Category Archives: Sexual Anxiety

Sex Therapy—What Is It and Who Needs It? – Part 1

FacebookTwitterGoogle+PinterestTumblrShare

I’m often asked about my work as a sex therapist. I’m surprised at how few people have any sense of what a sexologist does. While I can’t speak for all my fellow therapists, I can tell you a bit about my own practice.

Most of the work I do is Cognitive Behavioral Therapy (CBT): short-term, goal-directed and personally liberating (I don’t believe this kind of therapy should become a lifestyle). Basically, I suggest that people with sexual issues change the behaviors that contribute to their problems as a surefire way to solve them. I try to give my clients all the tools they need to successfully work things out on their own once the therapeutic intervention is over. This approach doesn’t fit everyone; however, 99.9 percent of the people I work with respond positively.

I encourage my clients to give themselves permission to investigate their sexuality. This in turn assists them in taking charge of making themselves feel better and/or perform better. And as soon as they do, they almost immediately have a greater sense of wellbeing. Like they say, nothing breeds success like success.

Once we identify an area of concern, my client and I create a plan of action for them to implement. I believe the more an individual is part of their own healing process, the more productive that process will be.

Sadly, I find that fewer and fewer people are willing to give their sexual issues the attention they deserve. Rather than investing the time and energy to get to the bottom of their issues, many opt instead for the quick fix—the “Give me a pill for that” mentality. They’re often unwilling to make the necessary lifestyle changes to actually solve their problems. For example, I encounter people who are eating themselves to death, or abusing alcohol or drugs. Of course they have the accompanying sexual response issues—erection problems for men and arousal concerns for women. They may desperately want to resolve these issues, but without committing to any change in behavior—i.e.: “I want my erection back, but I won’t stop drinking”—such interventions almost always ends in disappointment.

Sexual dysfunction of one sort or another is the issue I see most recurrently in my practice, although the reason why a client reaches out varies. Sometimes an individual’s tolerance level peaks, and they finally decide to do something about an issue that may have been smoldering for years. Sometimes it’s a partner who brings in their proverbially “broken” partner, telling me to “fix him/her.”

Couples often seek sex therapy together, as sexual problems tend to be more obvious within relationships. However, by the time the couple comes for therapy, the issues have most likely been plaguing them for some time. The relationship often comes close to ending before the couple agrees to address the problem. For example: Say a guy brings his wife in because she’s “frigid,” whatever that may entail. They’ve been married for X-number of years, and he’s finally had it. She, on the other hand, doesn’t want to be in therapy, because she doesn’t really think there’s anything wrong with her. She just doesn’t want to have sex anymore, and she doesn’t want to discuss it. Period.

This is a difficult way to start therapy. Resentments are high and frustrations rage. If the couple does continue, we usually discover that there’s also something desperately wrong with the husband. Inevitably, we ascertain that he’s an ineffectual lover—and his inability to pleasure his wife is the root of her “problem.” It’s often painfully clear that he knows little (if anything) about his wife’s sexual needs or desires. Meanwhile, the wife has never had permission to know her body, so she’s unable to help or direct him. As you can imagine in a case like this, there’s a load of remedial sex education that must come before anything else is resolved.

Couples also seek therapy when one spouse has cheated on the other. The “cheat-ee” declares, in no uncertain terms, that this therapy is the last-ditch effort before “the end of the road.” Often in such cases, it’s too late for a successful intervention, because each partner is so angry and shamed that the chance of turning the situation around is slim. Sometimes the best we can do is end the relationship with as little acrimony as possible.

In difficult couple counseling situations like this, my first effort is to get the couple to disarm. There will be no sex therapy—and God knows there is a need for sex therapy—until there is some semblance of peace between partners. If we don’t establish at least a small bank of goodwill, our efforts are doomed.

We’ll pick this up next week at this time.

Got a Sex Question?
You’ve come to the right place.
Contact me here: questions@drdicksexadvice.com

No time to write?
Give Dr Dick a call.
(866) 422-5680
Toll Free — Voicemail — HOTLINE

Would you like to talk about your sexual concerns, feelings, lifestyle or experiences?
Arrange for a consultation HERE!

Either way, you can be assured of my complete discretion.

The Root of Our Discomfort

Name: Maya
Gender:
Age: 28
Location: UK
Hi there! I recently found out that my brother in law is gay. I wanted to know what makes people gay? Is it choice, genes, hormones, etc? Please clarify because his condition and opposition to his choice of sexuality has made him depressed and he’s on antidepressants and not very healthy. Please answer.

