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The Effects of Rape & Sexual Abuse on the Male

By Male Survivors Trust

Slowly but surely, the common myth held that sexual abuse/rape happens to women only is fading, but when a man is sexually assaulted or raped, and grows up believing that myth, he feels even more isolated and alone. This page tackles some of the issues that are rarely talked about, yet have a huge impact on almost all male survivors, and if left unsaid and sorted out, can stop them from recovering fully, leaving a residue of bad feelings and fears behind. Some of the things that can trigger you off and leave you feeling as if you’re back at the point of being abused are as follows.

bryan_tony_boxThe smell of others, especially aftershave or other body smells, can cause you to flashback and trigger bad memories Many male survivors state that when having sex with a partner, that they feel dirty, and unclean once they have reached ejaculation, and this is connected to the sight, feel and sensation of seeing their semen, which reminds them of being abused, and that alone can ruin any sexual relationships they may have.

You may also feel wrong, bad and dirty, so will need to bathe often, usually after having sex with partners, and if masturbating, will only do so as a function, not for pleasure, because the sensation and good feelings have been taken away and you’re left feeling dirty and ‘wrong’ again. There’s also the fact that you can get obsessed with masturbation , not just once a day, but several times a day, which can increase when you feel stressed, lonely, screwed up, etc.

Many male survivors hide behind the fact that they remain non sexual, and in doing so, are not seen as being sexual beings, Others eat, drink, misuse drugs to stop people getting too close to them. By taking on the work that’s needed, you can remove the ghosts of the past and can regain control of your life

Male Survivors share many of the same feelings of female sexual assault survivors. Common feelings such as;

BODY IMAGE* Do you feel at home in your body?* Do you feel comfortable expressing yourself sexually with another?* Do you feel that you are a part of your body or does your body feel like a separate entity?* Have you ever intentionally and physically hurt yourself?* Do you find it difficult to listen to your body?

EMOTIONS * Do you feel out of control of your feelings?* Do you feel you sometimes don’t understand all the feelings you are experiencing?* Are you overwhelmed by the wide range of feelings you have?

RELATIONSHIPS * What’s your expectations of your partner in a relationship?* Find it too easy to trust others?* Find it too hard to trust anyone?* Find it difficult in making commitments?* Still feel alone, even though in a relationship?* Is it hard for you to allow others to get close to you?* Are you in a relationship with some-one who reminds you of the abuse, or who is no good for you?

SELF-CONFIDENCE * Do you find it difficult to love yourself?* Do you have a hard time accepting yourself?* Are you ashamed of yourself?* Do you have expectations of yourself that aren’t realistic?

SEXUALITY * Do you enjoy sex, really enjoy it?* Do you find it difficult to express yourself sexually?* Do you find yourself using sex to get close to someone?* End up having sex because it’s expected of you?* Does sex make you feel dirty?* Are you “present” during sex?

MAJOR SEXUAL SYMPTOMS OF SEXUAL ABUSE

  1. Difficulties in becoming aroused and feeling sensations
  2. Sex feels like an obligation
  3. Sexual thoughts and images that are disturbing
  4. Inappropriate sexual behaviors or sexual compulsivity
  5. Inability to achieve orgasm or other orgasmic difficulties
  6. Erection problems or ejaculatory difficulty
  7. Feeling dissociated while having sex
  8. Detachment or emotional distance while having sex
  9. Being afraid of sex or avoiding sex
  10. Guilt, fear, anger, disgust or other negative feelings when being touched

EXISTING EFFECTS ON MALE SURVIVORS.

Listed below are some of the current effects that sexual abuse, and after-effects it has upon a male Survivor.

Nightmares, (Intense, violent, sexual) – A real fear that everyone is a potential attacker. Intense shame. – Intense anger. – Intense guilt. – Fear in expressing anger/difficulties in being angry. A need to be in control. – A need to pretend they are not in control. A fear of being seen/fear of exposure.- Running away from people/situations. A fear of intimacy. – “Avoidism”. – Memories of physical pain. – Intense sexual flashbacks. Intruding thoughts. – Sexual dysfunction. – Asexual feelings. – Feeling unreal. – Self doubt. – Jealousy. – Envy. Sexual acting out. – Fear of men. – Fear of women. – Fear of speaking out. – Inability to relax. Disconnection with feelings. – Feeling alone. – Poor choice of partners. – “Out of body” experiences. Linking abuse to love. – Keeping secrets. – Forgetting childhood experiences. – Detached from reality. Inability to comfort their children. – Feeling inadequate. – Unable to accept compliments. – Low self esteem. Isolation. – Addictions/crime. – No emotions. – Fear of others motives. – Inability to say no. – Fear of rules.

