Better Sex

Benjamin Domb, M.D. is the Founder, Medical Director, and Orthopedic Surgeon at American Hip Institute & Orthopedic Specialists. His group pioneers advanced, comprehensive, and non-invasive treatments in a mission to cure hip pain. AHI uses Hip Arthroscopy, Robotics, Resurfacing, and Regenerative Medicine to treat hip pain in their Chicago office. Now Benjamin is reaching out to discuss the ways that hip pain can create and contribute to pain during sex. Painful Intercourse Can Be Caused By Hip Problems Benjamin notes that when women feel pain during intercourse, their first impulse is to head to the gynecologist. He admits this is sensible, because there are a lot of ways that gynecological problems can lead to pain during intercourse. While a gynecologist is the first step, Dr. Domb hopes women will learn that hip injuries are another, nongynecological cause of pain during sex. He explains that the pain during sex happens when the hip is brought to its endpoint of motion, where the hip bone meets the hip joint, stating that pain occurs when bones grind against bones, or when impingement occurs. Dr. Domb emphasizes that hip pain felt during sex is nothing to be embarrassed about as many women feel pain during intercourse. He reminds us that it’s both common and treatable. How Localized is Hip Pain? Dr. Domb shares that, unfortunately, the body isn’t very good at keeping hip pain localized, which contributes to the wrong diagnoses people tend to get before their hip pain is identified correctly. According to Benjamin, hip pain can be referred to several locations, including the groin, vulva, penis, or even the abdomen. Doctors Often Don’t Realize Hip Injuries are Causing Groin Pain Gynecologists often don’t consider the possibility of hip injuries causing groin pain, according to Dr. Domb. He tells us that isn’t a bad thing; each specialty in medicine is very focused, and rarely understands things outside of their particular discipline’s scope, but he encourages physicians to learn about causes of discomfort that interact with their discipline more often. Currently, 60% of people he treats for hip injuries were initially misdiagnosed and took an average of seven months to receive a correct diagnosis. Men Can Also Feel Hip Pain in the Groin Benjamin clarifies that this isn’t exclusively a female problem. Men also present with pain in the penis or testicles when they really have hip problems. Often, he observes, men in those conditions see a urologist as their first step. How are Incorrectly Diagnosed Patients Treated? Some patients he’s seen have gone through treatments or even have surgery for conditions like endometriosis or hernias they don’t have thanks to their referred pain. He conveys that one in five of his patients were recommended surgery for conditions they did not have due to their undiagnosed hip trouble. The patients themselves are often the ones who figure out their problem is rooted in the hips, he reports, as they’re best able to notice what movements and situations exacerbate the pain. How Labrums are Torn One of the more common hip injuries that cause painful intercourse are torn labrums (the cartilage rings around the hip socket). Dr. Domb has found that slight abnormalities in the shape of the hip bone or socket wear away or injure the cartilage and cause pain. Most of us have hips that fit imperfectly in the socket, making these injuries a common sight for Dr. Domb. Sometimes these injuries are caused by discrete events like sports, but usually he sees people whose joints are damaged slowly over time. How to Prevent Hip Injuries Benjamin reminds us that not everyone is built the same way, and different people will be able to tolerate different degrees of hip extension. According to him, everyone should accommodate how they are built and not push hip extension past a...

Benjamin Domb, M.D. is the Founder, Medical Director, and Orthopedic Surgeon at American Hip Institute & Orthopedic Specialists. His group pioneers advanced, comprehensive, and non-invasive treatments in a mission to cure hip pain. AHI uses Hip Arthroscopy, Robotics, Resurfacing, and Regenerative Medicine to treat hip pain in their Chicago office. Now Benjamin is reaching out to discuss the ways that hip pain can create and contribute to pain during sex. Painful Intercourse Can Be Caused By Hip Problems Benjamin notes that when women feel pain during intercourse, their first impulse is to head to the gynecologist. He admits this is sensible, because there are a lot of ways that gynecological problems can lead to pain during intercourse. While a gynecologist is the first step, Dr. Domb hopes women will learn that hip injuries are another, nongynecological cause of pain during sex. He explains that the pain during sex happens when the hip is brought to its endpoint of motion, where the hip bone meets the hip joint, stating that pain occurs when bones grind against bones, or when impingement occurs. Dr. Domb emphasizes that hip pain felt during sex is nothing to be embarrassed about as many women feel pain during intercourse. He reminds us that it’s both common and treatable. How Localized is Hip Pain? Dr. Domb shares that, unfortunately, the body isn’t very good at keeping hip pain localized, which contributes to the wrong diagnoses people tend to get before their hip pain is identified correctly. According to Benjamin, hip pain can be referred to several locations, including the groin, vulva, penis, or even the abdomen. Doctors Often Don’t Realize Hip Injuries are Causing Groin Pain Gynecologists often don’t consider the possibility of hip injuries causing groin pain, according to Dr. Domb. He tells us that isn’t a bad thing; each specialty in medicine is very focused, and rarely understands things outside of their particular discipline’s scope, but he encourages physicians to learn about causes of discomfort that interact with their discipline more often. Currently, 60% of people he treats for hip injuries were initially misdiagnosed and took an average of seven months to receive a correct diagnosis. Men Can Also Feel Hip Pain in the Groin Benjamin clarifies that this isn’t exclusively a female problem. Men also present with pain in the penis or testicles when they really have hip problems. Often, he observes, men in those conditions see a urologist as their first step. How are Incorrectly Diagnosed Patients Treated? Some patients he’s seen have gone through treatments or even have surgery for conditions like endometriosis or hernias they don’t have thanks to their referred pain. He conveys that one in five of his patients were recommended surgery for conditions they did not have due to their undiagnosed hip trouble. The patients themselves are often the ones who figure out their problem is rooted in the hips, he reports, as they’re best able to notice what movements and situations exacerbate the pain. How Labrums are Torn One of the more common hip injuries that cause painful intercourse are torn labrums (the cartilage rings around the hip socket). Dr. Domb has found that slight abnormalities in the shape of the hip bone or socket wear away or injure the cartilage and cause pain. Most of us have hips that fit imperfectly in the socket, making these injuries a common sight for Dr. Domb. Sometimes these injuries are caused by discrete events like sports, but usually he sees people whose joints are damaged slowly over time. How to Prevent Hip Injuries Benjamin reminds us that not everyone is built the same way, and different people will be able to tolerate different degrees of hip extension. According to him, everyone should accommodate how they are built and not push hip extension past a...

