Autumn A.M.A.

It has been such a blast doing this Ask Me Anything. It’s my pleasure to be able to offer education and support, and I’ve loved hearing through your posts and emails that so many of you found value in this experience.

Please note that while I do indeed offer therapy, this AMA is not therapy. It is intended for your education only.

Many of the following are reposts in digest form from my Reddit AMA. The originals can be found here.

What does the typical session consist of?

This depends entirely on what the client came in for. Somatic (body-focused) therapy can look from the outside very much like any other modality. What makes it different is the heavy focus on and inclusion of what’s happening in the body. As we talk, together we track what’s happening in the client’s breathing, muscle tension, heart rate, etc. So when it comes to exploring sexuality, there’s oodles of information there because it’s such a body-based experience. Because the early muscular patterning of the body shows up very quickly when we talk about sex, we get to see where a person has blocks. Let me ground this in an example for you…

If someone comes in wanting to figure out how to have more sex in their relationship, we start to track what comes up when they try to initiate sex. Maybe she’s attracted to and feels safe with her partner, but when it comes to asking for sex, her muscles tense, her heart rate skyrockets, and she just wants to hide. Once we tune into those sensations, we can begin to find their source. A common thing that comes up there is the fear of rejection or as being seen as “over-sexualized.” Once we know the nature of the block, we can begin to practice a new way of being. In this scenario, we might do some deep breathing, some opening of the chest muscles, reality checking with the partner, etc.

How does sex therapy differ from sex-work? I know there’s a difference, but I’m not entirely sure what the difference is and where.

Most people who call themselves sex therapists mean that, like myself, they are psychotherapists who specialize in sexuality. Sex work or sexual surrogacy, etc. typically involves having sexual contact as part of the healing process, which doesn’t occur in sex therapy.

Here’s a link to an interview I did with a local sexual wellness store. I say a good amount about that here:

How important is a man’s size to a woman –really?

I have a few things to say here. Let’s start with the good ol’ “it depends.” It can certainly affect intercourse if the man’s penis is particularly small or particularly large. But let me encourage you to consider that intercourse or any type of insertion is only one part of sex. Clitoral and anal stimulation are favorites for a lot of folks, so be wary of over-focusing on insertion. Focus instead on getting to know what you like, and what your partner/ potential partner likes. If you haven’t yet had sex (or have been scared away) and are concerned about potential partners enjoying what you provide, gift yourself with some books and classes on anything that interests you: oral sex, anal sex, mutual masturbation, etc. And don’t forget that a significant portion of what’s happening in a sexual encounter is mental and emotional.

What was the most uncommon/unexpected or surprising sexuality-related case/client you ever had?

This has been a really interesting question to ponder. What I’m finding as I reflect is that I’ve never been very surprised at what comes up. I think the closest I’ve come to something like that is when a client shares something about their sexual activities or fantasies that tells me something about them that I didn’t know before. But that’s exciting to me because it means I get to know them even better. One of my favorite things about my work is that I’m always learning new things about people, so maybe my struggle to give you a nice juicy answer is that I’m constantly working with the unknown. But what I learn about any individual always makes sense- at least once I know enough about them- because it’s part of their unique experience. It’s their reality.

I’ll keep thinking for you, though, too. 😉

What do, when ones wife’s libido has completely disappeared?

You’ll have to find out why that’s happened. And remember that she may not know herself. Is she willing to talk to you about it?

Follow up: Not without being defensive. From previous conversations it’s because of the weight she put on after our first kid was born. She doesn’t feel sexy, doesn’t want to have sex. (Except when she’s under the hormonal cocktail of fertility, apparently.) For me this sounds like sex, for her, has nothing to do with me. But then I feel selfish for wanting it when I know she doesn’t. But dang, I made vows when we got married, but celibacy wasn’t one of them.

(From a fellow Redditer):What about asking her to join a gym with you? a shared goal of better health, both feel more confident and the sex will come with that as she appreciates her body more.

It’s good advice. And I know this will sound like excuses… What this boils down to is, like many, neither of us have ever been able to stick to a gym routine. Her because she pushes too hard right away and ends up injured or way too sore. Me, because repeditive motion bores me to metaphorical tears. I wish there was a parkour gym or obstacle course gym near me. That said she does try to lose weight, and I have been consistently, if slowly, shedding pounds by consuming lots of protein in the morning.

(Me): Ah swell, you know what? I just got a lot of useful information out of reading about her relationship to her body, and to exercise. If she isn’t comfortable with her body, then she’s not going to want to be feeling it in order to have sex. Sex means feeling all kinds of sensations, which make a person very aware of the body in which they exist. It’s part of why it’s so wonderful. But if what she feels when she is present and embodied is un-sexy and unattractive, then of course she doesn’t want to be reminded of that. And you don’t want her to dissociate from that in order to make sex happen, either. Your wants and needs certainly matter just as much, and it sounds like what’s needed is for her to be more active in working this through. It’s going to be important that you are very warm and supportive about this, even if you’re also giving her some firm nudges towards therapy or reading some good books about this. Approach it like it’s a mutual struggle, because it is. And how you deal with it will help or hinder the process. It needs to be safe for her to explore and then share with you what’s underneath her self-consciousness.

I also mentioned that there was useful information in finding out that she overdoes it and tires out. For a little re-patterning there, practice together doing small and easy things. This can be sexual things, if she’s willing. Ask her if she’d be willing to kiss for a little while with no intention of moving towards heavier petting, even if you get aroused. Let her slowly re-inhabit her body in safe little increments. You’ll get some nice contact out of that, too.

Because I can hear your frustration, I want to strongly encourage you to get support with this. If she isn’t willing to do couples therapy together, go alone. It will help. If your frustration is too big and has built up over too long a period of time, it may be nearly impossible for you to be supportive and patient in the way that’s needed for you two to get through this.

Can celibate people get therapy and will it complicate their lives and make them die early deaths?

No matter what’s going on in someone’s sexual life, they have sexuality. Asexuality, for instance, is also a type of sexuality. The exploration is about better understanding yourself and how you relate to others.

For the latter part of your question, I’m not exactly sure I have your question right… Therapy can absolutely be difficult and challenging. And sometimes things can feel worse before they feel better. But with a good relationship with a good therapist, awesome stuff can happen. I’d argue that that prolongs life.

“Sexuality is the best source of information about how you relate to others”: can you explain this please? I’m not sure I understand and so can’t tell whether I agree. Somewhere in there, can you offer a contextual definition for “sexuality”? Just trying to understand. And, lastly, what’s one tip you would give to anyone regarding fostering a healthy sexuality / clear sign that they might need therapy in this? Thanks for your ama!

Ok, so first of all, the presenting “problem” is never just about sex, but about a person accessing the self and expressing themselves to others. Let’s look at a scenario. What happens during masturbation versus sex is always a great vehicle for exploring this.

Let’s say that a person masturbates daily, usually in the afternoon, and uses a vibrator (the details of how, when, why and where matter a lot). When it comes to sex with their live-in partner, maybe they initiate two or three times a week at nighttime, and they don’t bring in the vibrator. For the sake of simplicity and answering your question, let’s assume that the partner would be cool with whatever this person brings into their sex life. You can see from this that there are differences in relating to this self versus the other. In therapy, we would explore different aspects of this in order to understand the dynamic. Maybe we’d find that the person isn’t comfortable with her partner knowing that she masturbates daily, because she was taught that masturbation is unhealthy, or past partners shamed her for it, etc. Or maybe we’d find something slightly more complex, like that while her peak arousal usually happens in the afternoon, she isn’t comfortable with that amount of light when it comes to partner sex. So she’s comfortable with it in the total safety of solitude, but not with the vulnerability of being seen. Once we know we comes up, we can start to re-pattern things in such a way that allow the client to be more fully who they are naturally. Sexuality is the vehicle for exploring a person’s go-to dynamics.

I somewhat answered your second question in there, but I’ll be more explicit. Defining sexuality gets to be a really big process, and I think that that’s good and as it should be. It’s necessarily complex. I think the simplest answer I can conjure is that it’s your unique energy, how it moves through you and through the world around you.

And finally, regarding fostering healthy sexuality, I think the short answer is to stay curious and open. When you feel turned off, constricted, uncomfortable, etc., get curious about why and seek out support for your exploration. That can come via conversations with trusted friends, books, workshops, and of course, therapy.

Regarding when you “need” therapy, well, I consider therapy to be an ongoing supportive process in which you get to learn and develop in order to become more of who you already were deep down in there. So I’m very big on being in therapy simply for the sake of the work, not just in an emergencies or to “fix” something. If you aren’t satisfied with an aspect of your sex life, then therapy can help! =)

Is low or non existent libido more common in a homosexual lesbian couple than a heterosexual one?

Oh such a tricky question! I’m assuming you mean when both partners are experiencing low or non-existent libido. I can’t speak to the statistics on this, but I think the answers probably lies in the fact that women tend to have more blocks to exploring low desire than do men. We’re more often expected to not want it as much or as often, to be the recipients rather than the initiators, or simply be politely indirect or quiet about our needs. So if you’re dealing with two women with low desire in a relationship, then maybe you see that problem perpetuated for longer.

You mention neurodiversity. What are some of the challenges you help people address that are related to that?

One of the very biggest topics in the room is often how the client can honor themselves, and how they can be understood and supported by others. This is very much any client’s work, but with clients who are on the autism spectrum, for instance, we focus heavily on a sort of translation of experience. A lot of people are misunderstood and/or targeted for the ways in which they differ from many others (especially during their childhoods), so they tend to need a lot of space to explore what’s possible when they aren’t being told how to be.

It’s one of my favorite areas in which to work, because I find it delightful to answer questions like, “Why do people have sex?” How does one answer that?! Well, we answer it together. We look at what they like about sex (or think they might). Somatic work is hugely beneficial here, because everyone’s common language is the body. When you understand better how the body (and specifically: your body) functions, it’s like having this secret code. Ultimately, that works for anyone, but lands really well for the concrete thinkers.

That said, it’s a huge spectrum, so no two people’s work will look the same.

Follow up: Thank you for this answer and doing this AMA. Do you talk with other professionals or autism advocacy groups to learn/develop techniques to improve your approach?

I do! I particular enjoy the work of Jade Ann Rivera ( Nick Walker (, and Sara and Bob Yamtich ( and I also attend consultation groups in addition to supervision, and I read books and try to stay current with the research. A big portion of my own work is to keep an eye out for my own blindspots. This is always important, but I sometimes wonder if internalized neurotypicalism is more rampant than other -isms, as it occurs cross-culturally. So I try to stay frosty!

What happens if i masturbate daily, anything bad?

Good news! Nothing bad! That is, nothing purely physiologically bad. And in fact, as someone mentioned, there are health benefits no matter what your gender.

But since you’re asking, I’m going to assume that you have some discomfort with masturbation. If you feel guilty or ashamed (or anything unpleasant) about it, then I would call that something bad and I encourage you to explore that. I’d love to just fix it for you by telling you that it’s ok, but I’m no match for years of you believing something else! Consider what you learned about sex and masturbation, particularly the unspoken messages, and then consider whether or not those things work for you. Do they match your intuition about it? What motivations might your parents/ teachers/ clergy have had in imparting that information? So much of therapy is removing the layers of junky stuff put upon us by others and by negative experiences. Get down there to you, and decide what’s best for you. And do it with the support of someone else, but we can’t explore or teach ourselves what we don’t know. There are lots of resources out there, too. You might consider reading Betty Dodson’s book “Sex For One” or my new favorite find “First Person Sexual” by Joani Blank to start.

I can not seem to stay interested in a sexual partner longer than 6 months. I try so hard and i really like the person but i find myself looking for another partner. I feel terrible about it but i just cant help it. Spicing things up makes no difference. Am i faced with relationship hopping for the rest of my life?

I’m so glad you’re asking, because this is such a debilitating problem when it comes to relationships. I’m reminded of my favorite Rumi quote: “Your task is not to seek for love, but merely to seek and find all the barriers within yourself that you have built against it.”