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COMMON REACTIONS TO SEXUAL ABUSE/RAPE

Emotional Shock: Feeling numb. Being able to stay so calm? Unable to cry.

Disbelief and/or Denial: Did it really happen? Why me? Maybe I just imagined it. It wasn’t really abusive.

Embarrassment: What will people think? I can’t tell my family or friends.

Shame or Guilt: Feeling as if it’s your fault, or you should’ve been able to stop it. If only you had…

Depression: How are you going to get through the day. Feeling so tired! It feels so hopeless.

Powerlessness: Will you ever feel in control again?

Disorientation: You don’t even know what day it is. You keep forgetting things.

Flashbacks: Re-living the assault! Keep seeing and feeling like it’s happening again.

Fear: Scared of everything. Can’t sleep, Having nightmares. Afraid to go out. Afraid to be alone.

Anxiety: Panic attacks. Can’t breathe! Can’t stop shaking. Feeling overwhelmed.

Anger: Feel like hurting the person who attacked you!

Physical Stress: Stomach (or head or back) aches all the time. Feeling jittery and don’t feel like eating.

UNIQUE ISSUES FACED BY MALE SURVIVORS
There is great denial of the fact that men are sexually abused. Other than in prisons, most of us don’t ever hear about the topic of male sexual abuse. The need to deny is often deeply rooted in the mistaken belief that men are immune to being victimized, that they should be able to fight off any attacker if they are truly a “real man.” Another related ‘belief’ is that men can’t be forced into sex. These mistaken beliefs allow many men to feel safe and invulnerable, and to think of sexual abuse as something that only happens to women. Unfortunately, these beliefs also increase the pain that is felt by a male survivor of sexual abuse. These ‘beliefs’ leave the male survivor feeling isolated and ashamed. Below are some of the unique problems and concerns that male survivors do experience: For most men the idea of being a victim is extremely hard to handle. Boys are raised to believe that they should be able to defend themselves against all odds, or that he should be willing to risk his life or severe injury to protect his pride and self-respect. How many movies or TV shows depict the hero prepared to fight a group of huge guys over an insult or name-calling? Surely then, men are supposed to fight to the death over something like unwanted sexual advances…right?

These beliefs about “manliness” and “masculinity” are deeply ingrained in many men and lead to intense feelings of guilt, shame and inadequacy for the male survivor of sexual abuse. Some male survivors even question whether they deserved to be sexually abused because, as they think that they failed to defend themselves. Male survivors see their assault as a loss of manhood and feel disgusted with themselves for not “fighting back.” These feelings are normal but the thoughts attached to them are not true. Remind yourself that you did what seemed best at the time to survive–there’s nothing un-masculine about that.” As a result of guilt, shame or anger some men may punish themselves by exhibiting self-destructive behaviour after being sexually abused. For some men, this means increased alcohol or drug use. For others, it means increased aggressiveness, like arguing with friends or co-workers or even picking fights with strangers. Some men pull back from relationships and wind up feeling more and more isolated. Male survivors may also develop sexual difficulties after being sexually abused. It may be difficult to resume sexual relationships or start new ones because sexual contact may trigger flashbacks, memories of the abuse, or just plain bad feelings. It can take time, so don’t pressure yourself to be sexual before you’re ready.

For heterosexual men, sexual abuse almost always causes some confusion or questioning about their sexuality. Since many believe that only gay men are sexually abused, a heterosexual survivor may believe that he must be gay or that he will become gay. Furthermore, abusers often accuse their victims of enjoying the sexual abuse, leading some survivors to question their own experiences. Being sexually abused has nothing to do with sexual orientation, past, present or future. People do not “become gay” as a result of being sexually abused. However, there are certain issues that are different for men:

Concerns about sexuality and/or masculinity

Medical procedures

Reporting crime to law enforcement agencies

Telling others

FINDING RESOURCES AND SUPPORT

No matter what is said or done, no one “asks for” or deserves to be assaulted. Sexual abuse/rape is nothing to do with someone’s present or future sexual orientation. Sexual abuse comes from violence and power, nothing less. Unfortunately, the health profession are reluctant to recognise that men can be sexually assaulted. This also includes the Police Forces, though that is slowly improving at last This attitude, combined with ignorance affects the way they treat men who have been raped/sexually abused, often using a stereotyped view of masculinity, rather than focus on the physical assault, the crime becomes the focus of the medical exam or police investigation.

