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Sex Addiction, or Too Much of a Good Thing?

This last post of 2010 will start with a declaration. One of my famous “Thus Sayeth Dr. Dick” sorta things, if you please.

Ready?

I categorically reject the concept of sexual addiction that has been floating around in the popular culture for the last 20 years or so.

And yes, I know this will rankle a bunch of you, but you’ll just have to get over it. You see, there is no such thing as a sexual addiction. Period!

Nowadays people bandy about the term addiction as if it can be applied to any and all obsessive behaviors. I have an addiction to chocolate; I’m addicted to shopping; I’m addicted to video games; I’m addicted to porn—or, I’m a sex addict. NONSENSE!

That being said, I hasten to add that I do believe there are sexual obsessions and compulsive sexual behaviors, plenty of ’em in fact. However, obsessions and compulsions are not addictions, and addictions, while they may involve irresistible impulses, are not the same thing as compulsions. Get it? Got it? Good!

I want to be absolutely clear about this. An addiction is a very specific condition. It denotes a dual dependency, physical as well as a psychological.

  • A physical dependency occurs when a substance is habitually used to a point where the body becomes reliant on its effects. The substance must be used constantly, because if it is withheld, it will trigger symptoms of withdrawal.
  • Psychological dependency occurs when the substance habitually used creates an emotional reliance on its effects. There is no functioning without it. Its absence produces intense cravings, which if not fed will trigger symptoms of withdrawal.

Check it out. With the help of my handy-dandy dictionary, a good place to start in discussions of this sort, I discovered these three very distinct definitions:

Addiction: The need for and use of a habit-forming substance (as heroin, nicotine, or alcohol) characterized by well-defined physiological symptoms upon withdrawal. Broadly: persistent use of a substance known by the user to be harmful. A state of physiological and psychological dependence on a drug.

Compulsive: Driven by an irresistible inner force to do something; i.e., a compulsive liar.

Obsession: A persistent disturbing preoccupation with an often unreasonable idea or feeling.

See? Different words. Different meanings. Not a particularly complex notion to grasp, right?

And listen, just because a bunch of yahoo afternoon talks show hosts and even a load of my esteemed professional colleagues banter these words about like they were interchangeable doesn’t make it so. In fact, we do ourselves a huge disservice by muddling these very specific concepts into a jumble. My fellow therapists should be the first to recognize this because finding help for an addiction or an intervention for an obsessive/compulsive disorder will be as specific as the problem itself.

One thing is for certain: identifying one of the things, as the other will complicate the problem solving. It’s like going to the doctor with a headache, and when the doc asks where does it hurt, you point to your stomach. It just won’t do.

Hi Dr. Dick,
I recently found out my boyfriend has been cheating on me. He wants me to forgive him, but he keeps on doing the same thing over and over again. He’s like addicted to sex or something. I love him very much, but I feel dirty just by being around him and knowing what he’s doing. It also makes me feel stupid putting up with all of this and at the same time I still love him, please give me some advice. Thank You.
— Darlene

Before we turn our attention to your boyfriend’s behavior, let me make a quick observation about you. You’re a big fat ball of contradictions, huh? How can you say that you love the person that makes you feel dirty and stupid? You’re deceiving yourself about at least one of those feelings. And if I had to guess, I’d say what you’ve got with your man ain’t love—it’s an obsession.

Your boyfriend probably has you figured out by now, and he knows that you will tolerate his misbehavior, which gives him tacit permission to do whatever he feels like doing. From where I sit, you’re the real sap. If you’re really serious about reining in your wayward BF, you’d better come up with a clear, unambiguous message about what you will and will not tolerate. Until you do precisely that, he’ll just think that he can roam wherever he wants and whenever he wants.

If the two of you are supposed to be living in a sexually exclusive relationship, and he’s taking his business elsewhere, then he’s got a problem, too. However, I caution you against thinking that his sexual behaviors are an addiction. Because they’re not.  And thinking they are will not help you find the solution to the problems you folks are having.

