Category Archives: Sex Therapy

Fear of Sex, Lasting Longer, Performance Anxiety, Preorgasmic Women, Sensate Focus

A Good Man Is Hard To Find

I got email from a friend of mine that I haven’t had contact with for ages. We worked together on a couple projects in the past so I was delighted to hear from him. What follows is the exchange we had concerning his love interest. (All names have been changed.) I share all of this with you because I know other people, gay and straight, who have found themselves involved with someone they probably shouldn’t be involved with. Perhaps my friend’s dilemma will strike a chord with others in my audience.

Hello Dr. Dick
I think it’s been about 13 years now since we worked together. Ahhh the good ol’ days, and oh how I miss them.

I came across a recent post of yours on Google + and it reminded me I could use some of your professional guidance.hug in the butt

I don’t want to bias my story any or waste your time with unimportant details as to the nature of events. I would like you to hear (read) my situation word for word, exactly as it has been playing out.

I have about 50 pages of text messages compiled in PDF format over the past year or so between me and a guy I really like. I don’t want to walk away from him too soon, also don’t want to wait around for something that may never materialize (It’s been 3 years since we first started having sex).

Could I ask you to review these texts and give me your thoughts about it all?

Thanks for your time
Jackson
(PS this 40y.o. guy I like identifies as being STR8, he is a total redneck, he is married to a younger 27-year-old female, he loves to fuck me and be fucked by me, he loves to suck cock and get his sucked too, he is hard from minute he walks in my door…it is the best sex of my life no question about it. And that’s sayin’ something.)

Hey YOU!
So nice to hear from you after such a long time. Yeah, I hear ya about the good old days. Unlike you, however, I don’t really miss them.

biker I would be happy to help you. Are you sure you just want me to read what you’ve compiled? Or do you want to talk about it?

Without prejudicing my appraisal of your document, what you tell me is very indicative of a problem that I have seen over and over throughout the years. And it sounds like you’ve got it bad.

Anyhow, how do you want to proceed? We can set up a Skype call, if you’d like. I do a lot of remote counseling these days, and Skype makes that possible.

I look forward to hearing back from you.

Great to hear back from you. A quick note on ‘the past’, I think what I miss the most is the social life I used to have. I had a lot of friends and always made time to see them.

The last 7 or so years have been very stressful but it’s paid off in the end. My home was foreclosed on; I fought hard, went to court many times and it took over two years but I did manage to save it. In 2010 (About a year after getting my home out of foreclosure) the state began a road construction project literally right outside my back door. It caused major damage to my 100-year-old home during the 3+ years the project went on. I am still fighting the state in an effort to resolve the issues that the construction caused.

Lol, I am not all negative like everything is all bad, or I never get a break from the weird stuff, it’s just been very unusual for me to have such a string of bad luck.hot

So back to Kevin & I. Would it be all right if you just read one short recent conversation, and then you tell me if you feel you could help? I imagine it will only take a couple minutes. Basically we are at a point where we get along amazing well in person, sex is incredible, & he loves everything the way it is. (We see each other for sex, nothing more). I, on the other hand, want to hang out sometime besides sex. This text exchange comes after not seeing or talking to him in about 10 days, which is pretty common.

Let me know Dr. :)

[Attached to the above email was a lengthy document that contained the contained the transcription of this latest text exchange between Jackson and Kevin. I’ll spare you the gory details.]

There’s a lot goin’ on here…beside the fact that the last part reads like a porn script. 😉

Here’s what I see. I see two men who have a “hook” in one another. One is happy on the hook the other is tortured on the hook.

Kevin, despite, or even because, of the hot sex you guys are having, is at a crossroads. If things continue as they are going, he will have to make adjustments to his life and have to make some very painful admissions about who he is at least to himself. He doesn’t sound even remotely ready for that. And even if he wanted to make this life-altering decision, he is probably ill equipped to do so. I’m guessing that he has been running from facing his true identity for decades.

Jean CocteauYou, on the other hand, know exactly what you want and how to get it. For you falling in love with this guy and living happily ever after would be as easy as falling off a log. You’re in love and you know how to handle yourself when love happens. We both know this is not your first time at the rodeo.

It’s like you’re dating a Martian. He only knows how to be a Martian. Despite, or even because, you appeal to him to stop being what he is (straight) and be this other thing with you (gay), he is petrified. And he may actually hate the very thing that you love about him.

Another thing that is really obvious is that Kevin’s sex with you is shame-based, not affection-based. He probably does get off on the hot monkey sex you guys have together, but he’s also probably crippled with guilt and shame afterward.

Stop and look over the document you sent me. Choose any one of those pages and count the words that you typed and then count the words that he typed. I’m sure that you will immediately see that you overwhelm him. You bare your soul; you write paragraphs of self-disclosure. He responds in monosyllables. I’m pretty sure he can barely stand the barrage. He’s trapped between what he wants and what he will allow himself to have and it is sheer torture.

Despite the fact that is wants, maybe even desperately wants, what you have to offer, and not just the sex, he can’t allow himself to have it. It would shake his world to its foundation. And since he can have the hot sex without the emotional attachment, he’s getting everything he (thinks) he wants. You, on the other hand, are living a life of non-to-quiet desperation. You’re at heaven’s door, but he won’t cross the threshold with you.

If I had to guess, I’d say there’s no future beyond the wham-bam-thank-you-sir part bumpin’ you’re already getting. And I also speculate that this arrangement has a half-life. I’d be willing to guess that ya’ll are already past the mid-point. Your dissatisfaction will grow and begin to manifest itself in the way you treat him. There will be an ultimatum. Then there will be an end. With a little luck it will end well, but there is also a big chance that it will end very poorly indeed. Violence is not unheard of in situations like this and I think you know this already.redneck

In his defense, I don’t think Kevin is holding out on you. He probably would if he could. But he simply can’t. And if I had to guess, he’s not ever gonna turn this around. You said he’s in his 40’s, right? That’s a lot of life lived falsely, no? I’d be willing to wager that you aren’t the first man he’s fooled around with over the years and I don’t think you’ll be the last. He’s gotta have his fix even if it compromises his perception of himself.

I don’t envy you this conundrum, my friend. You are in anguish; I hear that. This is not a happy place for you and all I can say is, I hope you don’t give up any more ground.

Let me know if you want to talk about this at some point. No need to walk through this on your own if you don’t want to.

Good luck.

That gave me chills… Its like you were here the whole time. You identified every detail exactly as I have been living it.

One part in particular, Kevin said pretty much word for word as you did. He said, “I’m not holding out on you. I would if I could, but I simply can’t.” I got to admit I don’t understand.

Tuesday I sent him this text:
“Why is this normal social shit so awkward in your mind? All I want to do is hang out sometime. Let me repeat, I want to do something other than hookup one time. That’s it, if you don’t like it I won’t ask again.

I know you like the other shit more, I likely do as well. But is it that big of a deal to just hang out like regular dudes as well?

I’m not asking for anything else whatsoever no emotional connection or expectations of any kind.”

redneck buttHis reply:
“I can’t. I’m sorry.”

His response blows my mind; it makes no sense. Sounds like an adult telling a child NO! I don’t have to explain, no means NO!

I think the truth is he just doesn’t WANT to do anything, even though he surely could. Ughhhh anyway.

I want to talk more with you about this Richard. I’ll hit you up later about the Skype thing. Thanks for being a sounding board for me.

Wow, that is interesting. Poor guy!

Again, in Kevin’s defense, he does have a wife. Maybe he thinks if he keeps his sex with you on the down low it’s not really infidelity. You know, guys doin’ guy things together. An emotional attachment to you would blow that delusion out of the water. It’s like being between a rock and a hard place. He can’t win for losing.

Anyhow, thanks for entrusting your woes with me. I look forward to connecting with you on Skype in the near future. All the best till then.

Review: An Intimate Life: Sex, Love and My Journey as a Surrogate Partner

Hey sex fans!

I have another swell sex-positive book to tell you about today. Anyone who frequents this site will already be familiar with my dear friend and esteemed colleague, Cheryl Cohen Greene. If ya don’t believe me type her name into the search function in the sidebar to your right and PRESTO!

Not only will you find the fabulous two-part SEX WISDOM podcast we did together, (Part 1 is HERE! And Part 1 is HERE!) you will find a posting about the movie The Sessions. You’ve seen it right? It’s the award-winning film staring John Hawkes, Helen Hunt, and William H. Macy. It’s the story of a man in an iron lung who wishes to lose his virginity.  He contacts a professional surrogate partner with the help of his therapist and priest. Ms. Hunt plays Cheryl, the surrogate partner in the movie

Cheryl also contributed a chapter on sex and intimacy concerns for sick, elder and dying people for my book, The Amateur’s Guide To Death And Dying.

With all that as a preface, I now offer you Cheryl’s own story: An Intimate Life: Sex, Love, and My Journey as a Surrogate Partner. The first thing I want to say is this book is it’s not a clinical or technical tome. It is an easily accessible memoir. And that, to my mind, is what makes it so fascinating.

She writes in the Introduction:An Intimate Life

I started this work in 1973, and my journey to it spans our society’s sexual revolution and my own. I grew up in the ‘40s and ‘50s, a time when sex education was—to put it mildly— lacking. As I educated myself, I found that most of what I had been taught about sex was distorted or wrong. The lessons came from the playground, the church, and the media. My parents could barely talk about sex, much less inform me about it.

What follows is a candid and often funny look into the personal and professional life of a woman on the cutting edge of our culture’s movement toward sexual wellbeing.

Cheryl comes out of her conservative Catholic upbringing and her often tortured family dynamics with what one would expect—her own sexual awakenings as well as the conspiracy of ignorance and repression that wanted to stifle it. This is a common story, the story of so many of us.

Starting when I was around ten, I masturbated and brought myself to orgasm nearly every night. … If my nights began with anxiety, my days began with guilt. I became convinced that every earache, every toothache, every injury was God punishing me. … I couldn’t escape his gaze or his wrath. Sometimes I imagined my guardian angel looked away in disgust as I touched myself and rocked back and forth in my bed.

The miracle here is that this troubled tween would blossom into the remarkable sexologist she is today.

rsz_1greenecherylSome of the chapters in her book describe one or another of her hands on therapeutic encounters as a surrogate partner, but equally important and compelling are the chapters that describe Cheryl’s own sexual struggles as she moved to adulthood and beyond. Cheryl’s acceptance of her own sexuality enables her to build a career out of helping others do the very same thing.

Everyone has a right to satisfying, loving sex, and, in my experience, that most often flows from strong communication, self-respect, and a willingness to explore.

Despite the frank discussion of sexual topics within the book, there is no prurience or sensationalism. For the most part, Cheryl’s clients are regular people, mostly men, who have pretty ordinary problems—erection and/or ejaculation concerns, dating difficulties, as well as self-esteem, guilt and shame issues. Cheryl helps each of her clients with the efficiency and confidence of the world-class sex educator she is. Most of her interaction involves her supplying her clients with some much-needed information, dispelling myths, and giving them permission to experiment. As she says;

I continue to be amazed at how solid education delivered without judgment can eradicate much of the guilt and shame that turns life in the bedroom into a struggle instead of a pleasure.

Her most famous client, Mark O’Brien, the 36-six-year-old man who had spent most of his life in an iron lung after contracting polio at age 6, was the author of How I Became a Human Being: A Disabled Man’s Quest for Independence, in which he writes about his experience with Cheryl. This, of course, was adapted into a film, The Sessions, which I mentioned above. For her part, Cheryl delivers a most poignant remembrance of Mark early in her book.

I explained Sensual Touch to Mark. Although he was paralyzed, he still had sensation all over his body, so he would feel my hands moving up and down. … I encouraged him to try and recognize four common reactions: feeling neutral, feeling nurtured, feeling sensual and feeling sexual.

An Intimate Life chronicles Cheryl’s life-long interest in human sexuality. Her life and sometimes-turbulent loves are on display, but in the most considerate fashion. She teaches by example. She’s even able to speak with great compassion of her time living with and through cancer.

As I inch toward seventy, I appreciate more and more how much I have to be grateful for and how fortunate I’ve been. I was lucky to find a wonderful career and to be surrounded by so many smart, adventurous, caring people. My personal sexual revolution auspiciously paralleled our culture’s, and in many ways was made possible by it. I am eternally grateful to the pioneers, rebels, and dreamers who made our society a little safer for women who embrace their sexuality.

There is so much I loved about this book, but mostly it’s the humanity I found in abundance. Cheryl’sdr.-cheryl-cohen-greene enlightened soul shines brightly from every page. Her no nonsense approach to all things sexual is an inspiration. And her perseverance to bring surrogate partner therapy into the mainstream is laudable.

…what separates surrogates from prostitutes is significant. When people have difficulties grasping [that], I turn to my beloved and late friend Steven Brown’s cooking analogy that I’ve so often relied on to help me through that question: Seeing a prostitute is like going to a restaurant. Seeing a surrogate is like going to culinary school.