I’d amend that a bit to say that you don’t actively build against things so much as you are patterned to do so by your experiences. So, to best answer your question, you’d need to get in touch with what you begin to feel as you approach six months with someone. The six month mark is a big deal time in a relationship, and a lot of them end around here. It’s when you start to really see someone, and begin to need to really show yourself. The fuller person shows up, and sometimes we don’t like what we see, or we don’t want to be more fully seen. It also tends to be the end of the intense bonding phase, and it’s very likely that your system has a difficult time with that. This is where therapy can support you in exploring what got missed when you were first learning to differentiate from another person, which includes looking at what you’re working with. As “alixinwonderland” suggested, sometimes it’s a matter of finding the right person. That too takes a sort of practice. We aren’t always good at pairing up with the people who can actually provide what we really want and need until the process is made more conscious.

You might like to read “Getting the Love You Want,” by Harville Hendrix which is a very straightforward, but strenths-based guide to understanding this better. I also like “Getting the Love You Want” by Bader and Pearson. I wrote up a review of it here:, and focused primarily on this phase of relationship, because it really is one of the hardest.

Follow up: Because i dont really want to hurt anyone i do keep partners at arms length a bit and i tend to just drift out of relationships more then abruptly cutting people off. Girls pick up on this fairly quickly and do get upset with me. I dont have an image of my perfect partner in my head and i am not sure that if i met them i wouldnt do the same thing. It’s a horrible way to live and you look for another partner quickly to bring some excitement back and fill the urge. I have done this for the last 10 years. I am 30.

Ah. Ok, so the area to explore is in what you said first there. Why does it seem as though you’ll hurt someone? Has that happened? Or did you watch that happen with someone else? It’ll be very important that you understand how and why that became a fear, and then work to be open about being wrong about that by learning and practicing how to safely get closer and closer to someone. There are always deeper layers on which to connect, and that keeps sex exciting and pleasurable. Check out the book, or just do some reading (from trusted sources) on differentiation. And definitely consider doing this work in therapy- it’ll be easier and faster!


Have you ever had a person who considers themselves asexual seek you out for advice?

I have and do! It’s not always the reason someone comes in, but sexuality is always not the only means of exploration in therapy. When it is the desired focus, there’s still plenty to explore! Feel free to ask a follow up- I imagine you may want to know something more specific.

Hi, thanks for the AMA – What is your primary goal in therapy? If a couple is having trouble being stimulated, how do you even begin to fix their issues? Do you feel embarrassed at times ? Do THEY ?

My pleasure! Thank you for participating.

The goal is always a mutually created one, and therefore entirely dependent on who’s in front of me.

And where to start also depends on where a couple feels stuck. There’s a typical orgastic cycle that you could peek at, if you’re interested: Each person may feel challenged by different places in the cycle. We begin our work wherever there’s the most energy, using existing strengths and resources as well as adding new ones. Would you like a random example? Or would you like to share a bit more?

I almost never feel embarrassed, because it’s not my stuff that’s being explored and I’m very comfortable with the topic. A huge part of my job is to have done a lot of the work as a client myself, and to know when my stuff comes up in the room. When it does, I name it, because it would be visible and/or felt in the room, and that’s exactly the sort of thing that we are there to focus on- what’s right here with us.

Clients definitely feel embarrassed at times. It’s such a vulnerable topic. If there were no embarrassment, I’d be concerned! People have varying degrees of comfort about it based on what they’ve learned and experienced, but I’ll tell you this: everyone feels relieved at having a space in which to share this stuff and to look at it together. Shame’s only real power is in keeping you silent.

How frequently do you see men in your practice who have a low (or almost nonexistent) desire for sex, whereas their wife/girlfriend is the one who is sexually frustrated? What kinds of things tend to cause this? And what can a woman do when her husband seems uninterested in sex (and is not having an affair, as a possible cause)?

My personal opinion is that this is much more common than is talked about, and a lot of women (and men) suffer greatly in secret, with no idea what to do about it.

This is such an important topic to bring awareness to! It definitely happens, and it happens way more often than one is lead to believe through media or even personal conversations. That can make it uniquely difficult to explore if either person feels shame (commonly, the woman will feel shame for being “too sexual” and the man will feel shame for not being sexual “enough”).

What causes it typically has nothing to do with gender. Low desire is typically a block, and blocks are in place for a reason. I say typically, because some people do just have lower libidos than others. I’m assuming you’re talking about a reduction in desire. A block, on the other hand, is a physical and emotional bracing against something that’s being deemed unsafe. It’s very important to understand why it’s happening, which can definitely take time and proper support. Will he talk about it? What comes up if you ask?

Do mental health issues come up during sex therapy, and if so, how often?

It matters what you mean by mental health issues. My short answer is yes, always. The mind and body are intertwined, so you can’t work in one realm without the other. Let me know if you meant something more specific.

In your opinion, how can someone who’s suffered sexual abuse at an early age heal from that trauma and emotionally prepare for sex? Surely there are better ways than just trying to learn experientially with each encounter.

This is so important. I’m so glad you asked. It’s entirely possible to having a very rich, enjoyable and fulfilling sex life despite past sexual abuse. And there are definitely better ways than experiential sexual practices. Those often perpetuate the struggle.

As with anything, it depends on the nature of the abuse, especially the relational pieces. Speaking broadly, what we do is find where the tension of the trauma is still being held in the body, and then work on releasing it. Breath work is extraordinarily beneficial for this. You work on breathing deeply, and track where the breath is constricted. When you tune into the places of tension and begin to release them, old thoughts and emotions will arise, but this time they are dealt with as they always should have been. Slowly, the body returns to equilibrium and sex is no longer a challenge.

Throughout this process, I am right there supporting the client with whatever is needed. A huge part of the healing is the relationship between therapist and client, and this is more intensely true for someone with sexual wounds. Sexual trauma hits a person deeply, and can become terribly intertwined with their sense of self. Untangling it must come with a strong sense of trust and safety in the room, and the work is necessarily slow and gentle. Much of this can happen with a good, informed and aware partner, but I always, always recommend that this is done with the support of a professional.

I just did some writing on how to work on fuller embodiment, which you can read here:

And there is a completely awesome book about this called “Healing Sex” by Staci Haines. It’s a comprehensive sex-positive guide to working somatically with sexual trauma. Here’s my review of it: I couldn’t recommend it more highly.

Swinger here, how many problems do you see people struggle with that are attributable to societal norms of monogamy?

Much of what people struggle with are societal or familial norms period. So much of therapy is figuring out how to get what you want and need by expanding your awareness of what is possible. So whether someone is polyamorous, swings, or is monogamous, it’s about exploring where they see their limits and then broadening their abilities. What comes up for my clients who are in non-monogamous relationships is rarely different from the monogamous folk, because you’re still dealing with a person’s relationship to themselves first and foremost.

I’m only 26, but I’ve basically had no sex drive for months now (and this isn’t the first time this has happened). I do have an anxiety disorder, but I don’t know if that’s the sole reason and I have no idea how to get my drive back. Any thoughts?

I’m sorry to hear that. That can be so upsetting! But I’m sure it arisen for a reason, so it’s vital to figure out what that is. Since you mentioned that you struggle with anxiety, the question becomes about where the tension originated, and how you can practice something new. In all likelihood, an old anxiety is getting periodically triggered by something external. You may already have a sense of what that is. Anxiety is the body’s alarm system. It tells us that something is unsafe and needs to change. But sometimes, it gets stuck in the “on” position. That means that the built-up tension didn’t get a chance to be safely released. That’s what an anxiety disorder is. And to heck with having sex while you’re on high alert! Anxiety won’t go away until your body deems it safe enough to turn off the alarm. I absolutely recommend that you treat yourself to therapy to get some relief from this. I also recommend that you concurrently practice meditation (Iyengar or Hatha- the body-based ones), yoga, swimming or anything else that helps you to be safely in your body. If you feel safe really getting at the sexual component, notice what arises when you masturbate or try to. The reasons “why not” will arise very quickly! But stay present with your body’s sensations. The more embodied you can be, the more you can track about what’s happening and understand what’s needed. This is just like noticing that you’re hungry, and then eating some healthy food that will satiate you. Learning to get more embodied will begin to restore some nice flow, which will give you back your typical energy (and sex drive).

Thanks for doing the AMA. Very professional, straightforward and fascinating to read! Is there a common theme with many of your clients, such as needing better nutrition (and/or exercise) for improved sexual health? Or is it moreso mental than physical? (Even more spiritual than mental/physical?)

You’re very welcome, and thank you!

Nutrition and exercise are definitely very important components of somatic work and sexuality, and I do make that a significant portion of most clients’ work. Someone dealing with a lot of anxiety, for instance, won’t be able to do much good work in therapy if they’re drinking many cups of coffee every day. It would be next to impossible to help their nervous system find homeostasis if we were up against a daily input of something that does the opposite of that.

I appreciate that you’re bringing up the spiritual component, because there’s this sort of trifecta in therapy of balancing sensations, emotions and thoughts. You could also think of it as body, mind, and spirit. The “spirit” (whatever that means to you) component can often get missed, but is important to explore, because it tells us something about a person’s locus of control. This in itself must be balanced, because if it’s too far inside oneself, dealing with the external world will always be frustrating. And if it’s too far outside (and this is where you sometimes hear people being accused of “spiritual bypass”) then the person won’t do enough for themselves, which can be scary, angering, depressing, etc.

Different people are in different places with all of these things, but most often, people begin therapy in need of some re-training on how to feel sensations and emotions. I think that this is largely due to how often we are encouraged to disconnect from these things. So when I ask, “What are you feeling?” it can be a struggle for many people to not give me a thought in response. But a huge portion of somatic sex therapy is about connecting to base input, which begins with sensation. One’s sense of smell is always a great example. We finally got some rain here in Los Angeles last night, and today I can smell (sensation) the wet sage outside. I feel warm and nostalgic (emotions) when I smell that, because it reminds me of my childhood (thought/meaning). Being able to connect all three is vital to the process, because if you always skip right to thoughts, you end up doing the equivalent of writing up academic papers without any research.

It’s easy enough to say, “I’m fine,” when you clearly aren’t, and somatics seeks to match the body’s expression to the mind’s. I’d say the spiritual aspect shows up in both realms.

Thanks for doing this AMA, just what I have been wanting to talk about. I am an older straight guy and a virgin. Here are my questions:

1) I can’t seem to imagine having sex with someone I am not physically attracted to. Do I have a problem?
The reason I ask this is because I see a majority of my friends on the opposite end of the spectrum and would be willing to have sex with anyone and everyone.

2) Can sexual attraction be built over time even if there is no attraction at all in the beginning? Even if I get to know someone and like them as a person, the physical attraction doesn’t seem to come with time.

3) I seem to be physically attracted to people outside my race in general which makes dating a lot harder for me. Is this normal or I am asexual or something?

1) There is definitely nothing wrong with you. Following your intuition is a good thing, especially when it comes to something so body-based. How could you not have some preferences? Having no preferences, as you’re suggesting is the case with many of your friends, is something to be concerned about. That can stem from lots of places, many of which are worrisome: dissociation, lack of confidence (I’ll take what I can get), negative beliefs about what’s possible for sexual connections, etc. And, of course, your read on them could be wrong. What’s most important is understanding that what works for them doesn’t have to work for you. Sexuality is incredibly unique. Isn’t that great?

I think the lingering thing here may be to explore how you choose your friends or what you get from them, and so on. Are you often left feeling different from them? Be curious about that.

2) This one is tricky. Yes, physical attraction can be built. Sometimes being surprised by your attraction once you get to know someone is especially pleasurable, because it means you weren’t projecting onto them. Being open to attraction arising can be very important.

But are you starting with indifference? For instance, why bother with forcing a connection if you don’t want it in the beginning? That’s a particular thing to do to yourself that I encourage you to explore.

