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When I first began writing this advice column, back in the Paleolithic era, most correspondence came via snail mail. Those were the days, huh? Email replaced letters as the dominant means of communication about 8 years ago, and so it remains today. Lately, there’s been yet another innovation — the Instant Messenger. Never fear, Dr Dick stands at the ready to console and advise even at cyber speed.
Instant messenger technology allows me to do something I’ve never been able to do before, save the whole shebang as a single document. This, dear readers, will provide you, as you will see below, an intimate vantage point to a crisis as it is being reveled.
What follows is an abridged version of an exchange I recently had with a good friend. This is someone I deeply respect and admire. However, my friend has been through a terrible lot this past year and the signs of stress are beginning to show. His judgment, generally razor sharp, is now clouded and he is consumed with self-doubt.

William: Hey Dick, I have a question. Do you know the current social standards surrounding marijuana use?

DD: Are there current standards? I didn’t get the memo.

William: Smart ass!
Let me put it a different way, is daily, long-term use of pot a sign of an addiction?

DD: Probably. Certainly designates one as a heavy user.
There is a simple test. Can/will the user go 48hrs without?

William: Here’s the deal, a guy I hang with smokes every time we get together. He says it relaxes him after a hard day. I told him I thought that was a rationalization. I don’t drink daily; so I have to deal with life as it presents itself, rough edges and all.

DD: I guess you told him, huh?

William: I know I can’t drink every day without it becoming a problem for me, but am wondering if pot smokers think daily usage is different than what I think about daily drinking?

DD: See my comments above.

William: My friend’s paternal grandfather was an alcoholic; his dad neverglory_hole_d29.jpg drank. My friend admits to doing 200 hits of acid in high school and crystal when first arriving in town 10 years ago. He claims he hasn’t done either for 7 years.
Trouble is my Dad was an angry alcoholic so this guy’s marijuana use triggers feelings of abandonment and flashbacks of abuse in me.

DD: Right about now you should be hearing yourself say out loud: “Whoops, where did I put my car keys? Gotta run! Call me when you get home from Betty Ford”

William: I confronted my friend about his pot consumption and he got all defensive. He countered with, “what am I supposed to do, not smoke while you’re around? He was already high when we had this exchange. He said I should have warned him about not smoking before he rolled the joint he just smoked.

DD: Wait a minute; he’s saying his drug “(ab)use” is now your issue? Why does this stink to high-heaven?
Here’s a tip; don’t be surprised when you confront a pot-head, while he’s ripped, about his habit and he gets, as you say, “all defensive”.
William, I’m pretty confident that was not a teachable moment, don’t you agree?

William: The problem is he’s generally stoned by the time we get together, so there’s no real good time to talk to him.
I even entertained the idea of smoking with him to get in the same mind set. Instead, I drank a half a bottle of wine. I realized later that both options were self-defeating.

DD: At least you’re clear on that. In this instance, sinking to the lowest common denominator is not a good idea.

William: Bottom line is I feel he needs to smoke to be around me.

DD: I suggest that he needs to smoke around everyone and everything, not just you.

William: I am thinking this is an indicator of his low-self esteem.

DD: You betcha! Aren’t all addictions?

William: Maybe I am projecting.

DD: What if you are? It doesn’t diminish the fact you called it right.

William: I also questioned what type of relationship we are forming if all our time together happens while he’s in an altered state.

DD: That’s easy, a codependent one!

William: I’ve been thinking, maybe he needs to smoke to have sex. Maybe that’s the only way he can cope with his guilt or shame. When he smokes he likes to top me. But when I top him, he’s a very passive. I told him what I like sexually, so he knows. But he doesn’t even try to please me. He doesn’t play with my nips when I top, which is the only way I can cum. When I bottom it’s simply out of desire for intimacy, it doesn’t do anything for me sexually.

DD: YIKES! Sounds like a match made in heaven.
Like my momma always used to say, “if it has four wheels or a dick you know you’re gonna have trouble with it.”

William: For example, when I realized I wasn’t going to get what I wantedmale_art2.jpg sexually the other night, I shut down. I got him off and he fell asleep.
He knows me well enough to know when I’m pissed. So the next time we were together, he asked if he had done something wrong. He’s a fuckin’ genius! He asked if he had been too passive as a bottom. Unfortunately, he was pretty stoned at this point, so I thought any further discussion would be fruitless.