There are root causes for his behavior, just like there are root causes for your behavior. To get to the bottom of all of this, each of you will need to invest a good deal of time and energy with a qualified therapist. One can only hope that there’s a big enough bank of goodwill between the two of you to carry the day because overcoming your obsession and his compulsions will demand all of your emotional resources.

Dear Dr. Dick,
I have been in a relationship for five years now and truly love my partner, however I can never seem to get enough sex. I am 30 and he is 29, but I constantly find myself in the chat rooms lookin’ for younger guys to have sex with. It’s more than just a hobby—it’s a habit! I’ve actually lost jobs because he’d be out of town and I’d spend almost every waking hour on the PC with a cocktail looking for sex, not caring about anything else. It’s like I’m addicted to sex. He knows I have played around (I actually have talked him into three-ways a few times), but he has no idea how extreme it’s become. I don’t know what’s wrong with me. I’m not unhappy with him. I just can’t seem to stop wanting sex with younger guys. Any suggestions?
— Brian

It’s interesting that you should tell me about your compulsive sexual behavior in the same breath that you tell me of your love for your partner. As you’ve probably guessed already, there isn’t really much of a connection between the two. Love and sex are two very different things. Sometimes they go together, but not always or even often for that matter.

It appears to me that you’ve really got two problems happening simultaneously: First, your compulsive prowling of the internet for sex (complicated, I might add, by your alcohol consumption). Second, the deception you’re practicing on your partner. Let’s deal with each of these in turn.

Your particular sexual activity, like any compulsive behavior (overeating, excessive shopping, etc.), is more than just a bad habit. It’s a serious psychological dysfunction. Take it from me: breaking this behavior pattern will be nearly impossible without some professional help. If the problem is as serious as you say, then you’d better seek help right away. This sort of thing, if left untreated, will not only destroy your relationship, it will ruin your life. When you seek that professional help, I encourage you to include information about your alcohol consumption. If there is an addiction in all of this, it’s the alcohol, not the sex. And in your case, the addiction may be fueling the compulsion.

Now, regarding your relationship. It’s imperative that you come clean with your partner about your sexual obsessions and compulsions, as well as your probable alcohol addiction. Not only will you feel better about not lying to him anymore, you’re going to need his support in overcoming the difficult obstacles you face. I suggest that you attend to this right away. There’s not a moment to lose.

Good Luck

Joining The Resistance

Name: Green Guy
Gender: Male
Age: 44
Location: Lowell, MA
Dr. Dick I am an African American gay man who was reared in a very psychologically abusive and conservative southern environment. I am very inexperienced with relationships, dating and sex. In fact, I have been celibate for the last five years, trying to figure out how I got so psychologically fucked up and what to do about it. I was in therapy for quite a while, but I still have many issues to deal with, including trusting men. I would like to be in a healthy relationship, but I don’t even know where to start. I feel that my personal life has been a total disaster. I want to change things around, but I feel utterly lost. Although I am professionally successful, I have serious issues with my body. I am somewhat overweight, but have recently joined a gym to get in shape. I just feel totally hideous, and depressed (I am on medication), and don’t believe any guy would ever be interested in me. Please help!!

Holy Cow, darlin’, you sure do know how to let it all hang out, huh? Did you notice how may superlatives you used: “very abusive, many issues, total disaster, serious issues, totally hideous” to mention a few. It’s clear to me, and probably any other human that comes near you, that you are soooo not ready for a relationship. In fact, if you are as icky and psychologically fucked up as you say, if you can’t trust anyone, if you’re a dating klutz, if you are totally hideous and misshapen, then why not just let it go and spare any other person the torture of being involved with you? You’re right, what guy in his right mind would be interested in the likes of you?