WHAT YOU CAN DO

Recognize that men and boys can and are sexually assaulted.

Be aware of the biases and myths concerning sexual abuse.

Recognize that stereotypes create narrow definitions of masculinity, and make it even harder for male survivors to disclose their rape/abuse.

As individuals and as a community, that we work harder to combat and challenge those attitudes.

It is important that male rape survivors have support, and are allowed to make their own decisions about what course of action to take. All too often, they feel forced to make statements or act against their abusers, without having had the time and space to think it through. I never advocate they prosecute their abusers, I suggest they perhaps begin their personal journey to recover from the traumas they are left with.

NOTHING JUSTIFIES SEXUAL ABUSE!

It doesn’t have to be this way though, you can overcome the issues listed and can recover. Just in case you need a reminder;

Men of all ages, and backgrounds are subjected to sexual assaults and rape.

Offenders are heterosexual in 98% of the cases.

Both heterosexual and homosexual men get raped.

Rape occurs in all parts of society.

Men are less likely to report being raped.

A PERSONAL VIEW.

The belief that the male population is the stronger sex, especially when it comes to sex, is deeply ingrained, believed, and supported within our culture, but not all men and boys are physically or emotionally strong, which explains why there are male “victims” of sexual abuse/rape. Male child sexual abuse is perpetrated by both men and women, of any sexual persuasion, with no regard towards the “victims” sexuality or safety. It holds scant regard for who we are, and is about gaining power and control over the “victim”. As children, we are placed in the care of our parents/guardians, family, family friends, schools, and more often than not, sometimes strangers. The ‘Danger Stranger’ campaign focused on the danger of strangers, with the intent of scaring children into not trusting strangers, but plainly ignored the fact that parents, siblings, family members, and those other “nice people” especially those people known as the “Pillars of Society”, are much more likely to sexual abuse children. As a result of our sexual abuse, we grow up with many mistaken beliefs, and many Survivors have fallen into a myriad of roles that include alcoholism, crime, depression, self harming, people pleasing, hardworking, etc. But, far from being powerless, we have drawn upon considerable reserves of inner strength to deal with, adjust and cope with the invasion of our bodies and minds.

Our previous actions in dealing with life may not have been what we wanted to do, and may have caused more pain on the way, but surely we have arrived at a time when we all need to face our past, forgive OUR actions, and move away from the guilt, shame and fear that has haunted us for so long. This possibly took many forms, but is something that we all need to forgive ourselves for, as long we don’t intend to ‘return there’. Some thoughts to have plagued male survivors have been “Perhaps I was to blame” “I should have told someone” “I was in the wrong place, at the wrong time” “I deserved it” “Maybe I gave out the wrong signals” “Maybe I’m gay”………,What we don’t want to hear is pity, or told “how awful” “so sad”, “poor little boy” as that concept is dis-empowering and perpetuates pity for the ‘victim’ and we are then seen as “not quite right”.

We are OK, we are capable of living our lives, and we are more than capable of overcoming the traumas that our abuser(s) left behind. I subscribe to the belief that in order to heal fully you have to face your abusive past, however difficult that may be, but in doing so, you can move on emotionally, forgive your actions, find inner peace, and be the person you want to be, not who ‘they’ wanted you to be. Please break the silence and demand the right to be recognized! If you want to join, we will support you in your struggle, be ‘here’ for you when you need us, and help you understand who you are, and what you want to be. The next step is from victim, to SURVIVOR, which is possible. It’s not easy, and involves you telling someone else all those deep hidden secrets, but once started, DON’T STOP!

Complete Article HERE!

Sexuality and Illness – Breaking the Silence

(This is a Companion piece to yesterday’s posting. You’ll find yesterday’s posting HERE!)

By: Anne Katz PhD

Sexuality is much more than having sex even though many people think only about sexual intercourse when they hear the word. Sexuality is sometimes equated with intimacy, but in reality, sexuality is just one way that we connect with a spouse or partner we love (the true meaning of intimacy). Our sexuality encompasses how we see ourselves as men and women, who we are attracted to emotionally and physically, what turns us on (eroticism), our thoughts and fantasies, and yes, also what we do when we are sexually active, either alone or with a partner. Our sexuality is connected to our image of ourselves and it changes over the years as we age and face threats from illness and disability and, eventually, the end of life.seniors_men

Am I still a sexual being?