Finally, An Intimate Life is the culmination of Cheryl’s life as a sex educator, her surrogate partner therapy practice being just part of that mission. I highly recommend you read this book. You will, I assure you, come away from it as I have, a better person—enriched, informed, as well as entertained.

Cheryl, thank you for being in my life and being such an abiding inspiration. Thank you too for this marvelous book; now you can be in the lives of so many others who need you so that you can inspire them along their way.

Be sure to visit Cheryl on her site HERE!

A molehill becomes a mountain

My problem is Sexual dysfunction, I can have a hard on and keep it for penetration but if I have to use a condom I lose my erection, most of the time. I also take to much time to cum. Most of the time I loose my erection and I can’t finish what I’ve started. I would like to find a solution for this, because I have been like this for a long time, and it is really frustrating for me. I do appreciate your help and look forward to hear from you.
Miguel.

Sounds to me like you’re racing to the finish line. Hey, where’s the rush? You may be experiencing a bit of performance anxiety, but I don’t think it’s a full-blown sexual dysfunction quite yet.

Look for the category pull down menu in the sidebar to your right. Scroll down till you find the category — Sex Therapy. Under that category you will find a subcategory labeled PERFORMANCE ANXIETY.

You’ll find loads of information about this issue in both written and podcast form.performance anxiety

Here’s an example of what you’ll find…

Simply put, there’s a difference between the psychosexual response we have when we are alone and the one we experience with a partner. There’s probably nothing wrong with your unit. It’s all in your head…or your mind, to be more exact. And I’m not being flippant.

Here’s how performance anxiety works. Say I have a less than satisfying sexual experience for one reason or another. Before I know it, I’m replaying the incident over and over in my mind’s eye till that’s all I can think about. The proverbial molehill has become a mountain, don’t ‘cha know. I then bring my anxiety to my next encounter. My hyper self-consciousness primes me for more disappointment. And I’m all prepared to interpret the disappointment as a failure. Well, you can see where I’m going with this, huh? My fears become self-fulfilling and I find I’m beginning to avoid partnered sex and my relationship flounders, I develop a full-blown sexual dysfunction and my self-esteem takes a nosedive. My preoccupation with my problem makes it less likely that I’ll be fully present during sex with my partner, which pretty much scuttles my sexual responsiveness and any hope for spontaneity.

Get thee to a sex-positive therapist ASAP! Believe me this is nothing to fool around with. Check out the directory at The American College of Sexology for a therapist near you.  If you can’t find anyone near you and you really need to talk to someone, check out my Therapy Available page.  I do remote therapy/counseling via Skype or phone.

When I see this sort of thing in my private practice, I always begin the therapeutic intervention by calling a moratorium on fucking of any kind. This immediately takes a great deal of the pressure off the couple. From there we begin to rebuild the partnered psychosexual response one step at a time. We begin with sensate focus training, stress reduction and relaxation exercises. I have the greatest confidence in this method; it succeeds over 90% of the time.

Good luck

What’s a mother to do?

What we have here is an exchange I had with a woman and while I don’t know anything about her, not even her name, I can make some inferences. If I had to guess, she’s in her 40’s. She’s married and has kids.

You must talk to a lot of women in your practice and hear from a lot of women through your advice site. What would you say are the main sexual concerns of women over the age of 40?

Research shows that approximately 40% of women experience sexual problems. But a 2008 study out of Harvard suggests that only a few — 12% — are concerned enough with these issues to do anything about them. I find that not only surprising, but shocking! That suggests to me that sexual wellbeing is not a high priority for a good number of women.  What a bummer!sexual-Frustration

Low libido, diminished arousal, difficulties with orgasm, pain with sex or body image concerns all play a part. A lot of this is directly connected with having an ineffectual partner. I mean, I’d give up sex too if I was consistently frustrated and unfulfilled. But what about masturbation? Are sexually frustrated women seeing to their own needs through self-pleasuring? I don’t see any hard data, you should pardon the pun, on that topic.

We hear a lot about the horny dad and the tired mom, but what do you do if the “roles” are reversed – and dad is tired and mom is horny?

Curiously enough, I hear from way more men these days, who are exhausted, depressed or overweight and who have little or no libido, than I hear from women with the same problems. Sign of the times? You betcha!

But don’t sink to the lowest common denominator. Here’s one of my most popular tutorials, Sex Play — Tips and Techniques.

