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Healing Sexual Trauma through Sensate Focus


One of the most difficult things for me to deal with as a therapist is the aftermath of sexual trauma. And I know that the trouble I have with this is only a tiny fraction of the difficulty my client has as he or she faces his/her past. I share with you a correspondence I’ve had with a 36-year-old man from Boston named Trent.

Dr. Dick,
When I was 10 years my parish priest molested me. It went on for over a year. Mostly, I’ve been able to put this behind me. I’ve been married over a year to this really great gal. She’s been very understanding and supportive, and we love each other very much. A couple of weeks ago when we were having sex, my wife started to massage my bottom. This was the first time someone touched me there since I was 10. At first it felt good, but then I remembered how I felt when I was a kid and freaked out. I started to cry. My poor wife was devastated at the thought of triggering this painful memory. I told her it wasn’t her fault, but we haven’t had sex since. I’m worried, but I don’t know what to do.

Working through a sexual trauma, like the one Trent experienced as a kid, is difficult. But it is essential for regaining a healthy sense of the sexual self. I told Trent—and this applies to any anyone else who has had regrettable early sexual experiences in their past—that I strongly suggested that he and his wife engage a sex-positive therapist to help them get back on track.

Many people have dealt with some kind of sexually related trauma in their lives.  However, some trauma is more severe than others. Emotional scar tissue and painful memories may linger, but you can learn to insulate yourself from the disruptive effects of the past in the present. Thanks to the indomitable human spirit, most of us live through our difficulties and go on to develop healthy, integrated sex lives.

Sensate focus is a process that helps individuals move through painful sexual memories and heal the rift between the affected parts of the body and the pleasure they can produce. I thought this technique would be of particular value for Trent because of something he’d said: “At first it felt good, but then I remembered how I felt when I was a kid and freaked out.” This tells me that he was able to enjoy the sensations before the association with the molestation kicked in and ruined everything. Sensate focus offers a way to short-circuit this disruptive connection and rewire it for pleasure instead of pain.

What follows are structured therapeutic touching exercises for couples. They are not a prelude to sex. You need to be clear on that. Your genitals will be involved. There will be pleasure and arousal, for sure. But the object of this process is to desensitize the trigger (in Trent’s case, his butt), then re-sensitize it for pleasure. These exercises take about an hour one day a week over the course of a month. If you embark on this course, make sure that you dedicate that kind of time commitment. Please, don’t short-change yourselves; this is an investment in your sexual health and wellbeing.

You and your partner will take turns being the one touched and the one doing the touching. Both of you will have 30 minutes to touch and 30 minutes to be touched: 15 minutes lying on your front; 15 minutes on your back.

Week 1—Breaking the Ice
Structured touching will be unfamiliar to you at first. I want you to use this first session to connect with each other in a sensual and playful way. I want each of you to explore every inch of your partner’s body from head to toe, first the back of the body then the front. This first week, however, avoid one another’s genitals.

This isn’t massage, where touch is directed toward pleasuring your partner. Sensate focus exercises are about gleaning information. Focus on how it feels to touch different parts of your partner’s body in a non-seductive way. Be aware of the different textures contours and temperatures. Use different pressures—heavy and light; different strokes—long and short. Use fingertips, palms, the back of your hands and forearms.

When you’ve finished the first 30 minutes, swap places. This will work best if the one being touched relinquishes control as much as possible. Keep verbal communication at a minimum. Once the hour is over, thank one another for the experience and get on with the rest of your day. Don’t try to process things right then and there, just sit with the sensations. Or better still; write your feelings in a journal that you might want to share later.

Week 2—Making Things More Interesting
Building on what you learned in the first week; this time, kick it up a notch by expanding the structured touching to include anal and genital areas. These are sexually charged zones, but the touch must remain non-seductive. Begin the exercise with some full-body touching before moving on to the new areas. Again, the emphasis is on obtaining information and awareness of physical sensations.

This is where things got a bit challenging for Trent. When his wife touched his butt, I told him I wanted him to want stay in the moment and focus on who was touching him and why. Trent’s wife was not touching him in a sexual manner; she was gathering information.

Staying in the present helps take the edge off. If anxiety builds, deep breathing can help you to relax. Your partner will probably be very nervous too, so breathing together can be helpful.

A guided touch technique can also be useful. Place one of your hands on top of your partner’s and guide it over your trigger area. Try using more or less pressure as you see fit. Remember your trigger spot is just like every other part of your body. Even though an early trauma has sensitized this area to be off bounds, sensate focus exercises will re-sensitize and reintegrate it with the rest of your body. You’ll have to trust me on this.

Week 3—Mutual Touching
This week, we move on to mutual touching. However, it must remain structured and non-seductive, both in the giving and receiving. Mutual touch will provide a more natural form of physical interaction than the previous weeks. You’ll also be shifting attention from how it feels to touch to being aware of how your partner is receiving your touch. Keep verbal communication to a minimum. Let your body tell your partner how you are enjoying the touch. If you must talk, assign a number code to the touch you are receiving: 5 being, ho-hum, 1 being Yowsa!

