Category Archives: Sex Therapy

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

Look, I can fly!

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Name: Wayne
Gender:
Age: 26
Location: Philadelphia
Hey Dr. Dick I have a little issue that has stumped me, my doctor, and numerous urologists. I figure there’s no harm in asking one more person. I have never, not once, been able to cum normally. (I suppose there is a normal way, considering every other guy I’ve ever met has been able to do it that way.) The only way I have ever achieved orgasm is by laying on my stomach, putting pressure with a slightly closed fist on the spot where my dick meets the rest of my body, and sliding back and forth. Weird aside — this was a way to lift myself up off the floor and “fly” as a young kid, then one day I found out that it was pleasurable. I know – weird little boy. But this is anonymous, right. Anyway, fast forward to my twenties and becoming sexually active and now I have a concern. I want to be able to cum by having intercourse or just jacking off. But I’ve never been able to. I can come very close, but the deal just doesn’t happen. (Never have a problem getting hard.) Any thoughts? Thanks for your time. Wayne

hint of hair

Interesting masturbation technique you got there, my friend. While it is unique, it is not the most distinctive style I’ve even encountered in my career. Someday I oughta write a book.

What’s most amazing to me about what you write here is that this predicament of yours has stumped all the physicians you’ve consulted. I suppose that says volumes about how informed most physicians are about human sexuality.

Simply put, Wayne, over the years you’ve habituated your body to respond pleasurably to a particular stimulus. Ever hear of Pavlov’s dogs? Right! What we have here is exactly the same thing, only completely different. 😉 You apply the stimulus — laying on your stomach, putting pressure with a slightly closed fist on the spot where your dick meets the rest of my body, and sliding back and forth. And your body responds with an orgasm.

Most all of us, both female and male, discover the joy of self-pleasuring accidentally. Your first encounter with masturbation, although you probably didn’t know that’s what it was called at the time, was through your boyhood attempts to fly. And fly you did! As you suggest, most other people discover self-pleasuring in a more conventional way, through touch. Thus the more “normal” — and I use that word in quotes — means of getting one’s self off…manually.

Your unique style of self-pleasuring is completely benign, but it doesn’t really lend itself to partnered sex, as you say. I mean, how awkward would fucking be if you had to get off your partner and on to the floor to cum? So is there a solution? Sure there is. And it’s not a particularly difficult nut to crack…so to speak.

Let me tell you about a former client of mine. He was about your age when we met several years ago. He presented a similar concern to yours. He learned to masturbate in the same position as you, lying on your stomach, but he got off by humping a pillow in that position. Try as he might, he never was able to get off any other way. This was driving him crazy. He couldn’t date anyone, because he was too embarrassed about the whole pillow thing.

outlookOver the next 4 or 5 weeks I helped my client learn a new way of self-pleasuring that would lend itself to happy partnered sex. The object was to rid himself of the need for the pillow altogether and we did this is incremental steps. Luckily my client was a horny little bugger. He masturbated at least twice a day, sometimes even more frequently. I decided to use his natural horniness as part of the intervention.

My client had to promise me that he wouldn’t masturbate in his traditional way for two weeks, absolutely no pillow sex for an entire 2-week period. If he failed to keep his promise, he would have to start all over from day one. At first he couldn’t see the purpose in this moratorium, but I insisted. By the time I saw him next, the poor boy had blue balls for days. So he was primed and ready to go. His next exercise was to change position for his first masturbation after the weeklong moratorium. He could masturbate with his pillow, but he had to lie on his back. He was not permitted to roll over on to his stomach. This wasn’t immediately successful, but his pent-up sexual energy finally carried the day and he got off in the first new position — on his back — since he learned to masturbate.

I gave him a new exercise the following week. While on his back, he could use the pillow to rub himself, but only to the point where he was about to cum. At that point, he was to put the pillow aside and finish himself off with his hand. This was only slightly more difficult than the previous exercise. And within two attempts he finally got himself off with his hand for the first time in his life. The rest of his therapeutic intervention was simply following this behavior modification course of action till he didn’t need the pillow at all.

I assume you see where I’m going with this, Wayne, right? You could do this same sort of intervention on your own to learn a new and more traditional way of masturbating, but you’d probably have more success working with a qualified sex therapist.

The firm desire to change a behavior or habit is the most important aspect of the process of change. Second is denying yourself the convenient and habitual stimulus — in your case, your flying masturbation style. This will drive you to find a replacement means of getting off — a more traditional manual style. Weaning yourself off one style of masturbation incrementally till you are successful in replacing that style with another is the most efficient means of behavior change. I encourage you to give it a try.