Ok, you see what I’m doing here? I’m joining the resistance. You want to pile it on yourself, swell. I’ll join you. I’ll pile on too and together we’ll heap on the insults and contempt until you can’t stand it any more, until you reach your tolerance for self abuse (and not the good kind). And from what I can gather, that’s gonna take some piling on. Of course, you could quit this self-abuse at any time. Seems to me 44 years of negative and undercutting behavior is plenty…even for you.

None of us is without our issues, my friend, least of all me. But to navigate social situations, even casual ones, one needs to be able to judge what the traffic can bear. If you come on like gangbusters, like you did in your message to me, you’re finished even before you begin.

Whatever therapy you did in the past, it either didn’t work or it didn’t have any lasting effects. Find a therapist that will challenge you not stroke you. Find someone that will jump on your shit, someone who will care enough about you to disallow you from hurting yourself with such cruel remarks about yourself.

When I have a client like you in my private practice I always lay down the law. For every self-critical thing you say about yourself, you must say something nice about yourself. That shuts the client up in a hurry. Once he or she is quiet enough to listen we start pulling apart the tangle of their self-hatred.

You were abused as a kid. Sadly, so are lots of kids. But that’s in the past. I’m sure you have scars, but who doesn’t have scar tissue. You don’t know how to interact with others socially, that a skill that can be learned. You’re fat and out of shape? You’re going to the gym to address that. You’re depressed even on antidepressants? Well, no wonder you’re sick of yourself. And that has got to stop, NOW.

Before you consider asking anyone else to love you — with all your flaws — you’re gonna have to learn to love yourself — with all your flaws. If you can’t do that, then don’t expect anyone else to do it before you do. Get off your pity pot and get to work. You say you are successful in your professional life. (Frankly I don’t see how that’s possible given the litany of your liabilities.) But for the sake of argument, let’s say you are telling the truth. How did you come to be a successful professional without at least some redeeming qualities? That is unless you are a professional executioner, or a professional hit man, or a politician.

You see you can’t have it both ways. If you have skill enough to make yourself a success in your professional life, then you have skill enough to make yourself a success in your private life. With the help of this new therapist you’re gonna get — the one who is not going to let you get away with your shit — you’re gonna learn how to marshal and channel the aptitudes you have that make you successful in one area of your life, to make you a success the other areas of your life.

Good luck

Name: Jose
Gender: Male
Age: 20
Location: Norwalk, CT
how can i approuch a good stripper to get into sex? even tho they just strip some do more off work. How do I know they are willing to do it?

I’m gonna go way out on a limb here and guess that English is not your first language, right Jose? I think I understand what you are asking. Let’s just hope the women you approach will also understand you’re meaning.

So OK, you know this fine stripper and you want to have sex with her, right? Swell! First thing you oughta know is that not all strippers are hookers. Some simply strip because they make really good money. They don’t sell sex, mostly because they don’t have to. The strippers that do offer sexual favors for a fee, don’t do so where they strip. It’s bad for business and, I hasten to point out, it’s against the law— except if you’re in Nevada — and you’re not.

There are two real good ways to go about this hunt for stripper sex. First, you could ask the vixen out on a real date. Personally I think this is the best way of going about gettin laid by any woman. If the woman, stripper or whatever, is available for a date, and you’re not a totally creepy putz, she might take you up on the offer. Just remember, many strippers already have a boyfriend, and he wouldn’t look kindly on you trying to hustle his filly, if you catch my drift.

Also, some stripping establishments prohibit their employees from fucking with the customers. If that’s the policy at the joint you frequent, let it go. Don’t pester the woman for something that will jeopardize her job. However, if she does accept the date, and all goes well, and you charm the pants off her, literally, you just might get a little slap and tickle. I just hope we’re clear on the concept that if any woman, especially a sex worker, accepts a dinner invitation it is not the same thing as saying she’ll fuck you, right? GOOD!

The second option is to ask the stripper if she does escort work on the side. Again, some stripping establishments prohibit their strippers from fraternizing with customers in any way, shape or form, especially fucking them. You ought also know that if the woman in question is indeed an escort as well as a stripper, your “date” with her is gonna cost ya. These women are professionals; so you’d do well to treat them with the respect you’d offer any other professional woman.