Alternatively, if you feel indifferent to almost everyone, then we know that something is going on in your boundary between yourself and the outside world. Then it’s important to understand how that came to be. Were relationships devoid of attraction modeled for you when you were little? Did you see people hurt each other a lot in relationships? Things like that would certainly leave your system in a shut down mode. If it’s never good, why bother to connect?

That’s a lot of stuff to explore, which I definitely recommend you get support with. You’d get to see that come up with a therapist, too, and then you could explore it real-time. I know that can sound really challenging, but the payoff is so great.

3) What’s wrong with being attracted to someone outside of your race? Shoot, if you aren’t allowed to pursue the people you’re actually interested in, then of course you’re struggling to feel any sexual charge with others. Do you have structural limitations here? Like a parent who would disown you if you were in an interracial relationship? Or are you finding that population to be racist towards your ethnicity? Those are different challenges and will take you helping to create as many external changes as possible. Either scenario will need support.

All of your questions revolve around being unsure about your natural tendencies, and I’m noticing a strong feeling of wanting you to be gentler with yourself, and to trust yourself more. Maybe you’re onto something with the distrust, and that’s where having a therapist is incapable. Concurrently, I bet it would be tremendously helpful to have a regular, body-based practice. Look for an activity that requires your body knowledge, like yoga but it can be anything active. Do it regularly and listen to your body. You can also practice this with eating. Are you hungry right now? What does that feel like in your stomach? Or are you full? What do you notice about that sensation? If you’re hungry, what would you like to eat? What would feel right? Go to the store or a place where you can see lots of foods if you have a hard time coming up with things on your own. Our dynamics show up about as readily with food as they do with sex. And p.s. this assumes that you haven’t struggled with disordered eating. If you have, don’t embark on that without a therapist.

You’ll love trusting yourself more. I hope that happens for you very soon.

I lose sexual interest in all of my partners eventually. How do people continue to be sexually interested in each other once the initial spark has gone?

Some of this I spoke to above in my response to LazeeBoy2003, so you might like to read that.

Are you willing to share what typically comes up for you? Is it often around the same period of time with someone? Do you begin to feel disgust? Just disinterest? Fear? Etc. Are there similar threads of experience between partners like, “no one wants to try what I like?”

I don’t get turned on the way I used too. No matter if it’s a serious partner or a one night stand deal I just don’t physically get aroused the way I used to. What could cause this? I also have an extraordinarily hard time reaching orgasm. I am a female 22 years old. What is wrong with me?

First of all, let’s not word it as “something wrong.” Your body is clearly saying something to you, so it’s important to listen to it without putting judgment on it, which just makes it hard to hear. Consider what was happening when this first began. What was going on in your life? Did you just graduate? How did you/ do you feel about yourself and your life right now? There is almost always something that triggers a physical response like this. And then consider what’s being triggered. A button got pushed. What is that button? Why is it there? It’s best that you have the support of someone else as you look at these things.

Where you’re getting stuck as you approach orgasm (or try to) has a lot of information. Do you take a long time when you’re masturbating, too? If not, then we know that the struggle is more relational than physical. Take a look at this: and see where you end up hitting a road block. Once you know that, what to do about it will be implied. But again, it’s always best to have someone’s support with this. We can only take ourselves as far as our existing boundaries.

What do you believe is the most common misconception/myth about sex?

Ooo there are so many! I suppose the belief that there’s one healthy kind of sex is the underlying belief with most of them. But for your angry enjoyment, here are few big ones worth mentioning: -That sex means intercourse. -That it should be kept secret. (This is distinct from private.) -That you should be inherently awesome at it. -That women take longer to orgasm. (They take the same amount of time on average when their favorite spots- like the clitoris- are being directly stimulated.) -That men don’t get emotional during or about sex. -That women want it less than men. -That orgasms should be the main goal.

Ok, who’s angry? Rahr.

Thank you for doing the AMA. I find this field very interesting, and I would like to ask you some questions.

1. How did you join this profession? What type of educational background, how common are sex therapists vs. regular ones, etc.

2. What types of misconceptions are just the ~worst~ that you always have to hear when you tell people what you do? (I’m a chemist. I am often asked if I make can drugs or blow things up.)
3. Is it common/does it get frustrating to deal with issues caused by blatant sexism/toxic masculinity/expectation that partner fills gender stereotype?
4. Do you have any interesting information or commentary on the positive benefits of BDSM relationships? (oddly specific, I know – that’s what me and my fiance do, and I’m vaguely aware that it might have some beneficial qualities).

Thank you so much! And I hope that your AMA experience is a good one! 🙂

Ok, your first two I answered above. I’ll add that it’s my belief that all therapists are or should be sex therapists. It’s a somewhat redundant term, except that not all therapists have the comfort level that those of us who use the title do. But if you’re in therapy with someone you really like, test the waters. You are likely to be pleasantly surprised. I happen to find it important to invite the conversation, which is why I make it clear that I’m willing to go there. I do the same with racism, homophobia, etc. When people have dealt with pain and embarrassment around a topic or experience, they won’t automatically assume that it’s safe. I want to make it clear from the get-go that it will be safe with me if and when they feel comfortable and ready.

And to add to #2, you can see some of those here. People sometimes assume that I mean I have sex with my clients. But the term is confusing. Art therapists use art in their practice, right? I don’t mind the question. I only mind unchecked assumptions. Like your experience of having people assume that you would or could make drugs, I think what can come up is the fear of your potential power. On the whole, we tend to fear what we don’t understand.

3. This is so interesting. While I’m dealing with -isms all the time, I don’t often feel affected by a blatant display of them. That’s not usually how it shows up. When it does, I usually know why. When I don’t, it’s actually pretty simple to get down to it. I have had instances where a client angrily utters “bitches” in reference to the entire population of women. Where I go with that is to wonder, “Which bitch in particular might we be talking about? What woman hurt this person?” That stuff doesn’t come from no where.

I’ve felt a shot of adrenaline go through me maybe twice, and both times it was because something was said that was just so counter to what I feel I know to be true (both occasions that I can recall were transphobic statements). But if exploring that isn’t in the client’s best interest at the time, or they aren’t yet ready, then we don’t go there. It’s not my job to get them to agree with me or to have my own agenda for someone. If I’m distractingly bothered by something, I process it with my own therapist. There are some instances when a therapist feels they can no longer work with someone because of triggers. Fortunately, I haven’t had that experience thus far. And frankly, I love when a client’s process inspires something to happen in my own work as a client.

4. That’s a big, awesome question. The answer lies in how the BDSM play helps a person’s body to release tension, to have a freer flow, to practice new things. That isn’t always how that goes, and that doesn’t necessarily correlate to a history of abuse or trauma (I’m asked that often). Would you like an example of somatic healing in BDSM play?

so, I have noticed since I got out of an abusive relationship My sexual tendencies have gotten more extreme, not like rapey but i have gotten really into bondage and enjoy being choked, its gotten to the point where i dont care about having another relationship, because i dont think they will be down with choking out their boyfriend, did having an abusive girlfriend, break my brain into thinking this is what i want?

Good for you for extracting yourself from that. It’s entirely possible that you laid some new pathways between intense sensations and pleasure, especially if you were together for a long time or it was physically reminiscent of what you grew up around.

Because this new play came out of an abusive situation, I strongly recommend that you explore it with a therapist. But know that it’s possible you’ll end up being happy as a clam with your new found tendencies, AND you are not alone in enjoying choking. Plenty of happy, healthy people safely engage in that kind of play. Stay a little concerned about it until you know more, but know that it may be a lot more complex that “this is bad and I have to keep it secret.” We especially don’t want you avoiding needed human connections because of it.

Look for a kink or sex-positive therapist in your area, or a trained and informed coach, if your options are limited where you live.

1. What do you find to be the most common issue you provide therapy for?

2. Have you ever had to alert authorities about a client?

3. How has your profession affected your personal sex life?

1. That’s easy to answer broadly: relationships. Everyone is looking for good, safe and pleasurable connection. I find it to be really heartening. It seems like the recipe for a lot of rich connections with so many people working towards it. And I get to see that happen all the time!

The sex-specific work is almost always resolving needs with beliefs about what’s ok. There’s so much secrecy with sexuality that a lot of people simply haven’t a chance to safely explore it.

2. Yes I have, but not for anything related to sexuality.

3. Great question! I’m very big on being transparent, so I’ll have to balance that with maintaining some privacy, which is important for my clients’ work… Much of it could be summed up by something that Shar Rednour said at the Catalyst Conference last weekend: “Having education about your pleasure means a lot more pleasure.” That has definitely been true in my experience. Not only physical pleasure, but emotional pleasure and connection and depth. It’s pretty lovely.

For a little while I felt some pressure to be stellar in my sex life. You know, being a “professional” and all. But that didn’t last long. I was able to recognize it as silly after a short time. That’s just not how it works. There’s always a dynamic. Even with masturbation.

I have had flashes of someone else’s abuse pop up at inconvenient times, and that’s really hard. Self-care and solid boundaries are vital to my work, and that stuff helps a lot. But I’m also just a person, I care tremendously about my clients, and being affected is a natural reaction to horrific events.

Overall, it’s a gift not only to my sexual life, but life on general, because there are more and more things to learn and explore. I love that.

What are your thoughts on female viagra?

If you’re talking about Addyi, that’s a simple one. I’m against it. It’s not a “simple” drug like Viagra, which is limited to assisting with arousal. Addyi affects the nervous system like an antidepressant. I’m not against any use of medication, but an attempt to artificially boost the libido is a different matter. Low desire is there for a reason, and defenses should be honored and explored, not plowed through. When you find the source of the struggle, you know what to do instead to free a person up to feel desire once more.

What advice would you give to someone in a long term, loving relationship, where the partners aren’t able to meet all of each other’s desires? My SO regularly comments about essentially needing a surrogate for my desires she wants no part of, but is that really even an option or is it destined to screw with our relationship? Alternatively, can I alter my desires to be more suitable? I have a strong tendency towards BDSM. While almost everything else about the relationship is perfect, she has no real interest and our sex life is unfortunately affected.

I second that reading that book [The Ethical Slut], as well as doing some couples work before you try to open your relationship at all.

But before that, how much have the two of you done to understand each others’ desires? Do you know what bothers her about some of the things you’d like to do. We so often assume we know why someone likes or dislikes something, but we’re often wrong when it comes to fantasies! And more often than not, I’ve seen couples come to not only an understanding, but even appreciation and excitement about their partner’s unique desires. It can really expand your sexual repertoire!

Likewise, you may be able to shift some of what you want to do. I don’t mean stifling desires or pretending that they’re being met, and it’s possible that you’ll decide not to pursue certain things for the sake of your relationship. But if you understand deeply your motivations for a particular type of sex play, then you might find that there are several ways to get those same sensations and emotions. BDSM play is a wide spectrum. I think you’re likely to find a way that works for both of you. In the meantime, be patient with her process. She’s uncomfortable for a reason, and you’re more likely to get what you want if you support that.

Here’s an article I wrote about sharing fantasies: You might also like my guide to BDSM, which you can also find on my blog. Good luck! I hope you two have some great new experiences ahead!

My wife has negative feelings about sex as a result of an ex who made her feel used and emotionally abused. Outside of going to see a sex therapist, what can I do for her? She tends to recoil or become withdrawn when I suggest new and very tame things. She’s only comfortable when she is the one making suggestions. Sex becomes a one sided conversation.

I most highly recommend therapy for this. If she won’t go for individual work, encourage her to go for couples work, reminding her that you’ll be right there the entire time. Be patient and encouraging. Sexual abuse (and emotional sexual abuse goes in the same category) is one of the toughest things from which to heal.

Concurrently with therapy, or while you’re in the process of getting in the door, read “Healing Sex” by Staci Haines. Read it together, if possible. It will be important that you are very informed about this so that together you can move past it.