Remember, no matter how sexually aroused you become, this is not a prelude to sex. If you need to release your sexual tension, feel free to masturbate afterward. No partnered sex during the exercises. Okay?

Week 4—Bringin’ It Home
This last week of exercises continues the mutual touching, with a focus on overcoming any final reservations you have about your trigger zone and the pleasure you derive from it. More of your partner’s touch should focus on that area. For Trent, I advised that his wife include a nice lotion or personal lube for this investigation. (Touching with a wet hand is different from touching with a dry hand.) While concentrating on his butt with one hand, I suggested she fondle his genitals with the other. By playing with the energy around Trent’s sphincter, his wife was able to redirect it and help him reconnect his ass to the rest of his body.

Try receiving your wire’s touch in different positions. Being proactive will facilitate the healing. While she is touching your trigger area, move your butt toward her to meet the caress. You’ll immediately see how being in control will help you move beyond any remaining anxiety. You are not just being passive recipient anymore; you are actively involved with inviting the pleasure. If there are still reservations, take it slow until they too, melt away.

Once he’d freed up his ass for pleasure, I told Trent be sure to incorporate butt play into his future lovemaking repertoire, but I also reminded him to take as much time as he needed to resolve the issue. There is no quick fix. I assured him, though, with diligence and care, sensate focus would remove the fear and shame of the molestation, and replace it with a sense of wholeness, joy and pleasure.

Good luck

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 Megan Andelloux – Podcast #220 – 07/21/10

Hey sex fans,

Get ready for some might fine SEX WISDOM that’s comin’ your way. That’s right; this is the podcast series that is all about chatting with the movers and shakers in the field of human sexuality — researchers, educators, clinicians, pundits and philosophers — all making news and reshaping how we look at our sexual selves. And today I have the honor of welcoming a colleague, my fellow sexologist, the beautiful and oh so saucy Megan Andelloux.

Megan is one of our country’s preeminent a Sexual Health Educators. She is consistently in the forefront of our culture’s discussions on sex; she’s a sought-after sexuality consultant for print media, and an author in the book “We Got Issues” A Feminist Response to Cultural Attitudes On Feminism. She is also the founder of The Center for Sexual Pleasure and Health in beautiful downtown Pawtucket, RI, don’t cha know!

Megan and I discuss:

  • The medical-centric model and the pleasure-centric model of human sexuality.
  • Her training and certifications.
  • Aspects of sexual health education.
  • Better sexual skills workshops.
  • Sexual rights activism.
  • Sex coaching.
  • How to talk to kids about sex.
  • Sex positions.

Megan invites you into her world by visiting her website HERE! And to learn more about The Center for Sexual Pleasure and Health visit them on their website HERE!

See a slideshow of Megan & friends at work and play.

Click on the thumbnails below.

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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.



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.

Sex Advice With An Edge — Podcast #85 — 10/27/08

Hey sex fans,

Today we have a fresh hot load of titillating questions from the sexually worrisome.  And I go out of my way to be sassy, sociable and oh so informative with my replies!  Hey, it’s what I do.  And just to make things well worth your while, I have a little sexual enrichment thing up my sleeve too.

  • Samantha’s BF is hung like a horse.  But he don’t know how to use that thang.
  • Ramon is a bear, but he doesn’t want to be.
  • Poppa’s husband ain’t puttin’ out no more.

Finally, a sexual enrichment tutorial: Basic Sexual Positions For One And All.


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.


Look for 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:  The Amazing Fleshlight & FleshJack.

Fleshlight Sex Toy

Several Steamy Summer Solstice Sexual Situations — SOLVED!

Don’t you just love alliteration?

Summer is here…at least in the northern hemisphere. All hail Sol Invictus! Instead of being outdoors enjoying the beautiful weather we’re having here in the Emerald City, I’m stuck indoors, at this freakin’ keyboard. HELP! Maybe if I hurry up and get my homework done, my mom will let me go out and play.

Name: john
Age: 58
Location: Detroit
married and testing the water, so to speak. Was with a man who is HIV and I swallowed a couple of drops of his cum. Should I be concerned/worried?

gettestedposter-english2.pngAhhhh, yeah! I’d sure enough be concerned, if I were you. I’d be concerned enough to get tested, that’s for sure — not just now, but again in 6 weeks or so. While it’s not overly likely that you’ve sero-converted by this incident alone, stranger things have happened.

I am of the mind that all sexually active people (especially you people who are being sexual outside of your primary relationships) be tested for HIV and other sexually transmitted infections regularly…at least twice a year. All you sexual athletes out there should test every other month. You shouldn’t even think about it, you should just do it. It is painless, discreet, but most importantly, it’s the responsible thing to do. If you make it part of your lifestyle, then there will be no embarrassment associated with the trip to your doctor or the local clinic. Made this happen, people.

Good luck

Name: Frank
Age: 18
Location: Brazil
I have never had sex with anyone before and i believe i am straight, as i feel attrakted towrds girls, but every now and again i like watching gay porn. is this a sign that i’m bisexual or gay? or is it just curiosity?