Michelle Belke currently works as a Mental Health School Counsellor at an independent school in Metro Detroit, Michigan. She has a part-time private practice in psychotherapy and sex therapy in Birmingham, Michigan. In her school setting, Michelle does a lot to make students feel comfortable coming to her and discussing sexuality and sexual identity, such as decorating her office with pride symbols and doing outreach through the school, and even setting up the school’s first Gay-Straight Alliance (GSA) and that a surprisingly large amount of her work for the school deals with LGBTQ+ issues and concerns. Forming Gay-Straight Alliances She shares that the GSA she and some students created at her school, is not an official Gay-Straight Alliance, but it serves the same purpose. Belke mentions that Gay-Straight Alliances are a key element in helping sexual minorities feel safe while on school grounds especially for transgender students but to all LGBTQ+ students in a broader sense, the risk of violence and suicide is much higher than in the general population. Michelle believes a GSA creates a safe space to discuss and find support amongst other LGBTQ+ students and allies, increasing the feeling of safety marginalized students can feel on school property. According to Belke, independent schools can be more conservative than public schools. In her case, establishing a GSA necessitated a group of students directly approaching the administration in person and making a case for the group’s establishment. Belke is careful to make clear that a GSA isn’t for talking about sex all the time but is meant to establish a safe place for sexual minorities. The Student Counseling Interview ProcessMichelle openly tells us that she’s often the first person LGBTQ+ students at her school speak to about their sexual identity. When speaking with people in these groups, she suggests listening without judgement, moving at the student’s pace, and reinforcing the confidential status of the counselling relationship. When young people are discussing their identities, Michelle is always sure to ask them what those identities mean to them, and often begins by asking how living as that identity feels to them. She also covers what to do about parental involvement with the student, whether it’s informing the parents of their child’s identity (with permission!), finding ways to resolve sexuality-based problems children are having with their parents or educating the parents about ways to be more supportive or involved. Gender Pronouns and Their Use Michelle discusses multiple points of interest when talking with students about their pronouns. Her first step is to introduce her identity and mention her pronouns before asking for the student’s pronouns. Then she asks which pronouns the students use—not which pronouns they prefer, but which pronouns they use—because their identity is not a preference. We learn that acknowledging pronouns is a profound way to establish respect and demonstrate acceptance. Our dominant culture can be very binary, Michelle highlights the importance of not pigeonholing your children into these identities, clothing items, occupations and manners of play that may not be appropriate for them. She reminds us that people may not only be transgender, but they might also be gender nonconforming or not identify with the concept of gender at all. She mentions gender-neutral pronouns as a solution to these issues. Despite advocating for the importance of showing respect by considering others’ pronouns, she admits that pronouns can be hard for parents and teachers to remember all the time. Her advice if you forget, is to own the mistake, apologize, correct yourself, and try to do better next time. Is it a Phase? Michelle says that regardless of whether a sexual or gender identity sticks for life, the important thing is validating and accepting where the students are when...

Michelle Belke currently works as a Mental Health School Counsellor at an independent school in Metro Detroit, Michigan. She has a part-time private practice in psychotherapy and sex therapy in Birmingham, Michigan. In her school setting, Michelle does a lot to make students feel comfortable coming to her and discussing sexuality and sexual identity, such as decorating her office with pride symbols and doing outreach through the school, and even setting up the school’s first Gay-Straight Alliance (GSA) and that a surprisingly large amount of her work for the school deals with LGBTQ+ issues and concerns. Forming Gay-Straight Alliances She shares that the GSA she and some students created at her school, is not an official Gay-Straight Alliance, but it serves the same purpose. Belke mentions that Gay-Straight Alliances are a key element in helping sexual minorities feel safe while on school grounds especially for transgender students but to all LGBTQ+ students in a broader sense, the risk of violence and suicide is much higher than in the general population. Michelle believes a GSA creates a safe space to discuss and find support amongst other LGBTQ+ students and allies, increasing the feeling of safety marginalized students can feel on school property. According to Belke, independent schools can be more conservative than public schools. In her case, establishing a GSA necessitated a group of students directly approaching the administration in person and making a case for the group’s establishment. Belke is careful to make clear that a GSA isn’t for talking about sex all the time but is meant to establish a safe place for sexual minorities. The Student Counseling Interview ProcessMichelle openly tells us that she’s often the first person LGBTQ+ students at her school speak to about their sexual identity. When speaking with people in these groups, she suggests listening without judgement, moving at the student’s pace, and reinforcing the confidential status of the counselling relationship. When young people are discussing their identities, Michelle is always sure to ask them what those identities mean to them, and often begins by asking how living as that identity feels to them. She also covers what to do about parental involvement with the student, whether it’s informing the parents of their child’s identity (with permission!), finding ways to resolve sexuality-based problems children are having with their parents or educating the parents about ways to be more supportive or involved. Gender Pronouns and Their Use Michelle discusses multiple points of interest when talking with students about their pronouns. Her first step is to introduce her identity and mention her pronouns before asking for the student’s pronouns. Then she asks which pronouns the students use—not which pronouns they prefer, but which pronouns they use—because their identity is not a preference. We learn that acknowledging pronouns is a profound way to establish respect and demonstrate acceptance. Our dominant culture can be very binary, Michelle highlights the importance of not pigeonholing your children into these identities, clothing items, occupations and manners of play that may not be appropriate for them. She reminds us that people may not only be transgender, but they might also be gender nonconforming or not identify with the concept of gender at all. She mentions gender-neutral pronouns as a solution to these issues. Despite advocating for the importance of showing respect by considering others’ pronouns, she admits that pronouns can be hard for parents and teachers to remember all the time. Her advice if you forget, is to own the mistake, apologize, correct yourself, and try to do better next time. Is it a Phase? Michelle says that regardless of whether a sexual or gender identity sticks for life, the important thing is validating and accepting where the students are when...

