Sexlessness

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I was recently listening to Esther Perel's podcast 'Where Should We Begin', a podcast in which each episode is a different couples therapy session. These are real sessions with real people and I absolutely recommend it for anyone who is wanting to learn about couple's issues, hear what a session looks like or are just nosy :-)

Anyway, one of the couples were coming to see Esther beacause they had no sex in their relationship. They had grown up in very traditional, religious families where sex was forbidden until marriage. However once married, sex became quite uninteresting to them both and was avoided. This is not an uncommon story, relationships where sex has become a rare chore is one of the most common reasons people come to see me.

Sometimes, sex hasnt ever been a part of the relationship due to lack of interest or medical issues, but other times sex started out enjoyable, but as time has gone on, sex is no longer a part of the couple's life. So many emotions come from this: guilt, resentment, anxiety, anger, sadness. And usually also grief. Individuals usually miss the part of themselves that enjoyed sex, that felt wanted and enjoyed wanting someone else, the fun of it and the closeness they experienced with their partner. 

It can seem so daunting to start to think about having sex again, that often it is avoided due to not knowing where or how to start. Here are 3 suggestions for dealing with sexlessness in a long-term relationship:

1. Talk about it - pick a time and space (driving in the car is often a comfortable place for both partners) and have a conversation about how you both feel about the lack of sexual contact. Focus on really listening and understanding where your partner is coming from and avoid any defensiveness about the issue. Once you are able to get an understanding of how you are both feeling, you can begin talking about what you would like to do about it. 

2. Choose a time to be intimate with one another, without any plan to have sex. Start by doing an enjoyable activity together (going for a swim, taking a walk, cooking a meal), then lie down with one another and touch each other. You dont have to touch genitals or erotic areas, it can just be massaging each others back, legs, arms. See where this leads, but without expectation. Focus on being mindful, focusing on just the present moment.

3. Book an appointment with a sex therapist - it can be really helpful to have a space where you both can come to talk about this issue and be guided with ways of increasing satisfaction within the relationship. We can talk about how you got where you are, where you would like to go and develop an action plan to get there. Having someone external to the relationship can be helpful to keep you on track and consistent. 

Have a great week! 

Kristen 

Relationships after baby

Having a baby is one of the most significant things a couple can do together. The journey through pregnancy is often exciting and full of anticipation for that first moment when you will look into your baby's eyes. Couples often report feeling well-connected through pregnancy, with so many occasions to share together, such as ultrasounds, baby showers, shopping for new bub and putting together the new bub's space. Then the day of birth arrives and again, it is often full of excitement and connection. 

But then, you have a new baby to care for and, eventually, the visitors stop providing constant distraction and offers of support. There are the countless sleepless nights - a torture that no one actually understands until they have been through it - as well as the exhaustion that simply comes from having to think about, and care for, another human being 24 hours per day, 7 days a week. There are usually differences in roles, no matter how hard you try for it to be equal. One person usually has to return to work sooner than the other. There are so many changes - financial, emotional, sexual, physical. For most couples, this is where the challenge begins. Resentment, anger, grief, despair. Unless you have some tight strategies to deal with these challenges, its enough  to lead to conflict and breakdown. I have heard from many couples who report the time after their baby is born as the most difficult time in their lives. They report constant arguing, lack of intimacy, lack of sexual touch, lack of touch in general, not wanting to spend time together and stone-walling. Research actually suggests that the first 3 years, after a baby is born, is the least satisfaction a couple will have in their relationship. 

So how can this period be made easier? Here are my top 5 tips:

1. Talk it out - this is a time when people report feeling the most isolated and that can lead to withdrawal. Don't stop talking to your partner about how you feel. In fact, make it a regular part of your day. Make a time, that suits you both EVERY day, for a check in. If you have been arguing with your partner, take time to cool down but then come back to the conversation. 

2. LISTEN - this is in capitals as I cant stress it enough. Listening to your partner is one of the most helpful things you can do for your relationship. All of us want to feel heard and validated by our partners. When I say listen, I don't mean being quiet until your partner has stopped talking and then carrying on with what you want to say. I mean actually hearing and understanding what your partner has to say - even if you don't agree with it or see things in a different way. Practice listening and telling your partner what you have heard them say, so they can see if you're understanding their perspective. 

3. Book time together - this may mean organising a baby-sitter or even booking the time for when your baby is sleeping. Do something you enjoy together. This could be playing cards or cooking a meal together, seeing a movie or visiting a museum or art gallery. This is about re-connecting as a couple. Sometimes becoming parents changes roles and its important to remember that you were partners before you became co-parents. Remember what it was that you enjoyed doing together and make time to do that. 

