My latest Psychology Today blog, What is "Bad Sex"?, has been promoted to an Essential Topic on their website! To read it, go here.
Many, many thanks to the readers of the North Bay Bohemian for voting me 2021's Best Sex Therapist in Sonoma County -- for a fourth time. What a pleasure it is to learn about this during these difficult times. I hope to continue to support the sex lives of Sonoma County (and beyond -- teletherapy has created a new world for us all) for many years!
“I feel like a teenager with this stuff.”
“I feel like I shouldn’t still be figuring this out at my age.”
I have heard my clients say these sorts of things about their sexual development. Whether it was a modest adult virgin learning about their body and their partner’s, or another client frustrated with themself for not knowing their body’s sexual response and what turns them on, these expressions of embarrassment and shame surround so many people’s interactions with their own sexuality which I hear almost every day through my Zoom screen.
And it is totally, completely, 100% to be expected.
I believe everyone raised in our culture has some aspect of their sexual development delayed or missing, even therapists and sex therapists. Our culture is still quite immature when it comes to understanding, honoring, and demonstrating the complexities of adult sexuality and sexual relationships. The fact that we are just now really grappling with consent on a societal level is proof of this—and we haven’t even gotten that totally right, because consent is not black or white; it is a nuanced and changing endeavor vulnerable to interpretation.
In a culture such as ours in which we do not value sexual discovery, only sexual mastery, the idea of learning about your sexuality and/or your partner’s sexuality or how to be in a sexual relationship is not (a) appreciated and (b) demonstrated practically anywhere. Another way to describe this idea is growth mindset vs. fixed mindset. When you try something new for the first time, do you expect to get it perfect? Of course not. That would be expecting mastery. So why do you approach sex with this assumption: Are you trying to be like the actors in porn? Does it feel too vulnerable to be in learner mode? Is your self-esteem tied to your sexual performance?
Even when sexual discovery is demonstrated in the media, it is usually portrayed with embarrassment, guilt, shame, awkwardness, and clumsiness, which then creates or reinforces such feelings as the ones my clients expressed above. What I so like about human sexuality is that, to borrow from Zen Buddhism, if you adopt a beginner’s mind about it, that mindset will benefit you more than you could possibly know. To have a beginner’s mind is to experience each moment with fresh eyes and without judgment, conditions, goals, or preconceived ideas — tough to do if you have ever seen any sort of media whatsoever. To have a beginner’s mind is to get curious and stay curious — even when your thoughts and feelings pull you into having a different experience.
Where people trip themselves up is when they expect sexual mastery. They make assumptions regarding something about sex, maybe based on a past experience or a past partner or what they have seen in porn or other media, but do not deal with what and who is directly in front of them: “Well, all my past sexual partners didn’t mind anal sex; why do you have an issue with it?” “All the women in porn seem to enjoy facials, what’s wrong with me because I don’t?” “I’ve never had a problem maintaining an erection before now so it must be because of my partner.” Nothing in sex is guaranteed — not erections, not orgasms, not getting everything you want, and certainly not pleasure. Your experience is your responsibility. You and your partner must take active steps to make anything enjoyable happen. You are not owed anything, not in life and not in sex. Once you understand this and begin practicing it in your sex life you will begin to grow up and stop feeling like a teenager.
The bottom line: Understanding your sexuality is a life-long journey and it changes over time. The things you learned about your sexual self as a teenager or young adult may no longer apply now that you have an adult or middle-aged body with some amount of experience and self-knowledge. This is a powerful point: Context matters. Sexuality does not happen in a vacuum and is not solely the result of biological processes. It can be, and is, impacted by many things. There’s a fluidity to it over the lifespan. And if you are lucky, you will be a sexual learner for the rest of your life.
“You’re not meeting my sexual needs.”
Have you ever thought this about or said this to someone else? Has anyone ever said this to you?
I have heard, and most likely will continue to hear, clients say this in my office. Either in an individual session about their partner or in a couples session to their partner. In a couples session, it generally becomes a high stress and high stakes moment because so many people interpret this statement to have negative implications within the context of whatever is going on in their sexual relationship. For example, it may be used to: complain about what one partner perceives to be the other partner’s deficiencies; ask (or threaten) to open the relationship; justify the decision to have an affair; or end the relationship all together.
This is a tough moment, no doubt about it. But IMO this language is misleading of their experience mainly due to folks not understanding themselves and having a consumeristic mindset. There are several things going on here, so settle in and let’s unpack it all.
First, the issue is when someone does not understand themselves. This is a common issue that people come to therapy for. For example, just the other day I asked a client the question, “What was behind that decision you made? What was going on for you to make that particular decision?” The client said, “I don’t really know.” And my response was, “That’s OK because that is what we are here to figure out!” So often people create really complicated sexual lives for themselves (and their partners) without examining their underlying motivation(s). Some folks have poor insight and struggle to make sense of their inner experience or are flat out scared to examine themselves. So in therapy we slow things down, get curious about what is going within them, and identify the thoughts and feelings that may drive their choices. We also look for patterns in thoughts, feelings, and themes, to (a) see if there are any and (b) if there are what does that mean. You know, ‘know thyself’ type stuff.
The second issue going on is about needs and wants. Generally speaking, many people confuse a need from a want. A need is a must-have, a requirement in order to live. Oxygen, food, water, shelter, safety, love and companionship, things like that. When the need is not met, a person generally deteriorates. By contrast, a want is a choice and I like to think of it as something that is added to or on top of a need. It falls into the category of “it would be nice to have.” For example, you need food because without it you will die; you want it to be tasty because that is pleasurable. If you have ever gone a long time without eating and then eventually do eat whatever food is available or given to you, you realize all foods are delicious - even the foods that you previously thought you disliked. Needs do not generally change over the course of your life, wants can and do change. That is part of what makes wants so interesting.
As I stated earlier, a problem in our complex 21st century life is that it has become increasingly difficult for many to distinguish between some needs and some wants. I believe capitalism, advertising, and consumerism have played a big role in our confusion about wants and needs. Is a cell phone a want or a need? It could be argued that it is now a need. But that sexy, slick, and fun commercial you just saw tried to convince you that you need the newest and most expensive iPhone in order to stay in touch with others - which you do not. That new iPhone with all the fun and cutting-edge features is a want. Is a car a want or a need? Depending on where you live, where you work, and where your family is located it could be a need - but you do not need a Tesla. That Tesla is a want. All reliable cars serve the same function: they get you from point A to point B. So I come back to my idea that a want is generally added to or on top of a need.
Third, where people, including mental health professionals, get confused is understanding an individual's reaction when a want is not met. Like I said, when a need goes unmet, a person generally deteriorates. However, when someone does not get what they want they may become grumpy or angry, irritable or impatient, slip into a low mood, or feel deep emotional pain. This is not the same as decompensating.
Fourth, in addition to making many of us confused about our wants vs. needs, the culture of capitalism and consumerism has also turned much of our wants and needs into commodities, things that are bought and sold, things that are exchanged. I need food - but where will I exchange my money and get my food, grocery store X or grocery store Y? Or let’s say I need a vacuum cleaner: I do my research, think about my budget, and then buy the vacuum cleaner that fits my criteria. I use it for a while but then it breaks. Since the vacuum cleaner stopped meeting my wants or needs and these days it is cheaper to just buy another one versus get it repaired, I throw it away and purchase a new one. When the very thing that meets a want or need has been commodified in this way, it is seen as only serving a function. Once it either serves its function or it breaks, it is time to move on. That want or need now has a transactional quality to it: I’m trading something (in this case of my vacuum cleaner, money) for a want or need to be met. And this perpetuates the consumeristic mindset, subconsciously commodifies our wants and needs, invites objectifiying the things (and people) that I think can meet them, and encourages throw-away culture. Yowza.
(BTW, my grandparents’ generation did not live in a consumeristic culture — when their vacuum cleaner broke they took it to get repaired at the vacuum cleaner repair store. They kept the vacuum cleaner and tried to fix it/make it better. Hmmm. Maybe that is a useful metaphor here and something we can learn from on several levels.)
Also, consumerism also creates feelings of entitlement - “I deserve that Tesla” is code for “I deserve to have my wants met.” Which on one level is true - I want all of us to get whatever it is that we want! Imagine that. The problem is, that is just not real life. In the real world there are plenty of times we do not get what we want, even when we want it really, really badly. And for many people that hurts like a MF and brings up all kinds of psychological issues. I am reminded of a quote by Jim Carrey that tells us that getting everything we think we want is, ultimately, insufficient: “I think everybody should get rich and famous and do everything they ever dreamed of so they can see that it’s not the answer.”
This is not to say I am critical of wants in general or specifically sexual wants. Hardly. Like I wrote before, I would love it if everyone got what they wanted. Getting what we want can be a means to personal growth, which I have written about before. I also firmly believe you have the right to want whatever you want, including in sex. What I want (ha!) you to do is own that it is a want, not a need. And to recognize that no one, including your partner, is required to meet your wants or needs. The fault is in expecting your partner to meet 100% of your wants or needs 100% of the time. And to also not demand or threaten that they must meet your wants and needs…or else. Because your partner has agency and autonomy to make decisions about their life just like you do. It becomes about practicing empathy, acceptance, and understanding more deeply the existential issues inherent in the interpersonal dynamics of relationships.
