Low Female Sexual Desire

Many women complain of having little sexual desire. Such women tend to feel bad about themselves because of what each may perceive as a personal inadequacy; often just another item added to their list of self-perceived short-comings.  While speaking to an area gynecologist, he voiced that he and other women’s healthcare physicians frequently hear this complaint from their female patients. The following is an exploration of many causes of low sexual desire, lack of desire and outright avoidance of sexual activity all together. This article makes many generalities which may be true for some, but not all women.

    The basis of this article is that sex is a healthy part of the human experience, for both men and women.  This article also is based on the belief that sex is integral to the human experience and need not be linked with shame.  Most relationships include some form of sexual expression and activity, and that an overwhelming majority of healthy partners expect, desire and even need some form of sexual activity to occur for the relationship to remain vital, satisfying and healthy.

    But what causes this phenomenon of low female sexual desire?  It is impossible to pin down what is a normal level of sexual desire, which exists within a broad range. Some healthy women feel that sex is not very important while other healthy women desire some form of sex on a daily basis.  Most women fall into the middle to lower end of this range.

    It is possible that a woman and her partner will have wide and potentially disruptive differences in their levels of sexual desire even while the levels of desire of both partners resides within the “normal” range. The friction between a woman with low sexual desire and her high-desired partner can threaten the very existence of their relationship. It can be the source of much pain and frustration.  A number of distinct factors contribute to women having the subjective experience of having little sexual desire.

Lack of Desire vs. Sexual Opposition

    What seems to be “low desire” may not even be low sexual desire. Having desire for sex is obvious in that it results in clear action of seeking out sexual activity, but the lack of such desire may actually be a wish to avoid sex, but for legitimate reasons.  The two are often confused.  Women may call her inner experience “lack of desire,” rather than distinguishing between these two distinct conditions. Low desire is characterized by devoting little or no effort to make a sexual experience happen, accompanied by little interest in doing so. A woman with low desire may not have an interest in sex, but also may not be strongly opposed to it either. Whereas not wanting sex, is not lack of desire, but instead is about an outright opposition to a sexual experience. Opposition may be expressed as a direct, “No, I don’t want sex,” or less obvious, passive maneuvers to render the possibility of a sexual experience unlikely.

Female Sexuality is Not Male Sexuality

    There may be an assumption by a woman and/or her partner that she should feel sexual desire in the way that a man does.  The temptation to view female sexuality through a lens of male sexuality can be destructive and create inaccurate conclusions as to what is healthy female sexuality, a practice of which at times both men and women are guilty. Just as male genitalia are obvious and “out there,” male sexuality is similar in that it is more openly expressed, direct and advertised.  The result of this is that male sexuality has become the model of sexuality as a whole, in which female sexuality mistakenly included.

    One assumption that exists about female sexual desire is that it should be similar to male patterns of desire.  An example of the male paradigm adopted by or expected of women is displayed in television shows such as Desperate Housewives and Sex in the City where women have high sexual desire and proactively act upon it. For many women this does not accurately reflect how they experience their own sexuality, but may function as a nice fantasy.

    It is not easy for men to understand their female partner’s sexuality. Men are much more likely to view their sexuality and their desire as a distinct part of themselves, whereas for women, it is more usual that her sexuality and desire is a part of herself that is intricately woven into her sense of self and all other aspects of her life.  Different than men who are more likely to use sex as an activity to relieve stress, most women experience sex as something that can be embraced when all else feels right. So a difficult situation, such as stress, problems, feeling overwhelmed or low self-esteem, may cause a man to have increased sexual desire while it can cause a woman to have lower desire.

    Rather than having desire that interrupts her through the day as a strong longing, urging and hunger, the way many men experience it, for many women, this experience is just not present.  And this is not abnormal or an indication of a problem.  Instead, a feeling of well-being, of self-satisfaction or of closeness with her partner, may result in a woman being receptive to a sexual experience.  But unlike a man, many women are not likely to experience anything similar to desire until after the sexual experience is underway and her body has become aroused.  It is then that many women feel desire. The expectations of many have the order of events reversed.  If a woman believes she should be the other way around, just her self-criticism may be enough to cause avoidance of sex.  Being criticized by her partner for not having “his kind of desire,” can be enough to dampen her receptivity.

Reasons For Opposition to Sex

    It makes sense that a woman might not want to be sexual at all if the physical or emotional discomforts outweigh her pleasures. Most of the reasons listed below as to why a woman would be opposed to being sexual fall into that category.  Many are emotionally-based causes for opposition, yet may not be obvious to a woman or her partner.

    The level of a woman’s self-esteem has a direct bearing on her sexuality.  If she does not feel good about herself, it is likely that she will not want to make herself vulnerable by allowing another to experience what she fears is an intrinsic lack of worthiness.

    A woman may hold beliefs that sex is dirty, bad or sinful, but be largely unaware that such beliefs are present.  Such beliefs are often subtly fed to women in their upbringing; since female sexuality remains tinged with societal ambivalence and shame. An early family environment lacking in positive touch, support and encouragement, the modeling of love and affection, and information about the healthiness of sexuality trains a girl to avoid closeness and positive touch; as a woman, she may feel uncomfortable with her body and her sexuality. An early family environment that also included shaming, criticism, and disrespect have an even more profound effect on developing unhealthy attitudes towards or avoidance of sex.

    At the extreme are damaging experiences of emotional, verbal, physical and sexual abuse. Woman who have been abused, which accounts for an estimated one in three, may not have the capacity to trust another or feel safe enough to let a partner as emotionally close as sexual activity demands. If her traumatic experiences remain unremembered, or undisclosed, a partner may incorrectly assume that the woman has no desire for him, whereas emotionally, she is uncomfortable with vulnerability.  

    Many women are unhappy with their bodies, feeling that their bodies do not possess the beauty or sexiness that a woman’s body “should.” Some women are uncomfortable with their vulvas, a possible contributing factor to the overall discomfort of a sexual experience. It is not uncommon that a woman has never viewed her vulva, and holds the belief that her vulva is an ugly, unappealing, even dirty part of her body.  Having discomfort with her vulva, a woman may avoid letting her partner get close, especially for oral or manual stimulation.