What you’re speaking to in regards to who initiates is a clear example of her sense of danger. If she initiates the suggestions, she has control, and therefore safety. Work to not take that personally. It’s simply that her body was trained to be on alert. It will take retraining through practice, with the support of a professional, for her nervous system to re-stabilize. What you can take personally, and what feels wonderful, is being the person to show her how safe and beautiful sex can be. So keep doing your part to prove that.

Don’t be afraid to express your frustration, but do work to keep it a mutual frustration, remembering that she’s frustrated, too. Keep it a clean venting- out of the realm of blame or shame. Be in this together- both your experiences matter.

It seems like through the years sexual taboos have been broken down. How far do you think this will go? Thanks!

I think you’re absolutely right, and I believe that that’s almost entirely wonderful. I suspect that it will continue to oscillate, especially generation to generation, with a steady trend towards increased comfort with sexuality as a topic and exploration. And I betcha sex education will become more integrated in schools in the next couple of decades.

What is your stance on pornography and masturbation?

I definitely want anyone interested in this topic to read this stellar article from Leandra Vane, the Unlaced Librarian: She’s one of my very favorite sex bloggers, and she’s had a bunch of personal and professional experience exploring the complexities of the pornographic landscape.

Ultimately it’s up to the person or the couple to decide what’s best for them, but I am pro-porn on the whole. But I believe very strongly that one should be responsible about what kind of porn they choose (my recommendations can be found here:, and to monitor their relationship to it. Because of how good we are at forming new neural pathways and muscular patterns in response to repetitive behavior, it’s vital to be mindful of what makes up your rituals. This applies to anything from what you eat to who you surround yourself with. Sex and orgasms are especially potent experiences- so much so that they cause a release of hormones! The oxytocin and vasopressin (for males) that’s released support a bonding process, so putting it simply: you’ll bond with whatever you orgasm to.

Keeping your choices and patterns conscious also helps to avoid things like masturbating to porn instead of initiating sex with your partner (assuming they’re safe, willing, etc.). Watching porn is very emotionally safe. It’s just you and the screen. That doesn’t make it not ok. That’s part of what makes it so lovely. But that too is something to track, as it can make the vulnerability of partner sex or even the solitude of masturbating without porn become less and less appealing.

You also want to be mindful, or as somatics guru Marjorie Rand puts it: “bodyful,” of remaining in your body as you masturbate. If you focus too heavily on thoughts or visuals to get you off, it can be difficult to go without them. That can get to be a real bummer and an upsetting barrier in partner sex. And frankly, it’s less pleasurable. Let yourself notice all the different notes of sensation: the tension, the tickling, the feeling of your breath quickening, the pulsating, all that good stuff. There’s a lot of great stuff to feel there, and porn should supplement your body’s natural orgasmic process rather than deter from it.

If you want to know any more about what I think of masturbation unrelated to porn, see my response PM_ME to above.

Is sex addiction a real thing, or just a convenient excuse for serial cheaters?

It is indeed a real thing, but let’s start by dealing with the pain that you’ve probably experienced personally. It doesn’t matter what was going on for someone else, if cheating has affected you, then it’s affected you. Nothing can negate that pain. And you certainly don’t have to prematurely forgive it or pretend that you have. But you can understand it, and sometimes that provides a lot of relief.

I’d first like to comment that I don’t really like the term “sex addiction.” It suggests that there is a normal amount of desire and sexual contact, and that’s just not quite how it works. It’s also a misnomer, because it’s not really sex that a person gets addicted to, but something about what the sex may be able to provide for them. VERY often, people who struggle with this are dealing with trouble bonding. Sex is an awesome way to bond if and when your system is capable of it. But for some people, a proper bonding and attaching experience didn’t get to happen, and now their system doesn’t really know what to do when the opportunity for it arises. They’re stuck in a sort of physical abandonment. It can feel like an empty pit or a dark void. It’s agonizing. You can imagine that a person would find any means necessary to come out of that place. Unfortunately, the sexual encounters only ever perpetuate the problem. What’s needed instead is a safe, slow, conscious bonding process with… guess who? A therapist. 😉 The healing experience is getting to have a solid, healthy, safe relationship with someone who’s present and available.

I’m so sorry that you’ve been affected by this. You know, people are pretty good at making us feel how they do. If this person is still in your life, you may find some common ground in the fact that they probably walk around constantly feeling the way they made you feel. In the meantime, don’t be afraid to be angry. Let yourself have your own mourning process with it. That too will be best supported by a therapist.

As a 22 year old virgin who’s incredibly insecure about their sexuality, how can one help both be less insecure but also less afraid and tore up about being with someone who isn’t a virgin/is much more experienced…?

Find yourself a lot of relief in the fact that you aren’t starting from zero. No one does. You know things. Movies and television aren’t entirely awful when it comes to imparting some information about sex. You can’t trust media as a reliable source, but it has most certainly given you a sense of what you might like to try. If you masturbate, all the better! And if you don’t, get cookin’. It will be important for you to know well what you like and love and really fucking love, and what you don’t like so much or absolutely hate. And that’s because each body is different, which also means that you’ll have to learn about the body of any partner you’re with anyway, and they’ll have to learn about yours. To boot, you have the maturity of a twenty-two-year-old. Imagine how much better you’ll be than a fifteen-year-old.

Check out some books and workshops on sex. Cleiss press is pretty great. If you live in a big city, find an informed sex store that offers classes (like the Pleasure Chest in Los Angeles). There are instructional videos on YouTube, but be particular about your sources. Be particular about any sources, looking for words like “sexologist,” “sex-positive,” “sex education,” “sexual wellness,” etc. Porn may also be a good resource for you, but not if watching others perform will worsen your insecurity, so judge that for yourself.

Finally, pick someone who feels really safe and warm. Ideally they’d know that it’s your first time, so that they can excitedly share the experience with you. So many people would be thrilled to be someone’s first. Find one that you’re thrilled about, too, and enjoy the heck out of it.

Have you ever worked with people who wanted to change their sexual orientation? Also, have you ever worked with people whose sexual orientation changed in the course of the therapy (in either direction)?

I don’t believe that a person can change their sexual orientation, because it’s not a choice. But I do have lots of clients who are coming out, or are trying to come out. On rare occasions I’ve had someone begin therapy in the hopes of suppressing their natural desires, but fortunately it gets very clear for them that that’s not a sustainable route. I can’t tell you what an absolute honor it is to support someone through really coming into who they always were. And those clients are some of the bravest and strongest people I’ve ever met.

In the course of my marriage (around 9 years) my libido started off very strong in the beginning years, then slowed down considerably (i guess as expected), but recently has become very strong again. Is there a biological explanation or could this be purely psychological (such as acting out defense or displacement)? I don’t see a noticeable change on the part of my wife that I could attribute this to.

There could absolutely be a physiological explanation, and you could check that out with a medical doctor. But in my experience, it’s most often something more complex than a purely physical change. Physical changes themselves are often brought on by psychological or environmental circumstances. And it wouldn’t have to be a change in your wife to which you’re responding. Has anything particularly enlivening happened in your life recently? Anything especially calming? Are you in better shape than before? Do you have more free time? Alternatively, if you feel that it’s problematically high, is there anything that may be triggering a push to bring in some new stimulation? I’m hoping that it’s a pleasurable experience, and that you’re just curious about who or what to thank.

My wife and I are recently married, and we both waited until marriage to have sex. I find that it is actually a lot of work to get me off and to get her off. The whole process, from warming her up to the end of the after glow, can take over an hour. That, coupled with the mess, really actually has turned me off the the idea of sex. What can I do to improve my attitude and desire to have sex with my wife more?

I’m sorry to hear that sex has been a bit of a disappointment thus far! What a bummer, and especially after waiting. Fortunately, this is very changeable.

First off, I suspect that you’ve been affected by untrustworthy sources (like movies, tv or porn) and their messages about sex. It’s not a quick and easy process where both people orgasm at the same time from the missionary position. It does take some warming up, and then some playing around until you find the right spots. If you don’t masturbate, I highly recommend that you start. You both need to be intimately acquainted with your body so that you can communicate all the subtleties of what you like and dislike to the other person. You can most certainly do this together, as well, but it will be important that you approach it openly and enthusiastically. You can also read books or attend workshops to learn more about tricks and techniques. I have a list of resources here: And in case you don’t know this: most women ONLY orgasm from clitoral stimulation. If a large portion of your time is being spent trying to draw out an orgasm from intercourse, then she could be getting stimulation that’s much too indirect. And remember that both of you should be doing the work. If someone gets tired, change positions. You can take turns trying oral stimulation, or for what’s often a nice little quickie, you can mutually masturbate. And mess-wise, it can be really handy to keep a clean stack of washcloths in a headboard or nightstand. Or if you’re typically ejaculating on the bedsheets, you might consider changing that up to her stomach, her thigh, your chest and stomach or anywhere that’s exciting to both of you. Ejaculate can be easily cleaned off of skin- not so much with the sheets and blankets.

But all of that speaks to physical techniques, and I’m wondering what emotional barriers might be surfacing for you. After reading all of those ideas, are you still left with similar emotions about it? If so, those are something to explore. Ideally you can do that together, but if you’d like to understand it a bit better first, then bring it up with a therapist. Sex is not an easy thing to venture into, and there is no shame in needing some support with the process. It’s so very vulnerable, and feeling that exposed can be scary, especially after you’ve already committed to them for life. So if anything like that is coming up for either of you, be patient with yourselves, and find support for your process.

I have a lot of self hate and a lack of self confidence that has caused me to fear having sex for years. I’m a 22 year old woman and I’m still a virgin, mostly because of my self hate. How common is this and how do I get over it?

I’m really sorry to hear that. Some version of self-consciousness is very common, but how you get through it is entirely dependent on what created it. Definitely find yourself a therapist that you connect with so that they can help you explore it. They’ll assist you in looking at the messages you received about yourself as you grew up, and help you to sort through everything. You have to have another person for this process, because the intensity of self-hatred is definitely keeping you from seeing things clearly. It can become too much a part of your identity. And for that, another person is required to be in the room with you to guide you back to seeing the awesome person that is you underneath all the junk sitting on top of it. Use the search engine on or to find someone you like the looks of. And don’t you dare let money hinder you. There are always low fee therapists and clinics. A friend of mine pays $12 a session for his totally badass therapist.

You may also like to read my response to mcflyjr above in regards to virginity.

Premature ejaculation….? How can I change this?

There’s a term I don’t care for, because who says what’s premature? Apparently that’s when your body is ready to ejaculate, so be kind and patient with yourself.

And let’s first knock out a couple of things. How quick is quick? I’ve had too many men think that not lasting beyond twenty minutes (even forty-five minutes in one case) meant that they were ejaculating prematurely. The average length of time from insertion to ejaculation is three to five minutes. So maybe you don’t need to sweat it so much. But ultimately, the issue is that you’d like to last longer. And even if you’re dissatisfied with twenty minutes, that’s changeable.

I also want to make sure that you know that if you’re simply finishing before your partner does, that’s very common. With vaginal or anal sex, it’s either impossible or simply takes longer for the receiver to orgasm.

But again, you can absolutely do some work to exercise more and longer containment. First you must rule out physical causes, like inflammation or hormonal imbalances. If that’s actually what’s going on, you won’t see any change without medical treatment. Psychosomatically, almost always what’s happening in the body with what we call PE is that charge is unable to be contained. It’s like having too small a balloon for the amount of air you want to fill it with.

What you do is practice expanding the container, which means working with your pelvis. (Again, don’t do any of these until you’ve had a check up.) You can lightly massage your inguinal (groin) area, your sacrum, and your buttocks. You can also practice a pelvic rock. Standing up with your knees bent, inhale and rock your pelvis back so that your back is arched. With your exhale, rotate your hips forward. You should notice your neck moving back on the inhale and forward on the exhale. Practice this back and forth motion many times through. An IBP (Intergrative Body Psychotherapy( therapist can support you with this if any emotions arise, as they likely will. And I don’t mean just the emotion of feeling like a goofball for doing this nutty pelvic rock. As you release the physical tension, you are likely to see a resurfacing of the reason you were bracing in the first place.