And finally, when it comes to sexual wants and needs, we tend to think of them as in a separate category. I can hear someone reading this and thinking “Well of course, Diane, I know that a new iPhone or Tesla is a want and not a need! But when it comes to my sex life, it’s different. If I do not get what I want sexually, it cuts so much deeper. It feels like my partner doesn't like me/has rejected me/has judged me/has shamed me.” And yep I have seen this happen for my clients. When partner A asks partner B for a sexual want and partner B judges or shames them for it or partner A perceives judgement or shaming, you bet it can just flatten partner A. However, I think that is about several things: for many people sex is an act of vulnerability, of revealing oneself to another, and risk-taking. So asking a partner to meet a want is like divulging a personal secret; it can be so private and intimate and it feels like so much is on the line that if it does not go according to expectation it is painful. But if your partner in fact judges or shames you for your sexual want, remember that is about them not you. And if your partner was not judging but you felt judged, you are practicing a type of cognitive distortion called emotional reasoning: “It feels like you’re judging me so you must be judging me.”
It is precisely this heady and murky convergence of mental, emotional, and sexual elements I just described that can lead a person to tell their partner “You are not meeting my sexual needs”. Because the pain is deep and the want is sincere it can easily be misunderstood if the person does not know themselves and they can default to certain socially-created scripts. It can have the person believe it is a need when it is probably a want. It is implying the want or need is a commodity to be traded in a transactional manner, and there is a sense of entitlement behind it. No wonder it is a high stress and high stakes moment for many couples - and their couples therapist. It is a rabbit hole that individuals and couples can easily fall down into. And in my experience if they hold tight to these damaging ways of thinking and relating it is impossible to climb out of that rabbit hole without harming each other and the relationship. Remember, you partner/relationship is not a vacuum cleaner, something you have in your life to serve a function and then get rid of/trade/get fixed in when it stops working.
The way through this high stress and high stakes moment is to make the conversation about the deeper experiences underneath the pain. The conversations and accusations are mistakenly about wants and unmet wants but they need to shift to being about assumptions (“Even though we never talked about it I just assumed you would do this for me”), disappointment and grief (“I’m disappointed and sad because my want is not being met”), and fear (“I’m afraid what will happen if I do not get my want”). The conversation needs to also be about how that partner copes when they feel disappointed, sad, or afraid. That comes back to the “know thyself” part. This is a multi-layered process: taking responsibility for your part (the assumptions, your feelings of disappointment, grief, sadness, and fear, and how you coped with them); then fully recognizing your partner has choice in the matter - when you ask for them to meet your want, they will decide if they want to do it. And once you can do these things, it becomes about practicing empathy for the both of you, acceptance of the both of you for wherever you are at, and understanding more deeply the existential issues inherent in the interpersonal dynamics of sexual relationships. And doing all this will probably bring up even more stuff.
Welcome to therapy.
We are finding ourselves in a horrible combination: fears about an unseeable contagion plus the need to socially and physically isolate from others. This is a brutal mixture for many because we often turn to other people to help lessen our anxiety: socializing with friends, going church or temple, time out in the world at restaurants, bar, clubs, shopping, and of course partnered sex. Most of those options are, for now, not possible, with the exception of sex (as long as you live with your sexual partner[s]). So where does that leave you and your libido?
Everyone is having different experiences when it comes to the impact of this moment in time on their libidos. Some, in the face of all this, are reporting that their libidos are increasing while others are reporting a decline or as someone described it to me “it's like it’s dropped off a cliff”.
In the last week I have seen several memes about how the quarantines/self-isolating/shelter-in-place orders have made some people more horny (like this one here). And I have been asked a few times how someone can cope sexually during this period of self-isolation or quarantine. In order to do that, let’s first talk about sex drive.
A person’s sex drive needs just enough anxiety/tension/uncertainty to get activated but not too much anxiety/tension/uncertainty or else the person can get overwhelmed, flooded, and then sex drive goes underground. Think of it like the Goldilocks principle: not too much (anxiety), not too little (anxiety), but just (the) right (amount of anxiety).
So maybe you are one of the ones who are finding that your libido has increased. Why might that be? Perhaps it is because there has been a refreshing twist in your usual daily/weekly routine; you are not spending mind-numbing hours commuting to work and that has enabled you to get more sleep; maybe you are working from home and therefore your usual work stress has diminished; maybe you are spending more time with your loved ones; maybe you are doing some creative projects; maybe sex and orgasm are a form of physical and psychological release for you; or maybe this pandemic has made you tap into your Eros energy. Eros was the Greek god of love, of creativity, of passion, and represented the life force. You might be one of the folks who is rising to the challenge with these unprecedented turn of events. Like I said, sexual energy needs just enough tension in order to flourish; you are feeling that tension and riding the waves. Jack Morin wrote about this in his book, “The Erotic Mind” — when there is an obstacle to overcome erotic energy can blossom. You are overcoming obstacles and feeling pretty darn good about it and yourself.
But maybe you are one of the ones who are finding that your libido has disappeared. Why might that be? Perhaps it is because you find yourself extremely worried about this contagious virus and what it might do in your community/country; maybe the stress of having the kids at home and adapting to distance learning has been hard; maybe you are preoccupied with your finances; maybe you are catastrophizing about the still-unknown future; or maybe the level of uncertainty you are experiencing is too much at times and you are having to do an immense amount of self care in order to just get through your day without falling apart. You find yourself in fight/flight/freeze often. Nevermind the constant need to adapt, adapt, adapt. Like I said, sexual energy needs just enough but not too much tension in order to flourish; you are feeling too much tension and uncertainty and your Eros energy has decided now’s not a good time and gone into hiding for now.
These are simply different ends of a spectrum. Or you may find yourself on one end of the spectrum one day and the other end the next day. That’s OK. There is no one right way to cope with what is happening and your sexual energy is coping just as much as you are. If you have an available sexual partner who is also feeling their Eros energy and open to sexual encounters during this time, I hope you are having a wonderful and wonderfully hot time together. And it is also OK to tell your partner “Not tonight, dear. I’m feeling too anxious about everything.”
But keep in mind what I repeatedly preach: touch is so powerful. Touch can help activate our parasympathetic nervous system, our “rest and digest” system, and that can calm our fight/flight/freeze response. Just make sure you communicate to your partner that you are wanting physical touch and not an erotic/sexual encounter. Hang in there. We will get through this.
We have to socially distance right now, but let's not emotionally distance.
With my own county officially in a shelter-in-place order, schools closed until who knows when, kids at home, many non-essential businesses closed down, people working from home/remotely (I myself am now conducting all my sessions with clients via videoconferencing), concerns about our under-resourced health care system, and everyone having the same spoken and unspoken fears of economic instability and insecurity on the micro and macro levels, shit is hard right now. Our collective future is unknown and uncertainty causes all kinds of anxiety and psychological disruption. This virus is calling on all of us to cope in ways some have never coped before. We are having to stretch hard and fast. That is generally not easy to do. How are you coping with it all?
I am going to stray from writing about my usual human sexuality content today; hope that's OK. In psychology there is a concept: dissociation. This is when a person disconnects from their own body and stops being present to and with whatever is happening for them in that here and now moment. If you have been an astute reader of mine, you know that I frequently write about a person’s inner life. Your inner experience - what are your thoughts, feelings, physical sensations, reactions, decision-making processes, values, etc. What you are noticing and how you are taking that information in. Similarly, dissociation is another kind of inner experience - however it is not taking any information in at all.
Dissociation happens on a spectrum. On the far, severe end of the spectrum is the type of dissociative episodes people describe doing who have experienced extreme bodily violation and/or abuse (torture, rape, profound abuse): “I left my body” or “I watched it happen to me from outside/above my body” or “I have no memory” or “My memory of the event is spotty, like flashes”. (Those flashes of memory represent how the person came in and out of their body.) On the other, lesser end of the spectrum of dissociative behavior is what every single one of us does, probably several times a day: daydreaming. We mentally leave wherever we are and let our minds wander to something more pleasant. “I wonder what my life would be like if X was different?” or “It would be so nice to be back on that beach in Hawaii right now instead of dealing with this.” Other language people use to describe this lower-level dissociation is they “check out” or “numb out”.
Dissociation is at the root of most compulsive behaviors. Have you, or anyone you know, ever said or done the following: “I started binge watching Netflix/playing video games/watching porn and before I even knew it 4 hours had passed”? This is another example of that lower-level checking out, of dissociating. Not staying present in your body to experience whatever you were experiencing.
Dissociation has been pathologized by my profession, and I disagree with this interpretation. Why? Because it is a perfectly appropriate response to a terribly difficult experience. It is the psyche's attempt to lessen the pain.
A “terribly difficult experience” is, of course, subjective. What may be intolerable to one person may barely register as a blip on the screen to another. That does not matter; we are not here to rate the legitimacy of anyone’s coping response. In my experience as a mental health professional I have repeatedly seen my clients over the years “check out” when they experience things like boredom (cue sexual dysfunction); anger, resentment, or overwhelm (cue sexual dysfunction); pain or fear (cue sexual dysfunction); and even joy and pleasure (cue sexual dysfunction). This is a way of emotionally distancing from the pain or intolerability of that particular emotion. Dissociating is way of distancing from your present reality.
So, like I wrote earlier, shit is hard right now. You may be having moments of being gripped by panic and fear. You may be struggling to regulate yourself in the face of near-constant Coronavirus information on every single media platform. You may even find yourself falling down the rabbit hole of reading/watching everything Coronavirus. And when you get overwhelmed, you most likely dissociate a.k.a. check out a.k.a. distance yourself emotionally from your current reality. You pull away or numb out. But I am curious: where do you go? Into your phone? Your own private thoughts? A mood-altering substance? A compulsive behavior?
