Holistic Sexual + Relational Health
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Holistic & Inclusive Sexual Health Therapy
Sexual health is an essential dimension of overall wellbeing. Hälsosam Therapy provides an affirming, non‑judgmental space to explore:
WHAT CAN YOU EXPECT?
Because sexuality is multidimensional, there are many factors involved. A psychosocial history is taken at the beginning of treatment to facilitate understanding how past experiences, beliefs, and learnings are relevant to the current presenting concerns. Also explored are the possibilities of underlying factors like stress, anxiety, depression, and side effects from medications, or chronic illness. There may be conditions that require a physician ruling out or treating medical issues before beginning or continuing sex therapy.
Please also take a look at our articles and resources for more information about sexual and relational health.
An Integrative Approach to Sexual and Relational Wellbeing
The Personal Sacred Mandala Garden weaves together multiple frameworks commonly used in trauma‑informed and integrative psychotherapy, including:
What This Guided Practice Offers
Through guided reflection, imagery, and paced inquiry, viewers are supported in:
Who This Resource Is For
The Personal Sacred Mandala Garden video is well‑suited for:
A Trauma‑Informed, Consent‑Centered Experience
All aspects of this guided practice emphasize:
Sexual health is an essential dimension of overall wellbeing. Hälsosam Therapy provides an affirming, non‑judgmental space to explore:
- Sexual identity and orientation
- Desire, arousal, and intimacy concerns
- Sexual shame or distress
- Healing from sexual trauma, boundary violations, or betrayal trauma
- Compulsive or self‑protective sexual behaviors
- Relationship and communication challenges
WHAT CAN YOU EXPECT?
Because sexuality is multidimensional, there are many factors involved. A psychosocial history is taken at the beginning of treatment to facilitate understanding how past experiences, beliefs, and learnings are relevant to the current presenting concerns. Also explored are the possibilities of underlying factors like stress, anxiety, depression, and side effects from medications, or chronic illness. There may be conditions that require a physician ruling out or treating medical issues before beginning or continuing sex therapy.
Please also take a look at our articles and resources for more information about sexual and relational health.
An Integrative Approach to Sexual and Relational Wellbeing
The Personal Sacred Mandala Garden weaves together multiple frameworks commonly used in trauma‑informed and integrative psychotherapy, including:
- Mandala‑based mapping as a visual and somatic organizing framework
- Buddha Family and Dakini Mandala principles, supporting grounded awareness, receptivity, and compassionate presence
- Mind‑body self‑healing and regulation (MMSH) approaches to nervous system safety and integration
- Integrative phenomenology, emphasizing lived experience and embodied meaning‑making
- Optimal intimacy research, translated into practical, reflective inquiry
What This Guided Practice Offers
Through guided reflection, imagery, and paced inquiry, viewers are supported in:
- Cultivating embodied awareness related to intimacy and connection
- Clarifying personal values, boundaries, and needs in relationship
- Developing language for inner experience that supports communication and repair
- Exploring intimacy through safety, consent, and self‑regulation
- Integrating contemplative wisdom with modern relational science
Who This Resource Is For
The Personal Sacred Mandala Garden video is well‑suited for:
- Individuals exploring sexual wellbeing and embodied intimacy
- Couples or partners seeking shared language for connection and communication
- Therapists, counselors, and coaches interested in mandala‑based or somatic relational tools
- Educators and clinicians integrating contemplative and trauma‑informed frameworks
- Anyone seeking a reflective, respectful approach to intimacy and relationship
A Trauma‑Informed, Consent‑Centered Experience
All aspects of this guided practice emphasize:
- Choice and pacing
- Respect for personal boundaries
- Curiosity over interpretation
- Safety as the foundation for intimacy and growth
Educational Video Series:
This six‑part video series offers clear, compassionate education to help you better understand how Compulsive Sexual Behavior Disorder (CSBD) and Problematic Pornography Use (PPU) can affect intimacy, trust, communication, and connection. You’ll also find practical, holistic tools to support sexual wellbeing—whether you’re seeking clarity for yourself, support for your relationship, or guidance as a clinician.