Can’t hardly say what you are, Frank. Maybe it’s too soon to be giving yourself a label.

What I can tell you is, I’m as queer as a $3 dollar bill (as we say here in America), and I sometimes watch straight porn. That sure as hell don’t make me straight…don’t even make me bi, honey. I guess that just leaves…curious, huh?

Good luck

Name: asianIndian
Age: 24
Location: San Diego, CA
I have been masturbating almost everyday for the past 10 years now. Last year was the first time I tried to get laid off. It was with a 30 woman and I found that I was not able to retain the stiffness of my dick while pumping her. At the end I had to pull out and masturbate to ejaculate. I tried it couple of more women on different occasion and I faced with the same problem. All the three times I had to pull out and masturbate with my hand. I felt really embarrassed and I am afraid of going out with any other women. I also noticed that when I masturbate I do it vigorously and for a prolonged period of time. But when I was having sex I was not able to pump the women for more than 3-4 minutes, I felt part exhausted and my penis too looses its stiffness. How can I over come this major problem?

Name: tanya
Age: 28
Location: ca
my boyfriend has trouble cuming durning sex.he can cum if we are doing anael or I give him a blow job. he takes a long time to cum if we do doggie style. but he cant cum most the time and he cant cum if hes on top. can it be metal or health wise? help please.

You guys are a real pair! I thought I’d respond to you both at the same time.

pic13981.jpgLots of guys find it difficult to cum in penis/vagina fucking. Sometimes there’s simply not enough friction due to flabby, out of shape untoned pussy muscles. Tanya darling, are you doing your Kegel exercises? You should be, if you’re not. If the BF can get off in your ass and with your mouth and hand, then that tells me you have more of a grip in these other orifices then you do in your whoha. It’s not the end of the world. It can be remedied with a little exercise.

Mr. AsianIndian, maybe your masturbation technique gives you more direct cock stimulation than what you get inside a pussy. If that’s the case, you’ll probably have to learn to masturbate with a lighter touch or find a tighter snatch. You could also try masturbating till you get close to shooting, and then stick it in again. Either way, there’s no need to feel embarrassed. Like I said, lots of guys can’t get off by fucking alone. Just like lots of women don’t have vaginal orgasms. They need to stimulate their clit for that.

Good luck

Name: james
Age: 18
Location: lewes, de
is there a way i can make my dick bigger without pills. my dick is so small i cant do alot of the positions i like. i even slip out doin misonary. so can you help me.

Name: ali
Age: 39
Location: glasgow
what is the best thinks to mack the (cock-peanas) biger)

Well. Boys, here’s the deal. Throughout history, men have obsessed with the size of their cocks. And when there’s that much attention paid to something that trivial, you can be sure there’s gonna be an entire industry poised to bilk the shit out of the willie worrisome, like you guys.

All of this unfortunate big-dick envy creates a never-ending parade of con artists tryin’ to sell a remedy, of one sort or another, to cure guys, just like you, of their “shame”. But, take it from Dr. Dick, the dick doctor; it’s all bullshit. And some of the bullshit is really scary and dangerous bullshit.

monsterpumped.jpgFor every little peanut out there, there is some kooky diet, ridiculous cream, bogus massage technique or worthless breathing exercise that is supposed to transform one’s mini-meat into the giant economy size. And let’s not forget the weights you can hang on your thang, the Vacuum device to pump up your thang. And of course the twenty-first century solution — cosmetic surgery — to put a happy face on your thang. The results are dubious if there are any results at all. And each has negative side effects, some of which are more revolting than others.

Here’s the last word on this — don’t waste your money on any of this crap. Or better yet, send me the money, and I’ll put it to good use. Here’s the very best advice I can offer a guy who is unhappy about the size of his schlong…learn to love what ya got and leave it alone.

Good luck

Name: spungee
Age: 36
Location: canada’s capital (you figure it out)
hey. i am a big time anal fan, both giving and receiving. spouse and i have enjoyed anal for some years now, both me giving to her and me gettin pegged. my concern is that while she was really into it at first, she seems to have cooled down a bit recently when it comes to nailing me. any thoughts on how to warm things up again? cheers, spungee

b758.jpgI know what the capitol of Canada is, it’s Ottawa. I went to collage, ya know. I was gonna vist Ottawa, but then I heard it’s filled with Canadians.

Why did things fall off, so to speak? Is the pegging all about you? What’s in it for her? If you get pegged, what does she get? Maybe she’s just bored. Maybe she thinks you’re being selfish. Have you checked in with her lately? Maybe she wants to see you get nailed by the real thing. Ever consider replacing the dildo with 100% prime Canadian Beef?

Good luck

Name: Carlos
Age: 24
Location: Colombia
does coffee have a negative effect on one’s erection? Does anyone know if this is true and why this would be?

Never heard of such a thing! Since Seattle is coffee central here in the good old US of A, I’m sure I would have heard of this, or seen some evidence of this here. I have not! Everyone here in Seattle has a huge stiff erection…all the time

Come to think of it, if you poured hot coffee on your unit that would have a negative effect your stiffy. That’s for damn sure!

Good luck

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