It’s OK if you find yourself doing this. Like I said, it’s a perfectly appropriate response to a terribly difficult situation. For most people I know here and around the world, this qualifies as a terribly difficult situation. The key is, once you notice you have emotionally distanced from yourself and those around you, just come back. Please. Don’t judge yourself for emotionally distancing - that will most likely start up your particular brand of shame spiral. Instead, praise yourself for noticing where you were and what you did. And then come back to the present moment. And breathe. Your community needs you.
© 2020 Diane Gleim
Hi friends, I apologize for not updating this space recently. As of late all my writing has been posted on my Psychology Today blog, Underneath The Sheets. So while I have been writing, I have not posted them here. I will start cross posting. In the meantime, if you wish to see what I have written feel free to go here and look on the right side under "Recent Posts":
I have been using previous blog posts I've published here to start my Psychology Today blog. I have written something new that I am sharing both there and here. Read on...
Like fish swimming in water, we are swimming in sexual shame to the point where most of the time we are utterly oblivious to it. No one is immune from sexual shame, not even medical and mental health professionals, and it can even happen within or by institutions. Sometimes a person’s sexual shame is so ingrained and feels so much a part of their deepest self that they simply cannot imagine themselves without their shame. Sexual shame is so ubiquitous that when someone or something does not evoke sexual shame and is actually “sex positive”, it can be a shock to the system and cause reactivity like discomfort, anxiety or fear, judgment, anger, threats, and sometimes even violence. All of us have seen this before. It's a difficult topic for many. So let’s pause, take a breath, and look at shame more closely.
Shame is considered a “social emotion” vs. “basic emotions” like happy, sad, mad, glad and what that means is that it is learned via socialization (all the complexities of interacting with others) and through the transmission of group norms. Whereas guilt can be described as “I feel bad because of something I did,” shame can be described as “I feel bad because of who I am” and examples are “I am unworthy” or “I feel unlovable.” Shame originates from morality and when we are talking about morality we are talking about what we believe is “good” and "bad” or “right” and “wrong”. Where do we learn good and bad, right and wrong from? Things like our family, church, school, storytelling (like movies, TV shows, books), art (like music lyrics and music videos), video games, peers, and the legal system all have influence on our sexuality and specifically our sexual shame. (Think about it: when one is charged with a crime in our legal system we plead “Guilty” or “Not guilty” and not “Ashamed” or “Not ashamed”.)
Unfortunately my profession has contributed to our culture’s sexual shame. We have our own shameful history of getting it wrong when it comes to understanding and working with sexual issues. “Treatments” have included shock treatments, castrations, torture, medications, lobotomies and most recently reparative and conversion therapy. Dated theories and treatments focused on so-called abnormality and malfunction and are based on traditional relationships, assumptions, roles, and beliefs. There has been an inability to see the influence of morality and shame on how we analyze (pathologize?) what sexual behavior is done, how much it is done, with whom it is done, and where it is done. Even today, my profession marginalizes sex in most education and training environments and as a result many clinicians’ own personal sexual shame goes unexamined and unchecked as it relates to its impact on their work with their clients. Therapists are humans swimming in sexual shame too and, just like our clients, are vulnerable to the same complex, contradictory, and confusing sexual thoughts, feelings, and behaviors. That is why it is imperative that we collectively proceed with caution on the huge topic of our clients’ sexuality and not continue the traumatic legacy of harming those who have the courage to seek out our help.
Having said that, here are some examples of both the sexual shame a person may have or where it may have come from. I hope these examples are helpful to you in identifying your own sexual shame. We can have sexual shame:
All of these examples of sexual shame are learned. They came from somewhere. You picked them up along the way. And they can be embarrassing, confusing, or even downright scary to look at in yourself. The good news is that since they were learned thankfully they can be unlearned. However, that is no easy task, it doesn’t happen overnight, and takes courage to do.
And like our own individual psychologies, sex is full of contradictions and paradoxes! That is what makes it so fascinating and gives it its edges. There is no reason sex should be feared, thought of as dangerous, judged, or shamed. In fact, your sexual shame is abundant material to explore in therapy. You might learn to move past your judgment and shame and into radical acceptance, experiencing pleasure more fully, and inner peace.
I am excited to announce that I am now an expert contributor on Psychology's Today's website. My blog, Underneath The Sheets, is now live. You see see my posts on that link. I will split my time writing for them and here. I hope you will check it out!
When you study human sexuality, you inevitably study human morality systems. How and why humans value what they value. And I think this is part of the reason why studying human sexuality is so threatening to some: if we examine something like sexuality (that is so laden with values and has been for centuries) then there is the possibility of separating out each piece of that puzzle, re-evaluating each piece, maybe hearing new information, deciding what to do with that new information (i.e. allow it to affect our value or not), then there’s the possibility of those new conclusions not being in alignment with our current life, and the cognitive dissonance that comes with that situation. Eeek, a scary prospect indeed.
Thanks to the work of Bill Stayton, a psychologist, sexologist, and Baptist minister, what I’ve learned is how human beings have three different value systems:
- The combination of acts-centered + relationships-centered
So let’s break this down.
Acts-centered value systems place an emphasis on acts or behaviors and believe that behaviors are choices. Acts-centered value systems (ACVS) have clear delineations between what is “right” behaviorally and what is “wrong” behaviorally. This is a black-or-white, straight-forward value system and way of relating in the world; you know what the limits are and what the consequences are if you do that “wrong” behavior. It’s about rules and it’s all very clear.
Relationship-centered value systems place an emphasis on relationships: with yourself, with others, with society. Relationship-centered value systems (RCVS) focus on identifying the motives (your relationship with yourself) and consequences (on yourself, on others, on society) of acts or behaviors and those motives and consequences determine if something is moral or immoral. This value system requires some amount of gathering information and some amount of critical thinking skills and predicting. RCVS believe context matters and that in one situation a behavior may be “good” while in another situation that same behavior may be “bad”. This way of thinking is more gray and takes time to come to a decision.
A perfect example is Robin Hood. Was he right or wrong to do what he did? Yes he robbed, and with an ACVS this is “bad”. But he robbed from the rich to help the poor, and in a RCVS this is “good”.
The combination value system borrows from these two other systems depending on the issue and the comfort with the “act” or behavior in question. It’s even murkier than a RCVS. It is generally confusing and it ebbs and flows. On some issues you may be black-or-white while on others you explore the motives and consequences.
Despite what you may think about yourself or others, the combination value system is the value system held by most people. For example when it comes to sexuality most people, or so it seems, seem to be acts-centered on things like pedophilia and bestiality — they have clear, straight-forward opinions about it being “wrong” (whatever their reason). Laws have been created to support this way of thinking on these two issues. While at the same time those same people might be relationship-based on another sexual issue.
So now let’s apply these and take an example straight from current events…abortion. First, let’s all take a deep, deep breath. It’s a heated topic right now and one that, IMO, maybe we can work to bridge the divide if we slow down and better understand ourselves and our perceived opponents.
The ACVS approach to the issue of abortion is: those people that are anti-abortion believe that abortion is “wrong”. These folks are basing this on their belief that life begins at conception and therefore ending that life via abortion is an act akin to murder so therefore this act is “wrong”. Remember, to those with this value system acts are choices so you can choose to act or not act — meaning you can choose to have an abortion or not have an abortion. If you choose to not act, then you are not “wrong” but if you choose to act and have an abortion, then you are “wrong”. Those people who have a RCVS ponder the dilemma of an unwanted pregnancy and look at the relationships with and consequences to those involved: what was the relationship between those two people who had sex and caused the pregnancy? Why is it an unwanted pregnancy (i.e. violence or trauma like rape or incest)? What are the consequences if the pregnant woman brings the pregnancy to term or terminates? What are the consequences if government bans abortion full stop? This is where factors like consent, ages of those involved, access to health care, financial means of support, the role of public school sex education, etc. come into play for the RCVS folks.
One “side” is focused on the behavior/act itself while the other “side” is focused on motive/cause and consequences. One “side” frames their position as “pro-life” because they value the life that they believe was just created while the other “side” frames their position as “pro-choice” because they value examining the consequences of a choice. These are two entirely different and separate aspects of the same abortion issue. They are not addressing the other "side's" assertions. Why aren’t the ACVS folks talking about the motives and consequences of an unwanted pregnancy? Some actually are: those who say abortion is permissible if it was caused by rape or incest. And actually, if someone believes that then I would argue theirs is a combination value system on abortion and solely ACVS. And why aren’t the RCVS folks talking about when life begins? No one is listening to “the other side”, that “other side” feels it, and when we feel not heard we usually talk louder, assert our position more unkindly, and get into a fight. On top of it all, emotions naturally run high on an issue like this. So things stay contentious, the divide between the “sides” remains deep and wide, and the impasse unfortunately calcifies.
This so reminds me of high conflict couples; it’s really not that different. Any good couples therapist would teach a high-conflict couple the importance of understanding. That understanding your partner’s “side” does not equal endorsing or agreeing with “their side” and it does not diminish “your side”. It simply means understanding their perspective, why they believe what they do, while holding on to “your side”. Unfortunately many people are defended against understanding their partner; it’s somehow threatening because it requires vulnerability (a.k.a. putting our shields down). But when we understand our partner it can lead to a more respectful dialogue and maybe, just maybe, finding a middle ground. This is what is desperately needed in today’s cultural and political climate. Acting — and listening — respectfully to our perceived opponent requires good self-management skills. I know that’s a big ask but I believe we can do it.
