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.
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.
'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. The common belief is that Valentine’s Day is the day to celebrate love, especially romantic love. In reaction many people get anxious, or feel insecure or angry, or become critical of the day. “Singles appreciation day”, “a Hallmark holiday”, and “It’s just about obligation” are things we have all heard. I want to offer you a different perspective on how to observe this day that has nothing to do with your romantic relationship status and everything to do with yourself.
Think of all the traditional gifts we give those we love on Valentine’s Day: beautiful flowers, sweet treats, a delicious meal, a soft teddy bear. All of these gifts involve the senses. The tokens exchanged on Valentine’s Day are not about love but are instead about sensuality. One of the sex therapy sub-specialties I treat is erectile disorder (previously called erectile dysfunction for you psych and sex nerds) which is defined as difficulty getting or maintaining an erection and/or decrease in erectile rigidity the majority of the times during a sexual encounter. Helping men with this issue is always a good portion of my practice - it’s a very common problem and the TV and magazine commercials sure know it.
Unfortunately during my week off from seeing clients between Christmas and New Year’s I got sick with a nasty cold. So instead of all that I had planned to do, the week was a perfect opportunity to both rest and read. I knew immediately which book on my nightstand I would grab: Esther Perel’s latest, “The State of Affairs: Rethinking Infidelity.” It turned out to be a great week after all.
This book is not a how-to-recover-from-infidelity sort of book — those books have been written. Rather, think of this book as a meditation on infidelity, relationships, and sexuality. Esther spends most of the book discussing and exploring the many facets of relationship betrayals and highlights some of the more interesting, and existential, issues that are always present. Her writing style is beautiful and poetic. Just like any good book, this one was a true pleasure to read. I hope you will consider reading it; you don’t need to have experienced an affair to ponder and learn. Wow, reading this article in the New York Times, The Power of Touch, Especially For Men, was like deja vu from my previous blog.
If you recall in that blog below, I discussed how non-sexual touch can be used to manage sleep issues after the stress of those wildfires that destroyed a good portion of Sonoma County. Now the NYT is discussing how American men need more non-sexual touch, especially amongst each other. Dr. Ofer Zur is, unfortunately, correct: most socially acceptable touch for men is limited to violence and sex. I see so many men in my practice get the majority of their touch needs, A.K.A. skin hunger, met via sex. So for those guys sex has a greater urgency, importance, as well as possible implications. That's a lot to put on sex and your partner! Especially when they're not available for sex. So this gets me thinking about about a really big question: how can we facilitate changing the culture of men to normalize non-sexual touch? I hope you will ponder this question too. Now that most of us are out of the immediate danger of these fires that ravaged our beautiful community, I’m hearing from many people that they are struggling with sleep: having trouble falling asleep, having trouble staying asleep, not getting restful sleep, waking at specific times, or even having active dreams, nightmares, and flashbacks.
This is due to what is called hyperarousal. If you've been watching the television news of Sonoma County's horrific fires, you may have noticed that the news teams are NOT at the evacuation centers interviewing evacuees. In fact, the evacuation centers have outright said "NO MEDIA ALLOWED." Interesting, right? Certainly different than in the past. Wondering why that is? Because as a profession, we're not sure if talking about a trauma in an unstructured way immediately after it happens helps -- we think it may make some people worse.
Here's an excellent article from The Guardian, a UK paper, that explains more. So if you're: hosting survivors in your home; plan to; know someone who has been evacuated; know someone who has suffered immense loss in the last 72 hours; know someone who might suffer immense loss in the next few days; or you fit any of these categories yourself, please read this. There are some useful tips on what you can do instead that truly are helpful. https://www.theguardian.com/science/sifting-the-evidence/2017/jul/24/is-it-always-good-to-talk-how-to-help-survivors-of-trauma Earlier this year I learned about and was fascinated by "the attention economy". Basically, the theory states that a human being's attention is now considered a resource and a commodity and various things (software applications, device/electronic companies, advertisers, other content creators) are all competing for our attention. Makes sense in this 21st century world, right? But why am I, a Certified Sex Therapist, writing about it? Because attention economics has direct applicability to human sexuality.
