Tag Archives: sex therapy

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?

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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.

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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.

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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

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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

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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.

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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

 

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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

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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

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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

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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/.

Remembrance of Sex Past: Talking to Kirra Cheers about The List

Modern sex, digital dating, hookups and contemplating past sex with a partner are all topics covered in THE LIST  Kirra Cheers’ upcoming immersive photography project in NYC.  I am so looking forward to leading a talkback after the May 19th show  which poses the question “what would your exes say about you?” after a friend gave her a list he had made of all the sex partners and experiences he had had.

Here’s a preview interview with her.  For those of you who don’t know Kirra’s work, she is the photographer behind the viral sensation Tinderella in which she photographed the men with whom she went on dates gleaned from Tinder to explore different aspects of modern digital dating life.

WHY?

SC: It seems like this piece flowed out of your first show Tinderella, that was a study on digital dating, what was the initial spark that was triggered when you were gifted the List? What were some of the questions about sex you were looking to answer?

KC: I saw the list of names as a puzzle. Each name represents a moment in time they shared together. I wanted to know, if I could piece together the moments, what would the narrative of his life look like? As with Tinderella, I play the role of the unreliable narrator, calling for the audience to reflect on their list and how people might judge them based on their time together. This experience of self reflection is different for everybody based on age, gender and individual experiences. Where one person might question, how many is too many? Another might reflect on how much they have changed as a person or who they may have hurt along the way.

HOW?

SC: In the work of sex therapy, we help clients get comfortable, get embodied, and help them articulate what it is they’re looking for in a sexual scenario? Did you find that the majority of partners with whom K had sex were open about their needs with him?

Kirra Cheers, The LIST

KC: As a society, we are used to being fed this lie that men want sex more than women. I think that women are more sexually adventurous than we give them  credit for. There was definitely this conversation about wanting sex and expecting so be satisfied but there seemed to be a communication breakdown in exactly how to achieve that goal. This might be because they didn’t feel  comfortable expressing their needs or perhaps they were still exploring their sexual desires.

SC: Often I hear from men who are single and dating that they aren’t as concerned about their partner’s sexual pleasure if they’re clear the sex is a hook-up and they’re not interested in getting emotionally close with them. Did you hear a range of reflections on how giving K was in the bedroom? Did it tend to coincide with how long they saw one another?

KC: Reviews on his sexual performance vary greatly. Everything from, the sex was “transactional” to it’s “the craziest sex I’ve ever had”. Hard to believe they were talking about the same person. I think it had more to do with how attractive he perceived them to be and therefore, how much time and effort he was willing to invest.

CONSENT

SC: Given the viral nature of the #CatPerson story in the New Yorker this past December, were there many women who expressed ambivalence during the act that they felt unable to express? Did many partner regret the experience? It sounds like one woman felt that the hookup was not consensual on their part? Did she ever tell him?

KC: I spent some time reflecting on why she opened up to me and chose to share her experience. I think that this was her way of telling him. It’s a hard read and unfortunately an experience that I believe most women will relate to in some way. There seems to be this accepted grey zone where it’s ok to pressure someone into an experience they’re not comfortable with. I used to think it was a matter of education but I’m not so sure anymore. Men understand consent, they just choose to ignore it. I think the problem lies in a power dynamic that has been exploited for far too long.

SC: Were these hookups freeing for some of the women who, like K were looking for sexual expression without commitment? What else did they discover about themselves in the process?

KC: Absolutely – many of the women on ‘The List’ are at a stage in their early adult life where they are exploring what they like and don’t like. It was refreshing to hear about women taking control of their sex life and feeling “empowered” by the experience.

TRANSFORMATION

SC: When sex therapists conduct what’s called a sexual history in therapy, we are looking to find out the influences on the way a person regards themselves as a sexual person, the influences of home, culture religion and how they explored their desire if they were allowed to. Did you feel his journey through these encounters/relationships had an intention behind it, questions he wanted answered or was their more emphasis on proving something to himself or others?

Kirra Cheers

KC: I ended the project at no.38 because I felt that he was beginning to have experiences just so they could be documented. In fact, I would go as far to say that he enjoys having an audience and has continued to explore that thrill in his sex life. As a somewhat quiet or shy person in his day to day life, I think he enjoys exploring a different side to himself when it comes to sex.

SC: What most surprised you about the way your own relationship changed with K over the period of the project? Did you discover further vulnerabilities of his as you delved further into the project? Do you feel his choices of partners reflected a wide palette of facets to his personality or were they more similar than you could have guessed?

KC: We definitely became closer friends over the time that I worked on the project. He allowed me full access to his personal life and at no time seemed embarrassed or uncomfortable with the information that was shared. I was very impressed, if the tables were turned I may have had a crisis of identity. He seemed content to accept that this was their experience, even if it differed from his own.

INTENTION

SC: Why do you think K gifted the list to you in the first place?

