Small Bumps & Bigger Blocks:
Why do we do what we do? Where do our behaviors and thoughts come from?
What’s happening here?
The way we start to deal with frustrations, misunderstandings and disappointments in adult relationships reflect our own personal back-story.
None of us were born into a bubble. For better or worse we were born into some sort of constellation of others, which I will refer to as ‘family’. I am including all family members, your parent or parents, sibling/s, aunts, uncles and grandparents, in fact any others who impacted, shaped and influenced your early years. But why would I mention childhood families when we’re speculating about difficulties in our adult relationships?
Well, to put it simply, our families of origin become our ‘blueprint’ of how we come to view and shape our adult relationships. As we grow up what we see, hear and feel around us shapes the way we come to understand relationships, so lets look at this in a bit more detail.
Emotions and childhood families:
If we were the lucky ones, we grew up in families that understood that different feelings and emotions are all part of simply being alive and in close relationship to others. Tensions, misunderstandings, anger and frustration are as much a part of healthy family life as closeness, attachment, laughter and fun. It is by growing up in ‘healthy enough’ families, that we come to understand how to approach and process feelings and emotions accordingly, neither being frightened and avoidant, nor overwhelmed and submerged. We come to recognize that there are many different sorts of thoughts and feelings, some confusing, anxiety provoking, and just generally messy, some bright, energizing and uplifting, but these are all essentially passing responses and physical states. We perceive and name what our bodies and minds are ‘feeling’, but these are subjective, fluid states. None is to be feared, none will stay forever, all will pass, everything will be re-experienced, all be it at different times and in different contexts.
The important bit here is that it’s not that we shouldn’t feel anger, sadness or upset, on the contrary, we should. What matters is our ability to calmly process our various states and these skills are slowly gained throughout childhood.
As children, if we have experienced the adults around us move towards, into and through ‘sticky moments’ as thoughtfully, reflexively and calmly as possible we simply absorb the skills needed as children. When we experience the adults around us handle difficult emotions with a sense of curiosity about what went wrong, with an understanding that EACH played a part in the situation, and that BOTH hold a shared interest in coming through with as little collateral, or long term damage, as possible, we learned some vitally important information. What we experienced was adults becoming upset and expressing emotions and words with strength and feeling but not sliding towards rage, aggression, silencing, and blame.
If what we experienced growing up were angry long silences, threats or walking out, we might naturally surmise that some feeling states could directly cause intolerable upset and should be avoided or feared. So what might happen when, as an adult, this person meets these states within their relationships? You can see there may be a ‘natural’ inclination to either become aggressive quickly through fear of being overwhelmed, or we may constantly avoid all possible confrontation leading to imbalance and dissatisfaction on our relationships.
So where to now?
If any of the above makes you inwardly wince, or brings back memories you’d rather forget, recognizing that there are better or different ways to operate in relationships is a big step forward. There is plenty to read on couples and relationships, and of course, there is always the invitation to talk and behave differently.
If this feels too challenging to know where to start, why not see what might be useful in a conversation with me?
I look forward to you getting in touch.
Karen
Loss of Desire
(This blog has been written for individuals who have not had a problem with sex as such, but rather, the difficulty lies in actually getting down to it.
If you suffer pain, or other sexual issues please refer to previous blogs or my website.)
It can feel so frustrating and complicated when the thing that felt so easy, straightforward and pleasurable at the beginning of your relationship, starts to feel labored, difficult and can become almost unbearable to talk about.
How did this happen and why can't we just 'do it’ again? Small doubts can start to take root in your mind and slowely grow. Uncomfortable questions can start to emerge to such as, ‘What if we’re not totally sure about whether we even want to do it again at all?’ and ‘If we don’t manage to get sex back on track, what will happen in the future if there is a future here?’
Its not one persons 'fault'.
It is important to know that, even though it may not appear this way, the partner who feels they have lost their sexual desire, does not feel good about this situation; they may feel ashamed and guilty and at a loss as to how to reverse this situation.
Even when you’ve pushed sex to the forefront of your mind and feel determined to ‘do something about it tonight’, it doesn’t seem to take much for there to be a bump in the road that derails you’re plans. How is it that a remark from your partner, or just a thought, manages to be a good enough reason for you to slam the sexual brakes on? The tension, frustration and disappointment rises so an argument starts, re-igniting familiar disagreements making it clear for both to see that, in ‘this situation’, sex certainly be won't be happening now.
Confused, deflated and upset, you both retreat from this uncomfortable arena to speculate quietly as to who was to blame.
This is a problem for, and in, your relationship together.
There are two issues worth considering at this point: firstly, on reflection you may not be quite so sure how good the past sex actually was and secondly, you might now feel there were some wider relational or sexual issues that you both ignored and remain essentially un-discussed.