    Since a woman’s sexual receptivity may be emotionally and relationally-based, the quality of the relationship between a woman and her mate can have a direct effect on her openness to being sexual. If the relationship is troubled or of poor quality, a woman may not desire sex with herpartner. The accumulation of negative emotions, such as anger and resentment, in a long-term relationship tend to extinguish the flames of sexual desire causing a woman to avoid being sexual.

In general, men seek to build a close connection to their female partner through sex.  Generally women build this connection through non-sexual means, such as sharing, non-sexual touch and affection, spending time together, talking, gaining understanding and mutual support.  In relationships, both partners make the effort to build and maintain connection, but because partners often go about this task in differing ways, tension and conflict can arise.  If the male partner is strong in his efforts to be sexual, but is not attentive to his female partner’s method of building an emotional connection, her interest and desire to participate in his methods, through sex, probably will diminish.

    In general, negative emotions negatively affect the quality of a relationship between a woman and her partner, and negatively affect the sexual relationships between partners.  Conflicts exist in all relationships, whether those conflicts are expressed or remain unexpressed.  All relationships include unresolved differences between partners.  The question as to what degree those unresolved differences contaminate the good will between partners or not is significant both for the health of the relationship, but also for its impact on the partners as lovers.  Especially in long-term relationships, where time has allowed for unresolved conflicts to fester, and for negative emotion, such as anger, resentment, bitterness, etc., to accumulate, these negative emotions can effectively kill sexual desire and eliminate sexual activity from a relationship.

    If there exists any tension between a woman and her partner regarding sex, then the sexual arena can become polluted with negativity.  Included in this is a partner’s request for sexual activities about which the female partner is opposed.  If she worries that her partner will request these unpopular sex acts, she may opt to not be sexual at all so as to avoid facing a situation in which she either says no, or puts herself in a undesirable sexual situation in which she would be selling out her own preferences. A woman pressured to be sexual in ways that are uncomfortable for her may contaminate sex and cause it to lose value for the female partner.

    If the sexual experience is painful for a woman, she may seek to avoid sexual activity.  Not all understand that if a woman is healthy, sex and intercourse need not be painful.  Yet without this understanding, some women think pain is a normal part of sex and subsequently choose to just “grin and bear it.”  Doing so may cause cumulative physical harm and sexual problems for both partners.  Healthy sex need not be painful.

Power Dynamics and Desire

    A facet of relationships can be a competition, battle or negotiation for power.  One place in which a battle for power can be waged is in the sexual relationship between partners.  In a healthy relationship, power is shared and divided in some kind of equitable manner.  In unhealthy ones, power is used in ways that do not benefit both partners. Sex can be one medium of exchange in the relationship or it can be an arena in which power is displayed. If power is unevenly distributed between partners, especially in the extreme, the female partner may lose sexual desire.  If she owns most of the power, she may lose respect for her male partner and subsequently not desire him.  If he has too much power, in her powerlessness she may feel bad about herself, have little self-respect or have resentment towards her male partner; either situation can produce a lack of sexual desire. A woman who feels she has no choice but to be sexual, whether or not she wishes to share herself, will lose desire as her sense of self and sense of her body are not being respected.

The Power to Choose

    Children cannot own power because they do not possess the judgment or cognitive skills to make responsible choices.  In a healthy environment, children are given small amounts of power by their parents so as to practice using power in constructive, successful ways without risking too much harm in the process. Adults, who as children, had not been allowed to practice using power, grow up without developing the capacity to make good choices, to make choices at all or to vocalize their needs.

    Such individuals typically were parented by adults who were controlling or abusive...parentswho were unable to let go of their own needs in order to address their child’s needs.  If a girl’sneeds were never considered, that girl will grow up to become a woman who will also ignore her own needs or be unable to assess or value her own needs including sexual needs.  

    Women who grew up in these kinds of family environments are unlikely to possess the kind of personal power commonly associated with adult maturity, such as emotionally participating in a relationship or sexual partnership as an equal partner. For such a woman and her partner, her behavior may look a lot like lack of sexual desire, but is probably less about lack of desire than it is about sexual avoidance, in which avoiding a sexual encounter is an automatic reaction as an attempt to side-step discomfort.  Such avoidance is not a conscious choice, but a reflexive reaction, much the way a person will duck without thinking if she or he see something flying at her or his face.

    Having power and the power to make a choice, but for a woman who grew up in such a family where she was given little power to make choices, owning this kind of power is not a choice.  Emotionally, for this woman, having power is not an option, and is not considered.  This emotional position, however, significantly affects the woman’s relationship with her partner, and the sexual relationship.  So much of a relationship is determined by how partners negotiate their differences and how each negotiates to get her or his needs met.  A woman who does not own her power cannot be a partner to negotiation. To have a position in a negotiation, a partner must own power. A woman who cannot own power will avoid such negotiation, will not take a stand on an issue, is not likely to speak up for herself, if confronted is likely to either emotionally break down, become silent, or explode in a defensive eruption; all of which prevent negotiation from occurring and a resolution from being reached.

    This lack of power shows up in the sexual arena when the woman cannot voice any choices or preferences for sexual activities.  She may participate passively in sexual play for her partner, but does not experience the interaction as for herself.  Her partner’s request for sex is likely to feel to her like a command, about which she has no choice, and in which she must please her partner or be a bad partner, but the power to voice choice in the matter does not exist.

    Still many women are able to own their power, but still feel they have no choice in the matter of being sexual or not.  Many women, in relationships with high or very high-desired partners feel that they must constantly choose between undesirable options: have sex and feel bad about themselves while avoiding conflict or say no to sex and be saddled with an angry, pouting or abusive partner.  A saying I have heard is: “If she cannot say “no,” then she cannot really say “yes.” Feeing that she does not have choice in being sexual has a high chance of producing in a woman no desire for sex.

    For many women, stress is a large, negative influence that interferes with sexual receptivity.  The feelings of being overwhelmed and exhausted may cause a man to seek sexual release as a way to rid himself of tension, but for many women, it is not sex which nourishes as much as other activities.  This is especially true of mothers of young children.  It is not unusual that the situations which cause stress are also factors which interfere with partners spending time together.  While for most men, sex is the way to reunite and re-establish a connection, the opposite tends to be true for most women; who need to re-establish an emotional connection first before sharing themselves sexually.  So for women living in very stressful environments, the lack of a sense of connectedness may look like a lack of sexual desire.

