Category Archives: Sex Therapy

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

A molehill becomes a mountain

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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

Monkey on my back

And now for one of our regular, semi-obligatory Meth-related questions. I get at least a half dozen of these questions a month. And each and every one of them breaks my heart. I know nothing about the fellow writing me; I don’t know where he lives or his age. I don’t suppose it really matters, does it?

I need some help and I hope you can point me in the right direction. I am recently divorced and trying to move on in life but I’m depressed all the time and also using meth a lot. I have tried to have different sexual partners since my divorce and every time I’m with someone new I can get a erection when we are messing around with no problem, but soon as its time for penetration I loose my erection I feel like I’m having anxiety issues and also I’m very nervous, and I’m not impotent so can it be the meth preventing me to keep it up, or do I need medication for my anxiety? How can I overcome this problem?

I’m certain I can point you in the right direction. Thanks for asking. Allow me to speak plainly. Quit the meth! Quitting won’t solve all your problems, but it is the first and most important step. And frankly, if you choose not to quit, all your other efforts to pull your life together are doomed.

MonkeyBackMeth is not a therapy for depression, nor is it gonna help you connect with a new partner. It most assuredly will not help your erection problems; in fact, it is the cause of your erection problems. But I’ll wager you know that already, huh?

You also have an underlying performance anxiety problem that needs to be addressed ASAP.

Find a competent sex therapist to help you. look to the directory of The American College of Sexology for someone near you. Or you can check out my Therapy Available page.

In the meantime, take a look at some of the stuff I’ve written and podcasts where I talk about meth. Use the pull-down CATEGORIES menu in the sidebar, to your right, and scroll down till you fine the SEX & SUBSTANCES category. It’s under that category that you will find the subcategory Crystal Meth.

You’ll also want to take a look at some of the stuff I’ve written and podcasts where I talk about performance anxiety. Again, use the pull-down CATEGORIES menu in the sidebar and scroll down till you fine the SEX THERAPY category. Under that category you will find the subcategory Performance Anxiety.

Here are examples of the stuff you’ll find.

On meth:

Name: Joey
Gender:
Age: 22
Location: Southern Calif
Love doing tina with masturbation and watching really hot porn. Think this is just social fun?

Nope, I don’t Joey. Despite the prevalence of this dastardly drug, there is nothing fun about tina…crystal meth for those unfamiliar with the term “tina”. If you love doing tina for whatever reason, I’d wager you’re hooked on that shit.

Listen, I’m not prude when it comes to using some crystalmakesmesexy.jpgdrugs recreationally. But I think that we’d do well to stick to those drugs that are more natural. The less processing involved (and meth is the worst in that regard) and fewer added chemicals (OMG, the crap they put in crystal) the better, in my humble opinion.

Despite the admitted high ya get, recent research shows that long-term meth use destroys nerve cells in the brain that regulate dopamine, muscle movement, memory, and decision-making. This damage can be wide-spread and permanent.

Your body reacts to crystal meth the same way it reacts to danger. Crystal floods the body with adrenaline — the same hormone that prepares us for emergencies. Adrenaline gives a super-charge of strength and endurance so the body can deal with danger and injury. But artificially triggering this response over and over again will have serious consequences.

When you use crystal, your nervous system shifts into high gear. The brain floods your body with “danger” messages. Your body responds immediately to what it thinks is a threat. It prepares to fight or to run away. Common body responses to perceived danger include:

  • Pupils dilate to let in more light.
  • Hair stands on end (“getting goose bumps”).
  • Blood vessels just under the skin constrict.
  • Body temperature goes up

Regular, long-term crystal use will diminish sores of neurotransmitters. Episodes of paranoia and anxiety become more frequent and longer lasting. Blocked blood vessels within the brain can lead to increased chances of stroke.

Crystal fucks with your dopamine levels. Dopamine delivers a sense of reward and pleasure. It is also associated with body movement. Too little dopamine causes paralysis or a Parkinson’s-like tremors and rigidity. Too much dopamine and a person can become paranoid, hear voices and get twisted thoughts. Sound familiar?

Crystal fucks with your serotonin levels. Serotonin is involved in regulating sleep and sensory perception. It plays a role in moods and regulating body temperature. Serotonin is involved with many emotional disorders like schizophrenia, phobias, super-aggressive states and obsessive-compulsive behavior. Too much serotonin can make it difficult (or impossible) to have an orgasm. And of course there’s the dreaded “crystal dick”…the inability to get it up.

Joey, listen up! You’re way too young with too much of your life ahead of you to self-inflict so much serious irreparable damage on yourself. If this weren’t such a troublesome drug, there wouldn’t be such a virulent anti and reformed tweeker community out there. Want to know the real truth about “tina” check in at: crystalmeth.org. You’ll be glad you did.

On Performance Anxiety:

I get a dozen or so messages a month on this topic. I’ve written about it in numerous postings and spoken about it in several podcasts, but still the email comes.

One of the real bugaboos for anyone, regardless of gender, is living up to our own expectations of sexual performance. So many things can get in the way, literally and figuratively, of fully enjoying ourselves and/or pleasuring our partners.