The way ahead...
Individuals can change how they think about themselves, sex and their partners, but not without conversation that enables some recognition of how our past experiences come to shape who we are today.
It might also be true to say that most couples’ need to air some relational cobwebs before feeling things are strong enough to move on.
Even if your relationship feels stable and essentially happy, deciding how you both move forward with issues of low desire can be challenging.
So how might we work with this issue?
Writers such Emily Nagoski , Esther Perel and David Schnarch all offer useful points and may contribute something positive here, however, past issues that are particular to you and/or your relationship need to be considered thoughtfully.
Areas of communication, sexual self-confidence and a sense of self-acceptance have all been productive to raise in my experience.
It can also be thought provoking to understand more about what actually constitutes attraction, arousal and desire as this, combined with an attitude of non-judgmental curiosity and adventure, can only be a positive way to move forward.
Coming towards this with a sense of exploration, and acknowledgment that we all change, may help to soften how we see things. Experiencing what it means to tolerate some unease and uncertainty may prove invaluable, as it will enable you to shape what it is you come to want for yourselves, rather than what you think you should be wanting.
Working towards increasing awareness and availability towards your partner, can hopefully be a powerful dynamic in enabling you both to move forward together on this issue.
If you’ve read this and have a response, I’m very keen to hear from you. Thank you.
Particularly Men....
Why are so many men coming forward for therapy? What are the issues that are bringing men into my clinic and what are the outcomes for them?
Problems for men
The issues that men bring fall roughly into 2 groups: those that feel most of their problems are physical or mechanical, involving problems around erections, ejaculatory control and/or sexual performance: and those believing their issues to be emotionally driven such as loss of desire, intimacy struggles and relationship problems.
What appears to be almost universal is the (natural) expression of anxiety around these issues. Often the anxiety bubbles up in the mind, seemingly prompted at the first thought of sex. However as you struggle to exert control over of your thoughts, there is often a dive of self-confidence and a feeling of shame that can contribute to a 'catastrophising' of what will happen in your mind.
A deeper understanding of how you've come to think and behave will enable us to re-establish new and productive ways of approaching these concerns. Of course there are many overlaps between our minds and bodies; we are all one being after all. However, learning to move your attention from your mind into your body and learning to simply be present to what your body is feeling and experiencing will help change your pathway through sex.
What matters here is how comfortable you are in your ability to express and understand your masculinity and sexuality. I am ever moved by the efforts men make to communicate in a more emotional and meaningful way. The men I see do not match those represented in our culture and society as 'typically male'.
Men and Porn
Recognizing that you are watching 'too much' porn is an awareness that's important. Porn affects individuals differently; it isn't inherently 'good' or 'bad' but affects some negatively.
Porn does not describe nor illustrate intimacy, sensuality, creativity nor sexual mishaps. It excludes smell, taste, touch and the normal and natural body. It can often stifle arousal in the viewer as one becomes unable to self-generate feelings of desire through fantasy and verbal connection to the other, becoming ever more dependent on porn for stimulus. Essentially the end result of watching a lot of porn is in direct contradiction to one of its apparent reasons for existence; used in excess it does not arouse nor excite, it squashes and extinguishes sexual desire. We become observers of ourselves rather than being able to immerse ourselves in the physical nature of sex. We can start to feel inadequate in terms of what we've seen in porn and compare 'real life' normality to onscreen fantasy, finding real life somehow lacking.
Anxiety and doubt can then culminate in disappointment with what we're doing, sometimes leading to erectile issues such as difficulties in getting or maintaining erections. It is only too easy to compare the everyday 'normal body' (your own and others) with to those you've seen onscreen, unable to celebrate nor see the beauty in both you and your partners imperfections.
Of course there are men who may recognise they have erectile dysfunction or have issues of rapid or delayed ejaculation, with little or no porn involved in the problem. Many men recognise they've had these issues from early adolescence, but for different reasons haven't come forward for help. Most men will be motivated to take action when relationships are threatened or are being avoided because of these difficulties.
The Way Forward
All aspects of change demand a degree of trust both in our working relationship and with yourself, in terms of your willingness to embrace and think about new ideas.
I can work effectively with men choosing to come for therapy alone, but depending on the nature of the problem, certain issues maybe more effectively treated with the partner involved as well. This is so because, although it may seem that the issues are all or mostly yours, this difficulty will now sit centrally as a problem in and for your relationship. Both of you may view the problem and its impact differently, but your couple relationship will only benefit and strengthen from both of you going through therapy, gathering the awareness and skills needed to experience a more satisfying sex life.
We can change our behaviors and our thinking. Some believe thinking differently leads to new behaviors, whereas others feel the opposite; it is only by behaving differently and repeating those changed behaviors that our thinking patterns eventually catch up. Lets discuss!