Boundaries

The emotionally stronger a woman is, the more she can define her boundaries, set limits, assert herself, while also being emotionally open to others and her partner.  A woman who is not emotionally strong may not have her personal boundaries defined at all and routinely allow others to violate what stronger people would experience as poor judgment.  The weakness of boundaries prevents a woman from being able to have the power to assure her own personal, emotional safety. The closer two people emotionally get, such as partners in a love relationship, the more effort and the greater sense of self it takes to keep these boundaries distinct.  If a woman’s sense of self is not strong, she may have the experience of losing her self, and her identity within the relationship.

    Boundary considerations are heightened during sexual encounters between partners because it is during sex that two people have the potential to emotionally and even physically merge. If a woman’s sense of her own self is not well defined or strong, sexual experiences can be anxiety-provoking and uncomfortable, causing such a woman to avoid the potential discomfort by avoiding the sexual experience.

    Partners sometimes make assumptions instead of obtaining the correct information that direct communication provides.  There is no arena within love relationships that is more negatively affected by this tendency than in sex. Because sex is often tainted with shame and embarrassment, partner commonly avoid direct talk about sex.  Yet sex is a team sport.  Just like all other team sports, the chances of victory are increased if the players communicate well.  Assumptions are boundaries that have not been well defined.  If the sexual needs, desires, interests, preference, dislikes and curiosities are never discussed, sex can be an activity complicated with uncertainty; a state which may cause a woman’s lack of interest.

Quality of Sex

    The quality of the sexual activity between a woman and her partner can affect her desire to be sexual.  Certainly men and women are not eager for bad sex.  Because of the tendency for men to not understand female patterns of arousal and the tendency of many women not to voice their own needs while ignoring their own body’s signals, the chances for highly pleasurable sexual experiences are not as high as they could be. Because women respond to stimulation and reach arousal much more slowly than do men, it is not uncommon for couples to engage in intercourse before the female partner is ready, resulting in a sexual disconnect between partners, an occurrence which prevents the female partner from experiencing as much sexual pleasure as is possible.  If this pattern develops, a woman may experience a lack of interest in engaging in a sexual encounter in which her needs and high pleasure are not incorporated into the timing of the sexual play.  This can occur without her conscious knowledge, but instead, she just has a feeling of “I’d rather watch TV.”

Sensuality and Pleasure

    Having lack of desire or lack of interest in sex does not mean that a woman has no interest in pleasure.  When non-sexual pleasures are considered, such as a delicious meal, fragrant perfume or the feel of a skilled massage for example, it may be evident that a woman’s sensuality is very much alive, even if the potential sensual pleasure in sex is nullified by other factors. A woman who lacks sexual desire does not always lack an interest or enjoyment of pleasure.  In fact she may pursue non-sexual pleasures.  The pleasures that are possible in a sexual experience are often discounted by a woman who opposes sexual activity, in that the possibility of pleasure is prevented by emotional or relational factors.

    Having developed a pattern of opposing sex, these tendencies may continue beyond the existence of underlying causes.  In other words, opposition to sex may be its own cause, having gone unchallenged in the pursuit of growth. If the causes have been eliminated or outgrown, acknowledgement of the potential sexual pleasure can be a path towards embracing sex as a healthy and important part of being female.

    While some pleasures may be acceptable to women in many ways, such as enjoying deliciousfood, or making a purchase or spending some enjoyable time with friends, bodily pleasures may be a distinct category of pleasure, which is tarnished by guilt or shame.  Subtle cultural and religious messages have pervaded the sexual development of women which have pronounced bodily pleasures sinful and immoral.  Many women hold themselves back from sexual pleasure for this reason, even if they are not conscious of these subtle learnings.  The only purpose of the clitoris

Having Sex When Desire is Not Present

    Since it is more common that the male partner is the “high-desired partner,” many women share themselves sexually when they have little interest in doing so.  While treating women for sexual difficulties, I hear from my female patients frequently, “I had sex with him just to get him off my back.” The pattern of engaging in sexual activity when no real interest is present potentially buildsresentment, which can deepen a women’s lack of interest in sex.  Also a woman sharing herself when she truly does not wish to, causes an internal disconnect between a woman and her body, her emotions and her self-respect. This is because her fundamental needs during the sexual experience and possibly in the relationship are not being met. In a relationship where there is a large difference in desire between partners, participating in sex, even when there is no desire to do so present, can be an act of generosity and love, that is if the participation is not due to control by the partner, or threat of anger.  The test as to whether sharing oneself sexually even without desire is harmful, is whether or not resentment results.

    Other factors which contribute to low sexual desire are health problems and medications.  Poor health and poor mental health contributes to lack of interest in sex.  Physical problems limit the kinds of activities…making sex more complex and the politics of sex more complex, thus increasing the moments when choosing not to be sexual is easier, especially when tired.

    Among the symptoms associated with depression are low energy, fatigue, lack of interest in the usual desired pleasures, lack of motivation and lack of desire for sex. Depression is not always easily detected, even by the depressed person. Depression can be low-grade and chronic, which has become to a woman just a normal part of her everyday life experience.  

The Ability to Relax

    Relaxing is necessary not only for a high quality of life, but also it is a necessary ingredient to have fun, to laugh and to have good sexual experiences.  The ability to relax is not always easy to come by, especially in our fast-paced high-tech contemporary lives where demands are high and time seems short. Much like a rubber band that has been stretched for a long time and can no longer snap back to its original size, many women maintain fast paced lives for so long that they can no longer relax.  Good sex requires a significant ability to relax.  Many women complain that they feel unable to slow their minds down during sexual experiences. If there is something about sex that is problematic for a woman, she might have trouble concentrating on the sensations provided by her lover’s stimulation in her body, and find herself thinking about non-sexual matters. This may also be true if she is anxious about sex itself. The discrepancy between the pace of daily life and the much slower pace of a sexual experience can cause an internal disconnect. Sometimes women seek to speed up the sexual experience, both to better match her internal pace, but also if she is uncomfortable with being sexual, to get the experience over quickly. If a woman is unable to relax, the sexual experience can produce discomfort simply by heightening her awareness of her inability to relax and of the potential pleasure she is incapable of experiencing at that moment.