4. Be intimate - this doesn't necessarily mean having sex. Sometimes just laying on the bed or lounge, talking or gently touching each other is enough to 'top up the intimacy cup'. Or it could mean sex or some kind of sexual activity. A woman's body can feel very different after having a baby so it's important to take your time and explore your body, getting to know what turns it on and off. 

5. Take time for yourself - this may sound strange in an article about relationships, however self-care is actually extremely important in a healthy relationship. Our partner cannot provide all that we need, no matter how much we would like them to. You can only have enough energy for your partner, by looking after yourself. Have your partner watch the baby while you take a bath, go for a walk, see a friend. Sometimes having even half an hour to yourself, to sit in the sun and have a cup of tea, can be enough to re-charge and be able to look at things with fresh eyes. 

 

Shame & Vulnerability

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It's no secret that I am a HUGE fan of Brene Brown. She caught my attention when she gave a TED talk (see here) which went viral, putting her and her work on the map. Since then, I have read her books and listened to other talks she has, which go into much more depth about the role of shame and vulnerability in living joyful, whole-hearted lives. It got me thinking about the role of shame and vulnerability in relationships. 

Have you ever experienced a moment in a relationship where you felt incredibly vulnerable? Perhaps you have had sex for the first time after having a baby or you initiated a new sexual position? Maybe you met the in-laws or your partners friends? There are so many times in a relationship that we put our most vulnerable selves out there. So many times that we may not even be conscious of it.

Vulnerability is integral to connection, which is obviously vital in a relationship. But how was this vulnerability met? Hopefully, your vulnerability has been respected and treated as the precious thing that it is. However, I am fully aware that so many people are carrying around shame which has started from a moment in a relationship, when their vulnerability was not treated with the respect it deserves. I have heard stories where men have been laughed at when they haven't been able to get an erection. Or yelled at when they have come too soon. These moments cause a lifetime of shame, a sense of not being good enough.

Vulnerability is certainly not an easy thing to lean in to - most of us run from it as though its the most scary thing we have ever encountered. And yet, when I look back on my life, the most memorable, rewarding moments are those in which I felt excruciatingly vulnerable. Having the courage to tell a boyfriend I loved him, before he said it first. Making a new friend by being the one to initiate a coffee date. Moving to another state when I knew no one. Travelling on my own to another country. The entire process of becoming a mother. All are moments where you risk rejection and subsequent shame, and yet these are the moments that actually make life meaningful. Without them, we just skim the surface and are constantly protecting ourselves from what may be. 

The thing that has helped me the most when I feel vulnerable, is to actually recognise it and resist the urge to run away by not speaking up, leaving the situation or not being myself. Brene talks about a mantra that she uses - I have been trying it out and finding it hugely helpful. When that sense of vulnerability comes along and you have an urge to avoid, say to yourself, "don't shrink, don't puff up, just stand in your space". What that actually means is don't under-sell yourself by not talking or not telling the whole story, but also don't over-sell yourself by making yourself appear cocky. Just be you. In your honest, genuine way. 

Sex Education

One of the most common and important aspects of coming to therapy for a sexual difficulty is learning about the difficulty itself, including how it originated and what maintains it. Even more so though, quite often therapy becomes somewhat of an education about sex and over time, it is so obvious that we, as a society, have not had great sex ed. 

I'm sure we all remember those classes - my introduction to sex ed happened over two evenings when I was in Year 5 at a Catholic school, where we had to attend the school with our parents and we learnt all about puberty and pregnancy. Not quite sure how pregnancy is the most relevant thing for an 11 year old to learn about, but we went nonetheless. All I remember is sitting next to my best friend, with our parents directly behind us in the next row, and not being able to stop giggling. We were laughing so much so that we were stifling snorts and our shoulders were moving up and down erratically. Which caused our parents to start laughing also. I don't actually recall any of the content but the image of that uncontrollable laughter is etched into my memory for life. Even now, when I see that friend we have a laugh about that moment.

The other memory that stands out is in year 10 being taught how to put a condom on a banana. Mind you, nobody ever told me how to negotiate the use of the condom, either before engaging in sex or in the heat of the moment, so again, I'm not sure what the relevance of teaching how to put one on a banana was either. 

