Madison Tincha, a licensed couples and sex therapist discusses her path from journalism and sociology to clinical mental health counseling, including research on “situationships.” She shares how she has worked with clients hesitant about therapy, working with unexpected disclosures during sessions, and the importance of confidentiality and consultation. She describes modern dating’s “paradox of choice,” the fragility of connection, and how situationships involve ambiguity, emotional intensity, and intermittent reinforcement, often tied to attachment and self-esteem. She outlines sex therapy topics such as desire discrepancy, pelvic pain, erectile dysfunction, communication, kink, porn-related distress, and defining monogamy versus ethical non-monogamy through explicit agreements. She also discusses hosting “