I’ve thought for a long time that Washington needs couples therapy. And so maybe this blog can help you look at this issue, and maybe other issues, and your so-called opponent, with a little more insight, understanding, and calm. IMO it’s the only civil way through this.
I usually write about sex and relationships, but on this sunny spring day I’m going to veer off that a little bit and write about technology with a little bit of sex thrown in.
I cannot seem to find a person who doesn’t have a smartphone anymore. Now I realize I live in northern California, one of the more affluent places on the planet and a mere 100ish miles from Silicon Valley and 50ish miles from San Francisco. Technology is what my region is known for (and on a micro level wine and weed too, but that’s another conversation for another time). People say that technology, and specifically smartphones, have radically changed our lives and our norms. True. Fifteen years ago would you have imagined you might willingly pay to sleep in a stranger’s home while you are on vacation or pay to get a ride in a stranger’s car?
(As an aside, I think it’s worth briefly mentioning how most everything we get from our smartphones is based on our own literacy. It seems lost in the conversation when we talk about technology. Last year I attended a conference where a speaker talked about the challenges her medical center had in providing care to patients who could not read or write *in any language* but who had smartphones. Think about that. It’s wild how quickly we take literacy for granted when it comes to smartphones.)
Back to technology. Lately I have been increasingly noticing the very language we use to describe what we are doing with our smartphones and other technology. We say we are “more connected” - but what we really have is more correspondence in the form of emails, texts, likes, and comments. We say we “go online” to look something up — but where are we going exactly? We are not going anywhere with our physical body - we are probably sitting on our couch or at our desk - and instead using the internet as a research tool or library. We say someone is “using porn” — when in reality they are most likely sitting by themselves viewing pornographic imagery. (Do you say you use walking? Do you say you use dinner with friends?)
I fully admit I am not a digital native. I remember when texting first really came into people’s lives. At the time I myself didn’t quite get it - why would I text someone but not call them? (Yep, I know I sounded a lot like “Get off my lawn!” and I own it.) Also at that time, I was a counselor at a middle school and of course the students had really grabbed ahold of texting with a frenzy. One day I asked one of my middle school-aged clients, “Why do you like texting so much?” And I will never, ever forget what that boy said: “Because there’s times I want to tell someone something but not have a whole conversation about it.” Aaaaaah, yes! From the mouths of babes. He described a one-way communication without a lot of risk or vulnerability. Ding ding ding! Ironically, soon after that conversation I was at a huge and loud outdoor concert and I was trying to find my friends…so I texted one of them and we found each other quickly and painlessly. Texting in that context made it so much easier to fulfill my goal. If I had tried to call my friends on the phone we probably would not have been able to hear each other, certainly not find each other in the mass of people, and just gotten more frustrated. Since then I have come to appreciate texting more and see the value to it as another means of communication/correspondence. But it is most definitely not connection.
IMO how we are thinking about and talking about the internet, technology, and how we use these two things is becoming increasingly problematic and inaccurate. The language we use to describe how we are incorporating the internet into our daily lives is sadly misleading and because of that our language is shaping our experience of it. The experience shapes our language and the language shapes our experience. It’s a peculiar feedback loop to observe. Now I also know that the same word can have different meanings based on a variety of factors. But I’m not sure we as a society get that when it comes to technology — certain technologies came into our lives so abruptly we adapted to it by using existing language to at best approximate what we are doing with that technology. We think we are connected when we are not.
We may have more easy access to other people and other information as a result of the internet but we’re most certainly not more connected. Most of the time we are sitting *by ourselves* having an internal-to-us experience with the technology in our hand or on our desks, several steps removed from real human-to-human interaction.
Technology is also a vehicle for our imagination and projections; it’s there for every flight of ideas we have without any limits. There is a growing body of evidence that tell us with the increased use of tech devices comes increased rates of dysphoric moods, not more euphoric moods. Using technology in certain ways makes many of us feel worse, not better. We think we are connected when we are not...and then we do not know why we feel bad. And when I work with couples and I ask them “What’s your goal in this therapy?”, it is quite common that I will hear the answer “To feel more connected to my partner during sex.” Connected - there’s that word again. If they are referring to that feeling we get when we are “connected” via the internet and technology, I don’t think that is what they are referring to; people don’t come to therapy to feel worse about their situation. Feeling connected from online activities is not even remotely the same event as feeling connected to another human being, in real life, who (maybe) loves and cares for you, and sharing a mutually pleasurable experience with them. Remember, while technology can make you cum it can’t hug you back.
I’m sitting in my office today and there’s a funeral happening in the church next door. (This happens regularly.) The church and my office building share a parking lot so the attendees’ cars have filled it up (the deceased person was clearly popular), the people are dressed up and wearing dark colors, there’s a couple of limousines, and of course there’s a hearse parked out front. Always stark imagery.
In case you didn’t know, my office is located in a building that used to be a Catholic school. After the school shut down, it sat empty for years. Then it was renovated I think about 30(?) years ago and converted into professional offices. It’s a majority of therapists in the building now. The church still owns the building (and I like to joke that I make my rent check out to “God” - because hey, don’t we all?) and it even still has a cross on the top it.
Having my sex therapy practice in an environment such as this has been a fascinating experience. One client many years ago who was raised Catholic said she could still smell the special incense used by the priests when she walked into the building the first time. My brother-in-law, who went to Catholic school, briefly came into the building one day to help with a quick furniture project and got the heebie jeebies. For those who have experienced the Catholic church first-hand, it most definitely has an initial effect and then they seem to move on. Other clients don’t notice a thing. Turns out it’s been a useful assessment tool, as sexuality is so often influenced by religion.
Setting aside the deeply troubling controversies of the Catholic church and its profound struggles with sex and sexuality, because of the funeral that’s happening next door today I’m thinking about sex and death. Those in my profession like to say, “Sex and death go together” and it’s true. Creation/destruction. Pleasure/pain. A beginning/an ending. Connection/abandon. Hope/despair. You get the picture. They are two sides of the same coin. It’s not a dichotomy but a complementary relationship. One exists because the other exists.
For example, have you ever been to a funeral or memorial service where there was laughter? I have several times. They weren’t just sad or somber events; they had humor too. Sometimes that humor was intentional and sometimes it was spontaneous. The times I’ve experienced this I’ve genuinely wondered if the laughter occurred because of what I thought was our collective discomfort with death and loss. But over the years I’ve come to think no that’s not the case. Rather, it seems like human nature needs the tension between these two forces of pain and pleasure, anguish and joy. Without it, life seems boring, one dimensional. It also makes life messier (and I say that in a non-pejorative way). Having adopted this opinion, it has certainly changed how I work, I believe for the better. It’s allowed my clients and me to have a fuller, more nuanced and layered experience of their lives both in and out of the bedroom. Helping my clients find all the layers actually brings me joy and a sense of awe for being human.
Sex isn’t just about a biological process in the body. Sex also includes greater ideas and mythologies we’ve internalized along the way. And like death, there is much in sex that is still a mystery. In my profession we call this the spiritual side to sex. Sex can be a transcendent experience, one where you feel an otherworldly communion with your partner(s) where time and space can temporarily fall away. We don’t really know how or why this happens; we just hear people say it happened to them — and maybe it’s happened to you. I sure hope so. It’s one of the better-feeling mysteries in life.
I say this often in my office. In fact, I said it just the other day to a client. I really believe people know this on some level. They understand that porn is meant for entertainment purposes, the majority of it with the male gaze in mind, and that like the rest of Hollywood it has all kinds of movie-making secrets and techniques to trick the viewer into believing what they are watching is really, authentically happening between the actors.
Yet in the absence of comprehensive sex education in our country, coupled with the inherent curiosity everyone seems to have about sex, I think it’s inevitable that some people look to porn to answer the questions they have about sex. Examples of those questions and curiosities can be:
“My body sexually functions a certain way - is that normal?” (And several of my clients know that the “n” word — “normal” — is not allowed to be said in my office because it’s a word predicated in shame)
“What do different shapes and sizes of bodies look like naked and sexually function like?”
“I’ve heard about or read about X but I’ve never seen it myself; in my imagination it turns me on. I wonder what that looks like.”
“I’ve always been turned on by and wanted to try Y yet I’ve never had a partner who expressed interest in doing it. Porn is where I get to experience Y.”
So much of porn is vicarious experiencing - of different bodies, activities, scenarios, and sexual appetites. It is fantasy brought to life. When we can understand and appreciate porn for this, then almost all of porn’s controversies practically disappear.
Let me also give mention the idea of ‘suspension of disbelief’, something I learned about as an undergrad when I took a few film classes. This phrase is often used to describe how viewers of film and television agree to follow along, so to speak, with the fictitious world they are watching. They stop thinking critically whether or not whatever is being portrayed can actually happen in real life - they are suspending (putting on hold) their disbelief (their doubts and skepticism) in order to join in with the fictional story. Doing this makes watching the story that much more fun for the viewer - gives us a greater, more intimate and emotional experience with the film or show. And this is precisely what art intends to do — give the consumer an emotional experience.