CBT (Cognitive Behavioural Therapy) and understanding what it means to be a man are our corner stones toward helping you create a more authentic and true sense of yourself. Erectile and ejaculatory problems can be worked with effectively using different homework exercises and re-framing some of your thinking.
I work with current research, clinically successful ideas and an emphasis on communication and feedback. What matters is understanding and working towards what you want for yourself, your relationship and your life.
I witness men from their early 20's to much later in life, making extraordinary changes for themselves. I don't think it's ever too early or too late to re-write your own story and improve the quality of your life.
Women who suffer pain during sex.
First things first.....
I have not yet met a woman who doesn't suffer shame, guilt and often a sense of hopelessness and confusion when affected by this this issue.
For many women, these feelings have been kept private, often exacerbating the difficulty in dealing with the problem. Years of silence and self-blame just compounds the guilt over knowing there is an issue with sex, yet feeling unable to start looking at it.
But...there's often a good reason why you might feel this way if you are one of a number of women who know they suffer pain during sex....
We live in a culture surrounded by images of, apparently, happy fulfilled women having endless, orgasmic sex.
'Everyone else can do it, but me...'
If you found sex difficult, painful or distressing, you may have discovered this during your teens or twenties, often not in relationships that could cope with broaching this kind of conversation. You may also have found it impossible to put into words your fears, concerns and experiences to others; for women of all ages, accessing appropriate help can feel daunting.
It can also be true that for women who have enjoyed a full and satisfying sex life, pain during sex can also occur for any number of other reasons causing much distress. Pain might be caused by;
trauma during or after birth,
irritating and debilitating skin conditions such as psoriasis and lichen sclerosus,
transition through menopause,
relationship tensions and poor sexual technique and other related issues.
A word on Vaginismus, Dyspareunia and Vulvodynia.
Often sexual pain will fall into one or more of these categories. Essentially they all refer to different types of pain;
Vulvodynia usually describes pain that has a burning sensation to it. This pain is usually located at one or more sites around the vulva, but may also occur inside the vagina.
Vaginismus is a diagnosis often give to women who describe tightness and/or varying amounts of pain at the thought of, or at the start of anything going into their vaginas. Some women can cope with a finger, but not a penis. Often these women have avoided using tampons and have not managed smear tests well, if at all.
Dyspareunia is a more generalised description often given to women who report recurring or persistent genital pain associated with sexual intercourse.
Please note: It is important to know that although some of this terminology may appear alarming, unhelpful or not describe the way you feel during sex, I would encourage you to see a sexual health nurse or informed GP to gain clarity and additional information where possible. There may be medical routes, or treatments with sexual health physiotherapists, suitable for your situation to alleviate pain.What can be done and how could psychosexual therapy help me?
Often the first thing that needs to happen is for us to talk; for you to tell me your story and for me to and listen well. This might be the first time you've taken the courage to come forward in an attempt to address this problem.
I will ask details about exactly what you are experiencing, or have experienced, so that we can start to find any patterns or reasons that may enable us to understand your situation more clearly.
We will discuss any medical interventions to date and what possibilities may have been overlooked or could potentially be explored.
We will then move on to look at how your thinking is affecting what's happening. We will look at re-framing certain ideas and developing new thinking patterns that give you a sense of control.
We will look at practical exercises based on your understanding of anatomy, develop relaxation techniques, and build self-confidence in your capacity to explore your sexuality and sexual response positively.
What if you are single or in a relationship but would like to come alone or with your partner?
I can work with any combination of the above; what matters is your comfort. Bringing your partner, if appropriate, is often the most productive way to work as both of you will be able to share learning and develop new skills together. Certain exercises are designed with partners in mind although many other 'homework' exercises can be done by yourself at home.
Coming as a single woman means that we can positively work on many aspects of this problem, but if you don't have the opportunity to put your learning into practice, we have some limitations. However, in these circumstances many women stop therapy when feeling more confident and knowledgeable, sometimes returning in the future with a partner to discuss any unresolved issues.
What's import for you is just starting the process.
There may not be a quick answer, or a magic key, but I would like you to take heart from the women who have worked with me over the years. Many report a fuller understanding of themselves sexually, have expanded ideas of what lovemaking is about and often have diminished pain as they positively practice different ways of being sexual. Some experience times of less pain, even pain-free sexual episodes, but, crucially, they can manage times of pain more confidently.
Useful Information can be found at:
http://londonvpsg.googlepages.com/home
Particularly Couples At Christmas and Beyond...
I don't need to spell out some of the tensions that exist at this time of year.....you know something is causing you more anxiety then a festive season and a short holiday period should.