of resources provides 16 hours of CE on a range of contemporary clinical perspectives to help support practitioners in working more confidently with this vast and complex subject. It combines a rich archive of:

  • Video and audio lectures and presentations
  • Interviews and discussions





Professor Brett Kahr
psychoanalyzis, Sexual Fantasy and Childhood Trauma

Brett Kahr gives an overview of Freud’s pioneering theories of sexuality and its role in the development of the psyche. He gives fascinating details of his own extensive survey that gathered the sexual fantasies of 25,000 British and American people aged 18 to 94. As one of the few therapists trained to work with both individuals and couples Kahr also shares the unique perspective this has given him on the role of sexuality in the couple relationship.

Video interview with slides – 1 hr 10 mins

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Dr Ronald Doctor
The Role of Violence in Sexual Perversion

This presentation argues that perversion serves both a defensive and destructive function. The patient with a perverse psychopathology operates a paradox: he knows something and does not know it. These two attitudes are held simultaneously and yet are apparently reconciled, and an internal world is created in which reality is distorted and misrepresented. The perversion arises in an attempt to create this false reconciliation between contradictory ideas that can no longer be kept separate and it is when the perverse solution proves inadequate to contain the patient’s internal conflict that violence erupts. Ronald Doctor describes a male patient who uses cross-dressing as a perverse solution to his outbursts of uncontrollable violence.

Video lecture with slides – 33 mins

The Role of Violence in Sexual Perversion – Q and A

Video talk – 7 mins

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Dany Nobus
Psychoanalytic Perspectives on Perversion

In this witty talk, Professor Dany Nobus describes the origins and development of the concept of ‘perversion’ and details the many attempts psychoanalyzts have made to define perversion in a way that reflects the breadth and extent of human sexual practices. He concludes that whilst Freud was perhaps right in thinking that the infant’s psyche is polymorphously perverse, he may have been wrong to conclude that as adults we ever entirely outgrow this aspect of our sexuality.

Audio lecture with slides – 34 mins

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Christiane Sanderson
Healing the Impact of Childhood Sexual Abuse on Adult Desire and Capacity for Intimacy

Christiane Sanderson shares her perspective on how therapy can best support survivors of childhood sexual abuse as well as her extensive knowledge of how this kind of trauma can affect a person’s sexuality and capacity for intimacy.

Video Interview – 1 hr 23 mins

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Dr Thaddeus Birchard
Treating Sexual Compulsivity in Men

Dr Thaddeus Birchard gives an overview of his Cognitive behavior Therapy group work with male clients who experience sexual compulsivity, which can encompass a wide range of behavior including internet porn addiction and paraphilias. His discussion of ‘Charles’ also sheds light on the internal shame-ridden world of the sexually compulsive and suggests that repeated childhood wounding influences the sexual blueprint in adult male survivors.

Video Interview – 1 hr 12 mins

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Janice Hiller
The Neurobiology of Falling in Love and Intimate Relationships

Janice Hiller explains the male and female hormonal reactions that take place during the life cycle of a relationship. She describes how the three evolutionary phenomena of lust, attraction and attachment (that are often in conflict) trigger neurobiological reactions that give rise to the human behavior that poets and agony aunts have been writing about since the beginning of time. She also briefly outlines how competing male and female arousal systems and reproductive priorities affect the couple’s sexual and relational behavior over the course of meeting, mating and sometimes, moving on.

Video lecture with slides – 50 mins

The Neurobiology of Falling in Love and Intimate Relationships – Q and A

Video talk – 8 mins

Understanding Female Arousal

Janice Hiller explores the various biological and social factors that influence women’s experience of desire and how these affect their sexual behavior. She gives an overview of the main historical research and theories of female sexual desire and details some of the sexual problems women experience along with factors to consider when treating their psychosexual issues.

Video lecture with slides – 43 mins

Understanding Female Arousal – Q and A

Video talk – 15 mins

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Professor Stephen Porges
discussion on Polyvagal Theory and Sexuality

Neuroscientist Dr Stephen Porges discusses how trauma affects the body’s tolerance for intimacy with reference to his pioneering Polyvagal Theory. He gives a detailed yet accessible account of how overwhelming experiences cause the brain to automatically enact various embodied survival strategies like dissociation that make relating painful and difficult.

Audio interview – 42 mins

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Dr Meg John Barker
The Conditions of Consent

Queer writer Meg-John Barker explores what we can learn about this current sex/gender moment by turning our attention to gender, sexual, and relationship diversity (GSRD). What can queer, kinky, asexual, and polyamorous communities teach everyone about how to navigate sex – and wider relationships – with consent?

