Therapy Can Work

Katherine Rabinowitz, LP, M.A., NCPsyA

Licensed Psychotherapist & Psychoanalyst
Union Square, Greenwich Village, New York, NY

We have detected that you are using Internet Explorer 9 or older.
Please upgrade your browser to access our website.
Upgrading your browser will improve your browsing experience.

Upgrade Your Browser.

Therapy Can Work

Katherine Rabinowitz, LP, M.A., NCPsyA

Licensed Psychotherapist & Psychoanalyst
Union Square, Greenwich Village, New York, NY

Intimacy & Sexuality


People often assume intimacy and sex are synonymous. But while sex can certainly be one of the most intimate interactions between two people, intimacy is about much more than just sex, and there are often times when casual sex happens with little or no intimacy. There is no right or wrong here – in some relationships sex and intimacy are equated, but in others not.


Intimacy does imply closeness, honesty, trust and a willingness to be exposed and vulnerable. Of course it’s part of a healthy love relationship, but it’s also, in varying degrees, part of other relationships in our lives – friends and family. You can be intimate with someone on an intellectual level – where ideas are what bring you close together. Or shared goals, causes and spiritual beliefs. It’s emotional intimacy that’s usually the hard one. Emotional intimacy is where the deeper bond is, or isn’t.

The Experience of Intimacy

“The easiest kind of relationship for me is with 10,000 people.
The hardest is with one.”
~Joan Baez

To have emotional intimacy means being able to share the good, the bad and the ugly. It feels good to share your joys and triumphs with someone who will be genuinely happy for and with you. Intimacy can be experienced without words. Two people who have been together a long time often develop a personal language that includes memories of shared moments, private jokes, a word and a wink that require no explanation – the relevant phrase or faintly nuanced gesture is understood, and the exchange feels intimate.

Sexual Intimacy

And of course there is also sexual intimacy, the ability to let go of inhibitions and be naked, in both the literal and metaphorical sense of the word, with another person. For some people, that loving and tender kind of energy is easy. They feel united and alive. Others feel vulnerable and ashamed.

Lack of Intimacy

Some people don’t get there at all, with any kind of intimacy, even in friendships. They are the people who tell me they can’t understand why they feel so lonely. They have lots of friends, do lots of things, but still they feel lonely. I am not surprised when I learn they have difficulty with intimacy. A lack of any intimacy can lead to chronic loneliness, and feeling unfulfilled despite professional or financial success.

Fear of Intimacy

It can be scary to disclose what makes you feel most embarrassed or ashamed. The more of yourself you feel willing to reveal, knowing you can trust the other not to take advantage of what you have shared, the closer and more intimate you feel. Perceived faults and weaknesses can be exposed because there’s trust in the other’s unconditional acceptance. Trust takes time. No matter how easily two people seem to click on first meeting, it takes time for most people to feel safe enough to really open up and expose the deepest parts of themselves to another person.

A fear of intimacy comes out of a sense of vulnerability to being emotionally hurt. It’s not the intimacy itself that most people fear. It’s being criticized, rejected, shamed, controlled, swallowed up, or losing oneself in the other that sets in motion the self-protective shutting down that keeps intimacy under wraps. There is often a correlation with low self-esteem and feelings of being unlovable, defective or even worthless. In order not to be found out, barriers to intimacy go up.

All kinds of self-destructive patterns have been put into place, usually from long ago, perhaps when some rejection, betrayal or trauma actually occurred. Emotional walls were erected, all in the service of self-protection. Ironically, the very means of protection in place only serve to widen the distance between people. Somehow, relationships just don’t work out. Close friends fade away or commit an act of betrayal. Family relations feel stilted or perfunctory, or worse – angrily conflicted.

Overcoming Fear of Intimacy

In therapy, when we take a closer look at what’s going on, we might discover you are someone who just happens to pick people to get involved with who aren’t really available for the kind of relationship you want. Or you might be someone who’s so afraid of being rejected that you give up those parts of yourself that are uniquely you. Or you think you keep being rejected when in fact you are pushing them away without even realizing it. Or you’re so afraid of being hurt, even within a long-established relationship, that you shut down emotionally, are hurtful to the one you say you love, and sometimes, even if you’re not afraid of being left, the relationship feels empty.

All of this is about fear of genuine intimacy. Overcoming it is hard. You have to be willing to be affected by someone else’s feelings, without retaliating, and to show your own. If your way of showing affection is always disguised by jokes or snide remarks, we’ll want to explore the need for an aggressive rather than a loving expression of your feelings.

Boundaries, Risk & Balance

We may need to work on establishing healthy boundaries, the value of risk-taking, or if you’re someone whose entire sense of worth is bound up in a primary relationship, the importance of developing your individuality, and the need for balance through outside friendships. Like developing trust in another person, this will take time, but therapy can work.


Sexuality is often confused with intimacy. For some people they can be one and the same, but not always. Being comfortable with oneself as a sexual person often involves many of the same dynamics mentioned above in the discussion about intimacy – ability to be vulnerable, open and expressive of your physical self, but that may not be why sexuality is an issue for you.

Sometimes other things interfere – a prolonged illness, chronic pain, financial difficulties, a family problem, the loss of a family member, children – all of these can be stresses that get in the way of your sexual self.

It is not unusual for couples’ involvement in sexual activity to wax and wane. There are periods where one or the other person loses interest. Change in hormones (both male and female) can play a role. Weight gain, weight loss, the normal changes in appearance brought on with age, or plain old fatigue because of work/child/relationship stress might be the reason for the change. The need to be alone can also change over time and affect how sexual you feel.

Sexual Identity

It’s possible you’re reading this because you’re questioning your sexual identity. Maybe you’re beginning to realize you’re attracted to someone of the same sex and you don’t know how to tell your friends and family, and are fearful of their rejection once you do. Or you’ve been with those of your sex and much to your surprise are now finding yourself attracted to someone of the opposite sex. Perhaps you’re bisexual. Perhaps you’re intersex (someone who is neither exclusively male or female, based on chromosomes and external secondary sex characteristics). Some people are now openly declaring themselves transgender.  Or maybe you’re simply completely confused and don’t know what your sexual disposition is.

All of these issues can be dealt with in therapy. But you have to give it a chance.

To learn more
Call: 212 228-2424 · Email: