Category Archives: blog

Will a New Year’s Resolution to Have More Sex Lead to More Happiness?

Many couples seeking to reinforce their relationships may resolve to have more sex in the new year. However, does more sex really make partners happier? Is this belief held up equally among single, gender-fluid, gay, lesbian, and polyamorous folks?

Whose happiness matters during sex?

The assumption behind the oft-made resolution to have more intimate/erotic times with one’s partner assumes that upping sex will make a relationship stronger and bring about more happiness between two partners. While some studies do show a correlation between partners’ sexual habits and their happiness, the nature of these studies’ participants reveals an intrinsic bias. There is bias about what is a working definition of sex for each partner, who experiences pleasure in couples, and whether by “couple” they mean heterosexual couples. Then, the bias continues: which partner’s opinions on pleasure are more readily available through research studies in general?

A November 2015 study from the Social Psychology and Personality Science titled “Sexual Frequency Predicts Greater Well-Being, But More is Not Always Better” points to the idea that more sex for heterosexual married couples tends to lead to more happiness for both people in the relationship. According to a press release from the Society for Personality and Social Psychology, the subjects “are most representative of married heterosexual couples or those in established relationships.” But does this type of claim take into account the different meanings of happiness for all genders?

IgorVetushko/DepositPhotos

In sex therapy, the experience of “happiness” can also have intersectionally different meanings. For a Black woman who may feel less-empowered in her relationship with a Latinx man, happiness may mean that she focuses more on her partner’s pleasure and less on her own, with the thought that this will protect their relationship from a non-consensual hookup or affair. However can she be keyed into her own sexual pleasure within a sexual encounter?  For an Indian-American first generation man, penetrative sex in which both he and his wife, who is white & third generation, climax, may have him report feeling “happy”  since they both have orgasmed, but may have a meaning that has more to do with his feel masterful and turned on because he’s proven himself “worthy” of her. Whereas his wife senses that he’s not fully present to his own experience and this leaves her feeling like the sex they’re having is more performative.  Perhaps she feels like her orgasm is for him and less about what kind of sex she would rather be having.

Sexual Quality over Sexual Quantity

For those in consensually monogamous  heterosexual relationships, more sex might be a good resolution; but some studies bring in the variable of affection to see if it changes the happiness quotient. In a  March 2017 study published by Personality and Social Psychology Bulletin, researchers asked sixty couples to take notes on their phones about their sexual and non-sexual activities, and when they individually experienced affection.

Couperfield/DepositPhotos

The study found that sex created feelings of affection not just immediately after the sexual act, but hours later. This suggests that sex can be a means to an affectionate end. A clear takeaway from this study is the idea that sex with affection between sexually-exclusive consensually monogamous couples can be the glue that makes that particular type of relationship stronger.

This may seem like an obvious result. However, what clients report in the therapeutic space is that while some partners want more frequent sexual connection, the quality of the sexual experience helps to make them feel either closer to or more distant from their partner.

In fact, in another study researchers explored the hypothesis that more sex would enhance a couples happiness. They asked one group of heterosexual couples to double the amount of weekly intercourse sessions they normally would have. The findings surprisingly showed that partner did not report feeling happier. I have clinically found through clients’ reports in sex therapy treatment that if partners create more time and relaxation around a sex date they are more likely to feel more intimate. Bringing more intention to their sexual and emotional connection and staying embodied is more likely to be increase pleasure on all body/mind/spirit levels.

Communication and Sex Within the LGBTQ+ Community

There  are many assumptions in the aforementioned March 2017 study published by Personality and Social Psychology Bulletin  to the finding of sex as a reinforcer for a happy relationship between a committed couple: one needs to examine the meaning of  the terms: “committed,” “happiness,” and “couple.” Largely, these terms belong to the world of consensually monogamous, sexually exclusive, heterosexual relationships. One needs to keep in mind that the sixty couples who were subjects were most likely to be married, heterosexual couples, and not representative of some parts of the population who don’t identify with one or all of these variables.

oneinchpunch/DepositPhotos

As a sex therapist who works with many types of couples, including LGBTQ+, consensually non-monogamous, kink-identified, in addition to sexually-exclusive heterosexual couples, I have found that the bonding or glue comes when there are two (or more) partners fully present in a sexual experience. When one partner is not fully present or is going through the motions, the experience of bonding may not be mutually enhancing.

When one partner is continually giving pleasure to another partner, they may not experience feeling as bonded. In addition, if one partner  feels it is their duty or responsibility to have penetrative sex, it may actually alienate that partner from their own embodied pleasure. This is why I give many mindfulness-based exercises to clients so that they can check in with themselves to see whether they are turning themselves off, avoiding feeling excited or feeling distracted from the sensations and experience. These sexual encounters  don’t always result in happier or more bonded couples.

The queer community might have higher rates of orgasm

dnf-style/DepositPhotos

2017 study from Archives of Sexual Behavior published by the NIH found that in heterosexual relationships, heterosexual men were most likely to say they usually-always orgasmed when sexually intimate (95%), while the women they were sleeping with reported the lowest likelihood, at 66%. The queer community had the higher reporting of orgasm, on average: gay men (89%), bisexual men (88%), lesbian women (86%), and bisexual women (66%).

In the clinical setting, LGBTQ+ clients tend to have a wider menu of sexual activities than heterosexually-identified clients. While it is not a requirement that all partners need to orgasm every time they have a sexual encounter, it is important that partners check in with one another on whether they’re satiated.  It is part of my Sex Esteem®️ model as a sex therapist and coach to help clients expand their sexual menu to include many erotic and sexual experiences. Orgasms are an important menu item for all genders.

Another step in the Sex Esteem®️ model allows for each partner to communicate the array of options they would be open to explore with a partner, whether they are a longtime sexually exclusive partner, a longtime consensually non-monogamous partner, or a person they are dating or hooking up with.

For those seeking to make a New Year’s resolution for a current romantic relationship, be aware that the resolution to “have more sex” is riddled with preconceptions about happiness, sex, orientation, relationship status and identity. It would do one well to do a deep dive into how you feel about each of these topics’ meanings for yourself personally before diving under the covers with one’s longtime bae or a new partner. This type of inquiry and practice would be what I call a New Year’s Sexolution and would boost your Sex Esteem®️ intelligence.

Watching The Crown’s Portrayal of Bulimia as a Sex Therapist

Princess Diana’s Bulimia Disorder

The Crown‘s latest season shows Princess Diana’s longtime cycle of Bulimia, an eating disorder involving binging on food then vomiting it up soon afterwards. The depiction of Diana’s patterned rituals is quite graphic in its detail.  In this period of social distancing, increased loneliness and upcoming meal-based holiday season, here are some psychological concepts  audiences can learn from the Netflix show.

After eating emotionally during a hearty holiday meal, it is all too easy for a person suffering from disordered eating and eating disorders to engage in a litany of self-criticism and potentially binging. The intensely negative self-talk often leads to internal negotiations around forms of restriction. Inevitably, the unforgiving rules imposed on oneself in moments of harsh guilt will reach a tipping point. At that moment, the person’s shame and rebellion lead to an overthrow of the restrictive policies leading to new overeating or binging. This is the cycle of eating disorders and disordered eating.

We see extreme cycles of Bulimia in the latest season of Netflix’s The Crown. The introduction of Lady Diana to the royal family was presented as a fairy tale romance in the press. Her public image, however, was somewhat a foil to her private life. In the television drama, we see Princess Diana in a secretive isolating cycle, experiencing years of intermittent bulimia. Starved of physical touch, kindness, sympathy, and sexual intimacy from Prince Charles, Diana sought control, expressing hurt, anger, loneliness  and possibly vengeance by binging on royal delicacies and then making herself throw up afterwards.

The Connection between Infidelity, Betrayal and Eating Disorders

lenschanger/DepositPhotos

Eating disorders (like Bulimia and Anorexia) and disordered eating patterns are interpersonal as well as intra-personal disorders, meaning that they are triggered by feelings of betrayal or abandonment by others then turned inward as hatred or humiliation of oneself. What Diana experienced was an extreme sense of  isolation almost immediately after she first became engaged to Prince Charles. Soon after the engagement announcement was made public, she became aware that Prince Charles was still romantically involved with Camilla Parker-Bowles. In Diana, In Her Own Words, a documentary also on Netflix featuring secret recordings of Diana, she states that: “The bulimia started the week after we got engaged.”

After discovering that the whole engagement and courtship was totally fake and that the marriage was solely “a call to duty” and nothing more, Princess Diana experienced infidelity’s pang of betrayal as a deeply interpersonal wound. Turning Charles’ rejection against herself, she tried to be more of what she thought her husband wanted, hoping to win him back. As a sex therapist working with couples after the discovery of infidelity or an affair, the betrayed partner frequently takes out feelings like self-blame and anger at their partner out on their own bodies.  At times they begin behaviors of binging, purging or restrictive diets to lose weight in an effort to compete with their partner’s lover or a paid sex worker, who they assume are thinner than they are.

teddybearpicnic/DepositPhotos

In a BBC1 Panorama Radio Interview Diana gave in 1995, she described how after spending her days fulfilling her royal duties visiting charities which involved comforting others, she was left feeling emotionally depleted and rejected by Charles who was giving his emotional and sexual attention to Parker-Bowles.

“I’d come home feeling pretty empty, because my engagements at that time would be to do with people dying, people very sick, people’s marriage problems, and I’d come home and it would be very difficult to know how to comfort myself having been comforting lots of other people, so it would be a regular pattern to jump into the fridge.”

Eating Disorders in the Media

 

photographee/DepositPhotos

While in reality, Diana’s eating disorder thrived in secrecy and shame for years, The Crown’s decision to portray bulimia in graphic scenes could be seen as glamorizing the disorder. Mary Anne Cohen LCSW, author of French Toast for Breakfast, says: “[Depictions of eating disorders in the media] can be a tremendous relief and, hopefully, become the first step to make the decision to get help and share one’s burden.”

Generally, eating disorders are treated by therapists who are specialists through individual and group therapy with a focus on healing a client’s attachment style, learning regulation skills, and mindfulness techniques while creating new habits.

Attachment Styles and Eating Disorder Treatment

Secure attachment to caretakers extends to one’s secure attachment to comfort in eating and feeling comfortable in one’s own skin. Insecure attachments, on the other hand, come from early unmet developmental needs. Diana revealed through her secret tapes In Diana in Her Own Words that she had been treated like “the virgin, the sacrificial lamb” by Prince Charles, the royal family and her own family.  “Isolation with pastry needs to be replaced by intimacy with people,” writes Cohen.

A crucial element of eating disorder treatment involves helping a client learn how to express their emotional needs directly to people they can rely on and to cognitively shift from a diet mindset to an anti-diet mindset. An anti-diet mindset is precisely what eating disorder specialist Alexis Conason Ph.D. recommends for those struggling with this punishing cycle.

A New Year’s Resolution Worth Trying: The Anti-Diet Mindset

netfalls/DepositPhotos

Dr. Conason suggests a sustainable and fundamental shift in mindset. “You haven’t failed your diet,” writes Dr. Conason, “Your diet has failed you.”

An anti-diet mindset is an agreement to eat in a way that honors your body’s needs, connecting to one’s body in a nurturing and peaceful way rather than a belittling, abusive one. Repairing this relationship with your own body is a way to repair the insecure attachment of childhood and the as outcome of infidelity.

People have traditionally created New Year’s resolutions to begin a diet after weeks of emotional holiday (Christmas, Chanukah, Kwanzaa) eating. However, given that 2020 saw an avalanche of COVID-19 weight-gain memes, with people feeling so guilty about their added pounds, we can logically expect  the 2021 New Year’s diet self-recriminations to be even more rigid and punishing.

Many times people who are dieting may feel too weak or less desirous of sexual intimacy. Whether they are waiting to show their body to a partner when their body is at the “perfect” size, or too ashamed to have their partner touch them for fear they will feel a part that has too much fat , many people with eating disorders deprive themselves of sexual pleasure.

Part of their healing is to understand that all emotions are human, including the desire for sexual intimacy and comfort. Helping them to turn toward a person instead of food or dieting to alleviate hurt and express anger is a critical step in their recovery.

The Trifecta: Sexuality, Eating Disorders and Body Dysmorphia

AndreyPopov/DepositPhotos

Sexual disorders, Bulimia, Anorexia and Body Dysmorphia are interrelated issues. Researchers in an NCBI study “Sexual Functioning in Women with Eating Disorders” found that more women with eating disorders had:

  • loss of libido
  • prevalence of sexual anxiety, tension, frequent changes and higher frequency of detached relationships
  • relationships without intercourse and fewer with intercourse
  • avoided sexual relationships

In Diana: Her True Story – In Her Own Words, Andrew Morton quotes the Princess of Wales saying: “My husband [Prince Charles] put his hand on my waistline and said: ‘Oh, a bit chubby here, aren’t we?’ and that triggered off something in me.”

Some of our CLS clients verbally express body disgust for their own bodies in session to their therapist in addition to directly telling their partner their aversions. Most often their partner still feels quite attracted to them, continually trying to reassure them of their desire for them,  yet feeling helpless to have their compliments authentically received. If a comment about one’s weight is made unwittingly by a partner, the partner with the eating disorder catastrophizes and thinks their entire body is revolting.

Another important fact to consider is that Body Dysmorphia (BDD a persistent and intrusive preoccupation with an imagined or slight defect in one’s appearance) is not exclusively a women’s disease. In one American survey, for example, found that an estimated 2.2% for men and 2.5% of women suffered from Body Dysmorphia. Whether the focus is on weight, the thinness of hair or the longing for more muscles, men can be as secretive about their body shame and disordered eating as women. BDD interferes with male sexual desire and connection in similar ways as other eating disorders.

How to Approach the 2020 COVID Holiday Season as an Anti-Dieter

tmcphotos/DepositPhotos

Understanding the larger context of a meal is the first step to enjoying the holidays as an anti-dieter. With the additional stressors of the COVID-19 pandemic this year, I encourage more self-compassion and present-moment mindfulness. Make sure you have a buddy who you can call on when feeling triggered to binge, purge or withhold food. Give yourself permission to take a walk to ground yourself if feeling overwhelmed.

Coach yourself to receive sexual pleasure. Erotic intimacy should be considered a place to play and feel aroused rather than a space in which one needs to perform or pose. High Sex EsteemⓇ means that one accepts the notion that erotic behavior is a pleasurable, connecting place we go to experience comfort, fun, stress relief and passion, all basic human needs. Given that most Americans won’t be travelling long distances to gather with large groups of relatives this holiday season, use the extra time to have some mindful, sensual touching sessions with a partner who you can rely on, whether that be someone else or yourself.

If you are struggling with an eating disorder, a free resource in the U.S. is The National Eating Disorders Association. They offer extra chat hours over the holidays: https://www.nationaleatingdisorders.org/.

The Importance of Rituals During this COVID-19 Thanksgiving

COVID-19 Holiday Season

Now that the presidential election has been called, Americans are gradually coming to terms with the results whether that’s letting out a celebratory exclamation of joy or sadly mourning the loss of their candidate. While many citizens are still worried and anxious due to the president’s refusal to concede, the holiday season is beginning with advertisement campaigns. Family members’ anxiety may be further fueled by the increase in COVID cases and deaths. The uptick may result in texting, chatting, and/or Facetiming one another with last-minute plan changes to the traditional Thanksgiving gathering.

In what has already been the most challenging 2020 year–given the COVID-19 pandemic, job losses, quarantine, and deaths of so many–the prospect of holidays spent apart from extended family and chosen family members can feel like a big mountain that feels too big to climb. As we begin to think about the upcoming holidays of Thanksgiving, Diwali, Christmas, Chanukah or Kwanzaa, it is really important to give space for both the sadness of who and what will be missing, AND consider what can be created anew to provide nourishment for the soul.

Pre-COVID Holiday Stress

CITAlliance/DepositPhotos

While pre-COVID Halloween is usually celebrated with the nuclear family or among adult friend groups, the upcoming holidays of Thanksgiving and Christmas are usually gathering times for extended family.  Holiday gatherings offer emotional and psychological grounding that is part of the foundation of our identity within our community. Meeting with those we love also reinforces our self-esteem.

The holiday season is difficult enough for many. It is notoriously the season of breakups, folks challenged by Seasonal affective disorder (SAD), facing ostracization due to gender non-conforming status or sexual orientation, and increased alcohol intake. Unsurprisingly, forced joviality often has the opposite effect, making one feel inauthentic and disconnected from oneself and those around us. The numerous additional stressors of 2020 present an even greater threat on Americans’ mental health than previous national crises. According to a recent study by Czeisler et al published by the CDC,  “the prevalence of symptoms of anxiety disorder (in 2020) was approximately three times those reported in the second quarter of 2019 (25.5% versus 8.1%), and prevalence of depressive disorder was approximately four times that reported in the second quarter of 2019 (24.3% versus 6.5%)”.

Rituals For Holidays and Lifecycle Events

In her paper “Rituals in the Time of COVID-19,” family therapist Evan Imber-Black writes of the importance of rituals. “Special time demarcates ritual time from regular time, enabling us to look forward to a ritual, whether it is daily, seasonal, or yearly. Special place may be a church or a hotel or restaurant or graveyard—or it may be a backyard, a kitchen table, a living room, all transformed by a ritual to become a special place.”

I have always let my clients know that it is helpful for one’s sense of agency, connection and continuity to consider restrictions as creative opportunities to come up with new rituals. As a former choreographer, dance pieces commissioned on a tiny stages required me to imagine movements I never would have created. Rituals like art provide us with structured time. Art is a way of marking the time as special and out of the ordinary, and imbue meaning that reflects our deepest values. They fortify our identity, and strengthen the connections to the people we love.

When past clients have had to face miscarriages, abortions, separations or coming out, I’ve encouraged them to create a ritual that is meaningful to them. Then, client could perhaps repeat each year to honor the pain, loss, relief and joy of a lifestage milestone that hasn’t been recognized in society or certain religions.

COVID Creativity; Innovative Rituals to Bring People closer During Holidays and Lifecycle Events.

serezniy/DepositPhotos

Around the world, families are coming up with creative ways to celebrate the holidays together in various states of distance: physical (due to a global pandemic) and, in some families, political (the drawn-out 2020 U.S. election). People across the world created new rituals for Easter, Ramadan, and for life-cycle events like weddings and funerals.

For instance, Ramadan, a holiday that starts on the evening of 4/23 and culminates on 5/23, sees Muslim fast during the daylight hours. As mosques closed due to COVID-19, those observing the holiday found ways to pray at home. Practicing Muslims focused on individual prayer habits and turning the isolation into inner peace. For Easter, families celebrated from a distance by decorating homes, playing virtual Easter-themed games like bingo, and hosting online family gatherings on Easter Sunday. Weddings and funerals became virtual affairs as well, with slideshows, streaming, and postponements becoming the norm. During the earlier days of COVID-19 I attended two shivas and a funeral via Zoom. They actually felt very intimate. One shiva created breakout rooms where I could speak with the mourner one-on-one. This is a good example of restrictions providing fodder for newer meaningful rituals.

SydaProductions/DepositPhotos

The wedding industry developed a new vocabulary in light of the virus. Many to-be-weds celebrated with “minimonies,” microweddings, or elopements. Graduation ceremonies this May took to the road, with teachers and families driving down neighborhood streets to mark commencement. Former President Barack Obama and Oprah Winfrey. addressed graduates in livestreamed speeches. Students recreated proms and yearbooks over social media. Witty pregnancy announcements went viral, with jokes about parents not social distancing and buying the wrong protection.

Thanksgiving Rituals

Thanksgiving as a holiday is not considered religious by most Americans. However, some experience it as a spiritual ritual that binds families and friends to one another. Due to an increased number of COVID cases in many parts of the country right now,  some families may choose to celebrate apart from one another according to updated CDC recommendations. However, there is still a need to create an intentional family ritual and celebration.

Sepy/DepositPhotos

There are creative ways to create rituals and a sense of togetherness over Thanksgiving to celebrate this spiritual awareness. For instance, for my family’s Passover Zoom, my brother and I planned songs and improv assignments for each family. This way, every family contributed something fun or meaningful to the holiday.

Here are some ideas to create anticipation, connection and meaning to your 2020 COVID-19 Thanksgiving;

  • Order craft supplies online and have them delivered to each family member’s home ahead of Thanksgiving. You can create themed DIY projects together via Zoom. For example, you can buy the makings of a fall wreath and each family can work on it together while catching up on Zoom displaying their crafting ability.
  • Safely prepare dishes and deliver them to family and neighbors in a way that does not involve contact with others. For example, leave them on the porch.
  • A game of charades is always fun, and can be played virtually.
  • Karaoke is a good way to bring music into your celebrations–belt out your favorite tunes over Zoom.
  • Schedule a time to share a meal together virtually.
  • Have people share recipes ahead of the big day. This way, they can cook their turkey, dressing, or other dishes alongside one another via video calls.
  • Once seated for dinner with your loved ones online, go around the screen and say what one is thankful for. This would be a wonderful new ritual to emphasize family bonds and heal potential family rifts.
VadymPastukh/DepositPhotos

Come up with mindfulness techniques to ground oneself and keep anxiety, worries and fears down.

You may also want to create a space for mindfulness during the holidays. This could be a private mindfulness breathing exercise each morning. Alternatively, one could host a mindfulness session with the family at the outset of the virtual gathering. Carving calm from the chaos is, as Dr. Jamie D. Aten writes, a necessity. “When disaster hits, life can feel chaotic, and our energy is used up fighting fires. But when the flames die down, it’s important to make space to do some of the things we once enjoyed doing.”

 

IgorVetushko/DepositPhotos

One in four older adults report anxiety and depression amid the 2020 pandemic. Historically, epidemics are accompanied by higher suicide rates. Researchers predict mental health repercussions of the COVID-19 pandemic for years to come. The holidays are a high-pressure microcosm of the difficult year we had. Adjusting to a new normal is only possible by keeping track of your own mental health.

On the eve before election day, I led a mindful grounding session for colleagues who were feeling anxious. This was a way I could give service and help others remain centered. Sending food to tireless hospital workers working over the holidays who are now swamped with COVID cases is another nice way to give back to your community. Be sure to reach out to neighbors, especially those who may live alone. A simple text or phone call could be enough to brighten their day. If you don’t feel able to deliver food to those homebound or homeless, find ways to donate time or money so those folks can have a holiday meal. These are ways, with the support and willingness of a community, to still come together.

Get the whole family involved in exercise during the holidays.

AlenaPhotos/DepositPhotos

A recent study showed that the pandemic has had a clear impact on diet and physical activity and therefore cardiovascular health. Exercising during COVID-19 to weave into creative ways for the whole family to move together during a Zoom family gathering. Some examples might be:

  • A younger family member can bring a dance move learned on TikTok to teach everyone else.
  • A young adult or avid music fan can create and share a music playlist for the family to dance to over Zoom.
  • An older member of the group can bring a family story or poem that they feel exemplifies the spirit of the holiday.

 

 

 

Facing a Post-Election Holiday Season with Compassion.

IgorVetushko/DepositPhotos

Because this Thanksgiving holiday takes place in the aftermath of a highly unprecedented election, it is important to create boundaries around political discussions before you all gather together (whether it’s virtual or in IRL).  Let family members know in advance that you plan to listen but would appreciate not discussing politics at the gathering.

It may be a opportunity this year, that relatives who have different political beliefs’ are at a greater physical distance. Physical distance might give family members a chance to focus on missing one another rather than attempting to win debates. We can use holiday rituals as an opportunity to heal political fissions by focusing on what we all have in common. This could be a great exercise in compassion. Meditation teacher and published author Sharon Salzberg emphasizes that compassion does not connote agreement; in fact, she says that agreement is not even a part of feeling compassion. “We are all linked, and compassion is the natural response of seeing that linkage. It is caring and concern rather than a feeling of separation into us and them…[Compassion] is the result of the recognition [of the interconnectedness of everything].”

Here are two guided gratitude meditations for the family or individual preparing for the holidays this year: Greater Good in Action and YouTube.

Developing mindfulness skills in advance of that Zoom holiday gathering or phone call might be the most powerful gift you can give yourself and your family/friends.

Please keep several mental health resources handy this upcoming holiday season.
  • National Suicide Prevention Lifeline: (800) 273-8255
  • SAMHSA’s (Substance Abuse and Mental Health Services Administration) National Helpline: (800) 662-4357
  • National Eating Disorders Center Helpline: (800) 931-2237
  • Crisis Chat: visit link
  • Crisis Text Line: Text HOME to 741741

Why Are Women Still Staying Silent About Their Sexual Pain?

When it comes to women talking about sexual pain, omission is a form of communication. 

 

Vulvodynia = Women’s sexual pain.

 

Our society still grapples with the experience of female sexual pain. Specifically, Vulvodynia (vulvar pain) affects some 16 percent of women. “Vulvodynia is chronic vulvar pain without an identifiable cause,” reads a statement from the National Vulvodynia Association (NVA), a non-profit created in 1994 to help improve the health and quality of life of women suffering from sexual pain. “The location, constancy, and severity of the pain vary among sufferers. Some women experience pain in only one area of the vulva, while others experience pain in multiple areas.”  While some sexual pain may be located on the vulva or in the vestibule (the vaginal opening), some women may feel pain internally as well. Unfortunately, millions of women experiencing pain during sex are being misdiagnosed.  And so, millions suffer in silence.

Dyspareunia is an older term to describe all types of female painful sex. The most recent diagnosis of genito pelvic-penetration pain disorder (GPPPD) is the clinical diagnosis in the Diagnostic and Statistical Manual Version 5. It is the name of the conditions formally known as vaginismus and dyspareunia. Vaginismus results from involuntary contraction of the vaginal musculature. Primary vaginismus occurs in women who have never been able to have penetrative intercourse. Women with secondary vaginismus were previously able to have penetrative intercourse but are no longer able to do so.

 

How Women’s Sexual Pain Shows up in the Medical Realm

Lydie Salaun/DepositPhotos

Epidemiological studies indicate that only 60% of women with vulvovaginal pain seek medical help and among those, 40% never receive a diagnosis. The lack of support from the health care system may contribute to feelings of invalidation and stigmatization often experienced by women with Vulvodynia. When it comes to pain specific to female anatomy, like the vulva, diagnoses frequently veer off-course. Doctors suspect menopause, PMS, depression, or anxiety. Yet surprisingly, many of the women sex therapists see are actually younger than 40 and nowhere near peri-menopause or menopause.

This gap in a detailed assessment process leaves a woman with the wrong diagnoses and still in pain, with the additional psychological pain and loneliness of being misunderstood. Women presenting with genital pain frequently experience rejection from their biopsychosocial environment. This contributes to a belief that silence is better than being misunderstood and embarrassed.

“There’s a huge problem,” Dr. Elizabeth G. Stewart, M.D., told attendees at a session on vulvovaginal disorders at Internal Medicine 2011. “There’s virtually no vulvovaginal training for clinicians.” Due to the minimal training doctors receive about women’s sexual health in medical schools, doctors may feel stymied when their female patients report having genital pain. Stewart also added that “clinicians also tend to rely on patients’ self-diagnosis and manage their problems by phone, or don’t do a physical exam before treating, which leads to incorrect therapies.”

What might cause Vulvodynia?

In a recorded webinar presented by Center for Love and Sex (CLS) created for professionals with my colleague gynecologist Dr. Chris Creatura titled “How to Help Women with Sexual Pain and Low Desire,” Creatura let therapists and gynecologists know that while examining a woman with vulvovaginal symptoms, a doctor must consider many differential diagnoses. Although we still don’t know exactly what causes all Vulvodynia symptoms, she explained that some contributing factors include:

  • An allergy
  • Atrophy
  • A drug reaction
  • Sexually transmitted infections
  • Infection
  • Low estrogen
  • A dermatological source
  • Disease elsewhere in the body
  • A drug
  • Cancer or a precancerous condition
  • A combination of these factors

 

How Women’s Sexual Pain Affects Their Partners and Relationships

Fabiana Ponzi/DepositPhotos

Many women often keep the reality of the level of sexual pain or discomfort from their partners (whether they are new partners or longtime partners or spouses). Omission in the realms of sexuality and intimacy is a mechanism women resort to in order to feel more accepted by a partner and society out of fear of rejection, shame, and exclusion. Recent research cited in Michael Castlemen’s recent post also illustrates that it is a reaction to a patriarchal society that privileges men’s sexual pleasure over women’s desire and pleasure. Women reported that the reason they don’t tell their partners about their pain is because they felt “they should subordinate their erotic pleasure to their men’s.”

In fact, studies show that male partners of women who experience sexual pain are also deeply affected by their own shame when they are aware of the pain. In a recent study published in the Journal of Pain researching women with Vulvodynia and their partners, women experienced greater pain when they also reported pain-related shame, while their partners experienced distress when they felt shame related to the pain they were causing their partner through sexual activity. Furthermore, on days they had sexual activity both partners reported greater levels of sexual distress. The authors of the study state: “Qualitative studies have reported that many of them feel inadequate, are apprehensive to speak about their pain, and fear this condition spells the end of their romantic relationship.”

 

How Can Sex Therapists Help Women and Their Male Partners

As a systemic sex therapist, I consider the reach and power of a woman’s genital pain, the impact on her partner, and their relationship. It is critical for a sex therapist to first validate and empathize with the woman’s pain, since most women feel like a complainer or at times even like a hypochondriac. To uncover the source, experience, and history of the pain, the sex therapist should conduct a thorough sexual status and history assessment. (The Center for Love and Sex offers two recorded webinars on these interventions for medical professionals including therapists, sex therapists, pelvic floor physical therapists and doctors.) But then they also need to conduct assessments of her partner.

Frequently, for women in committed sexual relationships (in the cases I provide here, the partner is male), the vulvar pain also has an effect on a man’s sexual functioning. Male partners, feeling guilty for causing pain in their partner during penetrative vaginal sex, may experience erectile dysfunction, uncontrolled ejaculation, or low desire. It is important for women to seek help not only on their own but with their partner as well.

The Plan

The research cited above provides a strong argument for therapists to work with both partners in couples systemic sex therapy. Within this type of couples sex therapy, it’s critical for sex therapists to:

  1. Provide sex education about Vulvodynia to both partners so they understand that this is a medical condition and no one’s fault.
  2. Refer the woman suffering from pain to a well-trained sexual health medical professional able to diagnose and treat Vulvodynia and GPPPD.
  3. Explain how the disorder impacts the entire couples’ system.
  4. Encourage the couple to use the therapy space to address both partners’ feelings of shame, anxiety, and sense of brokenness. Give them hope that these conditions can be treated, and that their reactions are understandable.
  5. While treatment for Vulvodynia is ongoing, outline a treatment plan to work on the pain treatment, their couple communication, and sexual alternatives.
  6. Teach them mindfulness techniques in order for them to become more relaxed and embodied and focused on giving and receiving sexual pleasure. There is a whole body of research and a recent book written by Lori Brotto showing the benefits of MBSR (Mindfulness Based Stress Reduction) for women suffering with sexual pain.
  7. Advocate and support women as they work with allied health care professionals.

 

Creating a Holistic Systems-Oriented Medical Team to Help a Woman and the Couple

Dmitry Pochitalin/DepositPhotos

In the second of CLS’s webinars on sexual pain co-presented with Pelvic Floor Physical Therapist Amy Stein titled: (“The Collaborative Clinical Care Model Between Therapists and Pelvic Floor Physical Therapists”), a case example showed a client (all identifying information was removed) experiencing severe genital pain who described feeling like a freak amongst her sexually active college peers. Another woman described a breakup with a boyfriend, suspecting the cause to be her pain during sex and the consequent lack of sex. In another example, a high-achieving professional woman worried she would lose her supportive fiancé once he started business school. In almost all cases, these women felt extremely isolated.

Therefore, silence about pain, shame, and distress creates a vicious cycle of communication and intimacy breakdowns. Excellent communication skills and having a team may ameliorate and amend communications. The system around a woman in pain–her gynecologist, therapist, physical therapist, sex therapist, and her partner(s)–must all work holistically to treat Vulvodynia and sexual pain. Sex therapists can create and coordinate care among all these providers. They can encourage women to speak authentically about the sexual pain to their sex therapist, their medical providers, and their partner.

 

References

Kearney-Strouse, J. (2011, June 1). Vulvovaginal disorders common but commonly misdiagnosed. ACP Internist.

Millions Of Women With This Condition Are Being Misdiagnosed: Here’s What To Know About Vulvodynia. (2018, March 14). National Coalition for Sexual Health.

Paquet, M., Rosen, N., Steben, M., & Bergeron, S. (2019, April 1). (174) Let’s Talk about it: Daily Associations between Shame and Pain and Sexual Distress in Couples Coping with Vulvodynia. The Journal of Pain. Brotto, L. (2018) Better Sex Through Mindfulness: How Women Can Cultivate Desire, Greystone Books: Vancouver

Vulvodynia Treatments. (2020). The National Vulvodynia Association.

What is Vulvodynia? (2020). The National Vulvodynia Association.

 Brotto, L. (2018) Better Sex Through Mindfulness: How Women Can Cultivate Desire, Greystone Books: Vancouver

 

 

The Attraction to Sex Parties: My Interview with Emma Sayle, CEO of Killing Kittens

As a sex therapist I’m privy to a variety of different sexual lifestyles that our sex therapy and sex coaching clients practice.  I had been working on this blog about sex parties based on an interview I did with Killing Kittens founder Emma Sayle right before the COVID-19 self-quarantine began.  I followed up with Sayle via Skype in order to find out how the stay home order had affected KK’s community. I am including both the Pre-Covid-19 Live Interview and Part 2 Online Covid-19 Skype Interview on the topic of group sex historically and what’s occurred online now that the shelter in place requirement has extended to both sides of the pond.  

History around Sex Parties 

Interest in sex parties and/or orgies has been around since the times of the Greeks and Romans. However it’s a less-studied topic in modern sexuality research. Recently the anthropologist Kate Frank published a book on the topic titled: Plays Well in Groups: A Journey Through The World of Group Sex in which she explores the history and range of behaviors that people practice in modern day sex parties. Frank defines group sex as “erotic or sexual activity that implicates more than two people and consists of various possible configurations of participants and observers”. 

Research on Group Sex, Sex Parties and Threesomes

While the majority of Americans prefer engaging sexually in private, there are a percentage of folks who enjoy engaging sexually in a group setting (either on their own or with a primary partner). Colloquially participants refer to these events as play parties.  In a recent cross-sectional, Internet-based, U.S. nationally representative probability survey of 2,021 adults (975 men, 1,046 women), many more men reported having ever engaged in a threesome (17.8% vs. 10.3%) or group sex (11.5% vs. 6.3%) while there was less of a difference between men and women ever having gone to a sex party (6.3% vs. 5.2 %).

 Perhaps this is because coupled partners may attend a sex party more frequently as a pair than as individual partners. Some couples report that these types of group sex dates can be a their top erotic interest or another way they “spice up” their sex life. Sex parties are commonly referred to as play parties and partners are called play partners. I would include threesomes under the umbrella category of group sex because sometimes couples may go to a party to find a third partner with whom to “play” rather than looking exclusively to play with another couple. According to Pornhub’s 2019 Year in Review page, the threesome genre was within the top 15 search terms coming in at #13. 

 There are many more options for Americans these days to intentionally experiment with strangers at public or private play parties in which attendees are vetted beforehand. Some sex parties can be organized by friends at a private home where there are perhaps six or fewer degrees of separation between guests and vetting isn’t required. Whether attendees identify as being: Polyamorous, in the “lifestyle”, “swingers”(a term used more by boomers), consensually non-monogamous or as being “into playing”, there are a variety of fantasies or specific sexual acts and scripts partygoers explore at sex parties. While some sex parties are exclusively organized for gay men or straight couples, others offer folks who are bi-curious, sexually fluid or bisexual to explore the wide spectrum of sexual interests.

 In a 2009 non-randomized study researching swinging culture, Professor Edward M. Fernandes  found that about 50% of the women engaged in woman-to-woman play only while about 8% of the men reported engaging in man-to-man contact only.  According to an analysis done by researchers D’Lane Compton and Tristan Bridges on the results of the 2018 General Social Survey data, almost 6% of women responding to the survey identified as bisexual compared with 1.5% in 2008.  And the most recent data on the question of sexual fluidity hints at the fact that about 14 percent of women and about 10 percent of men express some degree of same-sex attraction although many of them may identify as mostly straight. According to sexuality researcher Lisa Diamond “ the largest group of individuals walking around with same sex attractions are individuals who you would never know had same-sex attractions. They identify as heterosexual. They think they’re mainly heterosexual, but they’re, like, hetero-flexible.” 

The Connection between Sexual Fluidity,  Female Sex Esteem®

and Sex Parties 

One businesswoman innately understood that women were more sexually fluid in their fantasy life and if given the right opportunity, would enact these desires if given the right context. Emma Sayle had her ear to the ground at the right time just as the television show Sex in The City began inspiring women to talk more openly about sexuality. From discussing these shows with her peers and listening to their more candid conversations, she gleaned the fact that women are more curious to explore sex with other women.  While the audience for Sex in the City was predominantly white, resourced urban women, the underlying theme of single women’s being independent and unashamed to casually date and have sex was catnip to Emma Sayle, CEO of Killing Kittens.  Emma recognized a wave of female sexual empowerment that the show helped to unleash. This desire for more sexual fluidity and empowerment are key ingredients to what I teach in Sex Esteem® workshops and panels so was eager to find out more about KK’s origins.

Killing Kittens is a UK-based sex party and online dating and discussion community that brought her parties stateside to NYC two years ago.  The parties have flourished and she maintains the same model she did originally, creating parties for heterosexual and lesbian couples and single women to explore their sexuality in female-empowered, elegant surroundings.

Killing Kittens Panel: The Date Debate

I got a chance to sit down with Emma for an intimate interview after she had invited me to be an expert on her Valentine’s panel, The Dating Debate in a hip downtown hotel in NYC in pre-Corona February (which seems like a long time ago now). In the interview she explains the feminist origins of her very successful sex party model.  Soon after the COVID-19 required all clubs, restaurants and gatherings to close down, I got back in touch with Emma virtually to create an addendum to this blog. This is an edited version of both interviews. Enjoy and as always, I invite your questions and reflections. 

 

S: Can you tell me how you came up with Killing Kittens in the first place?

E: It was founded in 2005 and it was a long time coming, it wasn’t a sudden thing it was I went to an all-girls boarding school for ten years whilst my parents lived in the middle east, I kind of had this unbalanced view of women and what we could do. At school I was taught I could do whatever I wanted to be and do whatever I wanted to do, then you’d go home and see sort of the women were second class citizens and how they were treated out in the middle east.  And I had friends and sort of grew up running around with them. And the fire got lit very early and kept being flamed. That fire in this sex life isn’t right and it’s unbalanced, it’s not fair kind of thing.

S: How did this belief affect you once you became more sexually active?

E: I’d be out and about at university in my early twenties and seeing that if girls had a one-night stand they were sluts and all the slut-shaming going on. But if boys had a one-night stand they were legends and high-fived and I’d hear guy friends of mine saying: ‘Oh I’ve met a really  nice girl but she’s not girlfriend material.’ and I’d be like: ‘Why isn’t she girlfriend material?’ ‘Because she’s slept with loads of men’….That’s how society was.

S:What was the turning point from witnessing the double standard into creating a response to it?

E: Sex and the City came out and suddenly women were talking about vibrators and having sex lives and it became okay to talk about at the same time I was doing PR for a big erotica exhibition in London.  And I again saw loads of wonderful amazing people and businesses but it was all run by men. It was all run by men claiming to be female friendly.

S: Tell me why you felt it wasn’t female friendly.

E: It was all the porn stuff ,  brightly lit with white lights. And the more I saw it and that world, it was very black and white for men. If they saw sex going on, they’d be turned on. Women were much grey…. We kind of operate across the spectrum and our brain is our biggest sex organ and we need to be turned on. It’s the touch and the feel and the smell and it’s the mood. I was watching this and there was a massive difference.Everything out there was very male and in your face. …it wasn’t turning me on.

S: It wasn’t serving you, you weren’t the customer they were targeting with this type of entertainment.

E: Nooo. There were two dildos in your face, and it was nothing subtle, and I thought that’s what’s missing. Female-friendly in the end is that subtlety.

S: So for people in America who may still know about the term Killing Kittens, can you tell them where the name came from? 

E: That was the lightbulb moment, I was at a wedding in Ibiza with a loose hedonistic crowd. And who were all very strong, sexual women who sort of  slept with each other. And no one had really been asleep for 3 days and someone phoned up the groom who hadn’t made the wedding and asked: Are you guys just sitting around killing kittens at the moment? So we had this discussion and thought about what killing kittens was.

It’s a very old cyber slang meme, that every time a female masturbates, God kills a kitten. Or anytime anyone masturbates, God kills a kitten.

That’s where the name came from.  

I was like, right that’s it. I like it, it’s crazy but it’s kind of about pleasuring yourself, that’s what it stands for. And I liked the two Ks. K is a very strong letter. I want to set up an offline, online community that is all about women exploring their sexuality in a safe space. And it’s all about them, and they make the rules without any fear of judgement. 

S: Talk about the rules. Tell us how you created a boundaried setup for people and
what the parties are like.

E: The rules are still the same and they’re the same at all the events. And the same across online.Men can’t approach women they have to wait for the women to make the first move. And not letting in single guys, it takes that testosterone factor out. And they’re the main rules. 

S: I like the fact that you flipped the erotic power.. I talk about the term I use, Erotic Triggers which are a combination of the 5 senses and add psychology and emotional intimacy.  I discuss power exchange with Sex Esteem workshop attendees and what you declared to women was that  you now have the power to make decisions about where you want to go, and how you want to set it up.  

E: Exactly.

You discussed that good friends distanced themselves from you when you began this business which helped to spur you on even further. Can you articulate what you think it was that they were distancing from? 

E: I think people are scared, the majority of people like a comfort zone, or the norm.  

 Follow Up Post COVID-19 Shelter at Home Interview


S: Has there been more or less activity on the KK platform since the advent of COVID-19? 

E: We have seen a 330% increase in user activity online and 425% more messages being sent.

S: How many new members have joined? 

E: There’s been an 18% increase in new member sign ups.

S: How do you explain the increase in folks signing up for KK when there are no longer any in-person events going on? 

E: KK from day 1 has always been about community and has always had a strong online community, we now have over 160k members and over 60% of revenue comes from the digital side of the business so the events with approx 1000 attendees a month globally out of 160K online members are actually just the tip of a much bigger iceberg. Our chatrooms have always been busy as well as the direct messaging so now people are in isolation they have turned to the online side of KK to be part of that community.

S: In our pre-Corona interview in NYC you mentioned that there was at least 50% or more business on the dating platform versus the in-person parties, are people using the dating platform not necessarily identifying as folks into sex parties? 

E: Yes, most of our members do not ever attend a KK party, they join the online platform for the dating, social community side of KK, to belong to an open minded, sex positive ,non- judgemental environment that has women at its core.

S: Has KK begun to offer virtual sex parites? 

E: Yes we are doing weekly zoom house parties, featuring KK performers, DJ playlists and up to 100 members, hosted by some of our community kittens. We are doing uk , Australia and NYC parties now along with girls-only virtual cliteratti events.

 S: How have you encouraged continued engagement of your members? 

E: We are doing weekly virtual house parties, weekly virtual workshops and weekly insta live chats where I speak to dating, relationship, sex experts from around the world, along with more educational blog posts too so theres a lot of virtual activity within kk going on!

 S: Are any people going on first time virtual dates ? 

E: Yes, there’s a lot of hanging out, Netflix film watching dates, virtual drinks dates and just a lot of chat going on. Old school dating of actually getting to know people and not having 4 drinks before jumping into bed with them on night 1!

 S: What changes can you envision for sex parties in general and for KK in particular
 once we all emerge from self-quarantine? 

E: I think our parties will not change we will just keep a lot of the virtual offerings as it is a good way to engage our whole community which we haven’t really done before rather than seeing it all by city. The virtual world brings together the global community regardless of location.

References for blog:

https://inequalitybyinteriordesign.wordpress.com/2019/04/12/2018-gss-update-on-the-u-s-lgb-population/ 

https://qz.com/1601527/the-rise-of-bisexuals-in-america-is-driven-by-women/

https://www.ttbook.org/interview/new-science-sexual-fluidity

 

 

 

How to Get/Give Comfort from Your Partner After a Mass Shooting (Post Pittsburgh)

When Bad Things Happen to Good People, the world seems more fragile

When Robert Bowers, the gunman who ran into The Tree of Life Synagogue in Pittsburgh this past Saturday he murdered 11 innocent people and wounded 6 more.  The event also tore into the fabric of the American community’s sense of safety, respect and collective faith in the country.

Each time there’s been a traumatic event in the US whether it’s a terrorist threat (the bomb packages allegedly sent by Cesar Soyac last week),  the Las Vegas shooting one year ago at the Harvest Music Festival and the riot allegedly incited by white supremacists RAM members in Charlottesville, Virginia last year, clients come in to sessions and are palpably frightened.  They are seeking a place to express their feelings of rage,  fear and vulnerability (many of the bomb packages were mailed to locations all around Manhattan).  The rabbi of the Tree of Life Synagogue described receiving letters of condolence and support from people all over the world.  The media shows communities spontaneously gathering to hold candlelight vigils in cities around the USA.  What does a therapist who specializes in sex therapy advise after a traumatic event that shakes a nation like this?  How does this even connect with one’s sex life?

Vulnerability and Sex 

One of the main challenges for clients in my group practice Center for Love and Sex, is the longing they have for more meaningful sex.  This can come in the form of wanting more frequent sex with their partner or spouse.  It can also present as the desire to express a long-held fantasy to a partner in order to feel more whole in their sexual expression. It also can be described as the wish to lower one’s anxiety so as to feel more present and freer in partnered sex.  For many of these presenting problems, anxiety is a large contributor to the challenge.  According to the Anxiety and Depression Association of American,  anxiety disorders affect approximately 40 million US adults aged 18 and older.

One might not be surprised that folks who already suffer from anxiety will feel a spike in their anxiety levels when a mass shooting or terrorist attack occurs.  According to a Gallup Poll taken soon after the Las Vegas mass shooting 39% of Americans are either very worried or somewhat worried that they or someone they love will become a victim of a mass shooter.  These levels were similar to a poll taken right after the San Bernadino mass shooting.  So how do people with anxiety seek out comfort?  What is interesting to me is that while most of my female clients (whatever their sexual orientation) feel comfortable in seeking out comfort verbally from their partner or friends, most of my male clients are reluctant to ask their partner/spouse directly.  However, they may ask indirectly by initiating some type of physical touch,  whether a cuddle, a hug or some sort of more direct sexual signal.  Why might that be?

Men and Comfort, an oxymoron?

Most men are acculturated to repress their fear outwardly. They’re taught that to be “real” men they need to be tough and indifferent because that is the way you win and get ahead.  Never show your hand when it comes to cards, in business and at times in romantic relationships.  Thus there’s a small menu of emotions that are socially sanctioned in American life (although there’s some variance depending on your cultural background).  Some of these common emotional expressions include: anger, rage, disdain, belittling others (either in humor or with aggression), frustration, disgust and physical extensions of these emotions.

American men (this includes those that identify as gay, bisexual and queer) are  taught that they have to be the ones that their partners can lean on.  But in the years I have worked with men from diverse ethnic, cultural, religious and orientations, I have witnessed there’s one place they can experience a wider menu of emotions. This is in the sexual and erotic realm.  Through a sexual scenario a more vulnerable side (even if most men aren’t even conscious of it) emerges, and sex isn’t just something he is performing or doing. It becomes the place he goes to be held, rocked, whispered to allowing him to feel accepted, loved and yes comforted.

Meaning of Sex and Death Anxiety

When I work with men I help them become more aware of their own fears and how they might learn how to express their worries and concerns to their partners in other ways beside being  withdrawn, belligerent, complaining or in some cases angry when their partners turn them down for sex.  I help them uncover what sexual activity with their partner means to them in the larger significance of their lives.  For some it is a return to connection that is beyond having to prove themselves, for others it’s a space they can be gentle givers of pleasure, for others it’s where they’re given free reign to lead which quiets their fear of lack of control in the outside world. And for others it’s a haven from death. 

Death Anxiety and The Lack of Living Fully

Irving Yalom, the famous existential therapist and writer has written about his theory of death anxiety can keep people from truly living deeply, including shutting off their sexual desires.   He wrote: ““…the more unlived your life, the greater your death anxiety. The more you fail to experience your life fully, the more you will fear death.”  But when faced with death either through a terminal illness or at the top of the World Trade Center, a man urgently calls their partner and/or family to tell them in an emotionally authentic voice how much they love them, finally freed of society’s chains of decorum.

Ask for Comfort without Shame

When a massively violent event occurs like the Tree of Life Shooting last weekend, it tears into our day to day lives and threatens our own sense of safety. It is the human condition to want to reach out, to hold a partner close and to give and get comfort through touch. It’s our primal urge when we’re born and it’s a haven against our own fears regarding our own eventual deaths. I always let clients know that inside all of us are the children we used to be; playful, eager to learn, and longing to be comforted when we’re frightened.  This need is not something to be ashamed of.  The increase in mass shootings are fear-inducing for all Americans and for all humans.  If you have a partner, let your guard down, tell them of your fears and invite them to comfort you and offer yours to them.  If you don’t have a partner, reach out to friends, your community, attend one of the hundreds of interfaith vigils that are still occurring across the country and offer to give and receive a hug.  The only way through this is to confront pure hate with pure love and authentic comfort.

“Prurience” Exposes 3 Controversial Topics in America: Sex, Porn Addiction & Recovery

While I’m not sure in what order they should be listed, I have spent years helping people say the unsayable, articulate what turns them on, and supporting their journeys in coming to terms with the particular consensual erotic interests they find most compelling. At CLS, we also help those who tell us they have a porn addiction or who find that their porn gazing has become out-of-control.  In a recent performance called “Prurience” created and performed by Christopher Green at the Guggenheim’s Works & Process Series, Green created a space in The Wright restaurant that while not a safe therapeutic environment, still encouraged some participants/audience members/performers to communicate what they are erotically drawn to when watching porn or how their porn watching became what they deemed to be an addiction.

Christopher Green in “Prurience”

Green invited participants into an unusual immersion/theater which was a combination of a 12-step sex addiction meeting, a confessional, a one-way-mirror-interrogation, and a-funhouse-mirror-maze. I was lucky enough to interview Mr. Green during his show’s run in NYC given how it reflects on some of the issues our clients are confronting given their porn use whether as an out-of-control behavior on their own or wanting to incorporate the fantasies they enjoy with a partner or spouse

I wondered if the impetus to create the piece coincided with the changes in UK laws regarding pornography. Green stated: “Funnily enough no, it happened all at the same time. Suddenly when I was writing it, David Cameron became obsessed with it and started legislating and talking about porn all the time.” In 2013 Prime Minister Cameron proposed having all porn blocked by internet providers in the UK, where Green grew up.

The audience is invited by the person we think of as the leader of the Prurience group, an American artsy-man with an effeminate inflection in his speech played by Green, to make a circle with the chairs as usual before the “meeting” begins. He is apologizing for being late and haphazardly setting up the product table in the corner, offering up swag printed with the Prurience logo. Once settled, he begins the group by asking participants to share their first memory of seeing porn for the first time. This question aligns with many of the questions we ask at CLS when conducting a Sexual History as part of a full bio-psychosocial assessment to learn about our clients, their families of origin, their education regarding sex (formal and otherwise) both through self-pleasuring and/or partner sexuality.

In this immersive theater experience, several participants shared the discovery of their father’s Playboy, or a friend’s older brother’s stash of videos, or searching online at sites like Pornhub. In our practice, clients express how they watched their parents hold hands, or kissed a “crush” for the first time in 5th grade at a friend’s house party or happened upon porn online at age 14. The firsts of our lives leave an imprint, and at times it is so strong that it becomes a go-to fantasy that one seeks to recreate again and again whether in one’s imagination, online, or with a partner.

In “Prurience” we are led to believe that the members of this so-called self-help group are struggling with so called porn addiction. While the term sex addiction was not accepted as a formal DSM5 diagnosis, nor has it been accepted by the American Association of Sexual Educators, Counselors and Therapists (AASECT), the terms sex or porn addiction has been popularized enough by people like Patrick Carnes, the unscientific YourBrainonPorn site and the many rehabs that continue to charge thousands of dollars to help people with sexual behavior they may find out of control, sinful, shameful and unfaithful.

At CLS we work with people who struggle with Out of Control Sexual Behavior or hyper-sexual behavior that have put their relationships, family and livelihoods at risk. In a structured, thorough assessment process we discover what other overlapping challenges, potential diagnoses, past trauma and/or relationship dynamics are contributing to the behavior and collaborate with the client on the treatment goals and individualized plans we recommend.

In the Prurience porn addiction meeting one soon hears from people who are revealing ever more detailed descriptions of what they like to watch, what they desire and the level to which these desires haunt their waking and sleeping hours. The comments are sharp, humorous, disturbing, self-flagellating, erotic, disgusted and intriguing.

SC: How important was it for you to create an Uber-reality of a 12-step meeting?

CG: “Yeah, I wanted to unsettle people because one of the effects of porn as we know one of the effects of porn is it’s deeply troubling, or arousing in the fundamental sense of the word. It alerts us and wakes us up…I wanted to try and replicate that in a theatrical setting”.

SC: “Like in a parallel process kind of experience?”

CG: “Yeah, absolutely.”

The term I used in this last question, “parallel process” is a psychotherapeutic term to express the feelings or dynamics that crop up in the relationship between a supervisor and a therapist who is telling the supervisor about a particular client. While relaying the issues, the dynamic may well unconsciously mirror the dynamic that is occurring between the therapist and their client.

In his run on the West End in London, Green told me that some audience members got up at the break and walked out, never to return. They were too disturbed, or embarrassed or uncomfortable to stay through the 2nd part. The topic of porn is still rarely brought up in general therapy but in sex therapy, we try to help clients describe what turns them on so that they can articulate it to their partner(s). If a person is into porn, or erotic novels or other fantasy-type trigger, describing a scene or exchange can help them formulate what it is that fires up their erotic ignition.

Green wondered how I felt at witnessing his role as group leader who didn’t really “hold” the members of the porn addiction recovery group in a safe space by setting clear boundaries on the length of people’s contributions or the intensity of what was shared even when someone seemed to be in a high risk situation.  I thought it was an astute question since in fact I was quite aware that the experience was theater and that his playing the role in a passive manner was intentionally done.  It certainly unnerved some folks who felt unsure of what was to come. Much like getting on a roller coaster that might make you nauseous, many audience members were rattled by the tea break. 

This lack of structure and support that one sees in the group is NOT like a professional therapeutic experience where a therapist lets a client know what comes next in the process, allows the client to ask questions, holds their fears so that they don’t become overwhelmed and may stop someone who becomes hurtful to another.  The therapist closely monitors the clients’ experience, and checks in to ensure that the sessions are going at an emotional pace that they can handle.

I asked Green about the fact that the group didn’t seem to have a performer playing a partner who has suddenly discovered their partner/spouse’s compulsive sexual habits and come to the group to express their shocked, hurt and angry reactions. He let me know that in fact in the original version of the piece there had been a female character who had discovered her husband’s porn use and ostensibly came to the meeting as almost one would go to AlAnon to get more education and support but that in the final edits made by the dramaturge, he lost this character which saddens him at times.

In our work with a client wanting help with their compulsive sexual behavior at Center for Love and Sex we at times work with the individual and refer the couple to another therapist for couple/marital counseling. in other cases we’ll work with both the couple and each partner individually if it seems like a better plan. Like any secret kept hidden for years, the ripple effect after the discovery of an out-of-control porn problem has tremendous impact on both the partner with the issue and the relationship. For many of our clients the recovery of Out-Of-Control sexual behavior includes the opportunity to speak about all sorts of issues (including their sex life) which had been swept under the carpet for years.

We help them understand the behavior, treat the underlying or coinciding disorders that might have contributed to the behavior and then help them and their partners begin the long road to rebuilding trust, expressing hurt, articulate anxiety, and describe erotic desires. The split-off part of their self that was continually numbed out through the compulsive behavior can now emerge and be known not only to the individual but to their partner. And the therapist helps them stay grounded through the at times painful,  anxiety-ridden process.

I’ll quote Chris Green with his perceptive reflection on therapy and theater to end this blog:

“I think a lot of therapy is sitting with discomfort isn’t it? It’s being able to turn your face towards the thing you normally turn away from. And it’s.. to put that into theater you have to sit with discomfort, you have to encourage people to sit with discomfort. And it’s only through that that we make any breakthroughs in life” .

 

 

 

 

Embrace Sexual Liberty This July After the Fireworks

We have just celebrated another July 4th which marks this country’s liberty from the restraints of despotism. When the fireworks went off we honored the declaration of independence that promised Americans “with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness.”  How do these rights influence your sexual life? Many in Washington seem to be challenging the meaning of these ideals in as far as sexual liberty goes, including the right for a woman to choose whether she has an abortion, the right for a transgender student to use a bathroom that aligns with their identity, and the question of whether a business owner’s claims of religious freedom override the discrimination wrought when they refuse to sell their products based on the customers’ sexual orientation.

In this July blog I wanted to focus on the theme of liberty as it relates to a couple’s sexual relationship because as an AASECT Certified Sex Therapist and Director of Center for Love and Sex, the majority of our clients come to us seeking help in identifying and/or expressing their unique erotic “pursuit of happiness”.  According to Merriam Webster’s definition, liberty is alternatively described as

 the quality or state of being free:

a :  the power to do as one pleases

b :  freedom from physical restraint

c :  freedom from arbitrary or despotic control

d :  the positive enjoyment of various social, political, or economic rights and privileges

e :  the power of choice

When a couple first meets and they seem to click or hit it off they may feel hopeful that they finally found the ‘one’ with whom they can be totally authentic; free of restraints, or arbitrary control, and fantasizing about how they will enjoy one another to the fullest including in their sexual connection. Perhaps after that first date where they make out or the morning after they lay next to one another in the nude, the endless imagined erotic freedoms seem to pop like Independence Day firecrackers during passionate daydreams.  couple in loveThe last definition of liberty, namely “the power of choice” is where I find many couples get stuck. What do I mean by this? Once the first couple of years have passed, many couples find that the original sexual fireworks have mellowed to the flickering of candles with an occasional pop of a sparkler or firecracker. At this point, many couples tell us that they have become so close to their partner they feel like they have literally become ‘family’, experiencing the other more like a sibling or best friend. What happened to that erotic thrill they felt when their partner was less known? Why has their erotic connection lost its sizzle?

Once partners become joined, very frequently they may unconsciously regard the other under the same category as a member of their family of origin. What can become triggered are the many restraints one felt growing up in their particular family including restrictions dictated by: religion, community, and their particular culture. Those rules, boundaries and traditions may cause them to erect walls inside their minds leaving them powerless to choose who they want to be in their sex life.

A client at CLS who was engaged to be married was working hard with her sex therapist to recover from the Genito-Pelvic Pain Penetrative Disorder so that she could honestly tell her priest that she would be ready to “perform her wifely duties” once they wed. This priest had not asked about what she looked forward to in her sex life, nor did he ask her fiancé if he was ready to give pleasure to his fiancée once they were wed. The Roman Catholic ideal of wife and husband having intercourse was focused more on procreation than bonding, pleasure and intimacy for both partners.couple marryied by Catholic priestWhen I use the phrase “who they want to be in their sex lives”, I mean what fantasy they want to enact, what sexual acts they may want to try with their partner(s), and/or what kind of erotic power exchange they may have dreamt of playing in the bedroom. Do they want to be consensually taken, ravaged, or overtaken by their lover? Are they hoping to play out a scene from a movie that turns them on? Do they want to dress in particular clothing that heightens their arousal?

Couples can become what David Schnarch in his respected book Passionate Marriage describes as “emotionally fused” when they fall for one another and the idea of a person making the choice to express a desire that might differ from a partner/spouse’s can lead to their partner expressing ridicule, disdain, disgust or abandonment because it is alien, kinky or frightening. The partner who is hearing the request or fantasy may not even have to say a word but the roll of the eye, or raising of an eye brow may be all it takes to indicate surprise scorn. Like a firecracker going off the partner quickly shuts down further requests of new or different sexual interests for fear of losing their partner, not to mention wanting to avoid feeling put down, rejected or just plain weird.

Recently when I asked a married het couple (I’ll call them Chloe and John to protect their identities) who were having trouble infusing their sex life with more passion and excitement, if they had seen, read or heard something recently that turned them on and kept it to themselves. The wife tentatively began telling me how she and her husband loved to watch Showtime’s series Billions together. Billions couple enact a BDSM sex sceneWhen the scene of the lawyer Chuck Rhoades (played by Paul Giamatti) is being tied up by his wife Wendy (Maggie Siff) she quietly said that she noticed some tingling in her genitals. Her husband looked at her in surprise in the session as if seeing a new woman emerging. I asked her what happened next with this awareness and she said: I was turned on by the sensation and the scene but didn’t think I could share this with John, he would think it was weird.

So what happened in your body after you edited yourself, I asked. She looked down and said, the sensation went away and we continued to watch the show. I reflected that she had chosen to let the feeling go because she didn’t feel permitted to include what she considered transgressive turn-ons with John. Then I checked in with him and wondered what was going on in his body and mind when he heard this sitting next to her and he said: I was getting a bit turned on hearing her describe the scene, and felt surprised that she didn’t share it with me since I never knew she was into that. In fact, I was turned on watching the scene myself at the time but chose to keep it to myself to protect Chloe from my dirty mind. Each of these partners has remained behind their wall of excitement and passion for fear of how their partner might judge them negatively.

I helped them to anchor their physical experiences so that they don’t run off into analytic explanations and remain true in the session that is free of judgment and shame, so that they stay present with their authentic selves in the presence of their partner who is equally as vulnerable. In various ways with clients, I ask them these questions:

What aspects of ourselves do we choose to keep hidden or private from our partner?

What could shift in an erotic partnership if we choose to become more vulnerable, playful and curious with ourselves and one another?

These are the questions that have been continually asked by artists, scientists and creative thinkers for generations. My colleague Esther Perel asks in her latest Podcast, Where Should We Begin?, how can you want what you already have? The teacher and writer Alton Wasson offers participants of his Contemplative Dance workshops the metaphor of moving and witnessing the mover as an experience akin to a “chest of drawers”. Similar to partnered sex in which one partner is engaged in and witnessing/experiencing a partner, the choice to open a drawer to experience an aspect of ourselves and our partners happens only when there is “freedom from arbitrary or despotic control” (Declaration of Independence), meaning free of limits set by an external power. In this case it could mean external societal values, misunderstandings/myths of meaning when it comes to one’s fantasies, or limits placed on gender roles.

Myths or misunderstandings about sex, fantasy and erotic desire begins with a child’s learning from their family, religion and schooling about sexuality. Unfortunately, due to limited subjects being allowed in schools due to Abstinence Only education in the US, and heteronormative focus of sex education,  people grow up with the kind of limited information that inhibits them around speaking of their sexual desires with a partner. lesbian couple expressing sexual passion  They may have learned about STIs (formerly known as STDs), or protection like condoms, oral contraceptives and the IUD (why oh why are doctors not telling folks about the female condom, stay tuned for an upcoming blog on this topic!). Many people also believe that their partners should be able to read their mind and automatically know what turns them on. I can say from my clinical experience that it is almost impossible for people to be mind readers and know exactly what turns their partners on sexually without active and open communication.

 According to relationship therapy research conducted over many years by John Gottman, open and continual communications are the building blocks of a satisfying relationship). There is often a misperception that too much communication and frankness about sexuality in a relationship may lead to the end of relationship; however, couples who are emotionally and verbally expressive (whether strongly or even in moderation) tend to have long and satisfying relationships. In other words, it is important that partners in a relationship be comfortable expressing themselves in constructive forms of communication. Since partners don’t get this training early on, nor is it modeled for them, they are lost in the woods and revert to silence and emotional shutdown on this critical aspect of their lives. After the early novelty wears off,  a couple need more nuanced language to describe what they desire. Couples come to us months and sometimes years into a relationship that has been reduced to a tapering spark. 

My mission in creating CLS and the Sex Esteem® model is to provide people the education, the confidence and the curiosity to become more aware of their erotic triggers, their sexual fantasies, and explore the play space of their sexuality with their consciously chosen partners.  My background in modern dance and improvisation taught me from a very young age that exploration is fun, that there are no wrong movements (as long as all around you are safe and consensually there) and that you can create

from nothing an experience that is new, unique and fortifying when you are fully free.

Being able to constructively communicate sexual desires to a partner/spouse is not only freeing and gratifying for oneself and one’s partner(s), but the freeing nature of co-creating an experience serves as a bridge to a more intimate, authentic relationship. The rocket needs to be ignited again and again by each person to produce a sustaining spark of passion. And as the Declaration of Independence states “we mutually pledge to each other our Lives, our Fortunes, and our sacred Honor.”

Be mindful of your erotic liberty and honor your intentional choices this July to enhance your sex life.

 

 

Painful Sex: Best Therapy Practices for Women and Couples

Women who experience painful penetrative sex due to Provoked Vestibulodynia (PVD), Vulvodynia  and other forms of Pelvic Pain may have suffered in silence for years. They may have thought that the pain was due to being new to intercourse and that it would subside. Or perhaps they may have mentioned it to a gynecologist, only to be told that there was no evidence of any diagnosis, or that they had a bacterial infection and prescribed a medication that didn’t help. For some women who had painful sex that was intolerable, they may have avoided going to a gynecologist for their entire adult life.

Women we see at Center for Love and Sex who are in heterosexual relationships where penetrative sex is an expected part of the sexual repertoire over time develop tremendous shame, anxiety and fear of any sexual encounter if they feel it will lead to intercourse. Their partners may gradually avoid initiating sex due to the obvious reason of not wanting to cause their partner/spouse pain but in addition, of wanting to avoid being turned down which they experience as outright rejection, lack of desirability and at times shame.

As a consequence to the painful sex, some male partners/husbands may develop their own sexual disorder like erectile dysfunction or premature/uncontrolled ejaculation due to the anxiety that develops around their penetration hurting their partner. Couples like this tend to self refer to a CLS therapists when sexual avoidance has gone on for some time and couple is in crisis or fear of losing their sex life altogether. The physical ailment causes intra-personal and interpersonal challenges that have to be addressed in therapy. Many times these women can treat and heal their pain when working with a pelvic pain physical therapist.

When I mention pelvic floor physical therapists to friends and even other therapists, they have never heard that this specialty even exists.  As a systemic sex therapist, I frequently see women and couples who present with painful sex and collaborate with pelvic floor PTs to coordinate treatment in a holistic manner. I have had general therapists refer some of these cases to me after seeing clients for many months or years assuming the pain was a somatic outcome of early trauma.

It is critical for all therapists to understand the structure of the pelvis and causes of pain so that they know how to support, advocate and refer their client to the right doctors and pelvic floor PTs so that they can move ahead quickly with a treatment protocol that addresses their particular issue. It is also important for pelvic floor PTs to understand the consequences the pain has had on the client’s primary relationships, her Sex Esteem®, and shame level around discussing the specifics of her condition so that they can collaborate with the therapist. I will often assign homework assignments that will echo or support the exercises being assigned by the pelvic floor physical therapist.

Amy Stein Co Presenter

In my upcoming webinar for therapists, sex therapists and physical therapists titled The Collaborative Clinical Care Model Between Therapists and Pelvic Floor Physical Therapists Involving Sexual Pain, I’ll be collaborating with Amy Stein, DPT Founder and Director of Beyond Basics, a specialty PT practice in NYC and the author of Heal Pelvic Pain, a self-help book for people dealing with painful sex, urination and other physical activities involving the pelvis. I invite you to spread the word about the webinar which will be live and take place on Monday February 6th from 12:30-2:30 PM EST and is geared for professionals.

For those of you reading this who suffer from any sort of pain during sexual activity, I invite you to contact my practice, Center for Love and Sex via email sari@saricooper.com or coordinator@saricooper.com to discuss your situation and set up an appointment for an in person session or a coaching session if you’re outside of the NYC region.

Trump Redux: 5 Lessons this Presidential Nominee Illustrates about Narcissism in Relationships

There could be a lot of lessons to be gleaned by this very unusual primary season thus far but nothing has baffled politicians, pundits and journalists as the immense popularity of Donald J.Trump. I thought I would use Trump as a good example of a person who exhibits many of the behaviors consistent with a person who a therapist would diagnosis with Narcissistic Personality Disorder. I write this blog to assist those people who feel like they might be involved with a person who may have similar tendencies with hopes they can begin to see the pattern of negative dynamics, the low self esteem that their behavior engenders in others and look to ways a person might change their relationship or leave to preserve their sense of self. In my years as a therapist, I have worked with many people who complain that their partner or spouse is berating them for a small behavior, or degrading them for not being attractive enough to have sex with, or throwing a tantrum when their partner finds fault with some of the narcissist’s behavior.

Donald Trump at a rally
Donald Trump at a rally

The symptomatic behavior of Narcissistic Personality Disorder are expressed when a person to is compelled to rely heavily on others’ adulation to maintain their own self esteem at a high level. Underneath all that self-aggrandizement is actually a very fragile ego. One can see Trump’s lack of empathy and bullying manner as efforts to be viewed consistently as a take-no-prisoners winner in the nominee race. He keeps talking to drown out any doubt about his abilities. People with this disorder can be at one time charming in order to get what they want from others and the next antagonistic, displaying feelings of entitlement, selfishness, and attention seeking. His frequent displays of lack of empathy and disdain are illustrated in his immigration policies and rhetoric on minorities and women, and his heightened sense of self-importance. Past tweets including one that reads “…my I.Q. is one of the highest -and you all know it! Please don’t feel so stupid or insecure,it’s not your fault” exemplify just this.

Clients of mine who tell me that their partner either yells when they try to address a conflict or retreats into a depressive state express the feeling that they often feel stifled to ask for what they authentically desire in the relationship for fear of their partner’s reaction. The “walking on eggshell” comment is a frequent description of how they feel. Although only about 0.5-1% of the general population is diagnosed with the disorder, about 50-75% of those diagnosed are men. There are also those who do not qualify for all criteria of a Personality Disorder by still display a few narcissistic trait. For example a man may feel his boyfriend is with him merely because he has great looks and is well built but when they begin to have sex the experience feels empty, as if he’s there only to make the narcissistic partner feel special enough to have won such a good looking partner. His boyfriend may begin that he is not fully seen as a 3 dimensional person nor that his needs are really met with authentic concern.Ill man sitting on his bed

Trump says whatever he wants with little remorse or concern for the feelings he may have engendered in others. He constantly works to be the loudest, most powerful, and authoritative figure in every room that he enters. From statements of “I will be the greatest jobs president that God ever created” to “(John McCain is) not a war hero…He’s a war hero because he was captured. I like people that weren’t captured” ,Trump has made it clear that he is a bulldozer, will to squash anyone in his path to his final destination: presidential nominee for the Republican party.

You may have already noticed these patterns in your relationship but I use this blog to outline more specifically five patterns of narcissists which we have seen in Trump’s behavior to enable you to figure out if your partner fits into these types of patterns.

1. Narcissists are only connected to those who mirror back greatness in looks, success, and greatness.
As their values are rooted in their thoughts of their own superiority and greatness, narcissists surround themselves with only those who they see as superior as well. This is used as a mirror of their own excellence. Their relationships are based on the reward they see in each person, judged by how well the person matches their description of power, control, dominance, and superiority.
Trump has claimed that “all of the women on The Apprentice flirted with [him]” illustrating that he thinks he is a kind of irresistible hunk that no woman could resist. Trump seeks out women who have superstar looks(according to this society’s beauty ideals) as a reflection of his own looks and to illustrate his power. While this behavior is not that unusual in our patriarchal society, Trump takes it a step further when he boasts of his sexual porwess: “And, he referred to my hands — ‘if they’re small, something else must be small.’ I guarantee you there’s no problem. I guarantee”, inferring that because his penis is large he is deserving and sexually appealing to Melania his current wife, who is several years younger than Donald, and a much photographed professional model. While there may be a lot more to his wife than we know, she is only brought out as arm candy to adorn his designer suits and upscale photo ops.
at the "NBC All-Star Party" in the Hollywood & Highland Complex, Hollywood, CA 01-14-04
2. They seemingly have thick skins but in fact are either covering up deep wounds from childhood or a feeling that they aren’t as smart or as capable as their parents may have expected them to be. They cover the narcissistic wound by putting down others to elevate their status.
Trump speaks with horrific insults of groups of people who he perceives as lesser in extremely hateful and derogatory ways. When he announced his run for the nomination he described undocumented Mexican immigrants as “… people that have lots of problems and they’re bringing those problems with us. They’re bringing drugs. They’re bringing crime. They’re rapists”
He constantly searches to put others down in order to establish his own dominance and to cover up his deeper sense of inadequacy. His motto could be hit him hard, non-stop and fast so they don’t know how to hit back. man in boxing gloves
One wonders what woman in his history would cause him to degrade and demean women in his many years in public life.

The realization that a narcissist may have been demeaned or abandoned by someone they loved or looked to for praise in their past cuts deep and in response, they often add to their bullying pattern externally, a set of extremely challenging goals as revenge for their experience of victimhood. For example was Donald driven to building a larger real estate empire to show his critical mother that he is more powerful than his father, or beat a brother who was favored for his warmer personality? We may never know what that chip on his shoulder is.
If your partner feels like he has to be a the best in every category and his pursuit of money, prestige and attention override his engagement with you, his partner, it may be that he considers you just another possession that he has won along his path to success. Research has shown a possible link between narcissists’ low self esteem and structural differences in their brains, with weaker links of the brain regions involved in self- esteem.with weaker links of the brain regions involved in self- esteem.(Citation). Narcissists have underlying beliefs that they are actually frauds and they are in constant panic of being exposed of perceived failure, leading them to overcompensate in many ways. You may see your partner being extremely self-blaming about their own mistakes and project this anger on you their partner as well as others, who are around them on a daily basis, like children, employees and parents. Man yelling at girlfriend not looking at him black and white

3. They also lash out with narcissistic rage when someone criticizes them so that they never have to be vulnerable or responsible, this can leave their partner emotionally abused.
Given that their superiority is simply a facade to accommodate past questioning and failure, narcissists will attack those who question their dominance or criticize their ego. This is quick, easy way to maintain the illusion of entitlement and selfishness, as those who show any sign of weakening them are quickly devalued and diminished

Trump exemplifies this pattern, seen when he attacked Fox News Anchor Megyn Kelly multiple times. In August 2015, Kelly asked Trump a question regarding his language use toward women, calling them ‘fat pigs’, ‘dogs, slobs and disgusting animals’. Trump responded by claiming that she had “blood coming out of her wherever” (some took this as Trump referring to her menstrual cycle, although he denies this) and then went to Twitter to post public tweets, in form of a rant, about Kelly, her personal life, her professional success, and more. This illustrates the pattern of rage, lack of empathy, and aggression in response to questioning of authority.
In an intimate relationship, this rage and blame can leaving the partner emotionally and/or physically hurt, while the abuser shows little to no remorse, never taking responsibility for their contribution to an argument or fight. Instead, the attack leaves the narcissist feeling even more in control, in the right and remarkably calm.
Young woman arguing with her boyfriend

4. They will cut you off if you don’t continually feed them positive feedback.
Months after his attack on Megyn Kelly, Trump announced that he would not attend the Republican Party debate that Kelly hosted in Iowa . Although he later denied that it was because of Kelly, I argue that this was his way of cutting her off and avoiding the chance of future criticism and lack of positive regard. By doing so, Trump asserted his presumed power and continued his cycle of dominance.
He also broke up his first two marriages and while we don’t know all the details, given his vicious attacks in public during this primary, one could guess that perhaps his wives challenged him and he wasn’t going to accept that kind of behavior from a woman or anyone for that matter. His current wife stated recently that she and Donald don’t try to change each other. Perhaps, this is another way of her saying she doesn’t challenge him too much.
You may experience your partner will cut off communication, positive regard or even financial support if you do not constantly focus, support, and reassure them of their power and greatness in order bolster their superiority facade. They may ignore your phone calls, block you from social media, and remain silent. This makes the person feel in control and proud of their imposed emotional distance while leaving you their partner feeling rejected, at fault and abandoned. It is their last resort in establishing dominance while distancing themselves from potential harm.

Sad couple having an argument sitting on bed

5. As a partner you’ll feel superficially connected during sex. You may feel like you have to perform in bed, and feel anxious if you’re not thoroughly turned on causing you to ‘fake’ your arousal and/or orgasm. You may feel like you have to appear perfect and/or spend a lot of time and/or money on your appearance. If you feel like a reflection of your partner who expects everyone and everything in his life to be of the highest quality, there may come a time when you start questioning your appearance and develop some body image disorders or disordered eating.
Your partner may make comments about the size of your breasts, your weight or your nose or compare you negatively to other women. This pattern of verbal abuse can lead a partner to seek out plastic surgery, go on extreme diets and lower their sense of self to an extremely low level leaving a partner feeling depressed and demoralized.

Do any of these descriptions sound like your partner? Have you remained quiet and cautious of complaining of their treatment of you or asking for your needs to be met? Lastly, If you have this feeling of never being enough to satisfy your partner’s visual and performative expectations, feel like you’re constantly walking on eggshells and can’t express yourself honestly, I encourage you to seek help from a licensed experienced AASECT-Certified sex therapist or a coach who can help you gain back your self esteem and your Sex Esteem®.