Back in 2007 Solon.com featured a little piece called: Don’t Ask the Sexperts in their annual sex issue: State of the Sexual Union. Slate asked seven people who earn their livings thinking and writing about sex, what they’ve never been able to figure out about sex or sexuality.

One of the contributors was Dr. Ruth Westheimer. She’s the author of 31 books about sex and relationships. This what she said still remained a mystery to her.

“I’m sure there are many, but one nagging one is what causes homosexuality. I admit, I am curious—but the real importance in getting to the bottom of this question is that the answer would be helpful to the homosexual community. I suspect that the cause is genetic, which would mean all those people who say that gays and lesbians can change to become heterosexual would have to sing another tune. Instead of trying to “fix” a situation that doesn’t require fixing, they would have to learn to accept homosexuals. But I am not a scientist, so I can’t set about finding out the etiology, the cause of homosexuality. All I can do is act as a cheerleader to encourage scientists to come up with the answer.”

I was astounded when I read Dr Ruth’s comment. Here is one of the most popular names in the field of human sexuality saying such a startling thing. It’s not that she misrepresented the state of scientific inquiry into the issue of sexual orientation. What she said is true. We don’t precisely know what “causes” homosexuality, but more importantly…and this is what she leaves out…we haven’t a clue what “causes” any sexual orientation — straight, gay, bi, what have you.

What troubled me so about Dr Ruth’s comment is that, perhaps inadvertently, she perpetuates the myth that homosexuality (as opposed to say heterosexuality) has a cause. And when she uses the word “cause”, she denotes to her audience that there’s a cure. All I want to say is that if there’s a “cause” for homosexuality, there is certainly a “cause” for heterosexuality. If there would ever be a “cure” for homosexuality, there would certainly then be a “cure” for heterosexuality.

Do you see how obvious and pervasive the prejudices of the dominant culture are? I absolutely expected better from old Dr Ruth, don’t cha know. It’s true that she goes on to say that she thinks the “cause” of homosexuality is genetic, therefore us homos can’t change or be “fixed”. She then suggests, if this IS the case, the dominant culture would then simply have to learn how to accept homosexuals for how they are. I went, HUH???

Dr Ruth, darling, do you honestly believe that if, or more properly, when we discover the determining factors of sexual orientation — and I do believe there are more than one — the sexual bigots among us won’t militate to have the deviant orientations “fixed”? All I can say is to think otherwise shows an alarming naivety about human nature.

When Dr Ruth, or anyone else for that matter, separates out one sexual proclivity from all the others and suggests that it has a cause, whatever it might be, the rest of us run for cover and wait for the other shoe to drop. Imagine if instead of sexual orientation we were speaking about racial or ethnic characteristics. What causes black people? What causes Asian eyes to slant? What causes flat noses? What causes nappy hair? What causes short people?

Well you see where I’m going with this, right Maya? Questions like these presuppose that there is a norm — tall white people with round eyes, perky noses and straight hair. And you know what? There are a multitude industries out there poised to prey upon all the short, non-white people with almond eyes flat noses and nappy hair who feel they must conform to any and all arbitrary and culturally induced norms in order to be happy. It’s shocking.

So on to your brother’s case. If sexual orientation is chosen, why would he have embraced a lifestyle that makes him sick and depressed? It simply doesn’t add up. The self-hatred and internalized homophobia that is at the root of your brother’s discomfort is culturally induced, but it is also self-inflicted. We don’t know what “cause” homosexuality, but I can tell you for certain what causes homophobia. And that, my dear, is bigotry.

It’s up to your bother to fight this first within himself and then in the popular culture with every ounce of his strength. Because that’s what all us well adjusted, comfortable in our own skin queers do if we want to live happy healthy integrated lives. None of us is waiting around for someone to tell us what caused us to be the way we are, because we know that whatever “caused” us caused all the other differences and variations that appear in human kind.

And one final tip for you, Maya — despite your good intentions, the more you indulge your brother’s pathologies and commiserate with him, or wonder aloud with him why he is queer then you are part of the problem, as opposed to being part of the solution. I encourage you to challenge him to buck up and get right with himself. Help him throw off the yoke of his shame and guilt, to own and embrace his uniqueness and celebrate his sexuality, which is his norm.

Good luck

More of Shai Rotem – Podcast #181 – 01/20/10

Hey sex fans,

We’re back with my guest Shai Rotem, and Part 2 of our conversation about surrogate partner therapy; or as it is otherwise known as, sex surrogacy.  And this, my pretties, is the brand-spankin’ new SEX WISDOM podcast series, where we chat with renowned researchers, educators, clinicians, pundits and philosophers; who are making news and reshaping how we look at our sexual selves.