Good luck

The Dreaded Lesbian Bed Death

Name: Karen
Gender: Female
Age: 36
Location: Portland
I have a really big problem. I can’t keep a girlfriend because once I’m in a committed relationship I lose my desire for sex. I don’t mean it slacks off; it just totally stops. I’ve always been this way. I can have casual sex with women, but when things get serious sex goes out the window. This has been the demise of every relationship I’ve ever had. I’m currently dating this really great woman, but I’m afraid my problem will drive her away too. Is there anything I can do to stop this from happening?

Whoops, looks like another case of dreaded LBD…Lesbian Bed Death.

Lesbian Bed Death

Ya know it’s pretty common for lovers in long-term relationships to gradually lose interest in sex with each other. But lesbiterians are particularly susceptible to this malady. Some couples, but lesbians in particular, end all sexual expression between them; yet stay very committed and loving toward each other. Thus the somewhat humorous term, “lesbian bed death.”

You Karen, apparently suffer from a particularly nasty case of LBD. May I ask, is this an issue for you because, and only because, it kills off all your relationships way too soon? Or are you concerned about this because you yourself are uneasy about the complete cessation of sex once you nest? The reason I ask is, if your only reason for changing is to please someone else, even someone you like a lot, the likelihood that you’ll actually change is considerably less than if you yourself desire a change.

Let’s say you really want to change for yourself, but you just don’t know how. I’d advise working with a sex positive therapist. If you and I were working together, for example, I’d want to get to the bottom of what triggers your attitude shift toward sex when you nest. Is there some disconnect for you between sex and intimacy? If there is a disconnect for you, you’re not alone. People with self-esteem issues, or body issues, people with extreme scruples about sex, the kind that translates into guilt and shame often have a similar disconnect. And gay and lesbian people who have not resolved their internalized homophobia will frequently have a sex and intimacy rift.

Lesbian Bed Death2

Sound familiar? I would guess so. Reversing this is unhappy trend is not an insurmountable task. But it will take a concerted effort to heal the rift that you may have between your sexual expression and intimacy needs.

You say you’re met this really great woman and you want this relationship to last. FANTASTIC! Is it safe to assume that she has a healthier appreciation of sex then you? If she does, I suggest you engage her in your healing process. However, you gotta be totally up front with her about your past pattern of disconnect. Marshal her sex-positive energy to help you resolve your issues. She will need a heads-up on the impending sex shut down so she can help you resist it. With her help, the two of you could move through this.

Good luck

Sexual assault is any sexual contact without consent

Name: Lola
Gender: Female
Age: 37
Location: Tennessee
I have been married for 13 years. We have had a pretty healthy, fulfilling sex life. My husband does not like to admit to his insecurities but i think he has some insecurity about his penis size and lately, his problem with not lasting very long. He has developed an obsession with stretching my vagina and pulling my labia. He knows I don’t like it. The other night, he introduces a dildo he has secretly purchased. I have enjoyed dildos, even larger ones, in the past, but this one was ridiculously too big. It was over 12″ long and the circumference was as big as a baseball bat. I told him that it was hurting and that it was impossible. He forced it in me. I was crying in pain and he tells me later that he hasn’t been that aroused in years. I am hurt. It hurt me physically, I bled a little, but it hurts more emotionally. What do you think is wrong with him? He has never hit me or been abusive with me, in the past.

sexual assault

Jeez darlin’, that’s fucked up…big time.

Here’s the thing about men who have sexual insecurities. They can and often do project their perceived inadequacies outside of themselves and then act out. And almost always this projection and acting out is aggressive and abusive.

I suppose you know that what we’re talkin’ about here, Lola is sexual assault, right? I mean let’s not mince words. Your husband assaulted you. It was premeditated and worst of all he took pleasure in it. This is extremely disturbing, because, despite his non-aggressive past, he has just upped the ante exponentially. You know what they say about domesticated animals that inexplicably develop an aggressive steak. Once they get a taste for blood there’s no trusting them ever again.

I think your old man has severe anger issues. Issues that if left untreated will…not maybe, but absolutely will…escalate into more aggressive and abusive behavior. Your guy needs help. He needs to know that he stands on a precipice. That he is making a cognitive and affective connection between violence and pleasure and this is very dangerous for all involved, especially you, Lola.

campus-sexual-assault

You don’t mention that he had any remorse about this assault. This too is disturbing. Because you can’t precisely pinpoint the cause of his acting out, you’ll never really know when you’re safe and when you’re not. I encourage you not to treat this lightly. Confront him about this. Make it clear to him that he has violated the bond of trust between the two of you. He may try and shift the blame for this incident to you. But remember, you’re not at fault. Insist that he seek professional help immediately. Anything short of him doing that will nullify your relationship.