My guest is Melissa Fritchle. She has developed The Conscious Sexual Self Workbook, she is a mindfulness meditation teacher, a Holistic Sex Therapist, is an educator and workshop leader, and that’s just a few of her qualifications. Within this episode, she shares a lot of wisdom about communication between partners, mindfulness, and exploring sexuality. Really important work that Melissa is doing, and she has a lot of great things to say on the subject. Listen in! The “Conscious Sexual Self Workbook” Melissa said she wrote the workbook during a time that she realized the people she interacted with in her practice were self-identifying their sexual being solely through a lens of sexual behavior. For example, she would introduce questions and journaling exercises to participants who never really considered looking at their sexuality apart from a normative model of sexual behavior. So, Melissa likes to remind those who want to become more conscious of their sexuality should factor the complete picture of sexuality: this ranges from the events and discussions that you had as a child and teenager, to the less malleable reinforcements of adult sexuality. Within the workbook, there are plenty of exercises and prompts that help participants explore their sexuality and perhaps learn for the first time some of the true facets of sexuality that many assumed they learned in high school. As we explore within the episode, many adults feel like a window closed for learning about sexuality. Most are embarrassed to be in their 40s and ask questions about sexuality, so Melissa’s work offers a great platform for reopening those doors and discovering the sexual self. Does it Specifically Resonate with You? Melissa wants to remind you that there are a lot of great resources out there on sexuality but to remind yourself that there is also a lot of junk information as well. One of the most important considerations is that you take and apply the information that resonates with you personally. Often what happens is a particular person hears that something is working for someone and then they feel it necessary to incorporate it, even if it has hardly anything to do with their unique sexual self. How to Talk About Your Wants and Desires One of the added benefits of exploring your conscious sexual self is that you can work through the shame and uncertainties of your sexuality and get much more comfortable communicating with your partner or other people in general. This can still be a difficult thing though that requires consistent practice. Melissa suggests just talking about things at first. There should be no pressure to act on something immediately. Broaching the subject on a particular area can be powerful in itself. But there should be no immediate pressure to act right away. Another thing Melissa talks about is having the “what turns you on?” conversation can be a really productive and powerful conversation to have with partners. This sort of conversation can act as a bridge for other conversations as well, just because of how easy it is to have. Mindfulness and Sex Melissa says that instead of “performing” sex, being mindful and practicing mindfulness techniques can lead to better sex hands down. With it, you are much more present with your partner and conscious about the sexual act itself. She says that a lot of her clients end up losing focus and diverting their attention elsewhere during sex, which makes for less engaging sex. Resources for Melissa: Affiliate Link for Melissa’s book The Conscious Sexual Self Workbook: https://www.amazon.com/Conscious-Sexual-Self-Workbook/dp/150081086X Her website:

My guest is Melissa Fritchle. She has developed The Conscious Sexual Self Workbook, she is a mindfulness meditation teacher, a Holistic Sex Therapist, is an educator and workshop leader, and that’s just a few of her qualifications. Within this episode, she shares a lot of wisdom about communication between partners, mindfulness, and exploring sexuality. Really important work that Melissa is doing, and she has a lot of great things to say on the subject. Listen in! The “Conscious Sexual Self Workbook” Melissa said she wrote the workbook during a time that she realized the people she interacted with in her practice were self-identifying their sexual being solely through a lens of sexual behavior. For example, she would introduce questions and journaling exercises to participants who never really considered looking at their sexuality apart from a normative model of sexual behavior. So, Melissa likes to remind those who want to become more conscious of their sexuality should factor the complete picture of sexuality: this ranges from the events and discussions that you had as a child and teenager, to the less malleable reinforcements of adult sexuality. Within the workbook, there are plenty of exercises and prompts that help participants explore their sexuality and perhaps learn for the first time some of the true facets of sexuality that many assumed they learned in high school. As we explore within the episode, many adults feel like a window closed for learning about sexuality. Most are embarrassed to be in their 40s and ask questions about sexuality, so Melissa’s work offers a great platform for reopening those doors and discovering the sexual self. Does it Specifically Resonate with You? Melissa wants to remind you that there are a lot of great resources out there on sexuality but to remind yourself that there is also a lot of junk information as well. One of the most important considerations is that you take and apply the information that resonates with you personally. Often what happens is a particular person hears that something is working for someone and then they feel it necessary to incorporate it, even if it has hardly anything to do with their unique sexual self. How to Talk About Your Wants and Desires One of the added benefits of exploring your conscious sexual self is that you can work through the shame and uncertainties of your sexuality and get much more comfortable communicating with your partner or other people in general. This can still be a difficult thing though that requires consistent practice. Melissa suggests just talking about things at first. There should be no pressure to act on something immediately. Broaching the subject on a particular area can be powerful in itself. But there should be no immediate pressure to act right away. Another thing Melissa talks about is having the “what turns you on?” conversation can be a really productive and powerful conversation to have with partners. This sort of conversation can act as a bridge for other conversations as well, just because of how easy it is to have. Mindfulness and Sex Melissa says that instead of “performing” sex, being mindful and practicing mindfulness techniques can lead to better sex hands down. With it, you are much more present with your partner and conscious about the sexual act itself. She says that a lot of her clients end up losing focus and diverting their attention elsewhere during sex, which makes for less engaging sex. Resources for Melissa: Affiliate Link for Melissa’s book The Conscious Sexual Self Workbook: https://www.amazon.com/Conscious-Sexual-Self-Workbook/dp/150081086X Her website:

My guest today is Lindsay Tucker. She is the founder of artfulsleep.com and is on a mission for better sleep for all. When managing a snoring partner, she has a fresh perspective on the challenges that can arise. To her, instead of getting rid of the disruptions, she teaches the powerful concept of accepting the disruptions and becoming a better, stronger sleeper regardless. Within this episode, she shares anecdotes and expands upon the idea of becoming a more resilient sleeper. The Link Between Sleep and Sex Lindsay says that most people can see the link between sleep and sex because it can create a really special bond. It’s also an intimate setting – hello, it’s the bedroom after all – and any disruptions in sleep can have considerable carryover into a couple’s sex life. Lindsay actually shares a story about the first night she stayed the night with her husband. And right when he fell asleep, the whole house shook with his snores. She said it was so loud that she had to leave the bedroom and head to the couch. Upset and unsure if she would ever be able to cope with his seismic snores in the future, she didn’t know what to do. She says she doesn’t share the story to make her husband feel bad, of course, but only to accentuate the close connection between sound sleep and a harmonious relationship. Snoring is not Insurmountable Lindsay says that you’re never going to change the person who snores, but you yourself can change and learn how to sleep better. She says that you can work on getting rid of the disruptive blue light that messes with your circadian rhythms. This can lead to more peaceful sleep, even if your partner is a loud snorer. Additionally, instead of this subtractive approach, there’s also an additive method. Adding blackout curtains or a cool room to the equation can really help you embrace the snoring and become a better sleeper. Lindsay said she tried all of the “gimmicky” things like a noise-canceling app on her phone, earplugs, and more, but they didn’t work for her. Health Costs for the Snorer, and the Importance of Sleep Lindsay says that in her experience and expertise with snoring, really the only time that there are health risks for the snorer is if they have sleep apnea. Sleep apnea prevents the sleeper from getting adequate oxygen throughout the night, which often means the person is waking up multiple times a night, gasping for air, even if they are not aware. They can then awake and feel groggy, even if the clock shows that they did in fact “sleep” deeply for 8 hours. A big reason why Lindsay is so keen on talking about this topic is not only her own experiences with a snoring partner but also her interest in the importance of sleep. She calls sleep the one “constant” for all of us. Sacrificing your quality of sleep is a recipe for disaster. And being sleep deprived not only saps your energy but also reduces your sexual drive. If you are sleep deprived, you are most likely not wanting to have sex. This is just the simple reality of only having a finite amount of energy. As experience dictates for my clients and in Lindsay’s estimation, if you are tired, the last thing you want to do is have sex. Add sleep deprivation to an already rampant snoring problem and things can get complicated. For much more on this subject and details on Lindsay’s program, check out the rest of the episode! Key Links for Lindsay: Her website for her sleeping program: https://www.artfulsleep.com/ More info:Link to the free guide – Talking About Sex: http://bettersexpodcast.com/talkJoin my email list here: http://bettersexpodcast.com/listBook and New...