DD: Again, YIKES! Any more red flags and this would be a Chinese New Year Parade, for christ sake!

William: If I dump him, am I throwing the baby out with the bath water?

DD: Darlin’, there is no baby in the bath water! There’s just a fucked up stoner dude who is taking you for a ride. He’s welcome to live his life as he so chooses. You, on the other hand, need to find someone a less fucked up.

William: I like him, he is smart, affectionate and we have the same analytical way of thinking.

DD: When he’s not stoned, ya mean.
Here’s a suggestion, why not keep him as a friend. Have dinner together occasionally, enjoy his sparkling conversation and then, quick as you can, get back in your car and go home.

William: He takes care of my physical needs, except sexually. There is, after all, more to a relationship than sex.

DD: EXCEPT SEXUALLY????? That’s like saying he takes care of your nutrition needs, except for the protein and carbohydrates. Sheesh!
You’re right, there is more to a healthy relationship than sex. But given that you are an intensely sexual man, why would you start a relationship with a deficit like this?

William: This is triggering my deep-seeded feelings of inadequacy and self-doubt, which I fully accept as my own shit. I want to please him, so I did not ask him to stop smoking around me. But I did tell him how “not present” he is to me when he smokes prior to sex.

DD: I am so amazed that you are bottoming for this dude. What’s up with that? You hate being a bottom. Listen darlin’, you are way too needy at this point to be looking to someone like this to even begin to meet your needs.

William: He said that he did not think his personality changed when he smokes. But yet he thinks people liked him better when he’s got a buzz on.

DD: Where did you find this guy? Does he live under a bridge?

William: Is this a glitch in a new relationship? Do you think I should hang in there during this adjustment period?

DD: This is scariest thing you’ve said up to this point.
GLITCH??? Are you serious? Does a stripped down, burnt out skeleton of a car on the what_a_ride.jpgside of the road, suggest to you that the owner is having a problem with his windshield wipers? Good lord, man, what can you be thinking?
What follows comes from the deepest recesses of my heart, William. I put this out there because you are my friend. The fellow you describe would be a handful for you if you were at your peak of your emotional and psychological powers. But even then, I’d suggest you avoid him like the plague.
But now, dear William, you are in crisis. You’ve had a terrible lot happen to you this past year. You are hanging on by a thread. I support and encourage all your efforts to find your balance in your life once again, because you are a good and resilient person.
I empathize with your desire to connect with someone who will love you, stand by you and care for you during this difficult time. This is decidedly not the time to be taking on dead weight.
Look to yourself, care for yourself, nurture yourself, love yourself, heal yourself. Come back to us refreshed and whole. Then, and only then, will you be able to take on a complete wreck of a project like this dude.
Count on me to walk through this with you. Thanks for letting me be part of your life. Remember, I’m only as far away as your Instant Messenger.

Over and Out!

It Just Don’t Look Right

Name: Manson.
Age: 21
Location:
I was born with hypospadias and I was operated three times during my life. The last operation was when I was 16. Now, I am 21. My problem is that my penis is only 11 cm or 4.3 inches! I am middle-eastern. I am worried about my penis size, since I have heard it won’t grow longer after the ages of 21-25. What is the best method of penis enlargement that you can suggest in my case?
Thank you

First, a quick review of what is hypospadias is for those unfamiliar with the term. It’s an abnormality of the urethra in some men. It involves an unusual placed urinary meatus (piss slit). Instead of opening being at the tip of the glans (or dickhead), a hypospadic urethra opens anywhere on a (raphe) line running from the tip of the dude’s cock along the underside of the shaft to where the base.

hypospadic 2This happens when a guy’s dick does not fully develop in the womb.

This condition has levels of severity, from the hardly noticeable to very obvious. Some children are born intersexed, and have ambiguous genitalia, which requires sexual reassignment surgery. But I’ll save that discussion for another time.

Some guys, particularly those with conspicuous hypospadias can develop a complex about their appearance. This in turn, impacts on their self-image and complicates their ability to form lasting sexual/partner/marriage relationships. Severe hypospadias can also interfere with procreation. Other men, perhaps those with less conspicuous or severe hypospadias show little to no concern for the appearance of their dick and live completely normal lives.