The arousal stage of our sexual response cycle is particularly vulnerable to a disruption. And when there’s trouble there, there’s no hiding it. A limp dick or a dry pussy can put the kibosh on all festivities that we may have hoped would follow.

However, performance anxiety can strike any of us, regardless of age, and at just about any point in our sexual response cycle. This is a particularly galling when it seems to come out of the blue. And regaining our composure can be more far more difficult than we imagine.

Today we will be focusing on male performance anxiety. I’ll address female performance anxiety at a later date.
Complete Article HERE!

Good luck

The Little Engine That Could

Name: Terri
Gender: Female
Age: 24
Location: ND
I’m having a problem with knowing when I am feeling an orgasm. I feel like I have to fake it around my husband because I am unsure. Sometimes when I’m alone I just feel like I have to go to the bathroom so I stop myself and then other times I feel like my legs are paralyzed but that’s it. I don’t ever feel like I’m sexually stimulated. Just tired. Any ideas as to what I am doing or not doing or what might be causing it?

I’m gonna go way out on a limb here and guess that your are, what we in the business call, preorgasmic. My experience tells me that if you’ve actually had an orgasm, you’d know it. All the symptoms you list — feel like you have pee; feel like your legs are paralyzed; or just plain exhausted, don’t sound orgasmic to me.

clitoral anatomyI can’t actually say I know what you are doing wrong, if anything. You don’t really go into detail on how you pleasure yourself. But I will hazard a guess as to what is causing this. And that would be inadequate stimulation to your pleasure centers.

Even in this day and age where sexually laden messages abound in the popular culture, there are still some women, even young women, who are unversed about orgasms in general and how they could go about getting one for themselves in particular.

Orgasms don’t always come easily for some women, and that’s a fact. I suppose there are as many reasons for this as there are preorgasmic women. A woman’s pleasure center (her clit) is more subtle and less obvious than a man’s raging boner. Women are socialized about sexuality — even nowadays — in a much different way then men are. Men have more cultural permissions to be sexually adventuresome than do women. And if the truth be told, us men folk, — we don’t need no stinkin’ permission to get our self off!clit

The basic formula for achieving an orgasm is acquainting yourself with your pussy. Map out all the points of interest. Find out what feels good, and repeat it. The object of this first step is not to stress about having an orgasm it’s all about reconnecting with your cunt.

The more you know about this marvelous part of you the better you’re gonna be at slammin yourself a screamin’ meme when the time comes. Knowing your way around your pussy is also gonna be helpful in partnered sex, especially if your partners are men.

The first part of this exercise is called a self-sexological exam. Get a hand mirror and find a really detailed diagram of female genitalia on the internet. Using the diagram as a guide, work at familiarizing yourself and making friends with your pussy. Once you are certain you know all the parts, I want you to do a detailed touch test. I want you to test for sensitivity very square inch of your body from your asshole to your navel. I want you to draw pictures of your own cunt and surrounding area, then color them to represent the levels of sensitivity — red being the hottest and most pleasurable areas to blue being the more neutral areas and all the colors in-between. I encouraged you to try this exercise with both a wet hand and a dry hand. I suggest a nice personal lubricant for your wet hand exploration. Spend at least 30 minutes a day for three consecutive days on this home-play. You have a lot of reacquainting to do, don’t cha know. And this is private time; your partner(s) is not invited.

hitachi-magic-wandThe next step in your home-play will include a vibrator. If you don’t already have one, shop for one. There are plenty of suggestions for vibes on my product reviews site: DrDickSexToyReviews.com. (There’s a vast array of pleasure products on that site and all the guesswork has been eliminated. The Dr Dick Review Crew painstakingly reviewed each product so that you’ll be able to see what’s hot and what’s not.)

Now using the pictures you created of your genitals in part one of this exercise, I want you to kick-start that vibrator, throw it into first gear and start making small lazy circles around the blue areas, and work your way to the bright red areas. Do this privately for 30 minutes for three consecutive days or until there was a breakthrough.

The next step is masturbation. You may have tried it before without success, that’s ok. This time you’ll be better informed about all the hot spots of your cooch that you learned in step one. I’m a big fan of full body masturbation. So while you’re diddlin’ yourself spread the sexual energy all over your body — tits, ass, feet, mouth, whatever.Aloe Cadabra

Vary your technique: stroke, pinch, pat, massage, and rub yourself all over. Vary your breathing, gyrate your hips, listen to sexy music, rent some porn, watch yourself in a mirror, or throw in some Kegel exercises. Try a wet hand. Play with yourself in the bath. Hell, dance around naked with a jewel in your navel…whatever it takes.

Many women experience their first orgasm with the help of a vibrator. I encourage you to be adventuresome and experiment with one too. Try a dildo or another sex toy.

Be sure to keep a journal during this exploratory period. This will help you later to bridge the gap in communicating with your partner(s).

Finally, Terri, I want to turn you on to a fantastic website, www.Clitical.com. This is a one-stop shop for all things relating to female sexuality.

Good luck

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