About the presenter, Gretchen Blycker, PhD, LMT, CYT: Gretchen is a board‑certified sex therapist and sexual wellness educator at the University of Rhode Island. Her work blends research, trauma‑informed care, and real‑world clinical experience supporting sexual wellbeing, healing from sexual trauma, and treating compulsive sexual behaviors—always with careful attention to the relational impact on partners and couples.
This six‑part video series offers clear, compassionate education to help you better understand how Compulsive Sexual Behavior Disorder (CSBD) and Problematic Pornography Use (PPU) can affect intimacy, trust, communication, and connection. You’ll also find practical, holistic tools to support sexual wellbeing—whether you’re seeking clarity for yourself, support for your relationship, or guidance as a clinician.
About the presenter, Gretchen Blycker, PhD, LMT, CYT: Gretchen is a board‑certified sex therapist and sexual wellness educator at the University of Rhode Island. Her work blends research, trauma‑informed care, and real‑world clinical experience supporting sexual wellbeing, healing from sexual trauma, and treating compulsive sexual behaviors—always with careful attention to the relational impact on partners and couples.
- Aspects of Diversity: Identifying Symptoms of CSBD/PPU in a Romantic Relational System — Research- and case-informed markers of how CSBD/PPU can show up between partners, including common relational dynamics, communication patterns, and sociocultural influences.
- Treatment Needs for Women Impacted by a Partner’s CSBD/PPU — A trauma‑informed overview of how women may be affected and evidence‑informed clinical considerations for support, recovery, and sexual self‑esteem.
- Mandala of Sexual Wellbeing: Love, Communication & Consent in Intimate Relationships — Practical, mindfulness‑based tools to strengthen boundaries, repair, and respect‑based intimacy through clear communication and embodied consent.
- Integration & Personalized Action Plan — A reflective companion video to help you integrate insights, identify next steps, and translate learning into sustainable daily practices.
- Personal Sacred Mandala Garden: A Guided Embodied Practice for Sexual Wellbeing, Intimacy, and Relational Connection — A guided, somatic mapping practice that supports values clarity, needs awareness, and relational attunement through the metaphor of a personal sacred garden.
- Mandala of Sexual Wellbeing: Anatomy, Physiology, and Development — A foundational, developmentally informed review of sexual anatomy and physiology, emphasizing body literacy, interoceptive awareness, and holistic meaning‑making.
Aspects of Diversity: Identifying Symptoms of CSBD/PPU in a Romantic Relational System
Gretchen Blycker PhD, LMT, CYT is a board-certified sex therapist and a sexual wellness educator at the University of Rhode Island. Her clinical work focusing on promoting sexual wellbeing, treating sexual trauma and compulsive sexual behaviors and addressing their relational impact informs her academic work and perspectives.
Background: Symptoms and consequences of Compulsive Sexual Behavior Disorder (CSBD) or Problematic Pornography Use (PPU) may first emerge in a relational context, therefore an increased understanding of interpersonal experiences and dynamics in a romantic relational system warrants further investigation. Addictions not only impact the person suffering with the disorder, but also significant others. However, when the addiction involves the integral nature of sexuality there are significantly different and unique consequences that sets this dynamic apart from being intimate with a person with any other addiction or compulsive behavior.
Method: This presentation includes a review of research focusing on pornography use and compulsive sexual behaviors and the effects on romantic relationships, including sexual and relationship satisfaction. Sociocultural influences which may contribute to the normalization of experiencing symptoms of CSBD/PPU in romantic relationships will be elucidated by research findings, as well as through clinical case examples.
Results: Impersonal approaches to sex, devaluation of intimate sex and communication, a gendered pleasure and orgasm gap, empathy reduction, power and control dynamics, expectations for a partner’s sexual compliance or avoidance of partner sex, and the blaming of the non-CSBD/PPU partner for sexual and relational problems are among the many symptoms identified in relational dynamics occurring with a partner with CSBD/PPU.