IMO, I think when people suspend their disbelief with porn and believe “it’s real” it’s because much of it does look so darn real. That’s precisely what porn producers are intending to do - making the viewer believe what we’re watching is really happening - and they go to great lengths to make the viewer believe. Believing this is actually happening, or could actually happen, can deepen the emotional investment for a viewer and thus give the viewer an even more enjoyable viewing experience. In online porn this translates to more clicks or pay per views. What is so interesting, however, is that we don’t seem to suspend our disbelief when it comes to animated/anime porn (a human-shaped cartoon character having sex with a unicorn for example). In that situation, we know with certainty it’s animated, we know it’s just make believe…so why can’t we understand that all porn is just make believe and enjoy it for the entertainment value it offers?
Because porn is about sex and we don’t know how to think critically about either porn or sex. There are common tropes in porn - like the pizza guy delivering a pizza and a beautiful, lusty woman answers the door. Do we *really* think this happens to every pizza delivery guy? Of course not. If we did, I can think of a few men I know who would quit their current jobs right now and go get a job delivering pizzas. Other, more noteworthy tropes in porn are: how women are always willing to have sex; how women don’t have any sexual boundaries or say “Ouch that hurts”; how men are always able to get an erection without an issue, maintain their erections, control when they orgasm, and demonstrate no anxiety about any of this/always appear confident; how everyone’s always so enthusiastic to have sex/no one’s tired or had a stressful day and just not in the mood for sex. I think you get the idea. Like I said, porn is fantasy.
And finally, a common critique of porn is that it leads to unrealistic expectations about sex and your partner. This is true ONLY IF you do not understand that porn is fantasy and entertainment. And it can also lead to unrealistic expectations about sex if your actual, real life sex life leaves you unfulfilled. But porn isn’t responsible for your sex life; you are.
In a recent session, a client was struggling to accept and get on board with her husband’s ideas of what is sexy. According to her, he even went so far as to say he doesn’t find her sexy because she doesn’t look or act like the women he sees in porn and he finds those women sexy. (This is a perfect example of why we shouldn’t tell our partners everything we think and feel.) She then told me how she’s been trying, albeit with a lot of anger and resentment if she’s being honest with herself, to be more like the women her husband sees in porn but as a result of that resentment it’s been a half-hearted attempt and ultimately unfulfilling because that’s just not who she is. She’s come to see me to examine her husband’s ideas about what is sexy, how those impact her and their sexual relationship, and how she’s come to feel very un-sexy over the years. I interrupted her and said, “You don’t think you’re sexy?” She said no earnestly. And I said, “I see a smart and feisty woman who, after decades of conforming to her husband’s ideas about all things sex, is finally giving a shit about her own sexual experience and her own sexual pleasure. And THAT is sexy!”
Because it is. And I’ve learned over the years that most people seem agree with me. I’m referring to how my clients say they want their partner to “want to want to have sex.” That "wanting to want" is an IRL energy, attitude, and enthusiasm that is sexy to most people. More than any nameless digital visual will ever be. And if more people thought about ‘what is sexy’ in this way instead, perhaps they’d find the eroticism, sexual pleasure, and connection with their partner that perhaps they have been longing for.
On my way to work this morning (Valentine's Day 2019), I heard an internationally-known psychologist and expert on relationships be interviewed. In the course of the conversation about marriage and relationships, the interviewer asked “Some people say you need to work on the relationship while others say if you need to work on the relationship then something’s wrong. What is your take on that?” And the expert replied, “Well, I hate to break it to you, but you need to work on your relationship.”
NO NO NO NO NO. My profession’s marketing department has gotten this all wrong.
It drives me bonkers when I hear the phrase “The Relationship.” It’s not THE relationship - something that’s out there, separate from you and your partner, an entity that you manage like your checking account.
But this is, unfortunately, the bill of goods my profession has sold people to expect when they hear an expert on the radio say what they said today. So it's no surprise many clients come into therapy with a laundry list of complaints about their partner (because it's about "The Relationship", not me personally). They want the therapist to fix their partner while they sit passively by, nodding in agreement when the therapist points out their partner’s imperfections. They’re waiting for the “I told you so!” moment. At least that is what I think some people fantasize will happen in therapy. Like a form of destructive validation. Meanwhile, when one partner engages in that behavior, *of course* their partner is going to become defensive and/or counterattack and tell the therapist all the ways their partner is at fault. And we’re off to the races. This is not a productive use of everyone’s time in therapy.
The fact is, it’s YOUR relationship or even better yet it's OUR relationship. Try thinking about it this way instead: “I create this relationship together every day with my partner. This relationship is a part to me, it’s a part of my partner, and it’s a part of our life together. It is ours to own, change, and nurture.”
Because the reality is, you need to work ON YOURSELF, not “The Relationship.” This is what my profession needs you to know. Any relationship, but particularly the intimate one you’re currently in, *will* challenge you and you *will* feel uncomfortable feelings. It’s inevitable. And it’s not your partner’s job to make sure you aren’t challenged and don’t feel uncomfortable feelings. If they believe this (or you lead them to believe this), you will find out down the road all the harm it causes.
So how do you cope with all this? You need to work on understanding your feelings. You need to work on listening non-defensively. You need to give up black and white thinking. You need to work on identifying what you want and need (and what the differences are between these) while learning how to communicate those as requests, not demands or threats, and preparing yourself for disappointment. You need to learn about your anger and how to soothe yourself when you feel it. You need to practice empathy, loving kindness, and patience in those moments when it’s especially hard to do so. You need to remember why you chose your partner in the first place. And the built-in paradox of all this attention to self is that you need to learn it’s not all about you.
These are not things your partner, or your couples therapist, can do. Only you. And I promise that when you take your focus off your partner’s faults and instead focus on how you can grow and stretch yourself, “The Relationship” will improve. Not because of any magic that the therapist spun, but because you took ownership and responsibility for what you are doing and choosing to act differently.
Happy Valentine’s Day.
Last year my friend’s husband died suddenly and like when all young and thriving people pass unexpectedly it was and still is a huge loss for our group. A few months after he died, my friend asked if she could talk to me since, as she said, “You’re a sex therapist and all.” She told me about a specific pain and heartache she feels regarding the death of her husband. They had a monogamous relationship and with his abrupt death she also lost her partnered sex life that same awful day. She told me that sure she misses the sex, but what she is realizing in her grief is that she is also missing the laughing, the cuddling, the caressing, the hugging, the holding each other, the looking into each other’s eyes, the silly moments, the awkward moments, and yes even the disappointing moments. While masturbation scratched an itch, she said with partnered sex she had exactly that: a partner and intimate friend with whom she could share all those things. It was the 'sharing with' that felt particularly special for her, and is something she profoundly misses now. I was, and still am, deeply moved by her experience and her description of her experience. And with her permission, I share it here as a way in to discuss how partnered sex is different than solo sex.
(On a side note, she also said this issue has not been addressed in any of the grief support groups she’s been going to. Yet another time my profession falls short when it comes to sex. And just this morning on my way to my office I heard the radio deejays describe partnered sex as “that special connection you have with someone else.” It seems everyone understands partnered sex is fundamentally different than solo sex.)
As I talked about in my previous blog (see below), I define solo sex as your first and primary sexual relationship and it is a relationship you have for your entire life regardless of your external relationship situation. I also said that solo sex is your internal experience of your sexuality and chosen external expression of that internal experience. For those that also desire a partnered sex life (because there are people that do not and that’s just fine), solo sex is the foundation of partnered sex.
Partnered sex is when you decide to share your solo sexual self with another person or persons and they decide to share theirs with you. So all parties must first consent. While consent is necessary it is not enough. What exactly is everyone consenting to? For how long? In what order? What kind of safer sex method(s) will be practiced? Who decides when it’s over and how? And what will happen after it’s over? When I ask my clients that initial question (“What are you consenting to?”), they usually say “Duh, sex!” But that still is not clear enough because as I’ve learned everyone has a different idea of what sex is (and isn’t).
As you can see from my questions, when we choose to engage in a partnered sexual encounter, there is a lot more that needs to be addressed ethically. How many times in your life did you engage sexually with another person but you didn’t discuss beforehand about what would and would not happen or what you would and would not do? I think everyone. Looking back, what was missing? “Yeah Diane, it’s called communication” is probably what you’re thinking. OK sure. But that word, “communication”, is horribly inadequate to describe what skills are needed in a partnered sex scenario. A better description of what is needed are things like: self-awareness regarding your likes and dislikes, turn ons and turn offs, and hard and soft boundaries; verbally describing these things clearly and assertively — and of course having the courage to say it; knowing how to negotiate when differences occur; resolving your ambivalence if there is any about any aspect; understanding your hopes and expectations for the experience itself, what happens after, and describing these expectations; preparing for the possibility of disappointment (or judgement) and coping well if it happens; and then having the knowledge that, empathy for, patience with your partner(s) has all these things going on too. You don’t need all these skills in solo sex and this is what is precisely different about solo sex vs. partnered sex. And you can see why when partnered sex “is good”, it brings people closer together and they say they feel more connected - they’ve not only shared of themselves and shared something with someone else, but they’ve also revealed something about themselves to another and it was received with respect and (hopefully) tenderness. And you can also see why when partnered sex “is bad”, just why it’s so darn painful: partnered sex offered the promise of intimacy and connection, seeing and being seen, and mutual pleasure but resulted in hurt feelings, disconnection, and perhaps even relationship discord.
Yes, it is a complex process that in my experience most vanilla (as opposed to kinky) people don’t take the time to do…and when they don’t, they end up experiencing all kinds negative consequences. If you know anything about kinky folks, one of the the hallmarks of kink is how and what is discussed and negotiated beforehand. This is a valuable skill many vanilla people need to learn from kinksters.