Lack of Information and Unrealistic Expectations

Even in this age of great availability of information, women and their partners still may lack the right information and knowledge about sex and female sexual functioning.  Male partners do not always the understanding the importance of clitoral stimulation for a woman’s sexual pleasure and its importance in the achievement of the female partner’s orgasm.  A woman, even if she is aware of this, may not tell her partner. Many couples are uncomfortable speaking about sex and avoid doing so to minimize the risk of hurting the partner’s feelings or to avoid feelings of embarrassment.  Both men and women may expect that female orgasms should occur during intercourse, an activity during which direct clitoral stimulation does not occur. Statistics reveal that most women do not reach orgasm through intercourse.  Unrealistic expectations can make a sexual experience disappointing. They may contribute to the female partner not desiring the kind of sexual experience she and her partner routinely have.

Complexity

At its best, sex is an interaction between partners that is both natural and simple.  The more that negative differences between partners pollute the essential simplicity, the more undesirable the sexual experience can be for both partners.  If sex is complicated by negative emotions, sexually-related conflicts, a high frequency of problems, dissatisfactions and risks of disappointment, then sex becomes overly complex and loses its allure.  A woman may react to this state of affairs before her male partner, especially is she is the lower-desired partner. To her partner, she may seem to have lack of sexual desire.

Sexual Problems

Sexual problems are unfortunately common and tend to be more common as women age.  Among them are difficulties of becoming aroused and difficulties at achieving orgasm.  Both of these problems, if not attended to, could be an obstacle to a woman having sexual desire.  Some of the previously-mentioned factors, such as anxiety, or being sexual without desire can interfere with arousal. Medications also can inhibit arousal.  But if a woman engages in intercourse prior to being fully aroused, the experience may be uncomfortable and ultimately painful…potentially forming a vicious cycle including decreasing sexual desire.

    Orgasm, too, if problematic can be one element in a negative cycle that includes or causes low sexual desire.  Some women have never achieved an orgasm and are unsure about what it is. Many other women have routine difficulty achieving orgasm.  Roughly one-third of women have never experienced orgasm at all and approximately two-thirds rarely experience orgasm through intercourse, when direct clitoral stimulation is not present. Most women can learn to experience orgasm. Neither many women nor their partners are aware of the reality that these statistics bear out.  Unrealistic expectations regarding orgasms can lead to frustrations, disappointments and even accusations. Reaching orgasm can be nearly impossible for most women if strong negative emotions, such as anger, depression or anxiety are present.  It is an unusual woman who is eager to enter into a sexual experience in which disappointment is assured.

    Medications can reduce the possibility of orgasm.  In situations where a woman knows that orgasm is unlikely, and/or if there is pressure from her partner because her orgasm is important to him or her, it may result in the woman having very little desire to have a sexual experience at all.

    Most medications have a negative impact upon sexual response, such as interfering with arousal, evidenced by lack of lubrication, but also interfering with the ability to experience orgasm, thereby reducing the quality of, and can indirectly resulting in lack of desire for what may be perceived as a less-than-satisfying sexual experience. Many women are not aware that birth control pills have a negative side effect of lowering a woman’s sexual desire in that birth-control pills cause testosterone levels to fall. If unaware of this truth a woman may needlessly blame herself for her lack of sexual interest. Anti-depressant medications are notorious for reducing sexual desire.  Most medications have a negative effect of sexual functioning and response.

     Among the health considerations are hormone levels.  Just as for men, the hormone testosterone also plays an important role in female sexual desire, especially a factor for menopausal women.  If a woman has a low level of this vital hormone, she may then have a lack of desire for sex.  For general well-being, including a healthy level of sexual desire, proper balancing of the levels of all hormones, estrogen, progesterone and testosterone is optimal.    

    While not being the largest component in a love relationship, sex is an essential ingredient in most love relationships.  Low female sexual desire interrupts that essential ingredient, and if uncorrected can and does create great damage to many marriages and love relationships.  This article has detailed many of the factors which contribute to a woman’s opposition to and/or lack of desire for sex, but by no means has it explored all of them or in the most detailed manner.  Female sexuality is highly complex. The attempt to understand why a woman has lack of desire, or avoids sexual activity, must start with respect for and consideration of her uniqueness.

Andrew Aaron, LICSW


Loving Our Partner, A Spiritual Discipline

A majority of people join with another to form a love relationship. Coupling up is just what we do. Of those who have become single due to breakup or divorce, many go on to search for a new partner with whom to form a loving bond. Probably more than not make a commitment of love. What is underneath this urge to practice love?

In our lives love is of primary importance. Years ago a song declared in its refrain, “Love makes the world go round.”  Many songs are about love, or the loss of love.  A similar theme is expressed in most every world religion and many spiritual traditions; loving the divine, loving life and gratitude for life. Is the consistency of these themes across popular music and spirituality a coincidence?

No. Whenever and wherever we love the deepest purpose is always the same.  Music is considered a universal language, but an even more compelling element of universality is love, which exists among every people everywhere and during every time. Though how love may be expressed is unique in each time and place.

The strong pull of attraction to another often results in a loving bond. Early in a new relationship the intensity of attraction and connection is ecstatic. (See the article “Better Loving Through Chemistry”) It leaves an impression that lasts throughout the relationship or throughout a life. When a deeper love is possible, it is hard to resist.  Love is as essential as every breath we take. Love is the most powerful drug that exists. An even more magical quality that love possesses is its unifying ability to transform separate people into a community, a nation, a world and two people into one couple.

If love is so wonderful, then what about all the adversity romantic partners experience at maintaining a love relationship? The divorce rate is near fifty percent. Unmarried couples end their loving connections even more frequently. Relationships and marriage are hard. A truth often expressed is that hard effort is necessary to obtain something of truly great value.

Our love relationships are the arena in which we practice so as to strengthen our love...not the love that is most often spoken about, but the love that is unconditional and perfect. (See the article “Love is Perfect”) Just like when people go to the gym to strengthen their muscles, getting toned, fit or making muscles big requires hard work and much sweat and maybe tears. It’s not easy. Love is much bigger than that.  Love, or in other words the Divine, wants us and the way to get more of us is through love.

In spiritual traditions, seekers, aspirants or monks practice discipline to rid their lives of anything which separates them from the Divine, to have an ever closer relationship. It is an arduous grind characterized by asceticism. Loving the Divine through longing and devotion rids anything from coming between themselves and the One with whom they seek. For their hard work, and some grace, they are rewarded intimacy with the Divine.