Sadly, my experiences of sex ed are not uncommon. Most people I meet, of all ages, have had some variation of these classes and they stand by the fact that, yes they learnt about STI's and contraception, but nobody ever taught them about such complex things as giving and receiving pleasure or negotiating sexual activity. Even more concerning is that there really wasn't any education about navigating consent. On a side note to that, check out this wonderful little video about consent. 

So it's no wonder that many people I see are still struggling with the idea of giving and receiving pleasure, and they seek out information from anywhere, with pornography being the most common. Now I don't know about you, but I don't really think that mainstream porn is the place to receive an education. With all the bleached anuses, perfect bodies and lack of bodily fluids (except for the famous money shot of course), it's just not representative of the real world. Not to mention the horrific gender bias. Porn is entertainment, in no different way to the latest Tom Cruise movie or the latest episode of Keeping Up With The Kardashians. It would be much more helpful to have a conversation with your friends, to hear what they are up to, however, they are likely to be in the same position as you! 

Sex therapy, therefore, is often a great place to receive sex education. We talk about pleasure, consent, intimacy, connection, exploration of sexual self, in addition to the sexual health stuff of course. We often talk about basics such as anatomy (what is what in the genital area) and encourage communication about likes and dislikes. It is a safe place, where there is no judgement on what you know or don't know, but all about getting you to a place where you feel confident and competent. Have a think about your sex education and if you would like to know more, feel free to contact me for an appointment in either Shellharbour or Nowra. 

Intimacy and Sexual Desire

Many people ask me what the most common sexual difficulty is. Without a doubt, low sexual desire or libido is the most common in Australia and certainly the most common referral to me. This is particularly problematic in a relationship, where the partner has a higher libido, which is often termed mismatched libidos. This difficulty often leads to a lot of conflict and hurt within the relationship, with one person feeling rejected and as though their partner is not attracted to them, while the other feels pressured and as though their partner only wants them for sex. 

A study has just been published that looks at the relationship between intimacy and sexual desire and they found that it is not so much intimacy that is important, but actually responsiveness.  If one person has had a tough day at work and they come home to debrief with their partner, who tells them "yes we all have bad days", then this tends to lead to less sexual desire and a withdrawal. On the other hand, if the partner validates the tough day at work and listens, then this is likely to lead to more connectedness and, in turn, an increase in sexual desire. Listening has long been known to be important in effective communication and social connectedness, but now we now its also important for sexual desire. Check out the study and see what you think! 

The sexual scripts we form...

Lately I have been doing some reading and thinking about the scripts that are formed as a result of trauma. By scripts I mean beliefs and responses that become second nature. For example, learning to become submissive or cower when yelled at, as a result of being yelled at through childhood. Sexual scripts are quite similar. We train ourselves with responses and ways of thinking about sex, which can be helpful or unhelpful. 

Scripts start early in childhood from messages we receive about sex. Were you taught that sex should only be within marriage? Was sex spoken about in a negative or positive way? Was your first consensual sexual activity enjoyable or did it result on guilt or shame? These are messages that are often carried into your adult sex life. 

All of the latest research into therapy is suggesting that talk therapy alone is limited to making sustainable changes, therapy has to involve addressing the issue at a neuro-biological level. What this actually means is re-writing the scripts. This involves becoming aware of our scripts then actively changing them through talking and movement. An example of this may be that you find that whenever you talk about sex with your partner, you may feel embarrassed or ashamed and your body responds to this by slouching your shoulders or lowering your head. A change to this script would involve straightening your spine and holding your head up while you practice speaking clearly and confidently. Sounds strange but it actually makes a lot of sense - beliefs aren't just held in our thoughts or speech, they are held in our body. 

If you are looking for more information on this check out Janina Fishers or Pat Ogden's work.

Have a great week! 

Kristen Campbell

Book Review: The Elusive Orgasm by Vivienne Cass

I have recommended this book to so many clients, colleagues and friends that I feel like I should be approaching Ms Cass for some compensation ha! 

But seriously, this is one of the MOST helpful self-help books I have ever read. It is for women who are having some difficulty with orgasm (as the name would suggest). This might be lifelong inability to orgasm, it could be a recent difficulty or you may just want to improve your experience of orgasm. 

The first part of the book provides comprehensive education and also has some reflective questions to get you thinking. There are detailed pictures of female genitalia, which I have been known to show clients in session - they are just so darn educative! There are also treatment plans, both for individuals and couples. They go at a great pace but are challenging enough and very simple to follow. 