I’ve had clients tell me that there are times when they are in the mood for and ready to handle all the complexities of partnered sex that I just described and there are times when they are not in the mood and not ready for dealing with the complexities of partnered sex. I think that’s great - that someone has that much self-knowledge to know this about themselves. I hope more people will come to know and understand themselves better in this way.
I often talk with my clients about “solo sex” and “partnered sex.” If you Google “solo sex”, you’ll see that in the majority of the articles where the phrase is used, it’s referring to masturbating by yourself and that seems to be how most of my clients understand the term. OK sure, that’s fine — another phrase for masturbating — but don’t we have enough of those already? Ask any 14 year old adolescent male or Adult Swim viewer how many terms for masturbating he/she/they can think of in 10 seconds and you’ll see what I mean. Instead, I want you to expand your conceptualization of the term “solo sexuality” to include SO MUCH MORE. I think that if you do, your sex life will improve.
So what do *I* mean when I say “solo sex”? Yes, I can be referring to masturbating by yourself. That’s just one aspect of solo sex. But I’m also talking about your internal experience of your sexuality and chosen external expression of that internal experience. This can include your romantic, sensual, erotic, and sexual fantasies; your turn ons, turn offs, and how you relate to them (if you don’t understand what I mean by this just think of the ashamed fetishist); how you experience your sexuality in your body sensually, erotically, and sexually; your relationship to pleasure; how you utilize your mind and body to express this sexuality (so here’s where masturbating comes in but I also mean things like how you dress or dance or when and where you choose to feel sexual feelings and with whom); and heck even things like that pleasurable and fun zing! you get when you see an attractive person on the street or the decision-making involved when you decide to flirt with that cute barista who makes your latte every Friday just the way you like it.
Do you see what I mean now? Solo sexuality needs to encompass all this and more!
Your solo sexuality is your first and primary sexual relationship and it is a relationship you have for your entire life regardless of your external relationship situation. It can and does frequently change over the course of your life as you grow and have new experiences both challenging and successful. Unfortunately for many, their solo sexuality can also cause immense confusion, fear, and shame.
Based on the clients I have seen over the years and speaking in generalizations (something I should probably get a slap on the hand for), it seems that a lot of men regardless of sexual orientation seem to understand my broad concept of solo sexuality. They have already had hundreds (if not thousands or more) of private experiences with themselves and their solo sexuality. One subset of people that seem to need some help with this idea is women. Many of my female clients don’t have a solid understanding of, acceptance of, or pleasure in their solo sexuality. There’s lots of possible causal factors for this: our culture’s fear of a truly sexually empowered and embodied woman; the taboo nature of female pleasure; and how historically female sexuality has been minimized or denied or thought to be there for the purpose of men. Some women feel uneasy about masturbating (see my previous blog entry) or some women feel that they *should* (there’s that word) only experience their sexuality in a partnered setting. In fact, it’s not just some women who have this latter belief. Another subset of people who seem to need help with my idea of solo sexuality are a few religions and 12 step programs that say partnered sex is the only acceptable sex one can have. Ay yi yi.
Besides all the things I’ve mentioned above, another thing I tell my clients who have little understanding, acceptance, or pleasure with their solo sexuality is that their pleasure during partnered sex is dependent upon their understanding of their solo sexuality. How can you tell your partner where or how you like to be touched if you haven’t explored that on your own? In the absence of that knowledge, these clients stressfully default to focusing on their partner’s experience “I’ll just make it about you tonight”. So long as their partner isn’t pathological, at first this can be experienced as my client is giving them a gift and/or being sexually generous. But it’s been my experience that if this behavior happens repeatedly over time it’s inevitable that their partner will want them to become invested in a mutually pleasurable sexual experience. Their partner is asking for a sexual equal. What’s more feminist than that? This means knowing what you like and want sexually in a partnered experience. So once again we’re right back where we started: developing and understanding your solo sexuality. It’s a worthy endeavor to embark upon. And I hope that by reading this, you’ll become more attuned to your solo sexuality and its fascinating nuances and edges. In a future blog post, I’ll discuss more about the differences and similarities between solo sex and partnered sex.
One of the genuinely heartbreaking aspects of my work is how little cisgendered and heterosexual women know about their own bodies. In particular, how little they know about what I call the anatomy of pleasure. Now that being said, most, if not all, of these women have some knowledge about the clitoris. That when I say the phrase “sexual pleasure”, many of them tell me they immediately think of this one organ.
“Yes, the clitoris!” I say with excitement. "Talking about the clitoris a great place to start. Have you found its four legs on your own body with your own hand or a vibrator perhaps?” I ask. Most of these women give me a confused look or a blank stare. Then I often hear one of the following responses:
“The clitoris has legs? What do you mean?”
“I don’t own a vibrator.”
“I have never touched my genitals with my own hand.”
As I’ve said before in this very blog, I am so thankful for my clients’ honesty as it tells me precisely where we need to begin our work.
And so I tell them about the clitoris. How it’s not just the external nub; it has four “legs” inside the body. I can get quite animated and enthusiastic extolling the wonders of the clitoris. Hell, sometimes I even get out a piece of paper and draw a representation of it. (I always wonder what my clients think when they see this side of me.) If you don’t know what I’m talking about, here’s an article that explains more.
A good part of my work involves this kind of education (a.k.a. sex education) as the first step. But as any sex therapist can tell you, that’s often not enough. Putting this information into the context of the client’s own psychology and sexual relationship is the next crucial step.
First, integrating this knowledge into the person. Many women tell me they feel awkward, uncomfortable, and some even say they feel “dirty” or “bad” for touching their genitals with their own hand. I point out they touch their own genitals when bathing, when going the bathroom, dealing with their menstrual cycle, perhaps using certain contraception and safer sex methods, maybe even when changing or adjusting clothes. So we look more closely at why touching her own body for pleasure is taboo to her. Shame always is part of this and usually takes center stage; there’s usually a lot to unpack and reprogram.
Eventually comes the day when she gets a ‘homework assignment’ from me, her sex therapist: go home and touch yourself or buy a vibrator and use it on yourself. Then come back and tell me how it went because learning your own body is so crucial to understanding your own sexual response and enjoying a sexual relationship. And that’s when therapy can really enter a whole new dimension.
Different women have different reactions to this ‘assignment’. Some are so curious and motivated they leave my office and stop at the local sexuality shop on the way home. Some go home and immediately buy a vibrator online. Some make a point to take a private bath that night. Other women, though, are more hesitant or ambivalent. That’s OK, I tell them; that just means we need to work on the shame some more.
(And BTW it’s not just the clitoris that allows a woman to feel sexual pleasure. Other parts of the body are erogenous zones too like breasts, the inner thigh, neck, ears/earlobes, small of the back, buttocks, hands, feet and toes. It’s wonderfully unique from person to person.)
Women and their own pleasure. It’s such a huge topic that every woman needs to grapple with and decide where they want to land with it. The question is, where do you want to be / what’s your goal in terms of your own sexual pleasure? The answer to that question will tell you exactly the work that needs to be done to get there.
I work with many couples during and after the discovery of an affair or other form of betrayal. Let me tell you about one of them.
This couple came to work with me after the wife learned that her husband had had an affair with a work colleague. She was devastated and was openly questioning if she wanted to stay married to him. He was shame-ridden, deeply remorseful and afraid, saying he was willing to do anything to “save the marriage”. We spent the first year or so of their couples therapy working on managing the fallout from the affair, its impact on their relationship and the medical, financial, emotional, relational, sexual, and existential/spiritual consequences. Things mostly stabilized between them and they found a “new normal” in their lives.
Post-crisis, we began to discuss what their relationship was like pre-affair. This is an incredibly important part of the recovery work — I cannot emphasize this enough. They described an all-too-common situation I frequently hear from couples: her center of attention was being the stay-at-home parent to their young children while also managing her mental health; he focused on being the breadwinner and not causing her stress. As is so often the case, sex fell by the wayside. They described their sex drives as him having a higher libido, her a lower libido. He eventually explained how their lack of sex is what led him to have the affair. This resulted in her feeling guilty for not “giving him sex” (BTW, sex is not something you “give” another person but that’s another topic for another time), feeling angry that in his mind his decision to have the affair was about her not having sex with him during that very, very difficult time, and also feeling resentful about the now omnipresent pressure she felt to have sex with him to deter him from having another affair. He repeatedly said that if she would “just have sex with him more often”, he would be a happy guy.
Variations of this is, unfortunately, a narrative many couples create. When someone decides to do X (have an affair, be in a bad mood, start an expensive hobby) because “my partner doesn’t have sex with me.” People often make sex — or the absence of it — the reason they do something in a relationship. This is a false narrative!
When you make it about sex, you’re not making it about other important things, like your feelings about sex. When you make it about sex, it means you’re not being vulnerable with your partner and sharing what role sex plays in your life. When you make it about sex, it’s a sneaky way of shifting responsibility away from your own actions and experience and onto something — or someone — else.
Knowing that making it about sex is a slippery slope into avoidance behaviors I just described (and what would be the relationship implications if they did yikes), I didn’t want this to become their dominant narrative about his affair or their pre-affair sex life. So I asked him:
“What are you thinking and feeling when she doesn’t have sex with you?”
Him: “I’m thinking, I wonder if she still likes me, is she still attracted to me, does she still want to be with me.”
“Aaah” I said. “You have thoughts and feelings of self-doubt and relationship insecurity?”
He said yes.