For those of us who are not consciously following a spiritual tradition, the love we practice serves us similarly. By making effort to love more deeply, to love more kindly, more patiently and to stay with our loved one through adversity and dissatisfaction, we are perfecting our love which results in being ever near to love, which is none other than the One who is the love...the Divine. All along we didn’t realize that by being attracted to our partner we were being called to travel the path of love towards a closer relationship with life. Our love relationships are the discipline and practice that grinds us and perfects us so that we get closer to pure love, closer to the Divine.  It is hard work; no easier than the ascetic or monk, but nothing is easy that has real value.

Andrew Aaron, LICSW


Depression: When We Disappear

Depression steals a person’s energy, interest and life.  It is common. Most people will experience a period of depression at some point in their lives, yet the seriousness of depression as an emotional condition cannot be overstated.  For some, depression is part of a generational family pattern that has been genetically and behaviorally passed down from parents to children. For most others depression is situational, an emotional reaction to a painful event or adverse circumstances.

Depression exists along a broad spectrum from mild to severe.  At the mild end of the spectrum is Dysthymia, a mild but chronic depression that is persistently nagging but not dangerous just concerning. Far more severe is Major Depression, which may completely prevent a person’s daily functioning, often includes suicidal thoughts with a risk of suicide attempts and successful suicide, severely reduced interest in life and requires medication as well as a psychiatric hospitalization. Depression can be experienced in episodes that vary from very short (a day or two) to lengthy (months or even years) and in varying depths.

Depression should not be taken lightly as it may be life threatening, yet it is routinely dismissed by others due to the invisibility of an emotional condition as opposed to an obvious physical injury, such as a broken bone. Symptoms of depression may include depressed mood, low energy, lack of motivation, negativity, aggravated attitude, lack of pleasure in activities that used to be pleasurable (Anhedonia), increased or decreased appetite, increased or decreased desire to sleep, reduced interest in sex, withdrawing from life and seeking isolation, and possible alcohol or drug use as a way to escape the emotional pain.

For many who suffer depression, emotional habits may contribute to the development of depression. Regularly repressing painful emotions, especially angry feelings, may result in the rise of depressive symptoms. Low self-esteem (See articles on self-esteem) causes a tendency to seek to please others, avoid conflict, hold back from asserting oneself, and fulfilling one’s own needs all may contribute to this pattern. Perfectionism, ADHD and trauma also are conditions which may exist alongside depression. In addition to psychotherapy, depression and it’s emotional sibling, anxiety, are also treated with doctor-prescribed medication. Natural methods to relieve anxiety and depression include Tumeric and Curcumin.

A form of depression that used to be called Manic Depression but is now called Bi-Polar Disorder is characterized fluctuating moods which includes depressive episodes. Again Bi-Polar Disorder affects people mildly or severely.  Those who are severely afflicted experience volatile mood swings in which the depressive episodes are deep and may be life threatening, but also manic episodes which have symptoms of unbounded energy with an inability to sleep, sometimes grandiosity, unlimited spending sprees, running away from the home life, excessive sexual desire and irritability.

At its core a depressed person experiences a powerlessness to create a satisfying life. Depression is hopelessness. Love relationships are a rigorous life experience which may activate or “wake up” unresolved issues and challenge a partner regarding personal power.  Many a partner feels trapped with little control to influence the partner or quality of relationship, a situation that may easily cause depression.

Depression and Love Relationships

A partner who is depressed is unavailable for for a positive intimate and loving connection.  The depressed partner is occupied with having a relationship with his or her depression and is therefore less present for the relationship partner. Having less motivation and interest in activities that had previously been the source of enjoyment, a depressed partner becomes more solitary and less engaged in the relationship.  He or she may actively push the non-depressed partner away.

Depression Medication and Relationships

Many medications are available to help relieve the symptoms of depression and bring a depressed partner back to life, the relationship and their “old” self.  But medications do have a cost.  Most medications also produce side effects, but most comply the side effects are less problematic than the depression.  Typical side effects of anti-depressant medication include less sensitivity to emotions, flatter emotional experience, some cause weight gain, reduced interest in sex, and some cause inhibited or inability to achieve orgasm. Each individual and couple must evaluate their own situation to determine if the positive effects of medication outweigh the side-effects.

Andrew Aaron, LICSW has helped hundreds of individuals cope with the pain of depression and help to lighten or even eliminate the symptoms.

See Category about Depression


Female Sexual Problems

Sex is important to many women, yet many feel deeply conflicted about sex and their sexual selves. Influenced by society's impossible ideals of physical beauty and sexiness as well as many ambiguous developmental messages women receive about female sexuality many women are pained to allow their sexuality free expression.

Below is the description of many potential sexual stumbling blocks for women:

Low or No Sexual Desire

Lack of Arousal

Negative Body Experience

Lack of Orgasm

Pain During Sex

Discrepancy of Sexual Desire

Discrepancy of Sexual Interest

Vaginismus

Persistent Genital Arousal

Sexual Avoidance and Aversion

 

LITTLE, LOW OR NO SEXUAL DESIRE

The feeling of wanting sexual activity or sexual pleasure is common for most men and women and may be a little sign of health and vitality, but also of healthy sexuality. It is a problem when there is little or no desire for sexual activity, especially when in a relationship with a partner who does have sexual desire. This discrepancy of desire between partners can lead to significant conflict and tension between partners. Lack of desire may indicate an unhealthy physical condition, but also may be caused by numerous emotional conditions. Some people, but a small percentage, do, naturally, have little sexual desire without any accompanying health or emotional problems. Lack of sexual desire may also be accompanied by lack of sexual fantasies, lack of interested in others as sexual partners, and lack of a sexual response.

An important exception is vital knowledge. A majority of women, especially those who are older and post-menopause, do not have a regular or common experience of sexual desire.  A healthy pattern for mature women is desire that appears after an intimate experience has begun and her body has become aroused. This differs greatly from how men function. The difficulty posed by this difference is the tendency for women to hold the male pattern of sexual desire as the norm and assume because they do not feel regular sexual desire there exists something wrong with them. Women function differently than men in their experience of desire, which indicates no pathology.

“Getting over the hump” is a stressor for many women, which contributes to them choosing to say “no” to sex or avoid it altogether. For these women the “hump” seems just too high.  A good sexual experience requires a relaxed state, openness and receptivity.  These conditions seem to be impossible to achieve especially for women who are stressed, facing a constant onslaught of demands, have difficulty slowing down their busy minds and must cope with negative feelings, such as as the uncomfortable feelings that will be provoked by exposing their bodies during a sexual experience.  For such women, sexual interest is buried under too many negative elements.  Many women find that they just cannot “get over the hump” by letting to of all these issues to make themselves shift gears into a positive, receptive state.