Conclusions: More research is needed to explore the interaction effects between the addiction enabling phenomena of denial and dishonesty operating with the CSBD/PPU partner and relational dynamics. Future research assessing for CSBD/PPU may benefit by including collateral information regarding the relationship or partner’s experiences. Interventions that are informed by CSBD, promote sexual health, integrate skillful interoceptive attunement and healthy emotional regulation, such as Compassion-Based Resilience Training, for sexual wellbeing are beneficial.
Click the video below to view this presentation.
Gretchen Blycker PhD, LMT, CYT is a board-certified sex therapist and a sexual wellness educator at the University of Rhode Island. Her clinical work focusing on promoting sexual wellbeing, treating sexual trauma and compulsive sexual behaviors and addressing their relational impact informs her academic work and perspectives.
Background: Symptoms and consequences of Compulsive Sexual Behavior Disorder (CSBD) or Problematic Pornography Use (PPU) may first emerge in a relational context, therefore an increased understanding of interpersonal experiences and dynamics in a romantic relational system warrants further investigation. Addictions not only impact the person suffering with the disorder, but also significant others. However, when the addiction involves the integral nature of sexuality there are significantly different and unique consequences that sets this dynamic apart from being intimate with a person with any other addiction or compulsive behavior.
Method: This presentation includes a review of research focusing on pornography use and compulsive sexual behaviors and the effects on romantic relationships, including sexual and relationship satisfaction. Sociocultural influences which may contribute to the normalization of experiencing symptoms of CSBD/PPU in romantic relationships will be elucidated by research findings, as well as through clinical case examples.
Results: Impersonal approaches to sex, devaluation of intimate sex and communication, a gendered pleasure and orgasm gap, empathy reduction, power and control dynamics, expectations for a partner’s sexual compliance or avoidance of partner sex, and the blaming of the non-CSBD/PPU partner for sexual and relational problems are among the many symptoms identified in relational dynamics occurring with a partner with CSBD/PPU.
Conclusions: More research is needed to explore the interaction effects between the addiction enabling phenomena of denial and dishonesty operating with the CSBD/PPU partner and relational dynamics. Future research assessing for CSBD/PPU may benefit by including collateral information regarding the relationship or partner’s experiences. Interventions that are informed by CSBD, promote sexual health, integrate skillful interoceptive attunement and healthy emotional regulation, such as Compassion-Based Resilience Training, for sexual wellbeing are beneficial.
Click the video below to view this presentation.
Treatment needs for Women Impacted by a Partner’s Compulsive Sexual Behavior Disorder CSBD/PPU
Gretchen Blycker PhD, LMT, CYT is a board-certified sex therapist and a sexual wellness educator at the University of Rhode Island. Her clinical work focusing on promoting sexual wellbeing, treating sexual trauma and compulsive sexual behaviors and addressing their relational impact informs her academic work and perspectives.
Abstract
Background: Women in romantic relationship with a partner with CSBD or PPU are often affected in many ways before root causes of problems are identified or diagnosed. Women may experience challenges and unique harms, including trauma, due to the nature of an addiction or compulsivity operating in the sexual system of a romantic context where safety, trust, empathy, emotional intimacy, honoring of commitments, honesty, and sexual wellbeing are foundational to a healthy secure relationship.
Method: A review of research focusing on the impact on women as well as a review of conceptual models for treatment for women with partners with CSBD/PPU will be presented along with clinical case examples. A holistic model will be utilized to compare the seven domains that comprise sexual wellbeing and how each domain may be impacted for women with partners with CSBD/PPU.
Results: Women may be isolated without proper support and a partner’s sexual compulsivity, upwards comparison to pornography, preferring pornography to partnered sex, or focusing craving towards partnered sex and therefore expressing dissatisfaction or resentment of sexual frequency may all possibly interfere with a woman’s sexual self-esteem and feelings about her body, sexual autonomy and agency. Clinical recommendations for supporting women will be included.