Some parents of children with mild hypospadias seek a surgical correction to the problem. I view this as a highly risky means to solve a less relatively innocuous cosmetic problem. There are men who were operated on as a child who now, as adults, resent the interference. Are you one such man, Manson? You say you’ve had three surgeries. As you may know, matters are often made worse rather than better through surgery. And of course, there’s always the risk of complications, infections and the like. There are, however, more serious cases of hypospadias that demand reconstruction. If your dick issue is causing you anxiety or low self-esteem, help is available. Check out: The Hypospadias and Epispadias Association.

On to the size of your cock. While your cock falls on the smaller end of the spectrum, it still is near the average. You might want to google — average penis size to get the lowdown on that.

It’s true what you suspect. Don’t count on your dick growing any larger than it is. And frankly, there are no effective methods for permanent enlargement. Here’s what I wrote to another young man (18yo) who wanted to grow his dick bigger…

Jeez, this is just about my least favorite topic of all. I keep promising myself that I won’t respond to anymore “how do I grow my dick bigger?” questions. And then along comes a young pup, like you John, and asks the question again. Here’s a tip, everything I have to say about cock enlargement schemes I’ve already said. If you want to know my thoughts about this wearisome topic look for the CATEGORIES pull down menu in the sidebar to your right. Under the main heading Body Issues you will find a subcategory Cock Size. Once you read through all columns and listen to the podcasts you will have all the information you seek.huge pen..

But since you’re a youngster I will respond kindly. First, you’re not even completely through puberty yet, John. So if you could just chill out for a couple more years till your growing spurt is complete, you might find that nature itself will resolve your issue for you. If, by chance, you find that by your 18th birthday your cock is no bigger than it currently is, then it’s time to make your peace with your piece. Because basically that’s the dick you’re gonna have to work with for the rest of your life.

In other words, you have about as much chance of growing a bigger dick than what your genetics has determined for you as you do growing your feet bigger or adding inches to your height or changing the color of your skin. It’s simply not gonna happen. There is no true way of safely increasing either the width or the length of your johnson short of a surgical intervention. And I never recommend that.

Just like there are ways to give the illusion of bigger feet, darker or lighter skin or being taller than you really are, there are things you can do to create the illusion that you’re growin’ yourself a bigger dick. But all the creams, the jelqing, the pumps, the weights, the what-have-you, will only have a short-term effect if they have any effect at all. In the end you will have spent a whole lot of money, wasted a lot of time, been consumed with a great deal of anxiety and possibly even injured yourself to wind up having what you’ve always had and not significantly more.

May I suggest that you practice accepting what genetics has determined for you in terms of cock size and everything else. Because that will give you more time and energy to learn how to use what you have to its greatest benefit. Luckily, our capacity to be a good, and even great, lover has nothing to do with the size of our cock. Anyone who tries to tell you different is pullin’ your leg.

I hope this is helpful.

Good luck

Review: An Intimate Life: Sex, Love and My Journey as a Surrogate Partner

Hey sex fans!

I have another swell sex-positive book to tell you about today. Anyone who frequents this site will already be familiar with my dear friend and esteemed colleague, Cheryl Cohen Greene. If ya don’t believe me type her name into the search function in the sidebar to your right and PRESTO!

Not only will you find the fabulous two-part SEX WISDOM podcast we did together, (Part 1 is HERE! And Part 1 is HERE!) you will find a posting about the movie The Sessions. You’ve seen it right? It’s the award-winning film staring John Hawkes, Helen Hunt, and William H. Macy. It’s the story of a man in an iron lung who wishes to lose his virginity.  He contacts a professional surrogate partner with the help of his therapist and priest. Ms. Hunt plays Cheryl, the surrogate partner in the movie

Cheryl also contributed a chapter on sex and intimacy concerns for sick, elder and dying people for my book, The Amateur’s Guide To Death And Dying.

With all that as a preface, I now offer you Cheryl’s own story: An Intimate Life: Sex, Love, and My Journey as a Surrogate Partner. The first thing I want to say is this book is it’s not a clinical or technical tome. It is an easily accessible memoir. And that, to my mind, is what makes it so fascinating.

She writes in the Introduction:An Intimate Life

I started this work in 1973, and my journey to it spans our society’s sexual revolution and my own. I grew up in the ‘40s and ‘50s, a time when sex education was—to put it mildly— lacking. As I educated myself, I found that most of what I had been taught about sex was distorted or wrong. The lessons came from the playground, the church, and the media. My parents could barely talk about sex, much less inform me about it.