There are exceptions. A significant percentage of post-menopausal women report no sexual desire and no response of arousal even after a sexual experience has started, a significant loss for some. (See section below on lack of arousal) An important consideration may be that many post-menopausal women are in long-term relationships which may not possess the positive emotional connection many women report is vital to arousal. More than a few women voice in a frustrated, resentful manner, “If I never had sex again it would be fine with me.” Such a statement may suggest that sex has not been a positive or satisfying experience that supports desire.

Some of the potential causes of low or absent sexual desire are:

▪️Relationship difficulties: If partners are not emotionally connected, it may lead to one or both partners having low desire. Relationship conflict, lack of trust between partners, the build up of resentment, or feelings of anger between partners all can dampen or fully put out any flames of sexual desire.

▪️Stress, feeling overwhelmed, preoccupied, anxious and fatigued may all kill sexual desire.

▪️Having small children at home is one cause of reduced sexual desire in caregivers.

▪️Depression, which is often internalized anger or feelings of powerless usually will eliminate sexual desire.

▪️Anxiety, like it's sister, depression, may reduce desire and cause a person to avoid closeness.  In some people anxiety tends to heighten sexual desire.  People who have strong feelings of shame regarding their sexuality may have anxiety which negatively impacts the ability to have sexual desire.

▪️Medications often have a negative effect on sexual response and functioning.  Many medications also reduce sexual desire.  Anti-depressant drugs are notorious for the reduced sexual desire side-effect.  Birth control pills also tend to reduce the user's level of sexual desire.

▪️History of trauma or abuse tends to cause those traumatized to avoid closeness, and especially the intense closeness of sexual activity.

▪️Having had negative previous sexual experiences with the partner or previous partners that have caused frustration, disappointment or hopelessness about having a satisfying sexual experience.

▪️Physical causes may also contribute. There are many possible sources, of which I will not list here. If you suspect that a physical problem may contribute to your loss of sexual desire, consult your physician.

▪️Poor body image: if a person feels uncomfortable with their body, and thus would feel ashamed or embarrassed to reveal the body, this may result in having little or no desire to engage in sexual activity. This category can include feelings of shame associated with a person's genitals and breasts.

▪️A history of participating in sex when one does not wish to be sexual. This includes one’s needs and feelings being unknown to or invalidated by he partner.

▪️When sex with the partner is dissatisfying because of lack of sexual education, lack of communication, lack of skill and lack of desired outcome, such as good sexual performance, emotional connection or orgasm.  Andrew Aaron, LICSW 

See article on Low Female Sexual Desire

See article on: Curing the Sexless Marriage

 

LACK OF PHYSICAL AROUSAL

After partners have already begun to engage in sexual activity, whether it be talking about sex, kissing or even stimulating each other's body or genitals, a physical arousal response is normal and healthy.  A distinction should be made between a physical and psychological arousal.  A person may feel aroused or turned-on, but not have the accompanying physical response. The opposite is also possible.

This typically means an enlarging of her nipples, sometimes a red flush on her breasts, a swelling of her vulva due to a condition called vasocongestion and the presence of wetness, lubrication from within her vagina, which functions as lubrication for comfortable intercourse.  Lack of arousal may mean that the swelling of the vulva due to vasocongestion does not occur, the nipples do not enlarge, and lubrication is not produce from within the vagina. The potential causes are several:

Physical causes which range from an unhealthy physical condition, hormone fluctuations, a past hysterectomy, or the onset or presence of menopause, which tends to reduce or eliminate the lubrication. If a women experiences pain during intercourse, or has in the past, this can prevent arousal. Such pain may or not be physical in nature.

Emotions may also interfere with arousal.  Any negative emotion such as anger, resentment, depression, anxiety, fear, etc.can have this effect. A history of trauma or abuse can result in reduced or absence of an arousal response.  Andrew Aaron, LICSW 

Medications or drugs may also eliminate arousal.

See article on: Tiny But Mighty: The Clitoris

NEGATIVE BODY EXPERIENCE

While not exactly a sexual problem, how a woman feels about her body has an enormous, profound and negative impact on how she feels about herself as a sexual being. A woman looks upon her body through the filter her self-esteem. If she struggles within to feel good enough, proud of herself, she will experience this inner self-rejection as manifested as ugliness in her body. For her, her shame shows up as body imperfections which justify self-criticism, self-deprecation.

Poor self-esteem expressed as body shame has strong negative influence on women as sexual beings, especially within the context of a long-term love relationship. All of the sexual problems listed in this article may be caused by or contributed to by inner shame and poor body experience. Andrew Aaron, LICSW 

See article on: For the Love of the Female Body

PROBLEMS WITH AN ORGASMIC RESPONSE

The lack of an orgasmic response to stimulation during  sexual activity can cause frustration and disappointment, but also hurt feelings and conflict between sexual partners. Orgasm is an extremely pleasurable physical/emotional/spiritual reaction to enough stimulation in which physical tension is reduced and is accompanied by a pulsing of the muscles in the genital area.

As many as 30% of women have not yet been successful at achieving orgasm. Some women may believe that they are incapable of an orgasmic response. Unlike men, for whom an orgasm is a physical reflex for which no learning is required, women may have to focus their efforts to learn how to have an orgasm.  Some women may have orgasms, but may have difficulty achieving it, and the necessary amount of stimulation for orgasmic response may be significant require an half-hour or longer. For most women direct stimulation of the clitoris is essential for the achievement of orgasm. Roughly half of women do not achieve orgasm through the experience of intercourse.  Other factors may interfere with a woman’s ability to have an orgasm:

Physical conditions, such as health problems and physical discomfort may interfere with orgasm.

Emotions, always the negative kind such as anger, resentment, fear or anxiety. A past which included experiences of physical, sexual, emotional, or verbal abuse and trauma may emotionally eliminate a woman's ability to have an orgasm.

Inability to focus, relax or concentrate have a negative impact on achievement of orgasm.  If a woman cannot relax, or if she has difficulty eliminating stray thoughts, orgasm may not be possible.  A woman who feels uncomfortable with her body may be unable to relax sufficiently to have an orgasm.