Never, under any circumstance, offer to pay a stripper…or any woman for that matter…for sex. That would be pandering prostitution, and that’s against the law. If the woman in question is an escort, she will be exchanging her time, the pleasure of her company and her expertise for money; not sex for money. Get it? If she’s smart she won’t give you a second chance to get this right. So if you fuck up asking her the first time you may be out of luck forever.

My advice to you is, figure out ahead of time which way you want to go on this — a real date or escort hook up. Then approach her like a gentleman. If she’s not interested, respect her decision to decline your offer with grace and dignity.

Good luck

Sex Work — The Principle of Supply and Demand

No podcast today; instead there’s this…

Sex workers and their consumers are two sides of the same coin; the operative word being coin. Few things are more troublesome to the social hierarchy than the notion of sex for money. And yet, as the saying goes, there’d be no supply if there weren’t a demand.

I travel a lot for work and often get really lonely on long trips. I don’t go to bars, because I don’t drink. The idea of looking for sex in a bathhouse or sex club puts me off. Lately I’ve been thinking I should just hire an escort, but I wouldn’t even know where to begin. It must be a pretty common phenomenon thought, because I see tons of ads for escorts on line in every city I go to. Any suggestions on how I might proceed?
— Gabe

I presume you’ve ordered out for food while traveling for business, right? Finding a satisfying “order-out” sexual adventure is not all that different. In the case of an escort, the commodities are charming company, erotic massage, and possibly a little sex, instead of potstickers, mu shu pork and Kung Pao Chicken. (Now if only someone would devise a marketing plan to combine the two—erotic massage and mu shu pork? We’d all die from an overabundance of bliss!)

Not all order-out is created equal. Just as there is bad food, there are also unsavory escorts. Do your homework. You already know there are scads of escort or rentboy sites on the net. There are also plenty of review sites, where customers of the provider leave their comments regarding levels of satisfaction and the like. Most escorts, particularly the really good ones, immediately call your attention to the reviews they’ve received. It’s like having the Good Housekeeping Seal of Approval stamped on your ass.

Start by interviewing a few working boys. This can initially be done via email. Ask for further information about services and rates. Many escorts have photos of themselves available to send to prospective clients, so you might respectfully request those. If at all possible, include a photo of yourself—or at the very least, an accurate description.

When communicating with a service provider, NEVER suggest that you are offering money for sex; in most jurisdictions, that’s against the law. While most clients hope to get a little sex in the encounter, the money exchanged is not for the sex. It is for the provider’s time and expertise. This may sound like splitting hairs, but if sex happens it is by mutual agreement by consenting adults during the time you’ve arranged to be together.

Finding the right escort for you is your task. Know what you want and know how to ask for it. Don’t waste your time or that of the provider by beating around the bush. If you are new at this, say so. The rentboy, if he’s any good at all, will be familiar with this territory and help you though the initial conversation.

There are different levels of pros out there; each will have his own fee structure for services provided. If you’re looking for something kinky, be ready to pay more. Never bargain with the provider. If he’s out of your price range, move along. Or come right out with it and say, “Listen, I have X amount of money to spend. Are you available?” This gives the provider the option to see you at the discounted rate. You’d be a fool not to insist on safe sex, but there’s a shitload of fools out there.

When arranging an outcall to your hotel, there may be an additional surcharge for traveling cost. This should be agreed upon before the deal is struck.

Not all prostitutes are prostitutes because they want to. But most guys turn pro because they’re good at what they do. And most enjoy the accompanying lifestyle. The truly successful provider will have a string of regulars, men they have a somewhat more intimate connection with. Kinda like finding a great Chinese restaurant and becoming a regular there. The proprietor might just offer you something not on the menu as a way of acknowledging your preferred customer status. Get it?

