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: http://heatherbrewermft.com/blog/?p=94 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: http://theunlacedlibrarian.blogspot.com/2015/06/10-reasons-i-include-porn-in-my-marriage.html?zx=60844f831b0c6bb1 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: http://heatherbrewermft.com/blog/?p=89), 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:http://heatherbrewermft.com/Fun_and_Useful_Resources_for_Sex.html 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 goodtherapy.org or psychologytoday.com 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.

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 (https://www.facebook.com/drmrand?fref=ts) 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: http://heatherbrewermft.com/blog/?p=470.

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 mojoupgrade.com 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.