How can parents find common “ground” when it comes to when they might have sex (as in day of the week or time of day)? Does it always involve compromise? Can our internal clocks ever synch up?

Synching up schedules my not always be the solution. If we wait for that to happen, we could die waiting. The answer might be finding a middle ground. “I may not be up for full on fucking at the moment, but I’ll give you a fantastic hand-job.” Or “I can’t seem to get it up right now, but hand me your vibrator and I’ll send you to heaven!” I’m a huge proponent of mutual masturbation.

Another suggestion might be something like The MoodSign. We reviewed this very clever gismo awhile back. In fact, it was among our Best Products List for 2013. Check it out and see if something like this would help.

If parents are interested in kinking it up, what are some simple, not too scary ways to introduce it into the relationship?

Keep it safe and consensual. Always have a safeword. I developed a workshop called; The Gospel of Kink. I’ve also conveniently packaged this workshop into a workbook with the same title. You can find the book HERE!

GOK small cover

Both the workshop and book are designed to help people, like you, develop the skills they need to effectively communicate with one another and improve their problem solving skills. The workshop and book, as the title suggests, are specifically geared toward folks in kinky, BDSM, and alt-culture relationships, but even vanilla couples will find what I present very helpful.

Bondage games are always fun. And you don’t need anything beyond what you already have in your closets — silk scarves, belts, shoe strings, etc.

Nipple clamps, playing with sensations like ice cubes and hot wax, hair pulling, making use of blindfolds and gags

Discipline/Spanking is always fun too — a ruler, a hairbrush, a wooden spoon, a belt, rubber bands. See my tutorial: Spank Me, Daddy.

Role play is always a delight. Don’t forget about phone sex.

There are tons of instructional videos at Dr Dick’s How To Video Library.

I always suggest that couples read erotica aloud to each other. That never fails to get one’s motor purring.

I’d also love to talk with you about the taboo of sex, particularly with the parenting set, and how parents, moms, and dads, can work to break stereotypes without feeling like a sexual “deviant.”

Really? What would be so wrong about being a deviant?

Good luck

He Can’t Cum!

Name: Alice
Gender: Female
Age: 19
Location: Minnesota
My new boyfriend is really frustrated and doesn’t want to have sex anymore because he can’t come. He says he’s had this problem for a while and hasn’t come with any girl for over a year. I see how upset he is and I know he still wants to sleep with me, but says it hurts when he gets excited and nothing happens. Is there something I can do? I tell him to see a doctor but I don’t think he will. Thanks a lot!

Wow, that’s a bummer Alice. Unfortunately, you don’t supply me with enough information for me to make an educated guess about what might be up with him. Does he have erections? Does he masturbate? Is he on any medications? These are the first questions I’d ask him. Since he isn’t here and neither are you, I’m gonna make a stab in the dark.cover up

If I had to guess, I’d say your man is suffering from a real bad case of performance anxiety. He doesn’t need a medical doctor; he needs to learn to relax and be in the moment. If this is an arousal phase issue then that should help. If it’s and orgasmic phase issue, relaxing and enjoying the pleasure will also help.

Here’s how performance anxiety works. Say a fella has a less than satisfying sexual experience for one reason or another. Before he know it, he replaying the incident over and over in his head, till that’s all he can think about. The proverbial molehill becomes a mountain. He brings his anxiety to his next sexual encounter. His hyper-consciousness primes him for more disappointment. And he’s ready to interpret all disappointment as a failure. And this can interrupt either the arousal phase or orgasmic phase of our sexual response cycle.

Well, you can see where I’m going with this, huh? His fears become self-fulfilling. Before he knows it, he begins to avoid sex. His relationships suffer. He develops a full-blown sexual dysfunction. And his self-esteem takes a nosedive. His preoccupation with his problem makes it less likely that he’ll be fully present during sex with his partner, which pretty much fucks up his sexual responsiveness and any hope for spontaneity.

It sounds to me like performance anxiety is putting a damper on his sexual arousal and thus short-circuiting the rest of his sexual response cycle, including orgasm.

This is nothing to fool around with, especially for someone at his tender age. When I see this sort of thing in my private practice, I always begin the therapeutic intervention by calling a moratorium on fucking of any kind. This immediately takes a great deal of the pressure off the couple. From there we begin to rebuild the partnered psycho-sexual response one step at a time. We begin with sensate focus training, stress reduction, and relaxation exercises. I have the greatest confidence in this method. It succeeds over 90% of the time.

Good luck

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