Breathing exercises and yoga are incredibly helpful for this, as well. Be particular about the yoga though, and stick to the heavily embodied types, like Iyengar or Hatha.

Do your clients ever hit on you?

I’ve never experienced anything that I’d call being hit on. I have had clients develop romantic feelings for me, which is very normal and common in therapy. The entire space is focused on you, and the whole point is for you to feel like exactly who you are. That is a very appealing experience, so of course romantic feelings can come up. But those feelings are processed just like any others that arise in the room, and frankly, it can be very useful. This is especially true for people who have never had a healthy relationship. Within the boundaries of our professional relationship, they get to practice what it’s like to have a really good, strong, safe connection.

I’ve never experienced anything that I’d call being hit on. I have had clients develop feelings for me, which is very normal and common in therapy. The entire space is focused on you, and the whole point is for you to feel like exactly who you are. That is a very appealing experience, so of course romantic feelings can come up. But those feelings are processed just like any others that arise in the room, and frankly, it can be very useful. This is especially true for people who have never had a healthy relationship. Within the boundaries of our professional relationship, they get to practice what it’s like to have a really good, strong, safe connection.

I’ve been in a relationship with my SO for over 4 months. We are sexually active, however she has been very shy in showing me her body. She would need the room to be completely dark and she is always hiding under the blanket.

I don’t think its because she is shy and I’m not pressuring her to do anything she doesn’t want; but i just thought it is a bit weird.

Is there anything that I could do that would make her more comfortable being naked?

Well unless she’s just cold or something like that, then I’d say she probably is shy. And it’s probably not weird, because it happens for a reason. Most likely there’s something that she’s uncomfortable with having seen, and that could be something physical, but it could also be something more emotional. Sex is so vulnerable, and it creates in many people a desire to hide a little bit. It’s wonderful that you aren’t pressuring her, and because it sounds like you’re approaching it safely and gently, you can probably invite her to practice incrementally showing you a little more at a time. You could even make it really sweet and flirty like, “How just this toe?” and then go on to give her a smooch or two along with some positive feedback. It will matter that she feels safe as this is happening. And it may end up being very important that she share the content of what happened to create this bashfulness in the first place. Be patient and kind- she may not know herself. But whatever it was, if you continue to show her how lovely it can be to be naked and visible, she’ll likely grow to feel very comfortable with it. I’m glad she has your support for this!

I am going through a dry spell for around 4 years (I’m a mal 31 old right now) and I don’t think I have a big problem with it, but I guess that it is not normal to not have sex at this age, and I’m more worried about that I don’t have a real problem with my dry spell (read: I don’t care that I don’t have any sexual relationship with someone). Can this be normal?

Well number one, there is no normal when it comes to your sexuality. I think it’s smart to be curious about your dry spell, but it could indeed just be an ebb and flow of your desire. In order to explore it, look at what was going on about four years ago. Have you been depressed? Did you just have a break up? Did you get a new job? Did you experience an illness? Did you put on some weight? Did someone close to you die, or did you see someone else lose a significant other? More broadly: why might it be good to not be very close to anyone right now? Very often things like this are set off by an event or series of events. It probably makes sense to your body. Do some self-reflecting and keep an eye on it. You may very well want to explore it with a therapist at some point.

How do you deal with anti-depressants and the frustrating side effects of other psych drugs. Are there any ways to help aid libido a bit? Other than bupropion I don’t know of anything that’s been helpful for people. An answer applying to both genders would be best.

There definitely are! And I don’t think there is an answer that’s gender-specific.

Begin with making sure that you’re tackling the reasons why you’re on anti-depressants. For most people, these meds serve to get you back to a level of functioning that allows you to do the deeper work that will heal your depression. If you’re struggling with bi-polar or borderline, then it may be useful to stay on them longer, as the healing process is longer. But regardless, I highly encourage you to focus most heavily on healing those underlying causes, if you aren’t already. Depression, possibly more than any other affliction, fools people into believing that it’s endless. That is part of the affliction. It’s this gnarly, depression alternator. But depression is very treatable. And of course, always be consulting with a pro-therapy psychiatrist along the way; never make a change without her or his approval.

I can talk to you about the somatics aspect of how to aid libido. Have the support of a therapist for this, because it can be very difficult to get going on new practices, and emotions can be triggered along the way.

If you’re aiming to boost your libido for partner sex, make that you feel safe with and are excited by who you’re with. Your body won’t be able to build on something that isn’t there.

The key is to be fully in your body, and to physically build charge. Being embodied means being able to feel your sensations, including the subtle, and to be able to track changes over time. Most depression medication, Bupropion included, can sort of split you off from sensation. That’s part of why they can leave you feeling kind of meh. They just kinda screen your feelings (hence the feelings just waiting around for you to address them). So get really good at being in your body. Yoga (Iyengar or Hatha) and mindfulness meditations are excellent for this. The breathing videos found on Dr. Marjorie Rand’s Facebook page ( are also extremely effective, but be careful with these. Breathing is directly related to emotion. A change in one creates a change in the other, and you will very likely need somewhere to process the emotions that arise. Be patient and go slowly. It’s ok if it takes months or years. Starting the process drastically shortens the struggle. You might want to read my article on re-emboyding here:

Once you’re good and settled in your body, it will be time to work on building charge. This can happen in many different ways. Getting regular cardio exercise is vital, so ensure that you’re getting at least ten minutes at a time three or more times per week. Yoga is awesome for helping to build charge, but bear in mind that it doesn’t count as cardio. You can also do the pelvic rock: standing up with your knees bent, inhale and rock your pelvis back until your back is arched. With your exhale, rotate your hips forward. You should notice your neck moving back on the inhale and forward on the exhale. Practice this back and forth motion for several minutes. You should feel charge, and it should become a bit tiring. If you feel much discomfort or start to check out, this is something to bring up with your therapist.

You can also build charge with your favorite things. Apply those embodiment and breathing practices to your favorite settings. They don’t have to be energetic ones. Even reading has a texture and smell. The really cool thing about all of this is that it means practicing a whole lot of things that feel awesome. The unpleasant will pop up along the way, as they should. But you’re gonna get great at feeling pleasure. Not the worst homework, hmm?

 Having no interest at making love with any girls, means that he is a gay?

Not at all. That’s only one of many possibilities from a more complex sexual orientation to anxiety to depression. Would you like to give me a few more details?

I’m with my girlfriend for about half a year now, and I really love her an think she’s really sexy and turns me on, but we managed only once or twice to have sex.

I had a hard time (haha) to get hard or stay hard. It never happened before, never with previous partners or while masturbating. I have the feeling it’s because of fear or something, that I’ll dissapoint her or something, because she had way more sexual partners than me. Is there anything I can do, to tell my lower half of the body, that I really want to do it with her?

First off, it’s wonderful that you’ve got a lot of attraction here with which to work.. It is actually something that people sometimes overlook as part of the struggle, because some folks are used to not liking who they’re with.

I’m sure your intuition is right there the cause is a fear. Sexual ability does not increase with more partners. You both have to get to know each other’s preferences, so this is as new for her as it is for you. But this may run deeper than a surface-level belief, so keep an eye out for what in you may be getting triggered by this, because it’ll keep popping up different places if you don’t address it directly.

What might bring you some rapid change is practicing getting really good and calm before sex. It’s counter-intuitive, but while sexual excitation is exactly that- an excited state- it’s crucial that your muscles are going from relaxed to excited, not from tense to excited. Practice breathing slowly and deeply, working on relaxing all of your muscles (not just your lower half) as you breathe. Do this for at least two minutes. If you don’t yet have the level of comfort to do this in front of her, then do it in the bathroom before you initiate sex. When that fear sneaks in, work that meditation magic on it of acknowledging the fear and then letting it drift off. Re-focus on your breath, and feeling relaxation in your muscles. Again, you may see the reason for your constriction surface when you practice relaxation, so have the support of a therapist at the ready.

Finally, don’t forget that there are alllll kinds of things that you can do during sex that don’t involve an erection. It’s perfectly ok to be flacid in front of her for the entire show. This doesn’t have to mean that the focus is purely on her pleasure, either. You have lots of erogenous zones aside from the pelvis. Tell her about them or find them together.

Happy relaxed sexy time!

Have you ever had to turn away a patient based on an inability to help them?

I have had to do that, but next to never, and it was because my practice private setting was not the level of care that they needed. I’d like to say a little more to impart a few things to you, but I can’t think of a way to do that and still maintain full confidentiality. But I do want to to say that it is always an awful experience. The therapist-client relationship is such a strong and special bond (or should be!), and it feels very sad and very odd to have to end that.

I’m a 19 year old male in a long relationship to a girl I love her and I find her massively sexually attractive we are also sexually active, problem is I have lots of homosexual thoughts, dreams and fantasies again I still do consider my girlfriend attractive and am definitely attracted to her what’s wrong with me am I straight and horny?, bi, or am I gay, I consider myself straight but I feel these aren’t things straight people do .

You are definitely going to have to answer those questions for yourself, because you ultimately know best. But you must feel safe and open in order to hear the answer from your intuition. If it thinks its answers will be met with judgment, then it’s going to stay very tight-lipped! But any judgments that are there won’t just blink away. I’ll try to get at one in a moment, and you watch and see how you don’t fully believe me. 😉 Bring those things up with a therapist so that you can come to your own internal shift.

Guess what? Most straight people do that. Most! I’m not talking 51% here, either. I’ll have to spare myself the extra time it would take to fetch you the percentage, but you can get Google Scholar working for you and do so yourself, if you like. Know that it is very common, and perfectly healthy.

When you learn to feel comfortable and if you and your lady are in a nice, secure relationship, you might consider sharing your thoughts and fantasies with her. It’s entirely possible that she’ll enjoy sharing them with you. Many women do! I’m sure that sounds terrifying, and she may not be into it, but just keep it in mind for down the road. When it also feels safe, the amount of understanding and connectedness you get to feel in sharing fantasies is just awesome.

Is it true sex can help with hangovers and headaches? Need to know for those ‘not in the mood’ nights.

Orgasms can indeed relieve headaches, or many other aches like menstruation cramps, because they trigger a release and subsequent muscle relaxation. However, the build up of charge during sex can sometimes worsen a headache, because it’s an increase in tension. I can’t speak to the non-headache aspects of hangovers, but my hunch is no to that one.

“Not in the mood” nights are a different matter. If you’re talking about yourself, then do some checking in: your body will tell you if feeling unwell is purely physical or if it’s a way to avoid intimacy. It can also be a combination. Honor whatever you find. And if you’re talking about your partner’s “not in the mood” nights, then you REALLY have to do some honoring. You can warmly and gently encourage them to do this check-in themselves if you suspect that something emotional is going on. But you won’t get anywhere good with trying to sell an unwilling partner on the benefits of orgastic tension release. An unwilling partner means a partner who needs some things to be addressed before sex can be safely enjoyed.

Did you see The Sessions with Helen Hunt where she plays a sex therapist who has sex with her clients? Is that something you support?

Spoilers to follow!

I just saw that pretty recently, actually! I liked it a lot overall. And I do support surrogacy in some cases. The client in the film is pretty much the easiest example, but there are many people who find it to be a wonderful and healing way to explore their sexuality and/ or heal something. I haven’t yet referred a client to a surrogate, but I can imagine that happening at some point. That’s partially to say that I think the useful occasions are fairly rare. Sex just IS scary, because the amount of vulnerability involved is very intense. That comes up with surrogates, too, as we see in the film. So I think that it takes a very unique set of circumstances to make it more valuable than it is risky.

That said, it’s possible that my beliefs are greatly affected by the fact that I know viscerally that I wouldn’t be able to be a client of sexual surrogacy. I have trusted colleagues that believe very strongly in it, so I’m staying open to finding blindspots I may have with it. I think the idea of sexual education including sexual contact makes a lot of sense (check out the deep history of prostitution, for instance), so I haven’t quite been able to resolve that with my hesitancy to suggest it to clients.