No waffling on this, Lola! You do not want him to get the message that this incident can be winked at or overlooked. Your wellbeing hangs in the balance.

All unwanted, forced, manipulated, or coerced sexual contact or activity is sexual assault. Sexual assault is not about sex, eroticism or desire; it is about power, control and abuse.

Good Luck

The Real Reason Men Lose Their Erection When Using A Condom

by Raffaello Manacorda

Men Lose Their Erection When Using A Condom

That Awkward Moment When…

If you’re a man, you’ve probably experienced this. Everything is perfect, the foreplay is going great, and the stage is set for a throbbing, mind-blowing, heart-shattering lovemaking. Your erection is strong and powerful, and feeling it turns you on even more.

And then, that moment comes. Your lover looks at you sweetly but squarely in the eyes, and with a soft but firm voice says, “We need to use a condom.”

This makes perfect sense. The risk of STIs and/or pregnancy is real. So you’ve got to wear that condom.

But our genitals don’t understand logic. And, sometimes, it only takes a few seconds of this pause for your penis to soften. Her being sweet and comprehensive only makes things worse: something inside you tells you that you won’t be able to do it if you wear a condom.

I’ve gone through the same process. I used to consistently lose my erection whenever a woman asked me to wear a condom. It wasn’t pretty. I hate to admit it, but a couple of times I even lied to a partner, telling her that there were no condoms in the house, while I actually had plenty. I just was too scared of sexual failure. Boy, am I grateful that no one got an STI or got pregnant because of that dirty little lie of mine.

So why on Earth does this happen? Why do we men lose our erection because of condoms?

The Real Reason Condoms Turn Men Off…

You might try to fool yourself and others with explanations such as:

  • That you don’t feel enough pleasure with a condom.
  • That a condom squeezes your penis too much.
  • That the pause “takes the romance away”…

But deep in your heart, you know that those are not the real reasons.

As for sensitivity and comfort, you know well that your penis is not all that sensitive. In fact, the harder it is, the less sensitive it is. And as for the non-romanticism of the 2-minutes pause, you have fantasized or have been in way less romantic situations, where your erection stood strong and implacable.

So WHAT is the real reason why you lose your erection? And what can you do about it?

To answer this question, the first thing you need to understand is that your main sexual organ sits in between your ears or, if you prefer, inside your chest. It is your head and your heart that turn you on (or off).

So, the reason why we men lose our erection when a woman asks us to wear a condom is that some deeply uncomfortable thought and/or emotion arises in us in response to that request. And what might that thought or feeling be?

Although every man is different, that uncomfortable thought is virtually always a variation on the same theme: she asking you to wear a condom carries the message that she does not accept you inside her body. And this can be truly devastating for a man.

Some Truths About Male Sexuality

Men love to feel invited, welcomed, by a trusting lover that opens up to their force and thrust. When the body of a woman is welcoming, wet, inviting, this is a huge turn-on for a man. When the body and soul of a woman tense, close up, tighten – this is a turn-off.

Men deeply crave to feel accepted, welcomed, and trusted.

The request to wear a condom challenges that. It can seem to convey the following messages:

  • If you don’t wear it, I won’t let you inside me (you’re unwelcome)
  • I don’t trust you to be healthy, or to control your ejaculation (you’re not trusted)

This is the subterranean thought that runs into most men’s mind, and makes them lose their erection.

Understanding it is the first step towards liberating your sexuality from this blockage.

As a man, you need to realize that, even if you wear a condom, you are welcome and accepted. That she wants you just as badly. In fact, she wants you so badly that she wants to be fully trusting and surrendered. And in order for that to happen, she needs to feel safe. This conviction will take some time to build, but once it’s there, it will never leave you. Condoms won’t be an issue anymore.

In order to get there, the best thing to do is start practicing, both by yourself and with a partner.

Practicing By Yourself

Get familiar and friendly with condoms. Buy a pack of condoms and start experimenting. Wear a condom and play with yourself.

Now, I know that the condom instructions say that you should wear it only when you are fully erect. The reason they say this is that if your penis is not fully erect, then a condom can potentially slip away, which is not cool. But for now, you can forget about this. You are alone, and you can wear a condom even if your penis is completely flaccid. In fact, you should practice this skill. Wear a condom on your soft penis, and then stimulate your penis so that it becomes hard.

Familiarize yourself with the condom, and lose your aversion to it. This will be really useful once you practice with a partner.