I continued: “And so the way you know how to deal with those uncomfortable thoughts and feelings is to have sex with your wife. And when you have sex with your wife do those uncomfortable thoughts and feelings go away?”
“Yes,” he said softly, but he was looking me squarely in the eye so we all knew we were getting somewhere. She was quietly observing our exchange, riveted by what she was hearing for the first time.
I continued: “Well then, we need to help you find another way to cope so that you don’t always rely on having sex with your wife to alleviate those painful thoughts and feelings.”
There was a long silence in the room. This was big.
He risked vulnerability to show her his inner life. She saw a side of him that she had never seen before. Because he revealed this important thing about himself to her, he felt closer to her and she felt she understood him better. It was a powerful session, it shifted things between them, and was a moment they continued to reflect upon after it was over.
I hear a common complaint from my clients: “<Sigh> I just don’t have the interest/drive/desire for sex." These clients feel badly about this and wish it was different. Maybe their health isn’t what it was. Or maybe they feel pressured by their partner and that is what is bringing them in. Or maybe they long to have more sexual interest/drive/desire like they used to; nostalgia is a powerful force my clients and I frequently reckon with in my office.
What I also hear from many of these folks is how busy and full their lives are…to the point of regret or even downright dislike. They describe a life not of abundance but of near-constant responsibilities in all areas: demanding jobs, demanding kids, the high cost of living in northern California, aging parents, the wish to engage more in hobbies and socializing, the need to exercise and eat healthy and get adequate sleep, the never-ending cycle of household chores and errands, and some vague notion about pursuing personal fulfillment and happiness (“Is this all there is?”).
What many of these folks end up doing is relating to sex the same way they approach the rest of their pressure-filled lives: using a cost-benefit analysis with time and energy playing major factors in their decision-making. So for example, many people relate to their workday mornings as follows:
“I must be at work at 9am. Therefore I will need to wake up at 6am so I have enough time to walk the dog for 30 minutes, then leave for the gym at 6:30am and workout for 1 hour, then at 7:45am I will get showered and dressed, then at 8:20am I will start commuting to work and it takes me 30 minutes to get there but I will give myself a little bit of a cushion in case there’s traffic.”
Folks also tend to relate to their workday evenings similarly: “I have to leave work to pick up the kids at 4:30pm, then drive home, make dinner by 6pm, make sure the kids do their homework, get them bathed and in bed by 8:30pm, then maybe after that I can do the dishes, maybe a load of laundry, and in bed by 10pm.”
Every task is broken down into discreet chunks of time and prioritized according to any number of values (i.e. necessity, duty, self-care) while also assessing how much time and energy is needed to do that task and how much will be spent. I have heard more than once over the years a client say that when their partner invites them to have sex at night, they say to themselves “But I’m already so tired…how much sleep will I lose if I have sex tonight?” Wow - talk about unsexy sex. No wonder your sexual interest/drive/desire has declined.
Sure, sometimes sex is a box you check off your list of things to do. I don’t deny that reality and sometimes it honestly is a humdrum experience. In long term relationships that is going to happen…and when it’s disappointing and uninspired you need to practice resiliency, not blame your partner, and even move towards them versus away from them. After all, do you expect every dinner to be fantastic? You probably don’t, or I hope you don’t. Some nights you eat a bowl of cereal and move on, knowing that tomorrow and the next day and the next day you have another opportunity at dinner. Sex in a long-term relationship is the same way.
But when you perpetually consider sex a chore to maintain your relationship, it’s now in the same category as brushing your teeth or exercising to maintain your health. You do it because you should. There’s no emotional or relational investment to your partner, the sex itself, or a good outcome. You’re on autopilot. You do it to get it over with. When sex becomes “yet another thing you should do” in your life, you now relate to it differently and it inevitably loses its luster. (Cue that nostalgia. It’s often where people go in this moment.)
When clients describe their sex lives with a mindset that it’s “yet another thing to do”, I hear it and it honestly sounds pretty awful to me too. I feel sad for all involved. I hear one partner often trying to keep hope alive and keeping something afloat, while I hear another partner appreciating the other’s efforts but also feeling some degree of pressure and ultimately playing defense. The first thing I do is I usually encourage everyone to stop doing what they’ve been doing. I sometimes get push back from clients: “But then we’ll never have sex!”, they fear. “Doing that brings you the ho-hum sex you’ve been having, and isn’t that why you’re here in my office, to stop having that kind of sex?”, I say. Yes, they quietly acknowledge.
Creating a good to great sex life is not a emotionally or behaviorally passive experience and the work it takes to get out of these sorts of sexual ruts is proof of that. Your passivity is what in part produced your current humdrum sex life. It’s also not good to great because of your partner or because of mood-altering substances or because of the youthful and firm body you used to have or because years ago your feelings about your partner were mostly positive based on limited experience. Good to great sex is about you having an enthusiasm and openness to a not-yet-determined experience. Imagine that — not playing it out in your mind like a script that’s already been written and everyone knows their parts! This is a better mindset to have. And having the courage to tell your partner what you like and don’t like sexually helps too. But that’s usually step #2 in this process.
More on that later.
Besides doing an assessment based on the presenting problem in my initial appointments with new clients, I’ve begun to assess for how does this person or couple relax. So I ask “What do you do to relax?” And I hear common answers like “Exercise” or “Watch movies or shows” or “Play video games.” I hate to break this to you, but none of those things actually help you RELAX.
Exercise gives you a temporary rush of endorphins (i.e. make you feel good and that probably has a secondary sexual benefit when it comes to your self-esteem and body image) but it can also make you feel fatigued - or as a client recently described it, “spent.” And watching movies and shows or playing video games distracts us, takes our mind off other things, and is a bit like numbing ourselves. When I describe that relaxed is a state of feeling calm (vs. tense), alert (vs. distracted or numb), and awake and energized (vs. tired), many of my clients sheepishly admit “Yeah, I don’t really have that feeling regularly.” Some clients are even courageous enough to confess “I don’t really know what that feeling is.” Boy am I glad my clients are this honest; it tells me precisely where we need to focus our efforts.
I can’t tell you how many people minimize the need for regular and consistent relaxation in their lives. I think part of this is the economic realities of living in expensive northern California; part is the demands of our two-income, two children families and lifestyles; part is how omnipresent technology is in most people’s lives; part is a very American mindset regarding hard work and sacrifice; part is the individual’s psychological and trauma history; part is the existential anxiety we all start to feel at a certain age; and part is the individual’s relationship to and understanding of their own body.
Is it any surprise that those people who struggle to relax also have sexual issues? Absolutely not. The connection between these things is no coincidence. As I like to say, who we are outside the bedroom is exactly who we are inside the bedroom. My clients frequently tell me that when they begin a sexual experience with their partner their minds are elsewhere: on their stressful job, the never-ending household chores (this is where I’m reminded of choreplay as a way to “solve” one partner’s anxious feelings but if you've ever done it you know it doesn't really solve anything), the kids, what other productive thing they could be doing with this time instead, how much precious sleep they expect to lose if they have sex at this late hour, etc. What they hope happens, and I do too, is that at some point during the experience the sex becomes interesting enough or arousing enough or pleasurable enough that they are able to change their focus from those other thoughts to instead what is happening in their here and now and go with it. If they don’t or can't, sexual problems generally occur.
But I want to reverse that. What if you started a sexual encounter already relaxed and with a calm mind and body? What if you got relaxed first and then had sex? This is what people say a glass of wine or music or cannabis or candles helps them do. Problem is, all of those are passive ways of transitioning into sex and experiencing your sexuality. What if you actively took steps to not just set aside the worries of the day but to also get into your body, feel your sexuality, and prepare for partnered sex? What would that take?
Think about it.
One of my biggest frustrations as a mental health professional is that certain ideas and terms, promoted in pop psychology circles and then spread throughout media, get established in the culture as legitimate without widely-accepted scientific knowledge and research. Here’s a perfect example: “codependency” was a popular “diagnosis” in the mental health field several years ago. Many people entered therapy with the presenting problem “I’m codependent”. Treatment programs popped up all over the country, many of them very expensive, claiming they “treat codependency.” Codependent Personality Disorder was even proposed as a diagnosis in the DSM-III, the publication of mental health disorders, in 1987 but thankfully failed to be included due to a lack of scientific evidence.
As the two sayings go, everything old is new again and those who fail to learn from history are doomed to repeat it.
This is and has been happening again with the concepts of “sex addiction” and “porn addiction”. Once again many people, and statistics are showing that it is predominantly men, are entering therapy with the presenting problem “I’m a sex addict” or “I have a porn addiction.” Once again treatment programs have popped up all over the country, many of them very expensive, claiming to “treat sex addiction and porn addiction.” And once again Sex Addiction was proposed as a diagnosis in the DSM-V in 2013, its most recent publishing, but thankfully failed to be included due to a lack of scientific evidence.
I certainly do not expect the general public to understand the controversies and conflicting research surrounding such provocative “diagnoses” of “sex addiction” or “porn addiction”. Yet it is still paramount we, the mental health profession, ask questions like:
- Why are “sex addicts” predominantly men? They also tend to have more conservative and negative
attitudes about sex - why is that?
- What is the influence of mental health issues like depression, anxiety, OCD, or a personality disorder on their sexual functioning and sexual decision-making?
- What are the stressors (marriage, relationships, parenting, money, health, work) in these men’s lives and how are they coping with them?
- What messaging and values (from family, from religion, from culture, from friends, from his spouse) did he internalize about his sexuality? How do those square up with what is actually going on in his sexual self? Does he really believe those messages and values now? What are the consequences if he does and does not follow them?
