Ian Kerner on the Today ShowResearch shows that most important factor in effective psychotherapy is the therapeutic alliance between the patient and therapist and a collaborative approach. With that in mind, Ian's practice is focused in four areas: sex therapy, couples therapy, individual psychotherapy and peer consultation. Ian also offers a specialized form of combination therapy that integrates couples therapy and sex therapy for patients who want to address sexual and relational issues in parallel. All treatment is confidential and follows ethical guidelines as defined by AASECT and AAMFT. To make an appointment, please contact Ian via email. Before your first session, you can save time by printing and filling out the HIPAA and Consent forms.

Sex Therapy (for individuals and couples)

As a sex therapist, Ian works with both individuals and couples on challenges that are common to the “American bedroom” but often lead to lives of quiet desperation. He welcomes all forms of sexual orientation and takes a sex-positive stance. Ian encourages patients to understand, embody and express their desires and identities from a position of “sexual authenticity.” Areas of focus include:

  • Lack of sexual interest, sex ruts, low desire, mismatched libidos
  • Sexual incompatibility, sexual boredom
  • Premature ejaculation, erectile disorder, delayed ejaculation
  • Painful sex, inhibited arousal, orgasm issues
  • Expanding the sex script/enhancing sexual creativity
  • Problematic sexual urges, thoughts and behaviors
  • Erotic conflicts
  • Impulsive/compulsive use of porn
  • Sexual effects of internalized shame and guilt
  • Processing and recovering from sexual trauma
  • Sex after infidelity
  • Opening up a relationship, navigating consensual non-monogamy and polyamory
  • Sexual identity issues and mixed orientation relationships
  • Integrating kink, eroticized power play, and other forms of sexual adventure into one's sex life
  • Navigating changes in the sexual life-cycle
  • Special issues related to LGBTQ sexualities
  • Sex therapy with trans* patients
  • Working on the relationship issues in which sex problems are often embedded
  • Co-morbidity of sexual problems with other mental health issues such as depression, anxiety and the sexual side effects of medication
  • Addressing sexual narcissism, perfectionism, and performativeness

Ian takes a multi-layered, biopsychosocial approach to exploring sexual issues, and his therapeutic style is both psychodynamic and cognitive-behavioral. This means that Ian works from both the inside-out (locating the sources of issues in oneself) and the outside-in (changing behaviors and relational interactions). The sex therapy Ian offers is often short-term and focused on solving problems, but in an atmosphere of empathy, safety and thoughtful reflection. Sex therapy typically includes homework assignments as a way of implementing and measuring change. In some instances, Ian also uses EMDR (Eye Movement Desensitization and Reprocessing) to target sexual problems and the effects of sexual trauma.

Sex therapy sessions are generally scheduled every two weeks. When necessary, Ian will also help with referrals to specialists such as urologists, psychiatrists, endocrinologists and physical therapists. If you are already seeing a psychotherapist for individual or couples therapy, sex therapy can often be structured as an adjunct to your current therapy. To that end, Ian is happy to communicate with your primary therapist on an overall treatment plan that will not conflict with, but rather will enhance, your current therapy.

If you’re grappling with a sex issue and you’re also in a relationship, please consider couples sex therapy even if you and/or your partner feel like it’s your issue to deal with and resolve. As sex researchers Masters and Johnson wrote, “There is no such thing as an uninvolved partner in any relationship in which there is some form of sexual inadequacy.” Sometimes it’s also possible to begin with individual sex therapy and transition to couples sex therapy.

Couples Therapy

Couplehood is filled with challenges that unfold over the life-cycle. Most relationships come with periods of heightened tension, unrest and crisis, and, even in the best of times, managing a relationship can be stressful. Regardless of the reasons you are seeking couples therapy — money, sex, parenting — Ian provides a fresh perspective that will help you constructively communicate, secure your attachment, resolve issues and evolve as a couple so that you are better able to manage problems in the future. Ian often describes couples therapy using the metaphor of a house with a main floor and basement. The main floor is where the action is: it's where we eat, sleep, cook clean, argue, make love and generally deal with all the problems that life throws at us. But we also have a basement, which is our emotional underground (both our own and the one we've built with our partner). In the basement are our emotions, vulnerabilities, attachment schemas, traumas and the legacy of our childhoods. Couples therapy happens on both the main floor of the house (the world of behavior) and in the basement (the world of our deeper emotions and thoughts) and ultimately creates a solid staircase between the two so that we are better known to ourselves and to our partners and feel safe in the house we've created together. Areas of focus include:

  • Communicating in ways that engender a sense of connection rather than triggering defensiveness.
  • Revealing, appreciating and soothing each other's vulnerabilities.
  • Understanding and changing underlying patterns of negative interaction that repeat themselves regardless of the issue at hand.
  • Making structural changes in your relationship and family system that reflect your goals and reinforcing those goals with appropriate behaviors.
  • Navigating impasses and getting on the other side of difficult issues.
  • Reconnecting with the ideals, values, dreams and pleasures that brought you together in the first place and recreating positive internal images of each other.
  • Looking at where you may be enmeshed in your relationship and need more differentiation and where you may be overly-individualized and need more togetherness.
  • Learning to self-regulate your emotions as well as to co-regulate with your partner.
  • Understanding how your attachment needs may differ from your partner's and where there have been injuries to the attachment that need to be healed.
  • Processing emotional and sexual infidelity.

Like sex therapy, couples therapy often includes homework assignments that target areas for change. Couples therapy sessions are generally scheduled every two weeks.

If you are interested in a combination of couples therapy and sex therapy, please click here to read more about combination therapy.

Combination Couples Therapy/Sex Therapy

Sex problems and relationship problems often go hand in hand, so it’s only natural that most couples want to deal with both simultaneously. Unfortunately, many psychotherapists are not adequately trained in sex therapy, and thus often prefer to work on the relationship issues first with the idea that fixing a relationship will naturally fix the sex problems as well. This assumption is flawed. While improving a relationship in areas such as communication can indeed have a positive effect on a couple’s sex life, these benefits are generally minimal and indirect, and do not make sex problems go away. And when sex is regarded as a secondary concern to be dealt with later, untreated sex issues will often worsen, with disastrous effects for the overall relationship. Conversely, sex can be a source of tremendous resilience and positivity for couples who are grappling with other relationship challenges and be a "glue" that help couples survive difficult periods. Studies have shown that couples who maintain their sexual connection once a week are more satisfied overall in their relationships than couples who do not1, and that sex produces a positive "after-glow" that lasts for up to two days, and this afterglow is linked with relationship quality over the long term2. For these reasons, sexual issues cannot be placed on the back-burner. As a licensed marriage and family therapist and certified sexuality counselor with deep clinical experience, Ian has developed a form of combination therapy that seamlessly integrates couples and sex therapy into a single process, allowing couples to work in parallel on sex and relationship issues from the very first session.

In addition to assessing and treating the causes of sexual issues that may be challenging to one or both partners, during combination therapy we also pay close attention to the impact of sexual issues on the relationship and the discrepancies that have emerged. Common sexual discrepancies include:

  • Frequency of sex — a discrepancy in partners’ levels of desire is very common
  • Type of sex – a discrepancy in partners’ sexual preferences and sexual temperaments
  • Expectations of intercourse (e.g., length, style, positions, eye-contact)
  • Variety of sexual practices (e.g., preference for types of pleasuring, oral sex, anal sex, sex videos, BDSM activities, sexy apparel, erotic scenarios)
  • Sexual interaction (e.g., who initiates, arousal styles, orgasm patterns)
  • Acceptability of masturbation with/without partner and use of pornography
  • Acceptability of sexual fantasy
  • Acceptability of sex toys (e.g., dildos, paddles, vibrators)
  • Acceptability of substances to facilitate sexuality (e.g., alcohol or marijuana)

Once a discrepancy has been explored and reflected upon, it’s often possible to take a “Bridge-Bend-Bond” approach in which:

  • new sex scripts are negotiated
  • flexibility, vulnerability and resilience are demonstrated and acknowledged by both partners
  • and the relationship-benefits of overcoming a sexual impasse together are reaped3

1. Muise, Amy, Ulrich Schimmack, and Emily A. Impett. "Sexual frequency predicts greater well-being, but more is not always better." Social Psychological and Personality Science 7.4 (2016): 295-302.

2. Andrea L. Meltzer, Anastasia Makhanova, Lindsey L. Hicks, Juliana E. French, James K. McNulty, Thomas N. Bradbury. Quantifying the Sexual Afterglow. Psychological Science, 2017.