Video talk with slides – 30 mins

The Conditions of Consent – Q and A

Audio – 8 mins

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Dr Anton Hart
Attending to Sexuality in the Psychoanalytic Relationship

Anton Hart discusses the importance of therapists being open to and curious about their own and their clients’ sexuality. As infants our sense of mind and sexuality develops in relation to caregivers and, as adults, our sexuality and our attitudes towards it reflect much about our individual human experience. Issues of privacy, shame and otherness contend with desires for connectedness, union and fulfillment in ways that are unavoidably and revealingly re-enacted in relational psychoanalyzis. Hart believes therapists should strive to empathically inhabit all aspects of their patients’ desires, fantasies and behavior so as to expand aspects of their own identities and thereby their analytical capabilities.

Video interview – 1 hr

Good In Bed? Power and Ethics in psychoanalyzis and Life

In reflecting on the present moment, which involves revelations of high-profile rapists, sexual assailants, and those using their power to sexually coerce and exploit (including iconic figures Harvey Weinstein and Donald Trump), this article considers the relationship between the destructive and oppressive forces that underlie these abuses, and aspects of “ordinary” sexuality that people struggle to integrate in their relational lives. The author explores the ways that such ordinary sexuality, particularly under ubiquitous conditions of patriarchy, is likely to include aspects of objectification, coercion, and exploitation. Further considered is the psychical and relational fallout of the counteractions currently being mounted against such violations and abuses. Two brief case vignettes, one of a heterosexual man, the other of a heterosexual woman, are used as exemplars of the tolls that coercive abuses and their remedies may be taking on sexual relatedness.

Audio reading – 27 mins

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Joyce Slochower
A Conversation About Boundary Violations in Psychotherapy

Alice Waterfall, our Conference program Development Manager and an experienced couple therapist, interviews Dr Joyce Slochower. What constitutes sexual transgression with clients? Why does it happen? And what needs to be done to support therapists and protect their clients?

Video Interview – 27 mins

Don’t Tell Anyone – Ghosts That Haunt: Sexual Boundary Violations in Our Communities’

Sexual boundary violations-and their perpetrators-are ghosts that haunt us within (and of course outside) the psychoanalytic world. Reverberating well beyond the particular analytic dyad within which they occur, these violations invade nearly every professional community. Sexual boundary violations cast a long shadow over us; they generate horror, anxiety, curiosity, and sometimes excitement. Our need to deny what we know and to protect exalted mentors from scrutiny has led to a toxic collective silence; by and large, we have remained publicly mute while engaging in plenty of private gossip. Anxiety about the destructive consequences of “telling” further complicates our experience and can result in disavowal-a near total foreclosure of the reality of the breach along with our experience of it. In this paper, Joyce queries the dynamics driving our complex responses to sexual boundary violations and explore their collision with our professional ideal, using a personal experience to illustrate some of these issues.

Video talk to camera – 39 mins

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Cabby Laffy
A Live Supervision on How to work Sensitively and Effectively with a Client's Sexual Issues

Integrative Psychosexual Therapist Cabby Laffy supervises Nicole Scott with a focus on showing how therapists can best support themselves and clients and work more authentically courageously and responsibly with issues of sexuality and the process of erotic transference.

*Further Case Study Transcripts (see attached) – Through these transcripts Cabby Laffy shows her way of working psychosexually with clients through dramatizing three sessions with an imagined (but representative) couple who are experiencing distress in their sexual relationship.

Video Role-play – 55 mins

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Chris Oakley
Sexual Desire and Psychoanalytic Time

psychoanalyzt Chris Oakley argues that both analysts who deny any erotic feelings for clients and analysts who stress ethical behavior towards clients misunderstand the psychoanalytic method and the altered state generated by the analytic encounter. By its very nature, psychoanalyzis allows all feelings and thoughts, including sexual ones.

Drawing on the candor of analyst Harold Searles, Oakley suggests that sexuality is always present between analyst and client and that this generates the ‘alive’ quality that patients experience during the encounter. However, it is only the non-enactment of that sexual possibility that allows the client to become more fully alive to them-selves, which is the therapeutic goal. Sexual restraint on the part of the analyst is therefore not so much a ‘moral’ issue per se but more intrinsic to the basic method, aim and successful outcome of the analysis.

Audio lecture with slides – 45 mins

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Dr Andrea Celenza
Erotic Transference and Counter-transference

In this interview psychoanalyzt, Dr Andrea Celenza details the opportunities and challenges of working with an erotic transference and counter-transference. By thinking about and exploring patients’ erotic attachment, therapists can uncover the long-buried unconscious meaning of life-constricting neurosis, and in the process help liberate them into a full and rewarding relationship with self.