Conclusions: Education about the traumatic impact on women is essential for clinicians to provide a trauma informed approach to treatment. More is needed in the research and clinical fields to advance understanding and knowledge to inform evidence-based treatment needed by women impacted by their partner’s CSBD/PPU.
Click the video below to view this presentation.
Gretchen Blycker PhD, LMT, CYT is a board-certified sex therapist and a sexual wellness educator at the University of Rhode Island. Her clinical work focusing on promoting sexual wellbeing, treating sexual trauma and compulsive sexual behaviors and addressing their relational impact informs her academic work and perspectives.
Abstract
Background: Women in romantic relationship with a partner with CSBD or PPU are often affected in many ways before root causes of problems are identified or diagnosed. Women may experience challenges and unique harms, including trauma, due to the nature of an addiction or compulsivity operating in the sexual system of a romantic context where safety, trust, empathy, emotional intimacy, honoring of commitments, honesty, and sexual wellbeing are foundational to a healthy secure relationship.
Method: A review of research focusing on the impact on women as well as a review of conceptual models for treatment for women with partners with CSBD/PPU will be presented along with clinical case examples. A holistic model will be utilized to compare the seven domains that comprise sexual wellbeing and how each domain may be impacted for women with partners with CSBD/PPU.
Results: Women may be isolated without proper support and a partner’s sexual compulsivity, upwards comparison to pornography, preferring pornography to partnered sex, or focusing craving towards partnered sex and therefore expressing dissatisfaction or resentment of sexual frequency may all possibly interfere with a woman’s sexual self-esteem and feelings about her body, sexual autonomy and agency. Clinical recommendations for supporting women will be included.
Conclusions: Education about the traumatic impact on women is essential for clinicians to provide a trauma informed approach to treatment. More is needed in the research and clinical fields to advance understanding and knowledge to inform evidence-based treatment needed by women impacted by their partner’s CSBD/PPU.
Click the video below to view this presentation.
Mandala of Sexual Wellbeing: Love, Communication & Consent in Intimate Relationships Video Below
Dr. Blycker's Mandala of Sexual Wellbeing™ is a holistic sexuality education offering designed to support deeper self‑awareness, healthier communication, and empowered consent in intimate relationships. Grounded in the Mindful Model of Sexual Health™ (MMSH), this presentation invites participants to explore sexuality as an integrated experience of body, mind, emotions, relationships, and values.
Through mindfulness‑based reflection, trauma‑informed perspectives, and practical tools for boundaries, empathy, and repair, this learning experience supports individuals and couples in cultivating respect‑based intimacy, embodied consent, and compassionate self‑understanding. This offering is inclusive, non‑judgmental, and culturally responsive—created for anyone seeking to build healthier relationships with themselves and others through awareness, choice, and care.
Dr. Blycker's Mandala of Sexual Wellbeing™ is a holistic sexuality education offering designed to support deeper self‑awareness, healthier communication, and empowered consent in intimate relationships. Grounded in the Mindful Model of Sexual Health™ (MMSH), this presentation invites participants to explore sexuality as an integrated experience of body, mind, emotions, relationships, and values.
Through mindfulness‑based reflection, trauma‑informed perspectives, and practical tools for boundaries, empathy, and repair, this learning experience supports individuals and couples in cultivating respect‑based intimacy, embodied consent, and compassionate self‑understanding. This offering is inclusive, non‑judgmental, and culturally responsive—created for anyone seeking to build healthier relationships with themselves and others through awareness, choice, and care.
Integration & Personalized Action Plan Video Below is an educational video offering designed to support embodied wellbeing, self‑reflection, and intentional growth. Rooted in a holistic, mandala‑based approach, Dr. Blycker's presentation invites you to gently integrate awareness, boundaries, compassion, communication, and personal values into daily life. Rather than offering prescriptive answers, it encourages curiosity, choice, and self‑attunement—honoring wellbeing as a living, evolving process. This resource is offered as a supportive companion for those seeking deeper alignment, healing, and empowered agency within their own unique journey.