What follows is a candid and often funny look into the personal and professional life of a woman on the cutting edge of our culture’s movement toward sexual wellbeing.

Cheryl comes out of her conservative Catholic upbringing and her often tortured family dynamics with what one would expect—her own sexual awakenings as well as the conspiracy of ignorance and repression that wanted to stifle it. This is a common story, the story of so many of us.

Starting when I was around ten, I masturbated and brought myself to orgasm nearly every night. … If my nights began with anxiety, my days began with guilt. I became convinced that every earache, every toothache, every injury was God punishing me. … I couldn’t escape his gaze or his wrath. Sometimes I imagined my guardian angel looked away in disgust as I touched myself and rocked back and forth in my bed.

The miracle here is that this troubled tween would blossom into the remarkable sexologist she is today.

rsz_1greenecherylSome of the chapters in her book describe one or another of her hands on therapeutic encounters as a surrogate partner, but equally important and compelling are the chapters that describe Cheryl’s own sexual struggles as she moved to adulthood and beyond. Cheryl’s acceptance of her own sexuality enables her to build a career out of helping others do the very same thing.

Everyone has a right to satisfying, loving sex, and, in my experience, that most often flows from strong communication, self-respect, and a willingness to explore.

Despite the frank discussion of sexual topics within the book, there is no prurience or sensationalism. For the most part, Cheryl’s clients are regular people, mostly men, who have pretty ordinary problems—erection and/or ejaculation concerns, dating difficulties, as well as self-esteem, guilt and shame issues. Cheryl helps each of her clients with the efficiency and confidence of the world-class sex educator she is. Most of her interaction involves her supplying her clients with some much-needed information, dispelling myths, and giving them permission to experiment. As she says;

I continue to be amazed at how solid education delivered without judgment can eradicate much of the guilt and shame that turns life in the bedroom into a struggle instead of a pleasure.

Her most famous client, Mark O’Brien, the 36-six-year-old man who had spent most of his life in an iron lung after contracting polio at age 6, was the author of How I Became a Human Being: A Disabled Man’s Quest for Independence, in which he writes about his experience with Cheryl. This, of course, was adapted into a film, The Sessions, which I mentioned above. For her part, Cheryl delivers a most poignant remembrance of Mark early in her book.

I explained Sensual Touch to Mark. Although he was paralyzed, he still had sensation all over his body, so he would feel my hands moving up and down. … I encouraged him to try and recognize four common reactions: feeling neutral, feeling nurtured, feeling sensual and feeling sexual.

An Intimate Life chronicles Cheryl’s life-long interest in human sexuality. Her life and sometimes-turbulent loves are on display, but in the most considerate fashion. She teaches by example. She’s even able to speak with great compassion of her time living with and through cancer.

As I inch toward seventy, I appreciate more and more how much I have to be grateful for and how fortunate I’ve been. I was lucky to find a wonderful career and to be surrounded by so many smart, adventurous, caring people. My personal sexual revolution auspiciously paralleled our culture’s, and in many ways was made possible by it. I am eternally grateful to the pioneers, rebels, and dreamers who made our society a little safer for women who embrace their sexuality.

There is so much I loved about this book, but mostly it’s the humanity I found in abundance. Cheryl’sdr.-cheryl-cohen-greene enlightened soul shines brightly from every page. Her no nonsense approach to all things sexual is an inspiration. And her perseverance to bring surrogate partner therapy into the mainstream is laudable.

…what separates surrogates from prostitutes is significant. When people have difficulties grasping [that], I turn to my beloved and late friend Steven Brown’s cooking analogy that I’ve so often relied on to help me through that question: Seeing a prostitute is like going to a restaurant. Seeing a surrogate is like going to culinary school.

Finally, An Intimate Life is the culmination of Cheryl’s life as a sex educator, her surrogate partner therapy practice being just part of that mission. I highly recommend you read this book. You will, I assure you, come away from it as I have, a better person—enriched, informed, as well as entertained.

Cheryl, thank you for being in my life and being such an abiding inspiration. Thank you too for this marvelous book; now you can be in the lives of so many others who need you so that you can inspire them along their way.

Be sure to visit Cheryl on her site HERE!

A molehill becomes a mountain

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

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

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