Practicing With a Partner

This is potentially going to be scary, so you’ll need to set a firm intention: you won’t back off. You will wear a condom no matter what, whether you end up having intercourse or not.

Next time you have the opportunity, do not wait for your partner to propose using a condom. Once you have enjoyed your foreplay long enough, go ahead and say the magic phrase: “I’ll put on a condom now, just in case.”

That means that, whether you are going to penetrate your partner or not, you can wear a condom anyway and then continue with whatever you were doing. At some point you may even forget that you have a condom on.

Your partner also has a role in this. You can ask her to support you in a very simple way: by doing with your penis exactly what she would do with it if there were no condoms. Touching it, sucking it, teasing it—just as if that condom did not exist.

And now, if the moment is ripe for both of you, still wearing your condom, penetrate her. Don’t worry if your erection isn’t that strong. In that case, just make sure to hold the bottom of your condom with your fingers to make sure it doesn’t slip away. But do get yourself to the point where you can penetrate her while still wearing a condom.

This moment is a threshold, and after that, the rest will be much easier. The more you feel that things are going well, the more natural it will become to continue making love with a condom. You will notice that it isn’t all that different from not using it, and that wearing a condom will give both of you more confidence and a feeling of safety. Since you are practicing here, refrain from ejaculating inside your partner, even if you are wearing a condom. The purpose now is to gain confidence with condoms—not necessarily to have the hottest lovemaking of your life.

Every man on this planet should be able to make love with a condom, if necessary. We owe it to ourselves, and we owe it to our partners, men or women. Asking a partner not to use condoms just to protect our sexual pride is not an option. If two lovers decide to not use condoms, let that be a conscious decision, rather than a slippery workaround of a sexual blockage.

Have fun!

Complete Article HERE!

What Makes These Dominican Children Grow Penises at Puberty?

By Michele Debczak

guevedoces

In the Dominican Republic, the phenomenon of children who were raised female appearing to swap sexes at puberty is so common it even has a name. Guevedoces roughly translates to “penis [or “balls”] at 12,” and it’s the result of a rare enzyme deficiency that delays crucial steps of male sexual development until puberty.

When guevedoces are born, they appear to have external female genitalia even though their genes and internal reproductive organs are male. Parents assume their children are girls and raise them as such. But when these children begin producing large amounts of testosterone at puberty, their testes descend and they grow a penis—in addition to all the other changes that come along with male adolescence. 

Sexual development normally begins in the womb, and the same is true for guevedoces. Whether the fetus has one X chromosome or two, for the first several weeks of development its genes follow the same blueprint for both sexes. Then, sometime around the eight-week mark, the sex chromosomes get to work. For males, the undeveloped gonads become testicles and they start to release male hormones, including testosterone. In a structure called the tubercle, an enzyme called 5-alpha-reductase converts the testosterone to a stronger hormone called dihydrotestosterone (DHT), which is necessary to develop external genitalia. It’s this hormone that turns the tubercle into a penis; without it, it develops into a clitoris.

The rare enzyme deficiency found in guevedoces leaves them unable to develop external male genitalia in the womb. They still produce plenty of testosterone, which triggers the development of internal structures like the epididymis and vas deferens, but the lack of DHT makes the babies appear female at birth. It’s not until the second surge of testosterone these children receive at puberty that they grow testes and a penis.

The condition is thought to be genetic, tracing back to the female founder of a small village in the Dominican Republic’s mountainous hinterland. Outside of the nation, it’s incredibly rare.

For some guevedoces, being raised as female wasn’t an easy experience. “I never liked to dress as a girl, and when they bought me toys for girls, I never bothered playing with them,” Johnny, who had grown up as Felicita, told BBC Two, which features these kids in the second episode of the series Countdown to Life: The Extraordinary Making of You. “When I saw a group of boys, I would stop to play ball with them.” When Johnny, now 24, began to undergo physical changes, he was taunted at school and called nasty names by his classmates. He’s had a number of short-term girlfriends since going through puberty and dreams of one day getting married and starting a family. Another child named Carla began the process of transitioning to Carlos at age 9; he can be seen receiving a smile-inducing haircut in the photo above.

Most people with this condition live out their adult lives as men, but some choose to undergo surgery and remain female. The discovery of this disorder in the 1970s led to the development of a best-selling drug called finasteride, which is commonly prescribed to treat benign enlargement of the prostate and male pattern baldness. (You may know it by the brand name Propecia.) The drug mimics the enzyme deficiency by blocking the action of 5-alpha-reductase.

You can learn more about this rare condition and the people who have it on the BBC Two series Countdown to Life: The Extraordinary Making of You.

Complete Article HERE!