My guest today is Lindsay Tucker. She is the founder of artfulsleep.com and is on a mission for better sleep for all. When managing a snoring partner, she has a fresh perspective on the challenges that can arise. To her, instead of getting rid of the disruptions, she teaches the powerful concept of accepting the disruptions and becoming a better, stronger sleeper regardless. Within this episode, she shares anecdotes and expands upon the idea of becoming a more resilient sleeper. The Link Between Sleep and Sex Lindsay says that most people can see the link between sleep and sex because it can create a really special bond. It’s also an intimate setting – hello, it’s the bedroom after all – and any disruptions in sleep can have considerable carryover into a couple’s sex life. Lindsay actually shares a story about the first night she stayed the night with her husband. And right when he fell asleep, the whole house shook with his snores. She said it was so loud that she had to leave the bedroom and head to the couch. Upset and unsure if she would ever be able to cope with his seismic snores in the future, she didn’t know what to do. She says she doesn’t share the story to make her husband feel bad, of course, but only to accentuate the close connection between sound sleep and a harmonious relationship. Snoring is not Insurmountable Lindsay says that you’re never going to change the person who snores, but you yourself can change and learn how to sleep better. She says that you can work on getting rid of the disruptive blue light that messes with your circadian rhythms. This can lead to more peaceful sleep, even if your partner is a loud snorer. Additionally, instead of this subtractive approach, there’s also an additive method. Adding blackout curtains or a cool room to the equation can really help you embrace the snoring and become a better sleeper. Lindsay said she tried all of the “gimmicky” things like a noise-canceling app on her phone, earplugs, and more, but they didn’t work for her. Health Costs for the Snorer, and the Importance of Sleep Lindsay says that in her experience and expertise with snoring, really the only time that there are health risks for the snorer is if they have sleep apnea. Sleep apnea prevents the sleeper from getting adequate oxygen throughout the night, which often means the person is waking up multiple times a night, gasping for air, even if they are not aware. They can then awake and feel groggy, even if the clock shows that they did in fact “sleep” deeply for 8 hours. A big reason why Lindsay is so keen on talking about this topic is not only her own experiences with a snoring partner but also her interest in the importance of sleep. She calls sleep the one “constant” for all of us. Sacrificing your quality of sleep is a recipe for disaster. And being sleep deprived not only saps your energy but also reduces your sexual drive. If you are sleep deprived, you are most likely not wanting to have sex. This is just the simple reality of only having a finite amount of energy. As experience dictates for my clients and in Lindsay’s estimation, if you are tired, the last thing you want to do is have sex. Add sleep deprivation to an already rampant snoring problem and things can get complicated. For much more on this subject and details on Lindsay’s program, check out the rest of the episode! Key Links for Lindsay: Her website for her sleeping program: https://www.artfulsleep.com/ More info:Link to the free guide – Talking About Sex: http://bettersexpodcast.com/talkJoin my email list here: http://bettersexpodcast.com/listBook and New...

My guest, the sexuality educator, author, trainer, and psychotherapist Doug Braun Harvey is here to share his knowledge on an important distinction in the sexual health realm: Out of Control Sexual Behavior (OCSB). Within this interview, there are discussions about classifications of sexual health, advice for psychotherapists on how to let patients present their own vision of sexual health, and an overall fruitful discussion on the nuances of the field. Spoken eloquently and drawing from his wide experience in the field, Doug Braun-Harvey makes this a must-listen. A Specific Definition of Sexual Health Doug says that sexual health is the “balance between sexual health and sexual pleasure.” What he means by this is that you are not only being careful about your sexual activity but also equally focusing on pleasure. He also states that sexual health must factor in the sexual rights of all involved. When talking about the generally agreed-upon definition of sexual health currently taught in schools, the definition has not changed for many years – where the didactic preoccupation has centered on wrapping “sexual health” in a limited, encompassing curriculum of just pregnancies, STDs, or STIs. Classifying Sexual Disorders With classifications and conceptualizations of sexual dysfunction always being defined, assigned, and redefined, it’s difficult to find the point where an out-of-control sexual behavior becomes a disorder. Classifications are made that relate sexual compulsion to impulse control; this presents challenges from a psychiatric standpoint, and even more so because most of those definitions are not made definitively – so to speak – but are only established to get a dialogue going and the research flowing. In other words, there is a lot of gray area and malleability for sexual disorders that take professionals in the field to work out and categorize. It’s a fascinating and complex subject that Doug does a good job at explaining within this episode. Out of Control Sexual Behavior The core concept of this talk is Out of Control Sexual Behavior. Doug defines OCSB as “when a person’s urges, thoughts, or behaviors feel out of control to them.” He says this only applies to consensual sexual behavior. And the most important distinction he makes is that OCSB is recognized as a sexual health problem and not a disease or disorder. He says that someone who has OCSB is not aligned with six key principles of sexual health: - Sexual health is consensual - Non-exploitive - Protected from STDs, STIs, and unwanted pregnancies - Honesty - Shared values - Pleasure and mutual pleasure He says that for those patients who fall out of the realm of consensual sexual behavior, into the non-consensual categorization, there is a whole different specialist they should be referred to. That training is much different and the methodology changes for patients who are not participating in consensual sex. Doug says that getting in touch with a specialist who is equipped to help the patient with non-consensual behaviors is important. Allowing the Patient to Determine Their Own Sexual Health Vision Doug says that during his assessment process with patients, he doesn’t present a certain narrative to the patients. In other words, he doesn’t tell them they have a disorder or disease but lets them present their own vision of sexual health. A lot of his patients come to him because they align with particular writings or teachings that Doug has presented, so he lets them come to him and present their sexual health identity in that sense. He has his patients fill out forms that delineate boundaries that they shouldn’t cross, some they are ambivalent about, and then a sexual health column that presents where they want to be from a sexual health standpoint.