Knowledge and experience play a part.  A woman who does not have much sexual experience, or is not familiar with her own body, genitals, or sexual response, and has not "practiced," such as through the self-stimulation of masturbation to have an orgasm, may be unable to do so. Developing orgasmic capacity takes some practice.

Medications or drugs commonly have a negative effect on a woman's ability to achieve orgasm.  Medicine may reduce the orgasmic ability, slow the orgasmic response or eliminate it altogether. Andrew Aaron, LICSW 

See also article: Eroticism: What Turns Us On

See also article: Anatomically Different...Intimately

PROBLEMS WITH PAIN

Women at times experience pain during intercourse, which is called dyspareunia. Pain is a problem and is not part of healthy sex. If pain is experienced routinely during intercourse, there exists a problem which is best addressed with a doctor or another professional. The feelings of pain may or may not have physical causes. Sometimes a simple solution may be the use of a lubricant, but this will only eliminate pain caused by dryness.  Physical causes may include yeast infections, the presence of a sexually transmitted disease (STD), skin irritations and possible a cut or tear in the opening of the vagina or the inner vaginal wall.  Such pain during intercourse may also have an emotional source.  Women who have experienced physical or sexual abuse may have painful emotions associated with sexual activity and may experience this as physical pain during intercourse. Andrew Aaron, LICSW 

DISCREPANCY OF SEXUAL DESIRE

When sexual partners differ on the preferred frequency of sexual activity, tension may build between partners and even be the source of arguments. Unresolved, discrepancy of sexual desire may result in significant damage to the relationship and connection between partners, well beyond the arena of sex. As relationships transition through developmental phases, differences in sexual interest will increase and decrease causing tension due to frequency or infrequency. Andrew Aaron, LICSW 

See article: Sexual Desire and Men

See article on: Discrepancy of Sexual Desire

See article: Battling Desire Discrepancy

DISCREPANCY OF SEXUAL INTEREST

What each one of us defines as good or great sex varies from person to person. When sexual needs or interests vary widely, problems with sex are sure to follow.  Couples who easily and openly talk about sex may be able to resolve such a discrepancy, but most couples are not comfortable with talk of sex and do not engage in this kind of communication.  Unsolved, discrepancy of sexual interest may result in tension between partners, but also an accumulation of frustration, resentment and loss of interest in sex and infrequent sex. Andrew Aaron, LICSW 

See also article: Eroticism: What Turns Us On

See also article: Battling Bedroom Boredom

See article on: Curing the Sexless Marriage

VAGINISMUS

A different pain-related problem is called vaginismus. This is also a condition that is experienced only by women. This occurs when the muscles surrounding the vaginal opening are tightly closed, and prevent penetration for sexual intercourse. Vaginismus may be caused by emotions often related to discomfort with sexual intercourse and possibly due to uncomfortable feelings such as anger, resentment, disrespect for the partner, or from emotions related to past trauma, such as sexual abuse or rape. A physical cause may be the consequence of a woman having experienced painful intercourse chronically for a long period of time. The vaginismus may be an anxiety reaction to the anticipation of pain.

Originating from emotional or physical causes, women who suffer from vaginismus are unable to experience the comfortable penetration for intercourse.  In more extreme cases, penetration is prevented completely.  This results from the involuntary tightening of the muscles surrounding the opening to a woman's vagina either in reaction to the moment of penetration or more permanently, interfering with or preventing sexual intercourse.  So long as the basis for the development of vaginismus is emotional, as fear and anxiety may play a large role, sex therapy can be very effective at reducing the negative effects of vaginismus and of eliminating the negative effects from a woman's sex life. Andrew Aaron, LICSW 

Women complain that upon presenting to the gynecologist for an internal exam, the doctor is dismissive of their concern due to no physical evidence of a problem.  Women must not be dissuaded and instead accept their own experience as proof of a problem

See article on female problem with intercourse: Vaginismus: Painful and Harmful to Intimacy

DYSPAERUNIA

Is an emotionally-based sexual problem in which women experience pain during intercourse. If the problem is truly dyspaerunia, the pain is emotionally based, such as anxiety, fear, or unresolved past trauma, rather than physically-based, as the painful symptoms will suggest. Women complain that upon presenting to the gynecologist for an internal exam, the doctor is dismissive of the concern due to no physical evidence of a problem. Women must not be dissuaded and accept their own experience as proof of a problem.

PERSISTENT GENITAL AROUSAL DISORDER (PGAD)

Even though this a rare condition it merits inclusion here to potentially save a few women from tremendous discomfort.  This disorder in one in which a woman experiences chronic arousal, continuous orgasm or frequently spontaneous orgasm throughout every day, irregardless of situation or activity.  For most of us, orgasm is a positive and pleasurable experience, but for women who suffer with PGAD, orgasm is distracting and uncomfortable as well as unwelcome and unwanted. It is not a response to sexual stimulation, but instead it is a condition that may be emotional, hormonal or emotional or he combination of all three. Women afflicted with PGAD are often embarrassed and ashamed of a condition which introduces what is normally a sexual experience into all situations of daily life.  The condition is confusing.  Without much literature available and being a condition unknown to the general public, women with PGAD are unable to explain it to others without being dismissed because most think of orgasm and arousal as a positive experience. Even gynecologists may be unaware of this very difficult condition. Andrew Aaron, LICSW 

SEXUAL AVOIDANCE AND AVERSION

Lack of sexual desire and avoidance of sex are commonly confused.  While lack of desire shows up as no interest in sex, avoidance is expressed as opposition to sex.  At its foundation, sexual avoidance is based upon fear or discomfort with sexual activity.  A woman may not be conscious of her motives, but may notice that she would rather do most anything other than have sex, and is likely to cite reasons, rational and irrational, to escape from a situation in which sexual activity is a possible outcome.

Aversion is a deep revulsion of sex and sexual activity.  A history of sexual abuse may produce sexual aversion as can a variety of other historic emotionally harmful experiences.


Sexual Variations

Sex comes in countless forms and variations. The most common forms of sexual activity, those which do not challenge the partners’ comfort zones, are often referred to by those who do venture outside the common comfort zone as "vanilla sex."

 

But without any value judgements, people explore and experiment with innumerable ways to be sexual and every kind of sex is also a kind of normal. In a quest for intense excitement some sexual partners go beyond the line of "no more" for others. The types of experimentation and preferences excite and satisfy some while others regard these kinds of sex play as strange, weird and even disturbing. Andrew Aaron, LICSW has helped all kinds of sexual partners with the pain and limitations they bump into in their sexual journeys.