KC: K enjoys surrounding himself with interesting or eccentric people that can orchestrate different experiences for him. For K, this was the ultimate walk down memory lane. He is now in a committed relationship and I often wonder whether the experience was somewhat of a sexual renaissance, allowing him to grow in a new direction. Perhaps we should all reflect on our list and learn something along the way.

Kirra Cheers’ The LIST

THE LIST runs for a limited engagement Fridays & Saturdays, May 18-26 at 10pm at the Steve and Marie Sgouros Theatre (115 MacDougal Street).  Tickets can be purchased online for $20 at https://thelistbykirracheers.com/.

“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” .

 

 

 

 

How to Say Yes, No, or Some: A Post #CatPerson Sex Esteem® Guide to Dating #2

Since my last post on the #CatPerson story in The New Yorker,  we have had numerous sexual stories come out including the babe.net piece in which a woman identified as Grace had with comedian Aziz Ansari which she described as sexual assault, the highly researched story in the WSJ of sexual misconduct and assault allegations against Steve Wynn and the NY Times’ Maureen Dowd interview with Uma Thurman

(Courtesy Deposit Photos)

finally opening up in more detail regarding her sexual harassment allegations against Harvey Weinstein.

Aziz Ansari (Deposit Photos)

The Ansari story left the more than 2.5 readers split on what exactly the experience had been; consensual or coercive or assault? Grace wrote that her experience left her feeling violated while others have described the Ansari date as badly-mannered, insensitive badly communicated or plain ‘meh’ sex. The critical nature of the post #metoo movement requires a much more nuanced, articulate languaging of what is desired, what is possibly of interest, what is considered intrusive, coerced, and unwanted by both partners. The directives of consent need to be discussed at the beginning of an evening and then right before the sexual actions begin as well as during. Why? Since many people drink or use some sort of recreational drugs when hooking up, their ability to give consent changes over time, and especially if they are under the influence.

Have people gone too far in conflating bad sex in which people don’t take responsibility for what they do and don’t want with coercive sex and out-and-out assault in which a person is threatened physically and emotionally by the power of the other person? I think in the first wave of a reckoning the rage that had been building for so long can create a reaction that offers only a black and white, guilty/non-guilty verdict that does not reflect grey.

Given the upcoming Valentine’s Day when singles and newly dating couples go out to have fun, create some romance and potentially have some sexual fantasies in their expectations, I hope these further explicit discussion tips help to create a date that is remembered as sexually consensual, safe, sexy and sweet.

Dating Tips Post #CatPerson 


(Courtesy Deposit Photos)
  1. Don’t Have Any Sexual Activity if You’re Drunk, Period!

While I think the main character Margot, a college student obviously regretted her decision to move ahead with having sex with Robert, the 30-something man she met at a university town bar, the sex was not coerced or forced by Robert. Similar to the real Grace of the babe.net story who thought Ansari would have more sensitivity about what she would want and not want to do given his public comedic routines about his avowed feminist identity, both these women had agreed to go ahead with a sexual scenario perhaps for different reasons.

In my sex therapy practice CLS, we frequently see heterosexual women who have felt like they should have sex with a guy for all sorts of reasons that have nothing to do with healthy sexuality. Some of these reasons include internal dialogues similar to what Roupenian wrote of Margot’s sudden erotic revulsion to the idea of having sex with Robert: “But the thought of what it would take to stop what she had set in motion was overwhelming; it would require an amount of tact and gentleness that she felt was impossible to summon.”

This is one of the key moments to this story. As a sex therapist one of the things I ask clients is to describe their last encounter slowly and describe not only their actions but their internal emotional and cognitive states as well. If these aren’t aligned then the sex will be experienced as mechanical, empty, ‘meh’ or bad. “Cat Person” is not a story of active coercion on Robert’s part, it’s not a story of an older man putting pressure on a younger woman, but it’s a story of woman incapable of expressing her desires in the moment that a certain sexual activity is signaled.

I think that many women related to this story because they felt they weren’t comfortable saying or didn’t have the education to say yes to some sexual activities and no to others.

In the #Catperson story Robert states: “You’re drunk” after she suggests they leave the bar for somewhere else. Margot is drunk and says: “No, I’m not,” though she knows she is. Where is her personal responsibility here? If one has enough awareness that one is drunk they need to state the fact, and go home by themselves. And where is Robert’s confidence in what he perceives as her state to non only insist on driving her home but actually following through and driving her home to wrest on the side of caution? I am not siding with either of these characters but actually holding both of them responsible for creating a safe, sober and perhaps more sexy encounter.

(Courtesy: Deposit Photos)
  1. Check In with A Partner EACH STEP OF THE WAY During a Sexual Encounter

In my last blog I talked about all the ways partners can (sexily) describe what they’re interested in doing, what they’d consider and what are hard limits BEFORE a sexual encounter. What needs to be included in all enounters (whether they’re hookups or between longstanding partners) is a checking in along the way with the full understanding that THINGS CHANGE from moment to moment. Sex is a dynamic, living enactment of desires, fantasies, physical movements, that shift in the process.

