https://michigancouplestherapy.com/home daily 1.0 2026-02-19 https://michigancouplestherapy.com/scheduling daily 0.75 2025-05-20 https://michigancouplestherapy.com/office daily 0.75 2026-02-18 https://images.squarespace-cdn.com/content/v1/62850571e53ad32a58035ba8/81403a70-bba2-456a-9e39-c13c17673163/image8.jpeg https://images.squarespace-cdn.com/content/v1/62850571e53ad32a58035ba8/00a45773-22cb-442b-91de-0a91bb750ba0/image0.jpeg https://images.squarespace-cdn.com/content/v1/62850571e53ad32a58035ba8/6adf77c6-4ff0-4e88-b489-6b453b343ebd/image6.jpeg https://images.squarespace-cdn.com/content/v1/62850571e53ad32a58035ba8/3a287075-367c-4002-a2c7-581e0b3d79c3/image4_1+%281%29.jpeg https://images.squarespace-cdn.com/content/v1/5ede5d5c4e1eb54d74680dd4/1592257873663-UIEP0NPR7WLXHEWM0EJF/image-asset.png Office Space for Rent hand-drawn armchair icon https://images.squarespace-cdn.com/content/v1/5ede5d5c4e1eb54d74680dd4/1592257949474-24WVPWDYQ2XUALLQ3P2D/image-asset.png Office Space for Rent hand-drawn aim target icon https://images.squarespace-cdn.com/content/v1/5ede5d5c4e1eb54d74680dd4/1592257884218-5M8IJDOP8N07F4IMOC4Z/image-asset.png Office Space for Rent hand-drawn empty pill bottle icon https://images.squarespace-cdn.com/content/v1/5ede5d5c4e1eb54d74680dd4/1592257964989-8DUQISWFIW61SQVEJ0WJ/image-asset.png Office Space for Rent hand-drawn simplified needles in back acupuncture icon https://michigancouplestherapy.com/about daily 0.75 2025-05-20 https://images.squarespace-cdn.com/content/v1/62850571e53ad32a58035ba8/c654d352-e668-4f06-96b1-43c76c6252d2/ST-Portraits-5082.jpg About https://images.squarespace-cdn.com/content/v1/62850571e53ad32a58035ba8/c7213b5a-f8d0-4821-8258-c7bb55cc9d5e/sarah_pilot_photo.jpg About - Make it stand out Whatever it is, the way you tell your story online can make all the difference. https://images.squarespace-cdn.com/content/v1/62850571e53ad32a58035ba8/cefc8660-8176-4b8f-97f4-c4a088ac04a6/sarah_and_pomeranians.jpg About - Make it stand out Whatever it is, the way you tell your story online can make all the difference. https://images.squarespace-cdn.com/content/v1/62850571e53ad32a58035ba8/fb590c68-3ba5-45b3-8e25-01ca4ab2b230/let_perfect_burn_podcast_sarah_tomakich.png About I was interviewed on the Let Perfect Burn podcast. You can listen here. https://michigancouplestherapy.com/contact daily 0.75 2025-12-14 https://images.squarespace-cdn.com/content/v1/62850571e53ad32a58035ba8/2cf4c408-19fc-4354-a85f-d7d7c3911f32/DB14A92D-B49C-4D64-BEB6-0B2880461D23.jpeg Contact Sarah - Make it stand out Whatever it is, the way you tell your story online can make all the difference. https://michigancouplestherapy.com/ceworkshops daily 0.75 2025-12-14 https://images.squarespace-cdn.com/content/v1/62850571e53ad32a58035ba8/30fe0151-5369-4f74-ac4c-b60b57580eb4/Psychotherapy_Seminars_Logo.png https://michigancouplestherapy.com/sex-therapy/what-is-sex-therapy daily 0.75 2024-12-10 https://images.squarespace-cdn.com/content/v1/62850571e53ad32a58035ba8/6fcbc31f-c9aa-42f6-9220-c9e1539ac0e5/jan-tinneberg-unsplash.jpg What Is Sex Therapy? - Make it stand out Whatever it is, the way you tell your story online can make all the difference. https://images.squarespace-cdn.com/content/v1/62850571e53ad32a58035ba8/26db1c74-8f63-4509-9543-86339e39ad29/charlesdeluvio-unsplash.jpg What Is Sex Therapy? - Make it stand out Whatever it is, the way you tell your story online can make all the difference. https://michigancouplestherapy.com/relationship-counseling daily 0.75 2024-12-10 https://images.squarespace-cdn.com/content/v1/62850571e53ad32a58035ba8/1733869340505-UKLWVEAAXE16ACRK1KQN/unsplash-image-yH18lOSaZVQ.jpg Couples Therapy https://michigancouplestherapy.com/sex-therapy/pe daily 0.75 2022-06-16 https://images.squarespace-cdn.com/content/v1/62850571e53ad32a58035ba8/6a86823c-fc88-41dd-a04a-102ef5fa491e/yousef-alfuhigi-unsplash.jpg Premature Ejaculation - Premature Ejaculation Premature ejaculation (PE) is a common experience—a 2016 study notes that approximately 20 – 30% of men experience ejaculation within 2 minutes of penetration. If your doctor and/or urologist has ruled out an underlying medical cause, sex therapy may help in better understanding what is causing your premature ejaculation. Causes of Premature Ejaculation Possible causes of premature (or early) ejaculation can be evolutionary! In the past, it was critical to copulate as quickly as possible because you were the most vulnerable to predators during sex. While, logically, we know that today you