Overall the book is very simple to read but very informative and helpful - if you are coming to see me for an orgasm difficulty, know that I will recommend you get a copy for yourself to enhance therapy! 

Happy reading!

Kristen Campbell 

How do we learn about sex?

Meeting so many different people and hearing the variety of ways in which people have received a sex education and developed their ideas about sex has always intrigued me. I can't say I have ever heard the same story twice - everyone is so unique.

We know that we develop ideas about sex through a range of sources - media, family, friends, school, reading, direct experience. As a child, information received through parents or siblings is the most influential, but once adolescence hits, information received through media and peers is what we go off. 

I was reflecting on my own sex education and certainly media was incredibly influential. I have fond memories of sitting down to Home and Away which portrayed (heterosexual) relationships and their problems like infidelity and unwanted pregnancy. I also am old enough to remember what life was like before the Internet and the most common way to research was through encycolopedias. I remember finding a quiet corner in the school library with friends and pouring through books, as we nervously looked up "sex" and "orgasm". As I got older, shows like Dawsons Creek and Sex and the City became incredibly influential, as I navigated my own sexual relationships. 

Why does all this matter? Every time I see a client who comes in for a sexual difficulty, we do a sexual history taking, which not only includes their direct experience but also how they learnt about sex. This is important because, as with many other aspects of life, we develop values and beliefs about sex in our early lives based on what we are taught. This goes on to be significant when we are sexually active and, depending on the belief or value, can be potentially harmful to yourself or your partner. A classic example of this is the impact of religious beliefs on sex. If someone has been told from childhood that they shouldnt have sex before they are married, but they make their choice to become sexually active, they can be left with a lot of guilt and shame attached to sex. Guilt and shame are two of the biggest turn offs and can seriously impede on an otherwise enjoyable sex life. 

A lot of the time sex therapy involves exploring beliefs and values, challenging unhelpful beliefs and also providing accurate information about sex and bodies. 

I invite you to ask yourself some questions and reflect on the development of your sexual identity;

What influenced your beliefs or values about sex or sexuality?

How was sex spoken about in your family? Were there any family secrets about sex? 

Who did you feel most comfortable talking about sex with? Is that the same person now?

Are you holding any values or beliefs that are hurting your sex life? 

Kristen Campbell :-) 

The Secret Life of Penis Challenges

Hard on's. Boners. Stiffies. There are so many words to describe an erect penis. They really aren't very sexy words though. Just saying. 

The thing we never hear is erectile dysfunction. Or impotence. These words are even less sexy. But, the thing is, it is one of the most common men's health issues and we just aren't talking about it. Once you hit 50, 50% of men will experience difficulties achieving or maintaining an erection. 60% of men in their 60's, 70% of men in their 70s and so it goes on. It effects men in all different ways too. Some men aren't bothered by it and adapt their sex life to suit their functioning and still enjoying very satisfying and enjoyable sex. Others feel deeply ashamed and as though they have become useless in bed. Erections are a curious thing because they are often caught up in how a man sees himself. Having a strong, hard erection is often synonymous with a man feeling masculine and when it goes away, it can leave a man questioning his masculinity and identity.  

There are loads of reasons for having difficulties with erection, with the most common being physical health concerns like high cholesterol. Often if the physical health concern is addressed, a man's erection will return to usual. Psychological concerns are also a common cause, including performance anxiety or depression. Another really common reason is the use of particular medications, especially anti-depressant medication. 

There is that great myth that men's sexuality is purely physiological so, in true form, there are dozens of 'treatment' options that don't involve therapy. Viagra, injections, nose sprays are just a few. A lot of the options available commercially (i.e. without the involvement of an Accredited Medical Practitioner) are useless and if they do improve erectile functioning, it is usually a placebo effect. I have heard horrendous stories of men seeking treatment from commercial companies who spruik nose sprays, but the sprays themselves have caused other issues like burning of the nostrils.

The best advice is to always talk to your GP and be prepared to access a range of options; pharmaceutical in conjunction with psychological therapy (e.g. sex therapy) is best practice. Sex Therapy can be really helpful to discover other ways to enjoy sex. A lot of men don't realise that orgasm is possible without erection and there are also plenty of other things you can introduce into your sex life to promote satisfaction for both partners. Erection challenges are just another normal part of getting older, but it certainly doesn't have to mean the end of a fulfilling sex life or the end of masculinity, it actually provides a reminder of all the other wonderful things that you can try with your partner!

Thanks for reading!

Kristen Campbell - Sex Therapist