In the #Catperson story Margot experiences a major shift in desire when she sees Robert bend down to take off his shoes after removing his shirt and pants.

“Looking at him like that, so awkwardly bent, his belly thick and soft and covered with hair, Margot recoiled.”

These moments happen a lot more often than people admit either to their friends afterwards or to themselves, even when someone isn’t drunk. And it’s okay to change your mind. Let me say this again, it’s okay to change your mind and tell someone: “I think I’m good for now” or “I would rather just cuddle” or “I’m not feeling well now and would like to remain clothed”. In the same way, you can say: “I’m good for now, would rather not drink any more”, without shame, or embarrassment or feeling so uncool or stiff.

But this is how Margot felt about the idea of letting him know her desire had changed:

But the thought of what it would take to stop what she had set in motion was overwhelming; it would require an amount of tact and gentleness that she felt was impossible to summon. It wasn’t that she was scared he would try to force her to do something against her will but that insisting that they stop now, after everything she’d done to push this forward, would make her seem spoiled and capricious, as if she’d ordered something at a restaurant and then, once the food arrived, had changed her mind and sent it back.

Margot (and Roupenian) likened the thought of changing her mind to the embarrassment of returning food at a restaurant and what he would think of her for doing so. This to me is the crux of the story because what so many female readers of this story have described is the pressure they feel in following a man’s directives during a sexual scenario or what they had originally stated (if they did at all) wanting at the beginning of an encounter.

(Courtesy Deposit Photos)

The woman called “Grace” in the babe.net encounter with Aziz Ansari stated:

“He sat back and pointed to his penis and motioned for me to go down on him. And I did. I think I just felt really pressured. It was literally the most unexpected thing I thought would happen at that moment because I told him I was uncomfortable.”

 One of the crises in our culture is this moment, the moment of asking and the moment of owning your authentic response. If Ansari was signal-blind, ignorant, drunk or plainly assertive in wanting what he wanted, Grace needed to say:

“Look, I’m really into your massaging my shoulders right now and that’s about it. I don’t want to go down on you, I don’t want to have penetrative sex, this is my limit now so please stop asking for more. It’s turning me off.”

What I hope is that my suggested statement above gets into the “sexual gray area between enthusiastic consent and resigned acceptance” as described by Carolyn Framke in the thoughtful Vox piece as the place the babe.net story fits in the conversation we are having in this post #metoo reckoning.

  1. Know How to Say Yes, Thanks or No, Thanks or a Bit More of That

Whether it’s more sexual acts or the next date, be compassionate about your partner’s feelings. Many of my clients who are dating complain of ‘ghosting’ from people with whom they may have had long text threads, several dates or a 4 month-long relationship. Ghosting is the equivalent to not calling ever again, vanishing without a trace, or being stood up in the old days. One of the elements of Sex Esteem® which I teach to my groups is compassion. If you want to be treated with compassion by others, build a practice of compassion in all parts of your life. This means thinking about how the other person will feel, empathize with them without going beyond your limits and let them know if you’re done.

In The #CatPerson story, Margot avoids letting Robert know she is no longer interested. She thinks about ways to text him but perseverates about the perfect way to do it since they’d had sex but either texts excuses for not being in touch or ignores his texts altogether. And what Robert finally texts is what becomes one of the aspects of the story so many readers reacted to because of his inflammatory misogynistic message calling her “whore”.

Robert is a character, one we know about whom we know very little. But in this rageful, rejected pain expressed in this age-old insult for women who don’t give someone what they want, or who take their own sexuality into their own hands, or who reject someone who wants them, the story depicts a man who can be dropped into what many readers deem a bucket of deplorable men.  That is the assumption that most men are perpetrators who you can’t trust.  If Roupenian allowed the reader to get to know Robert, to figure out how this rejection triggered other old wounds perhaps, and offered him the opportunity to end by staying in the vulnerable state she had his character initially express when he didn’t hear from Margot, it might have offered a more dramatic view of a man than the original story offered. That of the male human who is openly hurt and vulnerable and remains in this expression.

“O.K., Margot, I am sorry to hear that. I hope I did not do anything to upset you. You are a sweet girl and I really enjoyed the time we spent together. Please let me know if you change your mind.”

Robert could have added: “I’m sorry you feel differently than I do.”

So if you have a date on Valentine’s Day or some time soon please try some of these Sex Esteem® steps before, during and afterwards. If you don’t feel you want to see the person again, think about ending with compassion and grace without malice, without humiliation, without sexist insults.

May we teach our children that speaking out without the fear of retribution is our culture’s new north star.”

Laura Dern on the Golden Globes

 

 

 

 

 

 

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®.