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

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.

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Sexual MYTHBUSTERS, Part 1 – The Big O

No podcast today, but there is this…

Angie is 20 and she’s having issues, lots of issues.

Hello, I would ask you a question that has been on my mind for a while. I seem to have a problem orgasming without stimulating my clitoris. I suppose that doesn’t really sound like a problem but it’s really starting to annoy me. I would like to be able to enjoy an orgasm without having to stimulate my clit every time! I love having sex and it feels super duper good but why can’t I climax that way? I mean I am aware of where my G-spot is and my boyfriend said he’ll be focusing more on hitting it “spot” on. There’s also another thing I have noticed, sometimes my boyfriend will hit my cervix and it hurts a bit, but is this even normal? Should he even be able to hit it? Or is there something abnormal going on here?

Let’s see, when you say you “love having sex and it feels super duper good but why can’t I climax that way?” Are you referring to full-on cock in cooter fucking when you say, “having sex”? The reason I ask is that not everyone means the same thing when they use that trite euphemism.

Since you’re not here to fill in the blanks, so to speak. I’ll assume you want to know why you can’t have or haven’t yet had a vaginal orgasm. But before I answer, I just want to say that I hope you are not setting up an orgasmic dichotomy where there doesn’t need to be one. That would truly be unwise.

If you are at all familiar with your genital anatomy, you will know that the pleasure centers in that area of your body are all wired together. Your clit, G-spot, pussy, taint (perineum) and butthole are all on the same circuit, so to speak. Each erogenous zone is distinct, of course, but they act in consort with one another. However, not all your parts will generate the same amount of buzz. Since a woman’s clit is at the center of this network of nerves, it tends to dominate all the others and it is generally the quickest way to intense pleasure for most women.

Ok, now my answer. I can’t really say why your not climaxing while you’re fucking. Other than the fact that an exclusively vaginal centered orgasm is a myth. The vast majority of women don’t have vaginal orgasms. In fact the degree of insensitivity inside a woman’s vagina is so high that Kinsey wrote in his seminal work, Sexual Behavior in the Human Female published back in 1953: “Among the women who were tested in our gynecologic sample, less than 14% were at all conscious that they had been touched.” That’s pretty remarkable, wouldn’t you say?

The vaginal orgasm myth is perpetuated, in part, by many women’s confusion and/or lack of knowledge about their own anatomy. Some women believe that an orgasm felt during fucking is centered in their cooch. This suggests to me that they aren’t being precise in locating the center of that orgasm. Other women believe in the vaginal orgasm myth because they think they need to conform to a male oriented notion of female sexuality — fucking = cuming. And that’s simply wrong, don’t cha know. Just ask all the preorgasmic women out there.

But ya know what? I don’t own a pussy my own self. All I can only tell you is what I have learned from those people who actually have a honeypot. The people I’m referring to, we’ll call them females, tell me vaginal orgasms, mythological or not, may simply be dependent on a tone of a woman’s pelvic musculature. As amazing as pussies are, and they are amazing, if the muscles that surround them are not taught and toned enough, a fucking generated orgasm may elude the owner of said pussy.

Some women haven’t developed their PC muscles enough to cum through fucking alone. Are you doing your kegels, Angie? If you don’t know what I’m talking about, you have some serious remedial research to do.

The elusive vaginal orgasm may also have to do with your partner cock, particularly the girth of his unit and opposed to its length. My women friends tell me that a thicker cock may have more of a chance triggering a vaginal orgasm then a pencil dick. No surprise there, I suppose. Position will also play a role. Why not give a bunch of different positions a try and see if one or another makes a difference? You on top cowgirl style, or doggie style might work best. But it’s your coozie, my dear, and you ought to know it better than I.

As to your G-spot question. That’s another thing all together. I am so glad that you are familiar with your anatomy enough to have found your own personal G-spot. And it’s great to hear that you have an accommodating partner who is working on stimulating this sensitive area. Good for you both! However, while I wholeheartedly endorse and encourage your further investigations and sex play, I do have one caution. I share the concern of most of my women friends. We want you to avoid all the G-spot hype floating around in the popular culture these days. Most women have a good time with their G-spot exploration. They report that it is not particularly difficult to find, but it’s also much harder to pleasure. If a woman, you perhaps, gets it in her head that something amazing is supposed to happen with a G-spot stimulation, she might be setting herself up for disappointment. In the same way some women, you perhaps, set themselves up for disappointment if they buy into the myth of an exclusively vaginal generated orgasm.

I encourage you to see your genitals as a whole, not a bunch of separate parts that somehow work independently of one another. If your pussy is happy and your pussy is making you happy; is it really all that important how the happiness comes to be?

In comparison us men folk are not all that fussy. What gets us off; gets us off. I never hear from a guy who is disappointed because he’s not having an exclusively prostate generated orgasm. They do happen, but we’re not the least bit concerned when they don’t happen. I also never hear from a guy who thinks he should be orgasmic through manipulation of his balls alone. That can happen too, but we’re not holding our breath for them.

What I do hear from guys is that we often need a particular kind of dick-oriented stimulation to get us off. And this is where the men folk and the women folk are a whole lot alike. You, like us, probably need a particular kind of stimulation to get you off. Be it vaginal, clitoral, G-spot, or whatever. If you acknowledge that your genitals are a composite of parts that work together to bring you joy, then you’ll be less likely to be swayed by the claims, hype and misinformation about female sexual response.

Regarding the issue of your boyfriend hitting your cervix. Yeah, that’ll hurt, don’t cha know. I’d be willing to guess that he’s in the wrong position and being too athletic in his pumping when that happens. If he’s bumping your cervix, but you like the depth and athleticism of his manly thrusts, simply change position. That should remedy the problem.

Finally, I’d simply advise you to respect the uniqueness of your body and your sexual response cycle. If it’s your clit that delivers the big O, even though you are being pleasured elsewhere. Then by all means, stimulate your clit while whatever else is happening, and enjoy the ride.

Good luck

Sex Wisdom with Jesús Ángel García – Podcast #191 – 03/10/10

Hey sex fans,

Ok, so here’s the deal. As you know, I’m all about bringing you the very best interviews I can for all my podcast series. Not to long ago I hooked up with this exceptional author who I think is absolutely perfect for The Erotic Mind series. But midway through our conversation I realize that we are discussing stuff that would fit equally well in my SEX WISDOM series.

So what am I to do but officially declare our very first twofer! Allow me to introduce you to Jesús Ángel García, the remarkable author of the multimedia novel badbadbad. His novel can be read on many levels. Those looking for a very engagingly and smutty erotic story will not be disappointed. However, his work is also infused with profound insights into the philosophy and psychology of why we are sexual. Getting to the marrow of this man and his complex novel is a sheer delight. You won’t want to miss this, my friends.

Jesús and I discuss:

  • How the man with such the heavenly name, Jesús Ángel, come to write such a devilishly profane book.
  • Why he writes under a pen name and the derivation of that name.
  • Is it a memoir or is it fiction?
  • The multimedia nature of his novel.
  • The intent and origins of badbadbad.
  • The prominence of religious imagery.
  • How psychological complexity is reflected in sexual expression.
  • His novel as a morality tale.

Adding to the sexual tension of today’s show, Jesús reads from badbadbad.

Jesús invites you to visit him on his site HERE! You’ll discover that his is the first novel to come with its own YouTube playlist.

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!

I wanna take a moment to remind you to check out another great website in the Dr Dick family of sites. It’s my new PRODUCT REVIEW site — drdicksextoyreviews.com

That’s right, sex fans, now it’s so easy to see what hot and what’s not in the world of adult products. I review of all kinds of adult related goodies — sex toys for sure, but also condoms, lubes, herbal products, fetish gear as well as educational and enrichment videos. DON’T MISS A SINGLE ONE!

Look for the drdicksextoyreviews.com. You’ll be so glad you did.

Today’s Podcast is bought to you by: Fleshlight & FleshJack.

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.

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Sex EDGE-U-cation with John and Deanna – Podcast #127 – 06/03/09

Hey sex fans,

Today we take another audio field trip.  I have the distinct pleasure of introducing the Co-Executive Directors of the amazing Sharma Center right here in beautiful downtown Seattle.

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John and Deanna welcome us to the center, show us around, talk about themselves, their lives together; we discuss polyamory, swinging and the sex positive mission of the Sharma Center.

This oh so charming and insightful couple add their voices to this Sex EDGE-U-cation series.   As you know, in these podcasts, we’re taking a look at the world of fetish sex, kink and alternative sexual lifestyles. And we are chatting with prominent educators, practitioners and advocates of unconventional sexual expressions and lifestyles from all over the world.  And John and Deanna fit that bill exceptionally well.

John and Deanna and I discuss:

  • Swinging, Polyamory and Open Relationships; what’s alike about them and what’s different.
  • Some common terms used by those in the lifestyle.
  • The education and enrichment mission of the Sharma Center.
  • Coming out as a sexual minority.
  • Her activities, including her double sessions and private lessons.
  • Personal morality v. the morality of the dominant culture.

Be sure to visit them at the Sharma Center’s website HERE!

See a slideshow of the Sharma Center.  Click on the thumbnails below.

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Today’s podcast is bought to you by: Dr Dick’s Stockroom.

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