Did you happen to miss the inaugural program in this series? Not to worry!  Part 1 of my conversation with Shai is archived right here on my site.  Use the search function to your right, type in podcast #179 and PRESTO!  Be sure to use the #sign when you search.

Shai and I discuss:

  • How one becomes a certified surrogate partner.
  • IPSA training and supervision.
  • His work history; beginning in Israel.
  • How his clients find him.
  • Common myths of surrogate partner therapy.
  • His role as mentor and advisor to and trainer of other surrogates.
  • What the future holds for him and his work.

Shai invites you to learn more about surrogate partner therapy by visiting the International Professional Surrogates Association’s website HERE!

BE THERE OR BE SQUARE!

Check out The Lick-A-Dee-Split Connection. That’s Dr Dick’s toll free podcast voicemail HOTLINE. Don’t worry people; no one will personally answer the phone. Your message goes directly to voicemail.

Got a question or a comment? Wanna rant or rave? Or maybe you’d just like to talk dirty for a minute or two. Why not get it off your chest! Give Dr Dick a call at (866) 422-5680.

DON’T BE SHY, LET IT FLY!

Look for all my podcasts on iTunes. You’ll find me in the podcast section, obviously. Just search for Dr Dick Sex Advice. And don’t forget to subscribe. I wouldn’t want you to miss even one episode.

Today’s Podcast is bought to you by: Eden Fantasys.

Sex toys - EdenFantasys adult toys store

SEX WISDOM with Shai Rotem – Podcast #179 – 01/13/10

Hey sex fans,

I have a fantastic show in store for you.  I am delighted to inform you that I am launching yet another podcast series today.  I call it the SEX WISDOM podcast series.

Besides the wildly popular Sex EDGE-U-cation series and The Erotic Mind series that have been running for the past year and longer, I thought it would be grand to chat with some of the movers and shakers in the field of human sexuality.   So in the course of this new series we will be chatting with researchers, educators, clinicians, pundits and philosophers who are making news and reshaping how we look at our sexual selves.  I can assure you that these conversations will be well worth the time you spend with us.

I have chosen a remarkable man as my first guest.  His name is Shai Rotem.  He is a certified surrogate partner; or a sex surrogate, if you prefer.  And he’s here to tell us about the critical work he is doing with his clients.  This is fascinating stuff, sex fans!  Please stay tuned.

Shai and I discuss:

  • A working definition of the term Surrogate Partner.
  • How a sex surrogate differs from a sex worker.
  • Being part of a scripted therapeutic intervention.
  • Surrogate partner therapy and the law.
  • Who can benefit from surrogate partner therapy.
  • The impact of a repressive religious upbringing on sexual wellbeing.
  • Cognitive Behavioral Therapy and Sensate Focus Techniques.

Shai invites you to learn more about surrogate partner therapy by visiting the International Professional Surrogates Association’s website HERE!

BE THERE OR BE SQUARE!

Check out The Lick-A-Dee-Split Connection. That’s Dr Dick’s toll free podcast voicemail HOTLINE. Don’t worry people; no one will personally answer the phone. Your message goes directly to voicemail.

Got a question or a comment? Wanna rant or rave? Or maybe you’d just like to talk dirty for a minute or two. Why not get it off your chest! Give Dr Dick a call at (866) 422-5680.

DON’T BE SHY, LET IT FLY!

Look for all my podcasts on iTunes.  You’ll find me in the podcast section, obviously. Just search for Dr Dick Sex Advice. And don’t forget to subscribe. I wouldn’t want you to miss even one episode.

Today’s Podcast is bought to you by: DR DICK’S  — HOW TO VIDEO LIBRARY.

drdickvod.jpg

Room With A View

Look for my new

Video Reviews!

This week we have two great titles: COUPLES MASTURBATION and EVERY COUPLE CAN.

dvd517.jpg

“I think we can all agree that there’s nothing more fundamental to a happy and healthy sex life than masturbation. Dr. Michael Perry. Ph.D., ACS, the producer of these fine movies, introduces the concept of masturbating with and for your partner.”

d306.jpg

“This R-rated video (EVERY COUPLE CAN) has much more of a story line than the previous one. First we meet Sam and Marie, a sexually frustrated couple. Sam turns to a sex surrogate to learn how to overcome his sexual problems in the hopes he’ll be able to save his marriage. Sam’s friend Trevor and his wife are having sexual difficulties too. What a surprise! “

…full reviews here

SEO Powered by Platinum SEO from Techblissonline