My guest, the sexuality educator, author, trainer, and psychotherapist Doug Braun Harvey is here to share his knowledge on an important distinction in the sexual health realm: Out of Control Sexual Behavior (OCSB). Within this interview, there are discussions about classifications of sexual health, advice for psychotherapists on how to let patients present their own vision of sexual health, and an overall fruitful discussion on the nuances of the field. Spoken eloquently and drawing from his wide experience in the field, Doug Braun-Harvey makes this a must-listen. A Specific Definition of Sexual Health Doug says that sexual health is the “balance between sexual health and sexual pleasure.” What he means by this is that you are not only being careful about your sexual activity but also equally focusing on pleasure. He also states that sexual health must factor in the sexual rights of all involved. When talking about the generally agreed-upon definition of sexual health currently taught in schools, the definition has not changed for many years – where the didactic preoccupation has centered on wrapping “sexual health” in a limited, encompassing curriculum of just pregnancies, STDs, or STIs. Classifying Sexual Disorders With classifications and conceptualizations of sexual dysfunction always being defined, assigned, and redefined, it’s difficult to find the point where an out-of-control sexual behavior becomes a disorder. Classifications are made that relate sexual compulsion to impulse control; this presents challenges from a psychiatric standpoint, and even more so because most of those definitions are not made definitively – so to speak – but are only established to get a dialogue going and the research flowing. In other words, there is a lot of gray area and malleability for sexual disorders that take professionals in the field to work out and categorize. It’s a fascinating and complex subject that Doug does a good job at explaining within this episode. Out of Control Sexual Behavior The core concept of this talk is Out of Control Sexual Behavior. Doug defines OCSB as “when a person’s urges, thoughts, or behaviors feel out of control to them.” He says this only applies to consensual sexual behavior. And the most important distinction he makes is that OCSB is recognized as a sexual health problem and not a disease or disorder. He says that someone who has OCSB is not aligned with six key principles of sexual health: - Sexual health is consensual - Non-exploitive - Protected from STDs, STIs, and unwanted pregnancies - Honesty - Shared values - Pleasure and mutual pleasure He says that for those patients who fall out of the realm of consensual sexual behavior, into the non-consensual categorization, there is a whole different specialist they should be referred to. That training is much different and the methodology changes for patients who are not participating in consensual sex. Doug says that getting in touch with a specialist who is equipped to help the patient with non-consensual behaviors is important. Allowing the Patient to Determine Their Own Sexual Health Vision Doug says that during his assessment process with patients, he doesn’t present a certain narrative to the patients. In other words, he doesn’t tell them they have a disorder or disease but lets them present their own vision of sexual health. A lot of his patients come to him because they align with particular writings or teachings that Doug has presented, so he lets them come to him and present their sexual health identity in that sense. He has his patients fill out forms that delineate boundaries that they shouldn’t cross, some they are ambivalent about, and then a sexual health column that presents where they want to be from a sexual health standpoint.

My guest, Charlie Glickman, has been a sex educator for over 25 years. But it wasn’t until about 15 years ago that he realized the power of bodywork for managing and working through sexual shame. After solely teaching and writing as a sex educator, Charlie experienced firsthand just how powerful somatic therapy can be in a sexual shame context. So, he then developed his own course and practice around that discovery. This episode traces the advent of his important work in the field and moves beyond that to deliver practical insights and knowledge on the topic. A really, really important topic that I hope you get a lot from. Thanks for listening! What is Sexological Bodywork? When asked to define the term, Charlie says that sexological bodywork is “somatic education in erotic embodiment.” To further break this down, he sums it up as follows: the central focus is on the somatic aspects – the body. Education, in the context of sexological bodywork, is achieved when his clients leave a session with more knowledge and experience than they had coming in. This is a huge goal of the practice. Erotic embodiment encompasses erotic activity, but also, it adds staying present and truly “embodying” the eroticism in the moment, in all moments, that it happens. The Power of Flirting Charlie shares interesting insights on a couple who struggled to discern each other’s sexual signals. When speaking to the wife, Charlie asked her to practice flirting with him, in a professional capacity, during one of their one-on-one sessions. After doing so, Charlie said that it was hard to tell she was even doing so because her body signals were not doing the communicating for her. Instead of feeling rejected by her husband, she realized her husband probably had no idea when she was flirting. This also turned out to be the case on the opposite end of the spectrum: the husband was wary about flirting because he didn’t feel like his wife was all that into him. Consent Considerations Charlie says that his practice factors in consent as one of the most important facets of bodywork. To that extent, Charlie will not do any bodywork unless the patient lays out exactly what they are ready to do that day. There should be no guesswork when it comes to consent, and he says it’s always a good thing when boundaries are established and there’s enough trust and accountability so tht the patient can immediately say “no” and be respected in that wish. The Many Areas of Sexological Bodywork Charlie gives an overview of all of the areas he focuses on as a sexological bodyworker. These focal points range from asking for consent, telling your partner what you want, maintaining boundaries, managing shame and rejection triggers if your partner says no to sex, and pleasure mapping. Charlie also works with patients who have experienced or are experiencing trauma, with the goal of getting back to a healthy state of equilibrium despite those traumas. Additionally, he works with those who have gone through considerable transitions in their lives: hysterectomies, gender transitions, postpartum mothers, and a wide range of circumstances that contribute to a diverse sampling of sexological bodywork needs. How do Prospective Patients Know When They’re Ready for Bodywork? Charlie says that if the idea of bodywork sounds a little too intimidating or scary, sexological bodywork might not be right for you. He says it could be that you just need to talk to a sex therapist or a practitioner and ask some questions to test the waters out. And because there are so many specialists in the profession, it really does help to do a little bit of research on various practitioners to see if what they offer and the testimonials they provide speak to your personal experience. Charlie says it’s completely normal to feel nervous about...