Personal Sacred Mandala Garden: A Guided Embodied Practice for Sexual Wellbeing, Intimacy, and Relational Connection
Personal Sacred Mandala Garden™ is a guided video presentation offering a contemplative, body‑based mapping practice to support sexual wellbeing, emotional intimacy, and conscious relationship. This resource integrates somatic awareness, contemplative psychology, and evidence‑informed intimacy research into a coherent, accessible experience.
This practice invites participants to explore their inner and relational landscape through the metaphor of a personal sacred garden—a symbolic mandala that supports awareness of values, boundaries, needs, and capacities for connection. Rather than focusing on performance or outcomes, the emphasis is on presence, safety, attunement, and self‑trust.
Personal Sacred Mandala Garden™ is a guided video presentation offering a contemplative, body‑based mapping practice to support sexual wellbeing, emotional intimacy, and conscious relationship. This resource integrates somatic awareness, contemplative psychology, and evidence‑informed intimacy research into a coherent, accessible experience.
This practice invites participants to explore their inner and relational landscape through the metaphor of a personal sacred garden—a symbolic mandala that supports awareness of values, boundaries, needs, and capacities for connection. Rather than focusing on performance or outcomes, the emphasis is on presence, safety, attunement, and self‑trust.
Mandala of Sexual Wellbeing: Anatomy, Physiology, and Development Video Below
The Mandala of Sexual Wellbeing: Sexual Anatomy, Physiology, & Development is a sexuality education presentation grounded in somatic, sex‑therapeutic, and integrative health perspectives. It offers a clinically informed framework for understanding sexual wellbeing through physical anatomy, neurodevelopment, and embodied awareness, with attention to the unified origins of bodily systems in early embryonic development. This foundational unity underscores the clinical interrelationship between genital, nervous, emotional, and relational processes across the lifespan.
Informed by the Mindful Model of Sexual Health™ (MMSH), trauma‑informed care, and somatic psychotherapy principles, Dr. Blycker's presentation supports body literacy, interoceptive awareness, and non‑pathologizing exploration of sexual experience. The inclusion of subtle body concepts is presented as an experiential and phenomenological framework commonly encountered in integrative and somatic clinical practice, supporting clients’ meaning‑making and embodied self‑regulation.
This educational offering is appropriate for individuals, therapy clients, and clinicians seeking a holistic, developmentally informed understanding of sexual wellbeing. It is inclusive, culturally responsive, and designed to support informed self‑reflection, agency, and therapeutic integration within clinical and educational contexts.
The Mandala of Sexual Wellbeing: Sexual Anatomy, Physiology, & Development is a sexuality education presentation grounded in somatic, sex‑therapeutic, and integrative health perspectives. It offers a clinically informed framework for understanding sexual wellbeing through physical anatomy, neurodevelopment, and embodied awareness, with attention to the unified origins of bodily systems in early embryonic development. This foundational unity underscores the clinical interrelationship between genital, nervous, emotional, and relational processes across the lifespan.
Informed by the Mindful Model of Sexual Health™ (MMSH), trauma‑informed care, and somatic psychotherapy principles, Dr. Blycker's presentation supports body literacy, interoceptive awareness, and non‑pathologizing exploration of sexual experience. The inclusion of subtle body concepts is presented as an experiential and phenomenological framework commonly encountered in integrative and somatic clinical practice, supporting clients’ meaning‑making and embodied self‑regulation.
This educational offering is appropriate for individuals, therapy clients, and clinicians seeking a holistic, developmentally informed understanding of sexual wellbeing. It is inclusive, culturally responsive, and designed to support informed self‑reflection, agency, and therapeutic integration within clinical and educational contexts.