Illness can affect our sexuality in many different ways. The side effects of treatments for many diseases, including cancer, can cause fatigue. This is often identified as the number one obstacle to sexual activity. Other symptoms of illness such as pain can also affect our interest in being sexually active. But there are other perhaps more subtle issues that impact how we feel about ourselves and, in turn, our desire to be sexual with a partner or alone, or if we even see ourselves as sexual beings. Think about surgery that removes a part of the body that identifies us as female or male. Many women state that after breast cancer and removal of a breast (mastectomy), they no longer feel like a woman; this affects their willingness to appear naked in front of a partner. Medications taken to control advanced prostate cancer can decrease a man’s sexual desire. Men in this situation often forget to express their love for their partner in a physical way, no longer touching them, kissing them, or even holding hands. This loss of physical contact often results in two lonely people.  Humans have a basic need for touch; without that connection, we can end up feeling very lonely.

Just talk about it!

seniors_in_bedCommunication lies at the heart of sexuality. Talk to your partner about what you are feeling, how you feel about your body, and what you want in terms of touch. Ask how you can meet your partner’s needs for touch and affection. The most important thing you can do is to express yourself in words. Non-verbal communication and not talking are open to misinterpretation and can lead to hurt feelings. Our sexuality changes with age and time and illness; we may not feel the same way about our bodies or our partner’s body that we did 20, 30 or more years ago. That does not mean we feel worse – with age comes acceptance for many of us – but we do need to let go of what was, and look at what is and what is possible.

The role of health care providers

Health care providers should be asking about changes to sexuality because of illness or treatment, but they often don’t. They may be reluctant to bring up what they see as a sensitive topic and think that if it’s important to the patient, then he or she will ask about it. This is not good. Patients often wait to see if their health care provider asks about something and if they don’t, they think that it’s not important. This results in a silence and leaves the impression that sexuality is a taboo topic.senior intimacy02

Some health care providers are afraid that they won’t know the answer to a question about sexuality because nursing and medical schools don’t provide much in the way of education on this topic. And some health care providers appear to be too busy to talk about the more emotional aspects of living with illness. This is a great pity as sexuality is important to all of us – patients, partners, health care providers. It’s an important aspect of quality of life from adolescence to old age, in health and at the end of life when touch and love are so important.

Ask for a referral

If you want to talk about this, just do it! Tell your health care provider that you want to talk about changes in your body or your relationship or your sex life! Ask for a referral to a counselor or sexuality counselor or therapist or social worker. It may take a bit of work to get the help you need, but there is help.

Complete Article HERE!

Sexuality at the End of Life

By Anne Katz RN, PhD

In the terminal stages of the cancer trajectory, sexuality is often regarded as not important by health care providers. The need or ability to participate in sexual activity may wane in the terminal stages of illness, but the need for touch, intimacy, and how one views oneself don’t necessarily wane in tandem. Individuals may in fact suffer from the absence of loving and intimate touch in the final months, weeks, or days of life.head:heart

It is often assumed that when life nears its end, individuals and couples are not concerned about sexual issues and so this is not talked about. This attitude is borne out by the paucity of information about this topic.

Communicating About Sexuality with the Terminally Ill

Attitudes of health care professionals may act as a barrier to the discussion and assessment of sexuality at the end of life.

  • We bring to our practice a set of attitudes, beliefs and knowledge that we assume applies equally to our patients.
  • We may also be uncomfortable with talking about sexuality with patients or with the idea that very ill patients and/or their partners may have sexual needs at this time.
  • Our experience during our training and practice may lead us to believe that patients at the end of life are not interested in what we commonly perceive as sexual. How often do we see a patient and their partner in bed together or in an intimate embrace?
  • We may never have seen this because the circumstances of hospitals and even hospice may be such that privacy for the couple can never be assured and so couples do not attempt to lie together.

intimacy-320x320For the patient who remains at home during the final stages of illness the scenario is not that different. Often the patient is moved to a central location, such as a family or living room in the house and no longer has privacy.

  • While this may be more convenient for providing care, it precludes the expression of sexuality, as the patient is always in view.
  • Professional and volunteer helpers are frequently in the house and there may never be a time when the patient is alone or alone with his/her partner, and so is not afforded an opportunity for sexual expression.