There’s one thing I’d like to note about the film, which is regarding the breached confidentiality when the therapist’s husband reads the client’s letter. We keep all kinds of precautions (locks and more locks and codes and P.O. boxes and encryption and code words and fake names and cryptexes) in place to protect against such things, and what happened was a major ethical mistake. So please know that that is very rare, and most therapists would be horrified by that. She was pretty horrified, but I wasn’t sure she didn’t have a role in it by perhaps giving out her home address.

Lastly, but perhaps most importantly… one of my FAVORITE things about “The Sessions” is that it’s a rare case of the therapist-client relationship being portrayed very realistically. It’s sort of too bad that it happened to be a relationship that includes sex, because I think it could accidentally perpetuate the notion that a high percentage of therapeutic relationships become sexual. That said, it’s obviously very important that they got that part right in a movie that’s spreading awareness about such a misunderstood practice.

Heather, Thanks for your AMA. I’m posting on a throw away account as i am worried about revealing too much personal information.

I’m a 23yo Male, I’ve been in a happy and loving relationship with my SO, 22yo Female for the past 3 and a half years. Over this time we have tried many fetishes and explored sex in a fun and loving way.

We have discovered many things we have liked, didn’t like, only liked after the 3rd time and also things that could go on the ‘maybe in the future’ list. I feel that i have been the driving force for this exploration, and that my partner would have otherwise been happy keeping it somewhat vanilla.

Here comes the problem; Recently i have found my self wanting to try more extreme fetishes. I cant think of a fetish that i wouldn’t enjoy. I seem to have a fetish, for fetishes! I feel like, I’m only 23, I shouldn’t have tried almost everything that Ann Summers can sell. I shouldn’t have tried almost every category of pornography on the casual sex website already. The only things we have not tried are what involve a third or fourth person, Or another knowing of what we do. Couples in previous questions who struggled to be sexually open were told about a website called I feel like i could put the list to shame.

My desire to try more and more extreme fetishes worries me. Sex toys and Golden showers don’t feel satisfying anymore. I strongly desire to have sex with other people, or with multiple people whilst my partner is adamant that she does not want this.

I’m not promiscuous in nature, i don’t desire to cheat on my partner however I feel that this addiction is driving me away from her. What can i do? How can i stop wanting this? Am i normal? Is this relationship, or my current definition of what a monogamous relationship is the issue?

I’m going to assume that you aren’t experiencing a physical manifestation of a desire to break up with your girlfriend. If reading that piques your interest, then definitely explore that possibility. But my intuition is that you may not be fully present for the exciting new experiences that you’ve been having, which would leave you not fully satisfied. It sounds like you have a very supportive and explorative partner, so I’d first recommend that you practice having some of your favorite kinds of sex with her, focusing on as many subtleties of sensation as you possibly can. If you truly are enjoying these different types of sex play, they should leave you pretty satisfied. And many of the same ones should be drawing you back in. That brings me to a major point about novelty.

Novelty, especially in sex, creates instant sensations. It’s almost completely unavoidable. But staying outwardly focused for stimulation can cause a sort of dependence on external forces. It’s very important that you can get yourself excited with little to no external stimulation. That doesn’t mean you aren’t supposed to enjoy those stimuli; you simply want to avoid dependence on them.

So find a physical practice- yoga or mindfulness meditation is great, but you can also use sports, swimming, etc.- and get really, really good at noticing all the sensations you have while engaging in it. I also recommend that you get really good at a quiet sitting practice, like meditation, journaling, drawing, etc. Since it sounds like you’re pretty well trained to depend on the next new thing, be very patient and stay dedicated. You will need to do some re-patterning, and that takes time. And don’t worry, as the end goal is not to get back to total simplicity or vanilla sex. It’s simply to keep you in that natural and elegant command of your own body, and for you to have more satisfaction all the while.

Hi, i was wondering how your profession has affected you. Has it been a burden on you and your relationships or has it been a positive aspect. I could see it making you analyze everything your partner is doing and changing things about yourself. Is it hard to separate work from home? Were you happier before or is it at the same level?

I definitely get why you’re asking, and I’ll tell you what. This is not an “ignorance was bliss” sort of situation, nor is the work about analyzing.

My role is to notice things and get curious about them. With clients, I name those things and we explore them together. In my personal life, it’s not my role, so I will only name things in so far as they affect me, if I’m asked, or if a situation really calls for speaking up. The way that you’re using the word “analyzing” suggests that it’s about me sort of making things up and figuring them out in my head. But the client is always the source of the information- not my brain. When knowledge about a person does come from me, it’s based on insight and intuition. That’s a much more body-based source than analysis suggests. It’s sort of like map-making on the spot as I’m escorted through a landscape.

It’s sometimes hard to separate work from home, but rarely in a troublesome way. I’ll still be thinking and feeling about something when I arrive home, or I’ll be reminded of a client in some way. And by no means are the reminders a wholly unpleasant experience. Of course I sometimes think of something that makes me angry or sad for someone, but most often it’s things like seeing their favorite food, thinking of a joke they made, or seeing some parallel between an experience they had and whatever I’m experiencing in the moment. And I dream about clients fairly regularly. Mostly I find that to be a useful source of information of my thoughts and feelings about them. If something is heavily on my mind or weighing me down, I have different rituals to help me shift out of that space. I think I’m pretty kickass at self-care, and that’s a very important aspect of being a therapist.

There are three things that I’ve seen change a bit over the course of my education and career. One of them is pretty funny. During grad school, my soccer skills took a bit of a dive by my being too aware of the people on the field. I’d find myself standing next to an opponent when the ball was across the field, and I’d want to ask how they’re doing! It would take me out of my focus on the game. Not so useful in sports. But that didn’t last too long. It was just overuse of the skill of being open and mindful.

Similarly, I can’t tolerate much violence in the films or television shows that I watch. The openness and awareness of this work makes the horror and trauma of such things very clear. This is common amongst empathetic folks, actually. I was a little self-conscious about this for a while, because some people will accuse you of being too sensitive. But I’ve come to realize that it’s a pretty darn good thing. It’s natural to react to violence with horror and disgust.

Last, and this is the biggest one, I have become more conscious of who I have in my life. My social circle is made up of a lot of really wonderful, insightful, kind and aware people. Not all of them are in therapy, but many are and all of them have a lot of emotional intelligence. That’s become even more important to me than it was before. Not having people like that around me is where I can imagine feeling something like a burden of knowledge.

The thing is, the more you learn about yourself, the more bliss you find. It’s not as though that information weren’t there and affecting you already, so it’s a real gift to become conscious of it. It’s not always a pleasant or easy process, but it pays off big time, because it leads to getting your needs met in healthy and fun ways. I am definitely happier as the result of being both a practioner and client of therapy.

Hi there,

I’ve had numerous relationships in the past and have never had a problem with getting it up on those occasions. However, if I’ve just met someone and we’re about to have a quick fling I’m perfectly comfortable doing all of the fore play stuff but as soon as it comes to sex I lose wood. What can I do to prevent this? Thanks.

That sounds like your body’s natural way of letting you know that it needs a little more emotional comfort before it’s ready to be physically inside another person. I mean, that’s pretty intimate and vulnerable stuff. And being in a relationship can (or should) bring a sense of safety and containment. It’s cozy. That makes it easier to relax and just let things flow. And bear in mind that an erection first requires relaxed muscles, not tense ones. Keep yourself calm and relaxed alongside your excitation during the beginning stages of sex. But also consider that flings may not be for you right now. Maybe they just aren’t for you at all, or maybe you just have something to address before you can be freed up for that. Get curious about what your body is saying to you about this, and allow your thoughts to assimilate to this new information.

Hi, thanks for this ama, how can a male virgin in his early 20s deal with the sexual frustration resulting from this fact other than masturbating?

What is your social group like? Do you have any best or close friends? Is there an object of your romantic and sexual desire right now?

Follow up: I am not the kind of person to have a lot of friends, but I have some small groups of friends in my home province and in university and in the activities I do, but I have very few really close friends.
I do have a best friend, a girl I’ve been best friends with since we were 6, we always rely on each other and she is the best friend you could imagine, and has been there for me in the hardest moments of my life, when I’ve felt the loneliest or worst, or when I’ve had problems. She always listens me, worries about me and helps me.
Despite how much I have come to rely on her, I had never in all of these years, fallen for her until last month.
I don’t know what to do about that, because I know she would never like me, believing otherwise would be plain delusion, plus she has a boyfriend, so I have to forget that whole train of thought.
But I can’t be friends with her anymore, because it is too painful for me seeing her with another dude , or her telling me how attractive she finds some guy, and I think back to all the things like that she has told me or merely to the fact that she has been able to have a great sexual and social life, I look in the mirror, and I think about how miserably I’ve failed in that throughout my whole life and I feel subhuman.
So I’ve just hid and stopped talking to her, which is not hard to pull off since we live 2000 km away because of our studies, and I feel guilty, because she has done nothing wrong, and I know I am hurting her, she relies on me a lot too, she tells me many things and we talk a lot, from her point of view it must look like I’m abandoning her for no reason, and she doesn’t deserve that, but my only other option is to tell her how I feel and ask her never to talk to me again. I don’t feel I can do that.
So I guess I don’t have a best friend anymore either way.
I don’t know if my whole answer was relevant, but thanks for your time, I really really appreciate it.

I’m betting you that the frustration you’re feeling is way more about her and what you feel about yourself than it is being a virgin, though you can read my other responses about virginity to get some support with that. Of course you’re frustrated right now. That is one heck of a painful situation to be in.

Feeling subhuman points to something much deeper than your current situation, so I encourage you to find yourself a therapist with whom you really click. It will be important to better understand yourself, how you’re going about getting needs met, and who you are choosing to attempt that with. You will find a lot of relief there, I assure you.

Regarding your friend, I believe it’s important that you share your feelings with her. You don’t have to put them in the form of a request, or to even have much more contact for now. She’s obviously tremendously important to you, and you to her, and I think that you both deserve to keep your connection. And while it will be awkward and painful, you will probably be able to move through it together. And then it will be far less unpleasant. It may even draw you closer.

I’ll openly admit this. I haven’t had sex in 5 years…yet I still have sexual urges….I’m not shy. I know how to talk to women. I’m actually very attractive (just telling the truth). What’s wrong with me? Am I a “sexual anorexic”? It’s come to the point that I’m actually afraid to kinda sorta be intimate with a women because I feel like I don’t know what to do anymore because it’s been so long…I’m googling articles how to kiss for God’s sake. I never was molested as a kid. I think my issue is that I’ve just grown weary of just “casual sex”….However, even a normal person who has grown weary of Casual sex doesn’t have a 5 year drought like myself. I do have “high standards” but nothing unrealistic……for instance, I’m not looking for a supermodel…….I just need to actually feel something for a woman these days rather just “bang a girl because she’s hot” like when I was in my 20’s (i’m 37 now btw)….sadly, I need that “emotional attraction” as well. Also, I don’t use internet porn so it’s not like i’m using the internet to compensate.

EDIT: one other thing I wanted to ask (and I’ll be using frank language here)

when I am intimate again with someone how do I explain to them that I may cum too fast because “it’s been a while”?

Thank you for sharing so much. That’s actually a form of practicing what I’m about to suggest!

It sounds pretty apparent that it’s time for you to experience a deeper relationship. Is it sad to need an emotional attraction as well? When and where did you learn that? I mean it, be curious about why that’s a belief you hold, because you’re going to encounter that belief system over and over as you practice being vulnerable with others. What you’re describing is a perfect beyond perfect struggle to explore with a therapist. Find someone you really click with. You get to practice that deeper emotional intimacy with them, and it’ll be in a nice safe container where sex will never be a concern.

Be really kind with yourself about all of this, because your body is responding to a very real concern. Be patient with your re-patterning. And remember that wanting a deep connection with a partner before, during and after sex is healthy and good and normal and lovely. Keep that at the forefront of your mind as you move through your process.