Some johns use the service of an agency, which can be a reliable way to go at first. However, I believe the hard-working independent entrepreneur is often one’s best bet.

You’ll also find among the independents a unique phenomenon—Gay for Pay. These are ostensibly “straight” (and I use that word in quotes with great intent) guys who will have gay sex with gay men for money. In the old days, we used to refer to them as trade. And like we in the business say, “today’s trade is tomorrow’s competition.”

Remember, a wise and informed consumer is happy and satisfied consumer.

I’m just out of college and have a ton of bills and no real job prospects at the moment. A friend suggested I do some escorting to make ends meet. Guys tell me that I’m hot and I like sex, but I don’t know if I could pull it off. Suggestions?
— Kevin

Being hot and liking sex are great assets if you decide to turn pro, but you’ll need a whole lot more than that. Being a sex worker is not like having sex for love, or even recreational sex. You will be exchanging sex for money and that makes it a business proposition. You’d be wise to approach this with as much forethought as you would any other profession. It is, after all, the world’s oldest.

You’ll need the physical fortitude to have sex with a wide range of people; some who may not be attractive to you. And when there’s an exchange of money, the john becomes your customer. And all pro sex is client-directed; it’s not about you even when it looks like it’s all about you.

You’ll also need the emotional distance and psychological resilience to cope with the intimacy issues this line of work creates. This is precisely the point where most fledgling sex workers flounder. They either give too much, or not enough. Some actually resent their clients for sustaining them; go figure! A lack of clarity on this issue will cause troubling boundary issues for both you and your john.

A cheap street hustler turning tricks to support a drug habit and an expensive rentboy who is attending the rich and famous face many of the same pitfalls. A lot of sex workers are self-destructive or have huge unresolved sex issues that they are trying to compensate for by making people pay them for what they usually give away.

If you still think this is a line of work for you, know that your mind and body are your greatest business assets. Take care of them. Keep them clean, fit and toned. Hygiene, both physical and mental, is a must. Improve your mind. Make yourself interesting. Stay abreast on current affairs. Develop other skills like massage and bodywork. Self-awareness, not the narcissistic type, and safe-sex practices are your frontline defense against STIs.

Stay clean and sober while on the job. More sex workers get busted for drugs than hustling. Know how to handle a drugged-out client. You’ll probably see a lot of those. Also know they can take forever to get off, and can sometimes be paranoid and dangerous.

Be fiscally responsibility. Plan for the lean times…and there will always lean times. You’ll probably be a hot property at first; the new meat phenomenon, don’t cha know. Don’t let this go to your head. There will be cuter, younger, hotter competition getting off the bus tomorrow. Try to cultivate a number of regular clients. Have a thought to how and where you will market yourself. And I encourage you not to do this full-time. If you find it difficult to pay the rent, you’ll be tempted to do more and more risky things just to make ends meet.

Sex work is often more about being psychologically present than a sexual performance. Your clients will often be more lonely and isolated then they are horny. Always treat them with respect.

You should have at least one trusted friend who knows your whereabouts at all times, or who has access to your appointment book. Never make a date with anyone who won’t share his/her phone number with you. And always make a call back before you head out. Keep an appointment book, in code if you must.

Have a travel bag prepared with all the basics you will need: condoms, lube, massage oils, handi-wipes, an extra shirt, toys, mace (or other protective equipment). Have that bag ready to pick up and leave if there’s trouble.

Finally, I suggest that you connect with other sex workers in your area. There is strength in numbers. Other rentboys will provide you with essential information about troublesome clients and help you get the lay of the land, so to speak.

Good Luck

Dr Dick’s Sex Positive Doctrine

No podcast today; instead there’s this…

Have you ever wondered about the term, sex positive? If you’re like me you see it all over the place, especially on sex-related sites. I confess I use it way more often than I should. It’s become one of those industry buzzwords that has, over time, become so fuzzy around the edges that it’s now virtually meaningless. In fact, if the truth be known, I believe the term sex positive has been taken over by the sex Taliban who have made it a cover for their strict code of political correctness. Oddly enough, this is the very antithesis of its original meaning.

If you want to shame someone in the sex field—be it a sex worker, blogger or adult product manufacturer—you label that person as sex-negative. You may not know anything about that person other than you were offended by something they did, said or made. But still, you hurl the epithet as if you were exorcising a heretic. This is a very powerful tool for keeping people in my industry in line. But I’ve begun to wonder, who is setting themselves up as the arbiter of what is and what is not sex positive? I have to ask: What is the agenda? I mean, could compulsory ideological purity of some artificial standards of thought or behavior be “positive” anything? I say, no!

Like all good ideas that have gone bad due to overuse—or worse, sloppy use—the sex positive concept once had meaning that was life-affirming and enriching. Sex positive has been in the lexicon at least since the mid-1950s. It frequently appears in journals and research papers to describe a movement that examines and advocates for all the other beneficial aspects of sex beyond reproduction.

I’ve been using the term since 1981 when I opened my practice in Clinical Sexology and Sexual Health Care. The opening words of my mission statement read: “I affirm the fundamental goodness of sexuality in human life, both as a personal need and as an interpersonal bond.” Way back then, I was flush with my quixotic pursuit to stand steadfast against all the cultural pressures to negate or denigrate sexuality and pleasure. I dedicated myself to spreading the gospel that healthy attitudes toward sex not only affect a person’s sex life, but his/her ability to relate well with others.

This came relatively easy for me, because I’d learned something very important about evangelization in my life as a Catholic priest. (Another quixotic pursuit, but we’ll have to save the details of that misadventure for another time.) One of the first things one learns in seminary is how to proselytize, to sow the seeds of a creed, and then nurture them taking root by endless repetition of the articles of faith. Of course there is a downside to this, too. Repetition fosters mindlessness, stifles creative thought, and worse makes things boring.

But the creed statements of the world’s three great monotheistic religions are masterful works of theological art.

Barukh ata Adonai Eloheinu Melekh ha’olam!
Allaahu Akbar!
In the name of the Father, and of the Son and the of the Holy Spirit!

Each contains the most profound kernel of religious truth the believer needs to know, but all are easy enough for a child to learn. And like I said, the secret is in the repetition. For the true devotee, these creedal statements are uttered dozens of times a day and to great effect.

Early on in my career as a sexologist, I decided to put the principles I learned in the Church into disseminating my new belief system. First, keep the message simple! I settled on: “Sex is Good—and Good Sex is Even Better.” This has been my mantra for decades. It contains everything you need to know about being sex positive, but it’s easy enough for a child to learn. Even now, I close each of my podcasts with this same article of faith. To this day it soothes me to hear myself say these words. And it comforts me in the same way blessing myself did in my priestly days.

Despite my apprehensions, I continue to be an apostle of the sex positive doctrine. I know that even though my industry has corrupted the concept, others have yet to hear the good news. And there’s something almost spiritual about seeing someone grasp the idea for the first time. Let me tell you about one such instance. Some while ago I was asked to offer a workshop for a group of doctors on the topic: Health Care Concerns Of Sexually Diverse Populations. Unfortunately, just a handful of doctors attended the workshop—which was pretty disconcerting, considering all the work I’d put into the presentation. I guess that’s why kinksters and pervs, as well as your run-of-the-mill queer folk, are often frustrated in their search for sensitive and lifestyle-attuned healing and helping professionals.

Since the group of doctors attending was so small, I decided to ask them to pull their chairs in a circle so that our time together could be a bit more informal and intimate. Frankly, I’ve never found it easy talking to doctors about sex; and discussing kinky sex was surely going to be very tricky. So, I decided to start off as gently as I could. My opening remarks included the phrases “sex positive” and “kink positive.”

Sitting as close to my audience as I was, I could see at once that these fundamental concepts weren’t registering with them. I was astonished. Here was a group of physicians, each with a large urban practice. Could they really be this out of touch? I quickly checked in with them to see if my perception was correct. I was right! None of them had heard the term, sex positive. The two who hazarded a guess at its meaning thought it had something to do with being HIV+. I had my work cut out for me.

I decided to share my creed with them. “Sex is Good—and Good Sex is Even Better.” I asked them repeat it with me as if I were teaching a catechism to children. Surprisingly, they did so without resistance. After we repeated the mantra a couple more times, I exposed them to the sex positive doctrine unencumbered by political correctness.

  • Sex Is Good! Sex is a positive force in human development; the pursuit of pleasure, including sexual pleasure, is at the very foundation of a harmonious society.
  • And Good Sex Is Even Better! The individual makes that determination. For example, what I decide is good sex for me, may be boring sex to someone else. And their good sex may be hair-raising to me. In other words, consensual sexual expression is a basic human right regardless of the form that expression takes. And it’s not appropriate for me, or anyone else, to call into question someone else’s consensual affectional choices.
  • Sex Is Good! Everyone has a right to clear, unambiguous sexual health information. It must be presented in a nonjudgmental way, particularly from his or her health care providers. And sexual health encompasses a lot more then just disease prevention, and contraception.
  • And Good Sex Is Even Better! The focus is on the affirmative aspects of sexuality, like sexual pleasure. Sexual wellbeing is more than simply being able to perform. It also means taking responsibility for one’s eroticism as an integral part of one’s personality and involvement with others.
  • Sex Is Good! Each person is unique and that must be respected. Our aim as healing and helping professionals is to provide information and guidance that will help the individual approach his/her unique sexuality in a realistic and responsible manner. This will foster his/her independent growth, personal integrity, as well as provide a more joyful experience of living.
  • And Good Sex Is Even Better! Between the extremes of total sexual repression and relentless sexual pursuit, a person can find that unique place, where he/she is free to live a life of self-respect, enjoyment and love.

Finally I told them they ought to think creatively how they could adapt this concept to their own practice. It was up to each of them to make this creed their own. As it turned out, this primer was just the thing to open my planned discussion of health of kinksters.

In a way this experience was a bit of a spiritual reawakening for me, too. Despite my misgivings about the contamination of the sex positive doctrine by malicious people bent on using it as a weapon against those they disagree with. I can’t tell you how refreshing it was to watch these sex positive novices hear, and then embrace, the message for the first time. It was nothing short of a religious experience.

Prostate Cancer Awareness Month

Scheduling difficulties prevent me from bringing you the latest installment of The Erotic Mind podcast series today. But with a little luck, that will resolve itself by next week.

Actually, I’m glad I have this positing opportunity, because September, as you may know is Prostate Cancer Awareness Month.  And I have something important to say about that.

Curiously enough, I was contacted by another website recently and asked to contribute to a series they were doing on this very issue. They were looking for a unique take on prostate cancer awareness. I told them I had just the thing; and proceed to outline what I think is an exceptionally important, yet universally overlooked, aspect of prostate health — prostate self-awareness. Alas, the folks who run the website thought the concept of prostate self-exam was too edgy for them. After they declined my offer I thought to myself; man, there is incredible resistance, on virtually every front, for us men to become proactive in this aspect of our health.

Name: Gordon
Gender: male
Age: 67
Location: Florida
I guess I have more of a comment than a question. I’m 67, a widower and have been recently diagnosed with prostate cancer. I never was very adventuresome when it came to sex. In fact, before my wife died two years ago, I never had sex with any other woman. I never gave prostate cancer a thought, never gave my prostate a thought either. Now I’m mad as hell that I didn’t. You see when I started to go to a prostate cancer support group I discovered I could have monitored myself better with a simple self-examination. Why don’t doctors tell us about this? Women are supposed to examine their breasts why don’t men examine their prostate? It’s so easy actually and yet it’s this big secret. Why don’t people talk about this? It makes me so mad because it could have made a big difference in my own life. Do you know about this self-examination Dr Dick? If you do why don’t you tell other people about this? I think it would help a lot if you could get the word out on this. Now that’s all I have to say. Thank you.