Health care providers may not ever talk about sexual functioning at the end of life, assuming that this does not matter at this stage of the illness trajectory.

  • This sends a very clear message to the patient and his/her partner that this is something that is either taboo or of no importance. This in turn makes it more difficult for the patient and/or partner to ask questions or bring up the topic if they think that the subject is not to be talked about.

Sexual Functioning At The End Of Life

Factors affecting sexual functioning at the end of life are essentially the same as those affecting the individual with cancer at any stage of the disease trajectory. These include:go deeper

  • Psychosocial issues such as change in roles, changes in body- and self-image, depression, anxiety, and poor communication.
  • Side effects of treatment may also alter sexual functioning; fatigue, nausea, pain, edema and scarring all play a role in how the patient feels and sees him/herself and how the partner views the patient.
  • Fear of pain may be a major factor in the cessation of sexual activity; the partner may be equally fearful of hurting the patient.

The needs of the couple

Couples may find that in the final stages of illness, emotional connection to the loved one becomes an important part of sexual expression. Verbal communication and physical touching that is non-genital may take the place of previous sexual activity.

  • Many people note that the cessation of sexual activity is one of the many losses that result from the illness, and this has a negative impact on quality of life.
  • Some partners may find it difficult to be sexual when they have taken on much of the day-to-day care of the patient and see their role as caregiver rather than lover.
  • The physical and emotional toll of providing care may be exhausting and may impact on the desire for sexual contact.
  • In addition, some partners find that as the end nears for the ill partner, they need to begin to distance themselves. Part of this may be to avoid intimate touch. This is not wrong but can make the partner feel guilty and more liable to avoid physical interactions.

Addressing sexual needs

senior intimacyCouples may need to be given permission to touch each other at this stage of the illness and health care providers may need to consciously address the physical and attitudinal barriers that prevent this from happening.

  • Privacy issues need to be dealt with. This includes encouraging patients to close their door when private time is desired and having all levels of staff respect this. A sign on the door indicating that the patient is not to be disturbed should be enough to prevent staff from walking in and all staff and visitors should abide by this.
  • Partners should be given explicit permission to lie with the patient in the bed. In an ideal world, double beds could be provided but there are obvious challenges to this in terms of moving beds into and out of rooms, and challenges also for staff who may need to move or turn patients. Kissing, stroking, massaging, and holding the patient is unlikely to cause physical harm and may actually facilitate relaxation and decrease pain.
  • The partner may also be encouraged to participate in the routine care of the patient. Assisting in bathing and applying body lotion may be a non-threatening way of encouraging touch when there is fear of hurting the patient.

Specific strategies for couples who want to continue their usual sexual activities can be suggested depending on what physical or emotional barriers exist. Giving a patient permission to think about their self as sexual in the face of terminal illness is the first step. Offering the patient/couple the opportunity to discuss sexual concerns or needs validates their feelings and may normalize their experience, which in itself may bring comfort.

More specific strategies for symptoms include the following suggestions. senior lesbians

  • Timing of analgesia may need to altered to maximize pain relief and avoid sedation when the couple wants to be sexual. Narcotics, however, can interfere with arousal which may be counterproductive.
  • Fatigue is a common experience in the end stages of cancer and couples/individuals can be encouraged to set realistic goals for what is possible, and to try to use the time of day when they are most rested to be sexual either alone or with their partner.
  • Using a bronchodilator or inhaler before sexual activity may be helpful for patients who are short of breath. Using additional pillows or wedges will allow the patient to be more upright and make breathing easier.
  • Couples may find information about alternative positions for sexual activity very useful.
  • Incontinence or the presence of an indwelling catheter may represent a loss of control and dignity and may be seen as an insurmountable barrier to genital touching.

footprints-leftIt is important to emphasize that there is no right or wrong way of being sexual in the face of terminal illness; whatever the couple or individual chooses to do is appropriate and right for them. It is also not uncommon for couples to find that impending death draws them much closer and they are able to express themselves in ways that they had not for many years.

Complete Article HERE!

The Heartbreak of Male Performance Anxiety

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

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

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

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

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

Here’s Bob, he’s 26:
Doc, this has never happened before. But I couldn’t get it up tonight, and this chick was H.O.T. Now I’m not gay at all, but I haven’t had sex in about 3 years because I was locked up…so I masturbated pretty regularly, about 3 or 4 times a week. But I can’t figure out why I was soft… the only thing I can think of is I ate clams tonight and I’ve never had them before. Could it be that or should I get checked out?