My guest, Charlie Glickman, has been a sex educator for over 25 years. But it wasn’t until about 15 years ago that he realized the power of bodywork for managing and working through sexual shame. After solely teaching and writing as a sex educator, Charlie experienced firsthand just how powerful somatic therapy can be in a sexual shame context. So, he then developed his own course and practice around that discovery. This episode traces the advent of his important work in the field and moves beyond that to deliver practical insights and knowledge on the topic. A really, really important topic that I hope you get a lot from. Thanks for listening!What is Sexological Bodywork?When asked to define the term, Charlie says that sexological bodywork is “somatic education in erotic embodiment.” To further break this down, he sums it up as follows: the central focus is on the somatic aspects – the body. Education, in the context of sexological bodywork, is achieved when his clients leave a session with more knowledge and experience than they had coming in. This is a huge goal of the practice.Erotic embodiment encompasses erotic activity, but also, it adds staying present and truly “embodying” the eroticism in the moment, in all moments, that it happens.The Power of FlirtingCharlie shares interesting insights on a couple who struggled to discern each other’s sexual signals. When speaking to the wife, Charlie asked her to practice flirting with him, in a professional capacity, during one of their one-on-one sessions. After doing so, Charlie said that it was hard to tell she was even doing so because her body signals were not doing the communicating for her. Instead of feeling rejected by her husband, she realized her husband probably had no idea when she was flirting. This also turned out to be the case on the opposite end of the spectrum: the husband was wary about flirting because he didn’t feel like his wife was all that into him. Consent ConsiderationsCharlie says that his practice factors in consent as one of the most important facets of bodywork. To that extent, Charlie will not do any bodywork unless the client lays out exactly what they are ready to do that day. There should be no guesswork when it comes to consent, and he says it’s always a good thing when boundaries are established and there’s enough trust and accountability so that the client can immediately say “no” and be respected in that wish.The Many Areas of Sexological BodyworkCharlie gives an overview of all of the areas he focuses on as a sexological bodyworker. These focal points range from asking for consent, telling your partner what you want, maintaining boundaries, managing shame and rejection triggers if your partner says no to sex, and pleasure mapping.Charlie also works with clients who have experienced or are experiencing trauma, with the goal of getting back to a healthy state of equilibrium despite those traumas. Additionally, he works with those who have gone through considerable transitions in their lives: hysterectomies, gender transitions, postpartum mothers, and a wide range of circumstances that contribute to a diverse sampling of sexological bodywork needs.How do Prospective Patients Know When They’re Ready for Bodywork?Charlie says that if the idea of bodywork sounds a little too intimidating or scary, sexological bodywork might not be right for you. He says it could be that you just need to talk to a sex therapist or a practitioner and ask some questions to test the waters out. And because there are so many specialists in the profession, it really does help to do a little bit of research on various practitioners to see if what they offer and the testimonials they provide speak to your personal experienceCharlie says it’s completely normal to feel nervous about going to a...

My guest is the author of Reviving Your Sex Life After Childbirth, a pioneer for diagnosing and treating pelvic floor dysfunction, and also a practicing physical therapist who specializes in the pelvic floor, specifically. Overall, she is one of the leading authorities on the PF and has a wealth of knowledge to share in this episode. She talks about treatment, what to expect during the “4th trimester”, and common ways of regaining sex drive after birth through pelvic floor physical intervention. Listen along! Postpartum Considerations Kathe says that what sparked her interest and important work with post-childbirth mothers was that no one was really helping mothers regain their sex drive. Additionally, she drew from her own experience as a mother to drive the work she would do with other mothers. More specifically, Kathe specializes in the all-important pelvic floor muscles. She says that obstetricians often don’t address the pelvic floor muscles and the importance of strengthening them after childbirth. The Most Common Impacts of Childbirth on the Pelvic Floor Kathe says that pain is the biggest reason why mothers come to her for physical therapy. She says that providing information and treatment for the pain not only alleviates the symptoms but provides a huge relief to mothers who might have uncertainties and stresses about regaining their sex drive. Other common reasons are simply a lack of sexual desire and incontinence due to weakened pelvic floors. Laxity and looseness is another common byproduct of childbirth on the pelvic floor, which can certainly contribute to mothers feeling uncomfortable about sex, making them more likely to avoid it. Kathe spends some time talking about the connecting fascia and tissue that comprise the pelvic floor and how childbirth can stretch out the tissue. It can take a lot of attention to strengthen the muscles back to form, so Kathe says it’s an important step to seek physical therapy. The Benefits of Kegels for Arousal and Lubrication Kathe says that a lot of mother struggle with getting adequately lubricated for sex after childbirth. This is a completely normal phenomenon, so she dispels the myth that only menopausal women struggle with it. Kegels and other physical interventions can really help with lubrication. Arousal is another closely related facet of sexuality that kegels can improve. During the “4th trimester” it’s hard for mothers to get aroused. Strengthening the pelvic floor can help immensely. For strengthening the first layer of muscles, she suggests the technique called the “wink and nod”. She says that if you squeeze and think about moving the clitoris, closing the vaginal lips, and winking the anus you can strengthen the first layer of muscles. For the deeper layer of muscles, you would seek to bring your anus to your pubic bone, so to speak. For much more on that, listen along! How to Release a Tight Pelvic Floor Kathe says that there are cases where the pelvic floor actually is too tight and could benefit from a regular release of tension. For those who perhaps are too tight, she has a wide variety of diaphragmatic breathing exercises that can help. She goes into much more detail on how to know if you can benefit from tightening or loosening exercises. Definitely, don’t miss that! Resources for Kathe: Her website: https://kathewallace.com/ Her book: Reviving Your Sex Life After Childbirth Free Pelvic Floor Handout: https://kathewallace.com/resources/free-handout/ Questionnaire for Females About PFD:

My guest is the author of Reviving Your Sex Life After Childbirth, a pioneer for diagnosing and treating pelvic floor dysfunction, and also a practicing physical therapist who specializes in the pelvic floor, specifically. Overall, she is one of the leading authorities on the PF and has a wealth of knowledge to share in this episode. She talks about treatment, what to expect during the “4th trimester”, and common ways of regaining sex drive after birth through pelvic floor physical intervention. Listen along! Postpartum Considerations Kathe says that what sparked her interest and important work with post-childbirth mothers was that no one was really helping mothers regain their sex drive. Additionally, she drew from her own experience as a mother to drive the work she would do with other mothers. More specifically, Kathe specializes in the all-important pelvic floor muscles. She says that obstetricians often don’t address the pelvic floor muscles and the importance of strengthening them after childbirth. The Most Common Impacts of Childbirth on the Pelvic Floor Kathe says that pain is the biggest reason why mothers come to her for physical therapy. She says that providing information and treatment for the pain not only alleviates the symptoms but provides a huge relief to mothers who might have uncertainties and stresses about regaining their sex drive. Other common reasons are simply a lack of sexual desire and incontinence due to weakened pelvic floors. Laxity and looseness is another common byproduct of childbirth on the pelvic floor, which can certainly contribute to mothers feeling uncomfortable about sex, making them more likely to avoid it. Kathe spends some time talking about the connecting fascia and tissue that comprise the pelvic floor and how childbirth can stretch out the tissue. It can take a lot of attention to strengthen the muscles back to form, so Kathe says it’s an important step to seek physical therapy. The Benefits of Kegels for Arousal and Lubrication Kathe says that a lot of mother struggle with getting adequately lubricated for sex after childbirth. This is a completely normal phenomenon, so she dispels the myth that only menopausal women struggle with it. Kegels and other physical interventions can really help with lubrication. Arousal is another closely related facet of sexuality that kegels can improve. During the “4th trimester” it’s hard for mothers to get aroused. Strengthening the pelvic floor can help immensely. For strengthening the first layer of muscles, she suggests the technique called the “wink and nod”. She says that if you squeeze and think about moving the clitoris, closing the vaginal lips, and winking the anus you can strengthen the first layer of muscles. For the deeper layer of muscles, you would seek to bring your anus to your pubic bone, so to speak. For much more on that, listen along! How to Release a Tight Pelvic Floor Kathe says that there are cases where the pelvic floor actually is too tight and could benefit from a regular release of tension. For those who perhaps are too tight, she has a wide variety of diaphragmatic breathing exercises that can help. She goes into much more detail on how to know if you can benefit from tightening or loosening exercises. Definitely, don’t miss that! Resources for Kathe: Her website: https://kathewallace.com/ Her book: Reviving Your Sex Life After Childbirth Free Pelvic Floor Handout: https://kathewallace.com/resources/free-handout/ Questionnaire for Females About PFD:

My guest Lucie Fielding identifies as a nonbinary femme. She is a Resident in Counseling, where she practices under supervision as a counselor in Charlottesville, Virginia. In addition to her professional education and experience in Counseling, Lucie has a Ph.D. in Literature, which has been invaluable for analyzing the narratives and power dynamics at play within our society. Those same cultural scripts have very real socio-political circumstances for LGBTQ and nonbinary communities, especially. Within this episode, she talks about the importance of finding the Embodied Sexual Self, of Intimate Justice, and a wide range of concepts that can only improve the quality of understanding for all who want to improve their sexual knowledge. This interview was a treat, and I know you’ll enjoy it. Changing the Patient-Caregiver Conversation Lucie says that things are not going to get better for nonbinary individuals if the dialogue between patient and primary caregiver does not come from a place of knowledge and nonbinary thinking. She says that there is a false dichotomy at play that doesn’t take into account the complex spectrum of trans–sexuality. Informing yourself and preparing for those conversations opens the door for progress and much broader conversations about sexuality and pleasure when it comes to hormone therapy sessions and the possible outcomes for each trans experience. She says it’s important to not foreclose conversations with “loss” or “function” based language. Instead, a much more open and optimistic outlook that factors in the wide range of potential experiences of trans–sexuality can truly become a great methodology for patient-caregiver conversations. Intimate Justice and Oppression Lucie states that a really key concept is one that was developed by Sara McClelland called “intimate justice.” This term defines sexual satisfaction through factors that vary from person to person and depends largely on the different strata of socio-political experience. In other words, a lot of the time, sexual satisfaction is output-heavy and hardly takes into account the existential burdens or oppressions that some people can experience in their day-to-day life. Because someone who is oppressed often has a narrower window for sexual satisfaction, intimate justice is key because it sets out to provide the full picture on sexual satisfaction, and not provide a binary framework that often pits “normal versus not normal” instead of more accurate designations. Lucie says much more within the episode. It’s really worth a listen! The Embodied Sexual Self Lucie defines the Embodied Sexual Self as coming into your own body: to experience the corporeal senses of your body and to come to your own understanding of your sexual being. This goes hand and hand with cultivating a passionate relationship with a partner or multiple partners where you experience the full embodiment of your sexual self. And there can be a wide range of relational energies that connect intimacy with passion from an interpersonal perspective. Providing a Safe Space for Sometimes Scary Conversations Lucie says that her practice provides a safe space for initiating difficult conversations and explorations of the uncertainties of trans–sexuality. In this sense, she encourages her patients to take the plunge and explore areas of their psyche and sexual identity they might have not had the courage to explore on their own. Creating these opportunities for transsexual and nonbinary individuals is absolutely essential for the overall psychological health of the community. She says it’s often a leap of faith, but one that’s so worth it because the benefits outweigh the costs. Mystifying Sex Within the interview, Lucie introduces the concept of mystifying sex – which, to frequent listeners of this podcast or advocates of continued sexual education, might seem...