3. McCarthy, B., Metz, M. E., & Epstein, N. (2017). Cognitive-behavioral therapy for sexual dysfunction. Routledge.

Individual Therapy

Ian also works with individuals who are experiencing anxiety, depression and other life challenges. Living as we do in a world of choice and possibility, many of us also feel an accompanying lack of external structure and experience a sense of groundlessness. Ian works with patients to excavate and articulate a "design for life" and to implement the structures, routines and habits that bestow our lives with a sense of meaning and accomplishment. In a city where people are often compelled to prioritize work above all else and to exist in a perpetual state of digital distraction, Ian embraces the opportunity to work with those who want to tune out the noise and tune in to their authentic selves in a calm, reflective space. Areas of focus include:

  • Developing a psychologically-oriented way of looking at yourself and your relationships and being able to communicate with others from a position of self-insight and clarity.
  • Exploring your emotional "underground" and bringing it "above ground" in ways that are non-destructive and additive to a healthy, positive, inter-connected approach to life.
  • Understanding your own temperament so that you can regulate your emotions in healthy ways and better tolerate difficult emotions and life-stressors.
  • Staying within your "window of tolerance" and being able to self-regulate and stabilize when you are outside of it.
  • Engaging in healthy behaviors and using positive coping mechanisms rather than negative ones.
  • Reflecting upon and making sense of your history to better understand the choices you're making; processing trauma.
  • Navigating inter-personal relationships; building up your sense of personhood; cultivating a theory of mind in order to accurately mentalize others around you and interact in ways that are multi-dimensional and maintain your personhood without compromising another's sense of self.
  • Making difficult choices; changing directions; addressing the unknown.

Therapy provides an opportunity to satisfy our innate need for human connectedness in a way that is becoming increasingly rare.1 Ian's approach is both psychodynamic and cognitive behavioral, and in some instances he uses EMDR (Eye Movement Desensitization and Reprocessing) to target emotional dysregulation and the effects of trauma. Individual therapy sessions are generally weekly.

1. Research has demonstrated that positive experiences of human connectedness fulfill the body's need to co-regulate biobehavioral states through engagement with others, and that connectedness provides an important neurobiological mechanism to link social behavior with mental and physical health (Porges, 2016).

Services for Other Therapists: Case Consultation and Supervision

Sex is a topic that is invariably on your patients’ minds, but to what extent does it enter the clinical conversation? It’s not uncommon for both patient and therapist to collude in avoiding sex-related issues due to mutual discomfort, or for a therapist to feel de-skilled when addressing sexuality. Many therapists will simply avoid the conversation altogether. This is unfortunate, as the field of sex therapy has a rich and accessible history of clinical theory and a body of practices that lend themselves well to integration with individual psychotherapy and/or couples therapy. To that end, Ian is occasionally able to make himself available to clinicians for case consultation and individual/group supervision.
In addressing your cases, we will typically discuss:

  • Therapist self-location when dealing with both heterosexual and LGBTQ sexual issues; using targeted psycho-education to normalize your patients experience of their sexuality; connecting with your patients around “hard to talk about” sex issues and building a therapeutic alliance that will encourage them to open up.
  • The assessment of sexual concerns; taking a sexual history, conducting a sex-script analysis and using validated scales and measures to diagnose sex issues; applying the latest sexual science to your case formulation.
  • Designing and implementing a sex therapy treatment plan and delivering therapeutic interventions, including cognitive-behavioral, psychodynamic, psycho-educational, and pharmacological approaches
  • Designing, co-constructing and customizing homework assignments; using the data and feedback from client homework to enhance your treatment outcomes

During supervision, we will be paying close attention to the development and deepening of the therapeutic alliance and the processing of clinical material that happens both in the room and in between sessions through homework assignments.

Fees and Insurance

For more information about fees associated with therapy, please contact Ian directly via email. Individual sessions are 60 minutes, couples sessions are 90 minutes and fees vary depending upon the length of the session. Ian sees individuals either weekly or every other week, and he generally sees couples every 2-3 weeks.

Ian does not take insurance directly, but he can provide you with a receipt for reimbursement if you have out-of-network benefits.

Ian maintains a limited number of sliding-scale hours in his practice, and those hours are offered during the day. Feel free to contact Ian as to whether or not there are any sliding scale hours currently available.

For those individuals and couples who would like to engage in sex therapy, but cannot afford it, Ian also works with a small group of accomplished therapists at the Institute for Contemporary Psychotherapy, one of New York City’s oldest and most prestigious not-for-profit training and treatment Institutes. The therapists are licensed CSW’s or Ph.D’s, and as with other ICP clients, fees will be on a sliding scale basis. ICP accepts some HIP, GHI, Oscar and HealthFirst insurances. For those who do not have these plans, ICP will establish a sliding scale fee.

If you’d like to see a sex therapist at ICP, please call 212.333.3444 and ask to schedule an intake interview. Be sure to emphasize that you are seeking sex therapy.