No, thank you Gordon. Thank you for sharing your concern with me…with us.

I’ve been a tireless activist of prostate self-exam for decades. Let me explain. My career as a therapist began in San Francisco in 1981. That was precisely the same year a mysterious new disease began showing up among gay men. Back then it was being called gay cancer, but soon it would have another name — HIV/AIDS.

As it turned out, my private practice focused down almost exclusively to working with sick and dying people. Luckily, I discovered that I was well suited for the job and I liked it very much. So much so that in the mid-90’s I founded a nonprofit organization called, PARADIGM; Enhancing Life Near Death. It was an outreach and resource for terminally ill, chronically ill, elder and dying people. This was brilliant cutting-edge work and I learned so much from the people I was working with. One of the things that struck me most was that regardless of the disease — cancer, HIV, MS, you name it, or even aging process for that matter — there was always a woeful lack of information about regaining a sense of sexual-self post diagnosis, or sexual wellbeing for seniors.

I recall one participant in particular, a man much like you, Gordon. He too had prostate cancer and, like you, he was mad as hell with the indifference of the medical industry toward prostate self-exam. One day during a group session, John was railing against doctors and cancer associations for their lack of interest in promoting prostate self-awareness. He pointed to the success of the cultural campaign to encourage women to self-examine their breasts. There is even a modest campaign to promote testicle self-exams. But apparently the medical industry draws the line at prostate self-exams. I guess no one is going to encourage a man to finger his ass, even to save his life.

Another group member, Clare, a senior woman in her 70’s and a breast cancer survivor, helped put things in perspective. She reminded us that breast self-awareness is a relatively new phenomenon. Her mother, aunt, sister and a niece all died of breast cancer before the self-exam campaign began in earnest. Clare went on to say that it was only through the hard work of individuals and grassroots organizations that actively campaigned for breast self-exams that things began to change. Eventually, this movement changed the medical and cultural mindset. Clare said that it was these individuals and grassroots organizations that helped all of us overcome the denial, shame and embarrassment that was associated with women touching themselves, even to save their lives.

This is an indication of just how ingrained the sex-negativity and body-negativity runs in this culture.

I continue to work with sick and dying people here in Seattle. I had a brief gig at a local cancer center where I developed an NIH (National Institute of Health) funded program for women newly diagnosed with ovarian cancer. At the same time, I was also working with a group of women with breast cancer and group of men with prostate cancer. Again every therapeutic intervention I encountered — government funded or foundation funded — was woefully lacking in any clear and unambiguous information about sexual health, wellbeing and intimacy issues post-diagnosis or surgical intervention.

To remedy this, I decided to produce a series of videos for people experiencing life threatening and/or disfiguring illnesses. Videos that would help them address reintegrating sex and intimacy into their lives post diagnosis. One of the first videos was going to be Public Service Announcement showing men how to do a prostate self-exam and what to look for. Unfortunately, I couldn’t find the necessary funding for this groundbreaking work. My grantwriting efforts turned up zilch. I did, however, get a whole lot of, “What a fine idea, Richard. Good luck with that…” brush-off letters though. No foundation would be caught dead funding sexually overt pattern films, even ones with the laudable intent of assisting people with the life-saving information they needed most.

I’m sorry to have been so long-winded in my reply, Gordon. I just wanted you to know that many have preceded you with outrage at the conspiracy of silence regarding prostate self-exam. Let’s face it; our society is so ass-phobic that we’d rather see men die than offer them simple instructions on how to finger their butt, find their prostate and keep tabs on their prostate health.

If we want this to change we all need to speak out…as well as stick a finger in our ass.

Keep up the fight, Gordon! And please, stay in touch.

Good luck

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