What do you think of nofap?

I don’t know what their practices are like, so my answer will be pretty limited. I know that they aren’t therapists, which causes a little alarm bell to go off. I’m also unsure where they stand on porn when it’s not being abused. But they do seem to be after something good and freeing rather than a boxing-in (like the Masturbation is Bad folk). I’m guessing that it’s probably an effective structure and support system for people who are distressed or encountering addictive patterns. If you know more and would like to ask me something about a specific practice of theirs, feel free to say more.

Is your profession often suspected to be a front for prostitution?

You’re the first! I understand that the term “sex therapy” can create a misunderstanding, and sometimes people think I mean sexual surrogacy, but that doesn’t happen much and has never happened in person.

Same commenter: That’s great, I guessed that’s what would keep people who need help away and attract others.

Absolutely. But people usually know what it means, or they simply come to me for therapy, and find out later that my specialty is somatics and sex therapy. Then they know that they can bring those things up if they want to.

My boyfriend and I take meds for our respective mental illnesses. My meds occasionally affect my libido while his completely lowered it to the point of practically nonexistence. When we do have sex, he cums after about a minute or so. He has no interest (as far as I can see) to masturbate. He and his psychiatrist have already discussed the issue and talked about a new plan for meds.

Is there anything I can do to help our sex life while he gets adjusted to this new plan?? (Note: he has a hard time explaining feelings and emotions, for which we are seeing a counselor together, so everytime I ask him how I can help he responds with “I don’t know”)

Ooo the “I don’t know.” Let’s start there, because in addition to the nearly nonexistent libido with which he’s struggling, that says a whole bunch about what his system is dealing with right now. Both of those are major examples of being far inside oneself and possibly of being rather dissociated, too.

Couples therapy is crucial for this, so it’s awesome that you’re already doing that work. Do you talk about sex with that therapist? It can be one of the fastest ways to work. But, of course, your hubs would have to be on board for that. Sometimes a struggle with emotional expression means that sensation expression is even harder, but not always. Sometimes people are super clear on what their bodies are saying despite not translating sensations into emotions.

And do you know yet what his major sore spots are? It sounds like he’s depressed, which means that he’s taken on major or chronic burdens. Who in his past is he mad at? It will be important that you’re each clear on the others’ history, so that you can help to avoid triggers and directly help with healing. His quick orgasms could be largely related to the long build-up. But it could also mean he struggles to be that vulnerable with you for very long. He is obviously very shut down right now, so be patient, but also firm about the continued therapy. Do you already have “homework” from therapy? I’d like to give you some somatic exercises that would supplement you’re existing work.

Follow Up: We just started seeing our counselor and so far we’re working on how to communicate more effectively on his end. He has a hard time discussing emotions and feelings but has come a long way! But there’s still that barrier, hence counseling. We have an appointment next week and I do want to bring up sex this meeting because I found it’s affecting me more.

His two main sore points are work and his parents, but those have always been there. He recently went on medication for his Bipolar so we’re pretty sure it’s mostly the medication. But he and his psychiatrist are going to be slowly changing his medication starting next week. But he also really hates his job right now, so I’m wondering if the stress of that is affecting his libido as well. Which isn’t out of the realm of possibilities really.

It’s been difficult to say the least but the good news is that we do talk about it. While he’s upset about the nosedive in our sex life, he’s been as open as he can be, so yay on that end!

To answer your final question, he has homework but the counselor hasn’t given anything to me as of yet. Any exercises are most welcomed!!

Ok, since things are pretty new in your couples work and he’s still learning how to open up, there are two main things I’d suggest for now: demonstrating your own opening up, and actively making it safe for him to do the same through lots of nonverbal stuff.

Bipolar is a struggle between over-contained and under-contained (too boxed in and then too out of control), and that’s what you’re seeing in his body with sex: he doesn’t want it, and then when he does engage, it’s a quick explosion and then it’s back to contained. Whatever his homework is- particularly since the goal is for him to get more embodied and to open up- yours is to help make it safe to do so. Invite him out of that box by being open yourself. When he’s in an “I don’t know” mood, let him know that that’s totally fine, and that you’re ready to listen when he does know. And that doesn’t have to mean that you don’t share your feelings about that. It’s simply both things- you would feel more connected and safer (et cetera) knowing what he’s feeling, and it’s ok that he doesn’t yet know or feel safe enough to share. That’s helping him practice something in between over and under-contained. Nonverbal goodies can be practiced throughout. Find out if some physical contact is helpful to him when he’s feeling quiet or depressed. Or maybe it helps to just have you nearby in those moments. When he does share something, make sure you’re making eye contact, and see if he might like to hold hands when it’s happening. All of these things show how safe you are and how much you care.

I mentioned before about who he might be angry with? Keep your eye on that with him. Hating his job could definitely be impacting his libido, especially if what he usually does with hating something is to swallow back the feelings about it. THAT is depression. Find out where he learned to do that. What environment did his parents create for him? It will be important that you know what pieces were missing, and that you help create them in your home. What is he afraid will happen if he shows his anger? Was he ever invited to know himself and to express it?

The same goes for him with you. He may not be able to do much of that right now, but if you continue the process, he will be. You are clearly a very understanding partner, and that’s wonderful. Keep in mind that the focus will stay on him until he moves through this. And that’s only because that’s where your mutual energy is stuck. Continue to share your own experience throughout, and soon there will be a shift to a deeper focus on you, and then to an even deeper focus on the space between you. That’s when things get extra lovely and satisfying. Keep at it, and in the meantime, make sure you have plenty of support for yourself outside of him.

How do you think the ubiquity of porn and sexting culture has impacted sexual health in relationships? Has it made it easier for people to explore new things, or does it detract from the intimacy?

This is SUCH an important topic now. It has been for many years, because internet access and cell communication has been a breeze for kids and teens for some time now.

When it comes to porn, I think that this can be risky because porn is not educational. Unless kids are good at finding responsible porn, which most are not, they are being exposed to a very narrow and very uncommon slice of sex. A lot of porn perpetuates all kinds of negative stereotypes and misunderstandings. I believe that this makes a solid sex education even more important, because there’s now even more to unpack and shift in people’s schemas about sex.

Sexting, on the other hand, I see as just our current most popular mode of communication. It speeds up and therefore can intensify an exchange, but we’ve been sending each other dirty notes for millenia. At least those are self-created. It doesn’t concern me much in terms of leading people down dangerous information paths, but it brings me to your second question.

I think it’s both. I think that instant screen communication can cause people to get intellectually ahead of their emotions and sensations. Have you ever experienced seeing someone shortly after you had a really intense text conversation or instant messaging chat? Suddenly you’re back to the level of comfort you had before that conversation, or you even feel bashful, or you can’t remember what you normally talk about. That’s getting ahead of yourself. It can be ok to get ahead of yourself, but you have to calibrate sometimes. You might have been operating off of more projections than reality, or you may not have been embodied enough to ensure that you were comfortable with everything as it was going along. Screens are safe. They don’t actually give us the practice we need when it comes to deeper intimacy. At worst, we sometimes violate our own boundaries, causing us to later throw up defenses that make it super hard to connect. But you can always come back into a more embodied state, and it’s vital to ensure that that happens.

Sex blogger Leandra Vane wrote an awesome piece about porn, which you can access here: There’s also a beautiful chapter about it in her latest book.

Thank you so much for this AMA.

I’m struggeling with my libido, in that it seems to be non existent. Im 28/f. Im on my second marriage, and am madly in love with my husband. That being said, I cant seem to bring myself to want to have sex. I feel bad, because I know it important in relationships, and we were really really hot and heavy in the beginning. I know its all in my head, but as time passes, I could really care less on if I had sex ever again. It feels alright, somethings I really hate, but I just don’t see what the fuss is about. I dont like to masturbate, Porn wierd me out, and even when I do try to watch it, I feel really dirty/ ashamed afterwards. My husband says that part of it could be from past sexual abuse, but I can honestly say I don’t think that’s really it. I was raised that sexual things were taboo, only to be done/discussed with your husband. I was always shamed and picked on for my body, and really hate the way I look.

Is this normal? What can I do? Should I see someone?

Hi. Thank you for waiting for my response, and I’m sorry to hear that this has been a struggle. It can definitely feel sad and a little scary or even hopeless to be in such different places in terms of libido. Fortunately this is very workable, and you gave me three really important pieces of information. Let’s go relatively chronologically in terms of your life…

Growing up in a household that sees sex as taboo can be a major factor in restricting your sexual exploration. Often the intention of “only do and discuss in a marriage” is to keep things private and safe. But it can inadvertently send the message that sex is a secretive thing- that it’s not to be talked about or explored (therefore not enjoyed)- and that quickly breeds shame. Private and safe can be great things, but it’s hard to know how to explore your sexuality within yourself if you aren’t taught how or encouraged to do so.

On top of that, you’ve been shamed and picked on for your body. I’m so sorry to hear that that’s happened to you, because it’s very unfair and very painful. Your body is the container in which you live. You do everything from inside of it. To have it picked on makes it really hard to do certain things, and it’s no wonder that sex gets increasingly less interesting to you. Sex absolutely requires use of your body. If you don’t like how it looks, then it’s very difficult to be inside of it. And to have dealt with abuse alongside that is really the third strike. That’s a lot of reasons to not be in touch with your body. Abuse solidifies those pre-existing hunches that the body is unsafe. When teasing and abuse occurs over and over, you become chronically checked out. So why the heck would you want to have sex, let alone watch other people with these fantastical bodies do so?

I do think that you should see someone. And don’t be too afraid of it, because not only will it go at your pace, but it will mean more and more enjoyment for you. I don’t mean just sexual enjoyment, either. There are lots of great things to feel. Remind yourself of this throughout. Your body can be re-taught to safely experience pleasure. And fortunately you’re crazy about your hubs! That will help so much.

You can take some initial steps right now. You’ve already been trying a few things, and that’s great. But it sounds like it will be important to focus less on the strictly sexual stuff. Practicing masturbation or watching porn is probably too intense right now. Some people never like porn anyhow. Take a look at this article:, and then look into reading Healing Sex by Staci Haines, or start doing yoga. But you must have someone to check in with if you do this before you begin work with a therapist. These kinds of explorations can be very evocative, and it will be vital that you have support at the ready. Have your husband read the book with you, and have him join you for the yoga, or go with a trusted friend. And you are welcome to email me if you need help finding a good therapist in your area.

I’m so glad you wrote. Good luck to you!

What are your thoughts on the novel “fifty shades of grey?”

“Ug” more or less sums it up. It’s wonderful that it’s gotten a lot of people interested (or admitting interest) in BDSM play, but I think it’s very unfortunate that it’s such an unhealthy example of how to do it, let alone of how to be in a relationship. Here’s the article I wrote in response to it:

If i may ask i can not stop thinking of having sex with every cute girl i see. I just love beautiful women and how amazing they look. I am currently 22 year old man/boy ? who has had sex with over 80 women. Anything you suggest just reading this?


There are a couple of things to consider when you find yourself thinking about sex nonstop, and are drawn to having many partners: your satisfaction, and any struggles with intimacy.

So do some reflecting on how satisfied you are during, and especially after sex. It sounds like you’re easily aroused, and are doing something with your arousal. Those are great things, and are strengths we want you to keep. They are important foundations on which sexual satisfaction is built. So look further down the sexy time road to what’s next… Do you enjoy yourself during sex before you orgasm? Does your orgasm happen like a reflex? After you orgasm, do you feel satisfied? Can you hang out and enjoy that feeling? Do you feel an increased closeness with your partner? Do you want to have sex with them again? Perhaps most potent would be the question, What do you feel if you aren’t thinking about or having sex?