Video Interview – 54 mins

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Dr Christopher Clulow
The Challenge of Working Dyadically with the Couple State of Mind

Dr Christopher Clulow discusses the particular challenges and rewards of working with couples and gives an insight into how the therapist can foster intimacy by creating the space in which partners can hear themselves and each other non-judgmentally.

Video interview with slides – 32 mins

Sexual Fantasy, Unconscious Fantasy and the Dynamics of Attachment

This talk explores sexual fantasy as an articulation of unconscious phantasy in couple relationships. Drawing on patterns of attachment and attending to “pretend” and “psychic equivalence” states of mind, it considers the potential of partners to combine in enacting shared unconscious phantasy through fantasy-driven sexual encounters. Observations about different forms of narcissistic object relating are made in this context, as are some implications for couple therapists.

The full version of this talk was published in the journal Couple and Family psychoanalyzis under the title ‘Sexual fantasy, unconscious phantasy, and the dynamics of attachment’. 2019: 9(1) pp 1-14.

Video talk to camera – 58 mins

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Dr Galit Atlas And Dr Jessica Benjamin
The ‘Too Muchness’ of Excitement: Sexuality in Light of Excess, Attachment and Affect Regulation. Dr Galit Atlas and Dr Jessica Benjamin interviewed by Dr Steven Kuchuck.

Dr Stephen Kuchuck explores with the authors the ideas contained in their ground breaking joint paper on the role of infant attachment in the development of sexuality and the adult’s ability to tolerate sexual pleasure. We recommend you read the paper before watching via this link:

Video interview – 56 mins

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Dr Estela Welldon
The Impulse to Murder: Shame and Childhood Trauma

Dr Estela Welldon suggests the principle cause of violent crime is the need to express rage, helplessness and humiliation rooted in unconscious childhood memories of abusive experiences and domestic violence. When these experiences have been extreme, and there has been a lack of loving containment by an attachment figure, something powerful is held inside the psyche until it is released in adulthood through loss of control, often triggered by a repeated trauma. Although the violent act may appear irrational, in the context of the patient’s past experiences it may be very meaningful. The violent act, furthermore, provides a sense of agency, of being seen and experienced by others. The key to forensic psychotherapy is for the patient and therapist to uncover the unconscious meanings of the act, through language. Hopefully this will be aired before the ‘splash’ – the moment when the crime is committed – if that person has access to therapeutic help. By gaining an understanding of their own past experiences of rage, impotence and humiliation the patient may resolve the unconscious impulses underlying the crime. We see that in effective psychotherapy, talking and thinking replace the acting-out.

Video talk to camera – 26 mins

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Institutional account (4 or more):
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Teaching license (10 or more):
$65 per student

Test and Certificate of Attendance:


A certificate of attendance may be applied for 17 hours CE on the basis of passing a multiple choice questionnaire. $50


  • 15 hours of video and audio presentations illustrated with captions, diagrams or images
  • Supporting notes, slides or references
  • Study guides
  • Bibliography linked to relevant articles and books
  • Additional resources relating to each speaker
  • discussion forum
  • A Certificate of Attendance through which you can acquire up to 16 hours CE on the basis of a multiple choice questionnaire assessing your knowledge of the module.


  1. To be able to describe the historical development of the concept of perversion, and to know the current clinical terminology and definition
  2. To be able to identify the differences between the male and female arousal cycle, and how this can impact the lifecycle of relationships
  3. To understand how Childhood Sexual Abuse impacts the ability to self-regulate affect and to tolerate intimacy
  4. To be able to discuss how psychic equivalence and pretend modes of relating can affect a couple’s sexual life
  5. To be able to describe the Window of Tolerance and Polyvagal Theory and their use in treating sexual trauma
  6. To demonstrate an awareness of the concept of consent and its complexities
  7. To be able to list the 4 diagnostic elements of sexual compulsivity and to understand the behavior cycle
  8. To be able to consider the ways in which sexual fantasy life can point to past trauma and attempts to live with it
  9. To be able to assess how your own sexual identity, as well as your attitudes towards sexual preference and behavior may affect your clinical work.
  10. To be able to assess and compare different interpretations of and approaches to psychosexual difficulties in your clinical work


  • Introduction
  • History
  • Terminology; diagnosis; labeling; classification
  • Biological, medical and sociological background
  • Trauma
  • Forensic aspects and the criminal justice system
  • Ethics
  • Diversity
  • Specific issues for psychotherapists and counselors