It weren’t the clams, darlin’! And I don’t think you need to get “checked out” either…at least not right away. If you could back away from the situation a bit and stop freaking out, I think you’d discover the source of your problem all on your own.

Here’s the thing—while you were out of commission there in the slammer, you relied, as you say, on jerking off. Okay, cool. We all do what we gotta do. Now the first time you try to score after your release…you go soft. This tells me you have a mild case of performance anxiety. We all get that from time to time.

There’s probably nothing wrong with you or your johnson. You just got the jitters first time you tried to get you some after being away, that’s all.

The anticipation of boning this H.O.T. chick—fueled by some predictable self-consciousness; what with just getting out of the big house and all—pulled the plug on your wood. No surprise there, right?

What I don’t want to see happen is for you to replay the incident over and over in your mind’s eye til that’s all you can think about. If you do, this proverbial molehill will become a mountain. You’ll then bring all this anxiety to your next encounter, setting yourself up for even more disappointment. You can see how this shit can snowball? If you interpret every less than satisfying encounter as a failure, your fears will become self-fulfilling. You’ll begin to avoid partnered sex and you’ll develop a full-blown sexual dysfunction. And your self-esteem will take a nosedive, too.

If you’re preoccupied with your performance, it’s less likely that you’ll be fully present during sex with a partner. This pretty much fucks up your sexual responsiveness and any hope for spontaneity. Why not just relax into the whole sex thing and not try to prove your manhood with your pecker?

Then there’s Steve with a slightly different take on this meddlesome problem:

My partner and I have been together for just over 3 years now in a monogamous relationship. I am the top and he the bottom. Our problem is not premature ejaculation on his part, but his inability to have an orgasm at all. No matter what I try and even if he masturbates, sometimes it is impossible to get him to cum. Is this a medical issue? Have you ever heard of this?

Delayed ejaculation is the difficulty one has ejaculating even with a firm erection and sufficient sexual arousal and stimulation. This problem is not uncommon. For most men, delayed ejaculation occurs during partnered sex more frequently than while masturbating. In fact, 85% of men with delayed ejaculation can usually cum by jacking off. However, in partnered sex, the guy may be unable to ejaculate at all, or only after prolonged partnered stimulation. This problem can be very frustrating and cause distress for both partners involved, as you already know.

What causes delayed ejaculation? Well, it could be a number of things. It could be something as simple as performance anxiety, or inadequate stimulation, or there could be neurological damage.

I don’t want to be too reductionist here, but most of us experts believe that the majority of instances of delayed ejaculation aren’t physical in nature, but rather are the product of psychological concerns. 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 partner’s unit. It’s all in his head…or his mind, to be more exact. If I had to guess, I’d say he’s got a real bad case of performance anxiety.

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 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 (Sensate Focus is a series of specific exercises for couples that encourage each partner to take turns paying increased attention to their own sensations. More about these helpful exercises in the weeks to come.), stress reduction and relaxation exercises. These applications are designed to reduce performance pressure and instead focus on pleasure. The idea is to get them to stay in the moment; absorb the pleasure present without worrying about what is “supposed” to happen.

Finally we address as frankly and openly as possible any fears or anxieties that they may have—as individuals or as a couple. I have the greatest confidence in this method; it succeeds over 90% of the time.

Ok, let’s recap shall we?

Overcoming sexual performance anxiety is dependent on five simple things.

  • First, a guy needs to be attuned to his sexual response cycle — arousal, plateau, orgasmic and resolution phases. He should know what kind of stimulation he needs at each phase to fully enjoy himself and satisfy his partner.
  • Second, the more worried a guy is about a performance issue, the more likely that problem will present itself. A bad experience in the past can often set the stage for its recurrence.
  • Third, don’t be afraid to talk this over with your partner. Withdrawing from your partner or shying away from sex altogether will only increase the likelihood that the problem will persist.
  • Forth, be proactive! Fearing the loss of your sexual prowess or feeling sorry for yourself is counterproductive. Confront the challenge head on. Employ sensate focus training stress reduction techniques and relaxation exercises to help you push past this temporarily impasse and regain your self-confidence.
  • Fifth, free yourself from the mindset that your dick is the center of the universe. Your manhood or your capacity to be a great lover does not reside in your genitals. Expand your sexual repertoire. Remember, pleasure centers abound in your body as well as your partner’s.

Good luck!

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