Wherever you struggle is the place to start your exploration. And that place will also point you to what could be keeping you from moving into deeper, lasting intimacy. Take a look at some information on the orgastic cycle (here’s my article on it: See if you can narrow down where along the cycle you might be plateauing or hitting a wall. Part of this exploration must include considering your relationships with who you grew up around, and what was modeled for you. Give this lots of air time. You questioningly called yourself a boy, and that is likely an arrow pointing to the past. What age do you feel when you think about this stuff? What was going on at that time? This process is definitely best supported by a therapist, so do some reading, thinking and journaling, but be ready to give someone a call, too.

It’s great that you’re asking the question. Keep curious about it, and you’ll be able to find more and more satisfaction and contentment.

Hi Heather. I’m a guy who has been dating a new partner for the past month and we recently started having sex. Sex has been great by all accounts, she is definitely not quiet and she isn’t unsatisfied with anything that I’ve been doing. After we had sex a few times, she brought me aside and told me that she has never reached orgasm through sex, be it oral, or PIV. She says she can reach orgasm via masturbation but that it’s extremely difficult for her to do so.

I told her I wanted to try to help her reach orgasm and she replied that she doesn’t think it will be possible and she doesn’t want me to focus on that when we are having sex. She insists that it’s a mental thing and that trying to focus on her reaching orgasm would interfere with the enjoyment of being in the moment us having sex. She is 31 and I’m 30 so it’s not like we are new to the game. Not trying to boast but I don’t think size is an issue, or my oral skills according to the feedback I’ve gotten.

I’m wondering if there is anything I could do to help get over her mental block, as I personally take pleasure in helping my partner reach orgasm, but I don’t want to “ruin the moment” by focusing on that too much, as she put it. Do you have any advice for this situation?

Hello! Thank you for waiting for my response, especially when you got a less-than-pleasing response from someone else. 😉

Arcticfoxtrotter (that’s a rad handle, by the way), IS indeed naming something important, but it’s not necessarily that you’re the one with the block. What they are onto is the need for your gal to feel comfortable and safe. It’s AWESOME that you want to help her to have an orgasm. Having a partner’s support with that process can be incredibly healing. And it will matter very much that that goes at a comfortable pace for her.

It’s actually entirely likely that the very focusing on the orgasm is problematic for her. It could be recreating a troublesome experience she’s had, or it’s inviting her to feel things that she isn’t yet ready to feel. It takes some major letting go to have an orgasm, and she undoubtedly has reasons to not want to do that. That doesn’t mean that those reasons are about you, or that they even ever had to do with sex. Orgasming is vulnerable. You momentarily give up any control, and it causes you to make a goofy face and collapse in funny positions. Instead of trying to coax an orgasm out of her, make the environment one that welcomes ANYTHING that happens. Take the orgasm off the table so that her body can practice being free to feel any amount of pleasure it wishes. Again, it’s lovely that you want her to have more enjoyment, but you don’t want it to be forced, or for your sake alone. And on that note, ensure her that she doesn’t need to be loud with you. Too often breathing and moaning is amped up simply because of a belief that one ought to sound that way during sex. Heavy breathing and moans are good, but only when they’re happening naturally.

Sometimes I feel like a broken record with referring to the orgastic cycle, but the fact is that it’s really important to understand it. I don’t know why it isn’t taught in high school or earlier. Take a look at this:, together if possible, and figure out where your strengths and stuck places are. If she struggles to orgasm while masturbating, then she’s probably having a difficult time with charge. A few notes on that, if you indeed believe this to be the case…

The body must be relaxed before moving into arousal. That means feeling safe, calm, not rushed, warm enough, connected enough, etc. You also want to be engaging in her favorite activities. Do you know what those are? Cunnilingus is a favorite for many women, and so are vibrators. What brings her the most excitement? She may need to do some exploring, together or through masturbation, to answer that, so do be patient there, too. But once you’re practicing those things, make sure that she is getting enough charge by ensuring that her leg muscles are engaged. This can be a really great way to build charge, but a lot of positions skip it because her legs are up in the air, wrapped around you, etc. Check in with your breathing, too. As I mentioned with making sounds, heavy breathing and moaning is good. It’s an indication of allowing things to build and flow through. You need lots of energy flowing through the body in order to get pushed over and off that ledge into orgasm.

Finally, if you have discomfort with the focus being more on you or with not providing an orgasm, do a little checking in there. Again, you don’t want her exploring this in order to please you. And it’s certainly ok for you to not bring her to orgasm. The best thing that you can do for anyone is to create the circumstances for more enjoyment. As you make space for her body to just enjoy whatever happens, you may find that you feel insecure or like you’re failing. You aren’t. Stay open and explorative. Think “Blue Lagoon” and have fun together. 😉

Have you had anyone get over their total disgust over bodily fluids?

Yes! That can sure be tough, and I feel for you if you’re experiencing that. VERY often a person who’s dealing with that has had a history of being inundated by another person. That can mean that a parent made everything about them, or was too close in some way (abusively OR not). That can create this bodily aversion to “other people’s stuff” that can show up with fluids. I’ve also seen circumstances in which someone experienced acute trauma that involved fluids, like a drowning scare, or falling into a tank of something icky at a young age. It depends entirely on the nature of the disgust, but it is always possible to repattern your body and your associations. Just take that process nice and slow. The idea is to invite the new association. If you force anything, the unpleasantness of the force becomes the new (or strengthened) negative association.

As a 19 year old virgin the pressure is starting to get to me. I’ve met plenty of nice girls at events and parties and got intimate with some of them, but I had to explain to one that I felt I wasn’t ready yet a while back. Now i’m concerned that i’m missing my opportunities or doing something wrong. I feel like I am ready for sex maybe with a partner of some sorts, but I feel like losing my v plates through casual sex is maybe the only way possible so far with no partner.

Do you think that casual sex with a partner you will possibly never see again appropriate for a first time?

I wish there were a way to say, “You’re still quite young!” without sounding like I was born an adult. But there you go. Do try to keep that in perspective. There are virgins MUCH older than you, and believe me- there’s nothing horribly wrong with them. In fact, some of the biggest advocates for the enjoyment and satisfaction of sex are people who had their first time in their thirties or forties.

That said, before you decide to go the “get it over with” route, do some more exploring of what may be making it tricky to move into having intercourse. What might be scary about getting that close? What end result most plagues you? Your answer probably lies within that. For instance, if you’re afraid that they’ll leave you after you’ve invested that much, then be curious about how you developed that belief. And then be mindful of who you’re choosing to engage with. Our fears often guide us right to the people who will prove them to be reality, because we don’t yet have the skills to do otherwise. If there’s any amount of fear about how you’ll perform, go easy on yourself. You can read books, watch videos (the educational ones please!), and go to workshops to get nice and studied up. In so many ways, sex is simply about being in your body enough to just let it do it’s thing. Our bodies have been having sex long before The Pleasure Chest opened in the 70’s. But my hunch is that it isn’t so much that as an emotion that’s making things scary. Do some exploring with that. A therapist can absolutely help you with that, and 19 is one of the most kick ass ages to be in therapy, because it means you get to launch into full on adulthood armed with so much more knowledge of yourself. That results in so much more hapiness and pleasure.

You may still seek out a one-time encounter to be your first. That can be perfectly fine, but you won’t know that until you know more about why you haven’t felt ready. It’s possible that that’s the worst scenario for you if, for instance, you’re worried that the partner you choose won’t stick around. But if you do decide on those means, be really conscious about who you chose. Preferably they would know that it’s your first time, so that they can support you through it. But whoever they are and whatever the circumstances, make sure that you feel really safe with them, so that you can relax, explore and just have fun.

Serious question: How to put on a condom on Uncircumcised penis. It’s confusing ? 🙁

Great question! If you aren’t the bearer of the penis, ask them, as many people have their own particular technique. But here’s the scoop…

Uncircumcised penises tend to need two steps that circumcised ones don’t: lube in the tip of the condom, and to have the foreskin moved back up towards the head of the penis once or twice before the condom is pushed all the way down. Check out this charming video, which includes lots of important details, including a sense of humor:

The condom you use can also make a difference. Some people prefer the kind with extra head room. Just be mindful that it still fits snuggly or it won’t be safe, and may even be painful on the receiving end.


**If you don’t see your question and response here, I either missed it or haven’t yet reposted it here. Shoot me an email if you think it’s the former.**

4 thoughts on “Autumn A.M.A.

  1. Hey, long sufferer of premature ejaculation have recently tried rubber banding and works pretty well. Not too tight but enough to slow down the rush. Opinion of physically rather than mentally stopping of finishing too fast? Afraid all other methods didn’t work

    • This was my response to Evanston on Reddit, and it answers your question. I’m thrilled that you’re interested in trying more physical things, but I highly encourage you to practice what I’ve outlined below rather than doing something forced like using a rubber band…

      There’s a term I don’t care for, because who says what’s premature? Apparently that’s when your body is ready to ejaculate, so be kind and patient with yourself.

      And let’s first knock out a couple of things. How quick is quick? I’ve had too many men think that not lasting beyond twenty minutes (even forty-five minutes in one case) meant that they were ejaculating prematurely. The average length of time from insertion to ejaculation is three to five minutes. So maybe you don’t need to sweat it so much. But ultimately, the issue is that you’d like to last longer. And even if you’re dissatisfied with twenty minutes, that’s changeable.

      I also want to make sure that you know that if you’re simply finishing before your partner does, that’s very common. With vaginal or anal sex, it’s either impossible or simply takes longer for the receiver to orgasm.

      But again, you can absolutely do some work to exercise more and longer containment. First you must rule out physical causes, like inflammation or hormonal imbalances. If that’s actually what’s going on, you won’t see any change without medical treatment. Psychosomatically, almost always what’s happening in the body with what we call PE is that charge is unable to be contained. It’s like having too small a balloon for the amount of air you want to fill it with.

      What you do is practice expanding the container, which means working with your pelvis. (Again, don’t do any of these until you’ve had a check up.) You can lightly massage your inguinal (groin) area, your sacrum, and your buttocks. You can also practice a pelvic rock. Standing up with your knees bent, inhale and rock your pelvis back so that your back is arched. With your exhale, rotate your hips forward. You should notice your neck moving back on the inhale and forward on the exhale. Practice this back and forth motion many times through. An IBP (Intergrative Body Psychotherapy( therapist can support you with this if any emotions arise, as they likely will. And I don’t mean just the emotion of feeling like a goofball for doing this nutty pelvic rock. As you release the physical tension, you are likely to see a resurfacing of the reason you were bracing in the first place.

      Breathing exercises and yoga are incredibly helpful for this, as well. Be particular about the yoga though, and stick to the heavily embodied types, like Iyengar or Hatha.

  2. Hello Ms. Brewer!

    I came across this through Reddit, thank you so much for doing this! My question was regarding something you said on Reddit actually. In your AMA post you say, “Sexuality is the best source of information about how you relate to yourself and others…”

    I was wondering if you could shed some light onto how you make that connection between sexuality and how one relates to their self and how that extends to our relations with others. Thanks again!

    • Sure! Here’s my response to someone else who asked the same question:

      What happens during masturbation versus sex is always a great vehicle for exploring this.

      Let’s say that a person masturbates daily, usually in the afternoon, and uses a vibrator (the details of how, when, why and where matter a lot). When it comes to sex with their live-in partner, maybe they initiate two or three times a week at nighttime, and they don’t bring in the vibrator. For the sake of simplicity and answering your question, let’s assume that the partner would be cool with whatever this person brings into their sex life. You can see from this that there are differences in relating to this self versus the other. In therapy, we would explore different aspects of this in order to understand the dynamic. Maybe we’d find that the person isn’t comfortable with her partner knowing that she masturbates daily, because she was taught that masturbation is unhealthy, or past partners shamed her for it, etc. Or maybe we’d find something slightly more complex, like that while her peak arousal usually happens in the afternoon, she isn’t comfortable with that amount of light when it comes to partner sex. So she’s comfortable with it in the total safety of solitude, but not with the vulnerability of being seen. Once we know we comes up, we can start to re-pattern things in such a way that allow the client to be more fully who they are naturally. Sexuality is the vehicle for exploring a person’s go-to dynamics.

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