Porn is polarizing. Porn is confusing. Porn can be alarming. For therapists, porn can push us out of our comfort zone and trigger negative countertransference. One thing is for sure: porn is everywhere, and it’s here to stay. So what do therapists have to say about it?

Even though our ideas about sex and sexuality have greatly advanced over the last half-century, our culture still holds a double standard about infidelity: we still tend to pathologize women or shame them for having affairs. In my view, far from being evidence of pathology or marital bankruptcy, a woman’s affair can be a way of expressing a desire for an entirely different self, either separate from the marriage altogether or still in it. By understanding this, therapists have an opportunity to help troubled couples create a new relationship with better communication, fuller intimacy, and realistic hope for a better future together.

Overall, putting together the new video course and the magazine issue was an oddly touching experience, because I felt that there was a deep sense of camaraderie, common discovery, and shared vulnerability. I had the sense that whether we felt uncomfortable, exhilarated, or just fascinated by what is, after all, an endlessly fascinating topic, we were all in this project together. And by “this project,” I mean not just our exploration of sex, but the whole human project.

The couples we see are often in terrible distress. Don’t they deserve the best we can give them? Couples therapy, like any form of psychotherapy, is an art form at its best. But underlying the art, we need methods built on the truth of what couples need to succeed, rather than those based in myths patched together out of stereotypes. So we come to our first principle for doing effective couples therapy: use research-based methods to treat couples. Science is the avenue that can best lead us toward truth. After studying more than 3,000 couples and participating in studies of 3,500 more, here's a summary of everything our couples have taught us.

When clients are emotionally worked up, caught in fight-flight-freeze mode, all their hard-earned skills in empathic listening and responsible (and responsive) speaking go out the window. Nothing therapeutic is going to happen until they feel calm enough and safe enough to reengage with each other. But by teaching behavior that helps clients' brains release oxytocin, a naturally occurring hormone which stimulates feelings of bonding and trust, and reduces fear and anxiety, we can create potent catalysts of psycho-physiological change.

Today, sexuality still seems to be a territory as private and filled with fear as ever it was. We haven't advanced far in our ability to talk of our own sexuality one with another. Part of what makes sexuality scary is that it's a realm all its own: one in which the rational and the measured are overwhelmed and subsumed. It's where we meet ourselves most directly, without filters, without verbiage, and, if we go far enough, without fixed roles. It's where we meet ourselves with and through the Other, a partner as fluid we are.

Nearly 40 million Americans visit Internet porn sites at least once a month. Not surprisingly, concerns about the effect of porn on individuals and relationships are also on the rise. Changes in how people access and use pornography have taken the therapeutic community by surprise. Many therapists don't yet comprehend the extent of the problems porn can cause, or how deeply its use can harm individuals and their intimate partners. What's more, pornography is quickly moving from an individual and couples' problem to a public health problem, capable of deeply harming the emotional, sexual, and relationship well-being of millions of men, women, and children.

In today’s changing world, therapists need a new road map for helping couples end unions with their dignity intact, their sanity whole, and in a greater spirit of cooperation and good will.

In this brief video clip, child psychologist and Symposium 2016 presenter Martha Straus discusses the benefit of using co-regulation with a young client in trouble. 

I was born overseas and practice therapy in the United States. Since the early days of my life in America, I've felt a sense of cultural dissonance with colleagues and friends about how infidelity is approached here, both in the culture and in the therapy profession. Many American therapists proclaim total honesty as the ideal for all marriages and the unearthing of the secrecy and lies at the heart of infidelity as a primary therapeutic consideration. Maybe it's time for a two-way exchange, so that we can learn from the wisdom of other cultures when it comes to disclosure about an affair.