But experts like binnie klein , a connecticut-based psychotherapist and lecturer in yale 's department of psychiatry , agree that alternative relationships are on the rise .
Kahr has spent years amassing this material , using face-to-face interviews and an anonymous questionnaire , as well as drawing on his clinical experience as a psychotherapist .
Sometimes , the causes of performance problems go deeper , and therapy is needed to heal past traumas , says david grand , a new york psychotherapist and performance coach .