Many manifestations of so-called “sex addiction” can be summed up with the following statements: “I like X and I shouldn’t like X” or “I do X and I shouldn’t do X.” What a wonderfully succinct description of an inner conflict! This is exactly what psychotherapy is here to help with - better understanding of self. “Why” is a question about motivation and it is a fundamental question in psychotherapy. It is a fundamental question sex addiction treatment providers generally fail to explore with their clients, other than ascribing it to the “diagnosis” of “trauma”. Another reason sex addiction treatment providers give for "sex addiction" is “because it’s addiction”, yet that’s a circular explanation that does nothing to illuminate the inner workings of the individual’s psyche.
So why would a man do X when he feels or believes he shouldn’t do X, you ask? Maybe he feels he shouldn’t do X because it’s illegal and he doesn’t want to get arrested and go to jail. Or because his family-of-origin messaging/religion said so. Or because if his wife found out he’s afraid she will judge him for it and that prospect is painful him. Or maybe because it’s a symptom of his depression but because he’s a man and male depression often presents differently than in women he (and his doctor) failed to recognize it. Or maybe because he’s angry at his spouse and can’t tell her so this is how he has been displacing and sublimating his anger. Or maybe because he hasn’t had sex with his wife in years and doing X is a way to stay monogamous.
These are just some of the reasons I’ve seen in my male clients for doing what they do. They are explanations and not excuses. That being said, explanations matter because when we understand the "why" we can better begin to change what we want to change. Calling yourself (or your husband) a “sex addict” jumps over the “Well, why is that?” question itself and the necessary exploration of the possible answer(s) to that question. As Douglas Braun-Harvey and Michael Vigorito described in their book, “Treating Out-Of-Control Sexual Behavior; Rethinking Sex Addiction”, when someone enters therapy saying “I’m a sex addict” and the therapist accepts this without much of an assessment, this is akin to you telling your doctor “Hey doc, I have cancer” and your doctor responding “When would you like to start chemo and radiation?”
Being a sexual person means accepting the consequences of your sexual choices. Hell, being an adult person means accepting the consequences of your choices. And let’s face it: that’s painfully difficult to do at times. For many it’s even more so when those consequences happen in the sexual arena of their lives and they lack an understanding of their motives. I work with these issues every day and see first-hand the consequences in people’s lives.
Sexuality, and more importantly sexual choices, do not exist in a vacuum and they are not solely driven by biological processes. Sexuality and sexual decision-making exists in a context that includes biological, psychological, and social factors and is constantly taking in and responding to the internal and external stimuli of these factors.
What ultimately matters is that I, as a sex-positive clinician, understand how a person’s relationship to sexual activities and/or pornography can be problematic in their lives and relationships. What also matters is that I hold a humane and judgement-free space for curiosity and respect for my client's lived experience while we explore their underlying motivations. I get that many people do not understand their sexual selves and may even be afraid of examining their sexuality. I am here to help.
Finally, I have no idea how far and wide (or not far and not wide) this blog post will travel. Many others with bigger and better credentials than mine have written about all of this before. Some of those people have received not just troll-y emails and comments for their opinions on this topic but some of them have even received threats of harm to themselves and their families. So not cool, Internet. It is alarming that a difference in opinion can generate such animosity and aggression. Tension can be healthy and has the potential to move us towards a better outcome; it is not inherently a threat. And as a society we need to learn to better tolerate our differences without resorting to attack.
A common issue I see is low or absent sex drive in women who report previously having a high(er) sex drive. These women usually, but not always, have been with the same partner for years. Their emotional reactions to the phenomena run the gamut. Some of these women are distressed by its decline/disappearance while some women are ambivalent while even others are relieved. Remember, sex is never one-size-fits-all and if I’ve taught you anything, dear reader, it’s that there’s always good reasons why she feels the way she does.
So I ask questions and learn about her sexual history. Was there a time when she had a high(er) libido? Was it with her current partner/relationship? When did it start to decline and what was going on in her life? What has she (or they) tried to increase her sex drive? Were those attempts successful? Why or why not? Why is she seeking treatment now for this issue? What are her partner’s thoughts and feelings about (A) her lower libido and (B) her seeking help for it? Are there any drawbacks to having an increased sex drive? And so on.
It’s incredible what these questions uncover. For example, maybe her sex drive changed after the birth of their first child when life, and her priorities, went a new direction and not to mention she felt fatigue like she never had before. Maybe after baby and baby weight she did not like her body and felt deeply insecure and judgmental about being sexual with it. Maybe her sex drive took a nosedive after her alcoholic mother was diagnosed with cancer and their historically tumultuous mother-daughter relationship became even more draining when she began to take care of her mother. Maybe her libido went underground as a result of growing resentments she had towards her partner. Or maybe she’s just plain bored and unsatisfied with the sex she and her partner do have but doesn’t want to tell her partner her truth for fear of hurting their feelings.
We examine these life and relationship issues and their impact on her libido but there’s a powerful detail in all this that gets easily missed. Often what is revealed is that at some point, she decided to sacrifice her right to sexual pleasure. She traded it in for something else she deemed more valuable: sleep, time with the children, advancing at work, completing household chores, or preferred emotional states like not feeling bad about her relationship, not feeling bad about her partner, or not feeling bad about herself. This usually seems like a worthwhile trade-off for a period of time until it doesn’t and the consequences become big…and she finds her way to my office.
Ladies, you must stop doing this! Sexual pleasure is not something to be bartered. When you make your sexual pleasure optional and unimportant you make sex optional and unimportant. You have a right to sexual pleasure so honor it. Pursue it. You have unique anatomy that allows you immense pleasure. Even the World Association of Sexual Health’s Declaration of Sexual Rights has stated we have a right to sexual pleasure. It’s #7 if you’re curious.
Recently I presented at the TransLife Professional Symposium here in Sonoma County, a conference for professionals who provide services to transgender individuals. There were physicians, psychotherapists, educators, and lawyers in attendance and the workshops represented the various medical, psychological, educational, and legal needs of the trans population. I presented on how to talk to your trans clients from a sex-positive perspective. It was an honor to be part of such a progressive conference.
Our society has come a long way in a relatively short amount of time to support, validate, and make legal the diverse trans experience. We (I think?) have a greater understanding of gender identity versus sexual orientation. We (I think?) understand the importance and in many cases necessity of hormone therapy and gender confirmation surgeries. We (I think?) understand that if one is transgender, not respecting this can lead to mental health issues including trauma, substance abuse, anxiety, depression, and suicide and all of those have public health implications. All of this (I hope?) feels greatly affirming to trans people. But where my profession still has a growth edge is in talking to transgender folks about their sex lives. It’s yet another taboo subject under the bigger taboo umbrella of “Talking About Sex In Therapy”.
A good portion of your sexuality involves your feelings about your own body both in general and regarding specific body parts. For example, cis-gendered folks have told me “this body part is too big” or “that body part is not big enough”. These are feelings of inadequacy, insecurity, and shame and also involves fears of judgement and rejection by others based on those body parts and their perceived deficits.
For a trans-identified person, this aspect of their sexuality is often made more complicated. In addition to the feelings I stated above (and others), sexual organs and erogenous zones can be full of emotional turmoil for additional reasons: perhaps those body parts represent a rejection — not by others but by themselves “this is not me”. Perhaps those body parts symbolize a disconnect from the body they were born with versus the body they want and need to feel authentic and whole. Or perhaps a certain body part represents sadness or anger because they do not have the resources to change it to what they envision and need. For many trans individuals, their bodies do not feel like home. Add to that the fact that those very parts are often where body-based sexual pleasure is obtained and sex is now made more confusing and emotionally messy.
Most people tell me that when they can receive sexual pleasure from their partner(s) they feel loved, accepted, and seen. Sounds amazing, right? But when a trans person has understandably conflicted and unresolved feelings about their own body, using that very body to engage in sexual activity can feel risky, scary, and downright unsafe - not necessarily because of their partner (although that’s true too), but because of themselves. Perhaps you can now see why it’s common for a trans individual to feel intensely uncomfortable with their own sexuality.
Trans folks have unique challenges when it comes to having sex, too, and my profession needs to support them in better understanding their sexual selves. Helping trans folks better integrate their sexuality — not just their gender identity — into themselves and their sense of place in the world, and learning how to be a sexual being with their body, is another important aspect of the transitioning process.
'Whole Again': A Vet Maimed By An I.E.D. Receives Transplanted Penis
This provocative news article is getting a lot of attention today because of these two words: "penis transplant." Certainly gets one's imagination going, doesn't it?
Headline aside, every war brings home new medical and psychological wounds that our veterans must live with every day and our health care system must learn to treat effectively. While many veterans of Iraq and Afghanistan are coming home alive, they are also not coming home intact. Whether a veteran is suffering from medical or psychological scars (or often both), many of them hope to resume their sexual relationships with their partner once home. Or if they're single, they hope to find a partner and build a life together. Sexual functioning represents "normalcy" to many but it also is about connection, one's sense of self, their ideas about their future, and as the article states, a wholeness. Genito-pelvic injuries have far-reaching consequences. We need to remove the shock, stigma, and shame surrounding them and treat these brave individuals with the respect and dignity they so greatly deserve. I'm happy to see this article illustrates the beautiful humanness in it all.
I am a licensed Marriage and Family Therapist and AASECT Certified Sex Therapist and Supervisor located in Sonoma county, California.