are not about to be eaten by a sabertooth tiger, sex can sometimes evoke similar vulnerability when you are with a partner. https://michigancouplestherapy.com/sex-therapy/ed daily 0.75 2022-06-16 https://images.squarespace-cdn.com/content/v1/62850571e53ad32a58035ba8/0ea8f394-27b1-44c4-8713-f40e6c590fb2/alain-unsplash.jpg Erectile Dysfunction - Erectile Dysfunction Erectile Dysfunction and/or Erectile Difficulties are common experiences that, in some cases, can be helped by sex therapy. If your doctor and/or urologist has ruled out an underlying medical cause, sex therapy may help in better understanding what is causing your ED. What Causes Erectile Dysfunction? ED can be caused by many things, and we will work together in our first session to understand the possible underlying causes of your ED so that we can make a plan to reclaim your sexual confidence and vigor. Sometimes, premature ejaculation and ED can co-occur and, if this is the case, please let me know during our intake so I can tailor our treatment planning to help you with your specific condition. https://images.squarespace-cdn.com/content/v1/62850571e53ad32a58035ba8/573dcef4-436b-492e-bc78-0101500203ec/elke-karin-lugert-unsplash.jpg Erectile Dysfunction https://michigancouplestherapy.com/sex-therapy/ide daily 0.75 2022-06-16 https://images.squarespace-cdn.com/content/v1/62850571e53ad32a58035ba8/5c8ad660-6d16-481a-b44a-78269a77e7ca/towfiqu-barbhuiya-unsplash.jpg Inhibited or Delayed Ejaculation - Inhibited or Delayed Ejaculation Delayed ejaculation is a form of sexual dysfunction affecting a man’s ability to reach an orgasm. The causes of delayed ejaculation vary, and most men will experience some form of delayed or inhibited ejaculation throughout their life. When it takes you longer than 30 minutes to reach orgasm, or you cannot ejaculate with a partner, that is a good time to seek help from a sex therapist. Prior to seeking help from a sex therapist, it is recommended you rule out any underlying medical causes for your inhibited or delayed ejaculation. I can provide referrals to area doctors who specialize in treating delayed or inhibited ejaculation. Primary cases of delayed ejaculation may not always be straightforward to treat, which is why it is important to seek the care of a specialist in this area. This condition often requires the help of professional psychotherapists; together, we can make a plan on how to best treat your delayed or inhibited ejaculation. https://images.squarespace-cdn.com/content/v1/62850571e53ad32a58035ba8/8bad398a-4bfc-4f90-82b6-1a5185427fac/alex-azabache-unsplash.jpg Inhibited or Delayed Ejaculation https://michigancouplestherapy.com/sex-therapy/out-of-control-behavior daily 0.75 2023-02-28 https://images.squarespace-cdn.com/content/v1/62850571e53ad32a58035ba8/8fabf854-2a9c-43a7-9683-eeecd8f549d0/rene-bohmer-unsplash.jpg Out of Control Sexual Behavior - What Is Out of Control Sexual Behavior? Out of control sexual behavior is any sexual behavior that feels out of control, impulsive, compulsive or addictive—whether it is pornography, hook-ups, chat rooms, infidelity, or any other sexual behavior that you want to change. How Is It Treated? To treat out of control sexual behavior (sex addiction, porn addiction, chat room worries, hypersexuality symptoms, etc.), I use a healthy sexuality model as an alternative to Sexual 12 Step Programs. To support this model, I tailor my treatment to clients who are thoughtful and invested in learning about the roots of the behavior causing them distress. I use an acceptance-based, non-shaming approach to discovery around your compulsive sexual behavior. Our work together will help you better understand the underlying causes of your out of control sexual behavior so you can create sustainable, meaningful, and lasting changes. This article from The Mind Embodied outlines how being intentional with language and treatment options can help you pick the right sex therapist for your needs: Sex Addiction vs. Out of Control Sexual Behavior: Definitions and the Importance and Impact of Language Many self-identified sex addicts have untreated mental health conditions and/or untreated trauma, abuse, and bullying in their history. Therefore, as part of my treatment planning, I assess each person thoroughly so we treat the whole person, not just the undesirable behavior. https://images.squarespace-cdn.com/content/v1/62850571e53ad32a58035ba8/93316a59-98b6-43d0-8367-6bf3e30544be/mitchell-hartley-unsplash.jpg Out of Control Sexual Behavior