John Gottman, famous marriage researcher, identified two types of problems in long-term relationships: solvable problems and perpetual problems. Solvable problems are exactly that: problems a couple can solve when they come up. For example, it can be whose family do we spend Thanksgiving with this year, or how should we spend the tax refund, or how do we help our child do better in school. The couple can work together to decide on a solution. Perpetual problems are those problems that always reappear whenever that particular subject or issue arises. They can be whose family do we spend Thanksgiving with this year, or how should we spend the tax refund, or how do we help our child do better in school. (See what I did there?)
It's not just women who fake orgasm. Men can, and do, fake it too, trust me. (Can't imagine how? Message me.)
I was reminded of the phenomena of faking orgasm recently and the impact it can have. Mainly, when a person fakes an orgasm they're making the decision to lie to their sexual partner: they are pretending that they are experiencing pleasure when they in fact are not. Why would someone fake an orgasm? Sometimes a person fakes it for the sake of their partner's ego. A previous blog post of mine from June 30, 2017 expanded upon how a man's sense of himself can depend on the sexual response he evokes in his partner and how he wants to be seen as a skilled lover. Sometimes a person fakes it because they are disinterested in sex either just that night or all the time and faking it gets the act to end quickly. What do you consider private and what do you consider secret?
After there has been a relationship betrayal of some kind (for example an extramarital affair, or sexual behavior not shared with the partner, or pornography viewing done in the absence of a partner), this question inevitably comes up. It's one of the most important questions we talk about in my office and yet one of the most scary for couples. Why? Because initially after the discovery of the betrayal, one or both partners want complete transparency: unlimited access to the cell phone, passwords to email and other online accounts, and heck, even ankle monitors! This is a direct result of the trauma felt by the betrayed partner and observed by the betraying partner (not to mention the guilt the betraying partner now feels): something was happening to/in their relationship without their knowledge or consent and now their world has turned upside down. What they thought was clear is now murky. Scary indeed -- to both partners. But complete transparency is impossible (believe me, I've seen and heard many clever strategies by the betraying partner to avoid so-called "complete transparency") and the betrayed partner usually end up saying something like "I don't want to be in the role of the cop", meaning they don't want to monitor their partner's activities 24-7. As their couples and sex therapist, I don't want this either. This can have profound implications down the road and it's my job to think about these things. The betrayed partner wants to trust. And if the betrayer is really committed to the relationship (and not doing the betrayal as a way out the door), they generally want to be trusted again too. This is from a Q&A pamphlet from a gynecologist’s office about what a patient can expect during a pap smear. Oy, it makes my skin crawl. Here’s why: While I understand every ethical doctors’ motives are to help their patients and this pamphlet has been created to do just that, this is horribly offensive to someone who is sex-positive. I don't doubt that some women do feel uncomfortable during this procedure and doctors try to ease their discomfort. Yet this paragraph demonstrates that doctors are expecting their patients to be embarrassed and uncomfortable during the exam and test. That's a dynamic the doctors are setting up even before the patient walks into the exam room -- and it tells me they've been trained to respond to it. But I ask: what is there to be embarrassed about? By getting a pap smear test, a woman (or a trans man) is doing something powerful: they are taking control of their health and getting tested for a potentially life-threatening disease (cervical cancer if you didn’t know). This is something to be proud of! It is empowerment and agency at its best. Doctors help us take better care of ourselves. Where’s the pamphlet from them that celebrates this notable act of courage? I concur with a lot in this article and research. I, too, notice in many of my straight male clients that they care very much if their female partners orgasm. This article and the associated research tell us there's a lot wrapped up in that experience for men when a woman comes:
- the man has an enhanced sense of his masculinity and confidence - he thinks he's perceived as a skilled lover and therefore she might want to have sex with him again |
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