Open Relationships

Some married and long-term partners seek increased excitement by including additional sex partners beyond just each other. Couples choose multi-partner experiences for many reasons. Some partners strongly believe that they cannot be satisfied with just one lover. Others seek excitement of greater intensity. The unique eroticism of a partner May crave a particular kind of sexual interaction.

     The variations of including other sexual partners are broad as well. Sometimes couples choose to play with other couples. This may be an intimate relationship with a specific other couple or many couples. The open relationship may be defined by the partners as each is free to develop relationships and sexual relationships with others outside the primary relationship. Another variation is that a couple may have a single friend who joins in sexual activities. The opportunities for novelty may make the open relationship arrangement attractive because novelty is an aspect that creates high sexual excitement.

     At the same time that playing with multiple partners may heighten the sexual excitement, each arrangement has specific challenges. Whenever additional partners are included, the complexity of relationships increases. If boundaries, communication, complete openness, honesty are not rigorous, multi-partner arrangements may easily cause hurt, jealousy and awaken painful insecurities. A danger exists that new connections result in affairs that go beyond the agreed upon boundaries resulting in hurt, feelings of betrayal and damaged trust. If partners are not strong and secure, with great care and sensitivity to each other. Multi-partner experiences may threaten and harm the primary relationship.

Swingers and Swinging

A group of people who gather for the purpose of friendship, connection and sexual excitement are known as swingers. They gather for the purpose of exploring multi-partner sexual experiences within the structured but safe and contained environment of an invitation only gathering or at a club devoted to the swinging lifestyle. They operate with a set of rules so an understanding exists among members how to behave and an etiquette to follow so that the positive experience is maximized among participants.

     The same excitement and cautions exist among those who participate in the swinging lifestyle as do those who choose to have an open relationship. If boundaries, communication, complete openness, honesty are not rigorous, multi-partner arrangements may easily cause hurt, jealousy and awaken painful insecurities.

Polyamory

A different variation of multiple-partner sexual arrangements is polyamory.  Participants are open to forming multiple long-term love relationships simultaneously. Often a polyamorous individual has a primary love relationship and also spends time sharing love and sometimes sex with a secondary lover, a relationship that is completely known, understood and accepted by the primary partner. Among polyamorous couples, both partners may be involved with many others. There may be couples in which only one partner enjoys multiple relationships. A society of polyamorous people exists that have codify methods and practices to aid in the success of creating multiple positive and stable love relationships.

     The challenges of a polyamorous lifestyle are slightly different and perhaps even more challenging than the two earlier multi-partner arrangements because polyamorous couples are attempting to balance and maintain long-term love relationships simultaneously. Balance is the key along with rigorous boundaries, communication, complete openness, honesty, otherwise the relationships may become destabilized. Managing feelings of jealousy and insecurity can be strenuous.

BDSM

It is an acronym that stands for Bondage, Domination, Submission and sado Masochism. This kind of sex play tests the participants personal boundaries, which is part of the thrill. BDSM may or may not include multiple partners. The issue of power is played with so that partners fill roles of powerful and powerless in the form of a dominant partner and submissive partner. The roles are determined by each partner's erotic make-up. 

     Bondage, or tying up and binding a partner, is the way in which the dominating partner renders the submissive partner powerless. Trust is of utmost importance as the submissive partner surrenders completely to the power and will of the dominant partner. The dominant partner has the life of the submissive partner literally in her or his hands. Because power play can be dangerous pre-determined rules are formed so as to insure safety...such as a "safe word" the submissive partner may express to discontinue all play when a limit or boundary has been reached.

     Some BDSM players include the use of pain within the sexual activity. Doing so increases the level of intensity dramatically. Playing with pain causes the both the vulnerability and secretion of endorphins to cause the experience to be extremely exciting, but also forms an intense intimate bond between sexual partners.

Kink

A broad assortment of sexual practices and experimentations which may or may not include BDSM and which go beyond what is generally considered "normal" sexual activities. 


Male Sexual Problems

Men take sex seriously!  Effective sexual functioning provides men the confidence and self-esteem both in and out of the bedroom. Performing well sexually provides a man with power to stand proudly with his partner, and also to own his power throughout the relationship. Men take great pride in sexual performance and their sexual skills.  Most men regard good sexual performance as a masculine obligation and put much pressure on themselves to succeed. 

Click the links below to visit the description of many sexual stumbling blocks for men:

Premature Ejaculation (PE)

Erectile Dysfunction (ED)

Erections and Aging

Delayed Ejaculation

Sexual Compulsion and Addiction

High Sexual Desire

Discrepancy of Sexual Desire

Discrepancy of Sexual Interest

Performance Anxiety

Pornography

Sexual Avoidance

Premature Ejaculation (PE)

A man suffers from premature ejaculation when he is unable to possess sufficient control over the timing of his ejaculation to satisfy himself and his partner. In extreme cases, a man may lack the control to delay ejaculation even before the penetration of intercourse has begun. Many men do not possess sufficient ejaculatory control to hold off on ejaculating beyond one, two, or three minutes into intercourse, but well before he would prefer to time his ejaculation.  Lack of control causes men to be burdened with powerfully negative feelings of shame, embarrassment and inadequacy.  Some men are so deeply bothered by their lack of ejaculatory control that they avoid sexual opportunities, and those that are single, avoid potential sexual partners that comes with dating. Men who suffer with premature ejaculation experience a cycle of performance anxiety where their worry interferes with ejaculatory success and resolving the problem.

See below the section on performance anxiety

Men in long-term relationships who suffer from PE get caught in a cycle of frustration with their female partners.  When disappointing sexual experiences become the norm, female frustration may progress to contempt. Some female partners discontinue all sexual experiences when their male partner has not demonstrated good ejaculatory control, enough to provide her with satisfaction. An array of negative feelings will ripple throughout the relationship making problem resolution many times more difficult while partner suffering increases. Men are able to develop the kind of control they desire. With an increase in muscular control, sensitivity to their arousal, greater awareness of their emotional state, an increased capacity to relax and improved confidence, a man can possess the kind of control he seeks. Andrew Aaron, LICSW 

Erectile Dysfuntion (ED)

This problem can be caused by physical or emotional obstacles.  Poor health, heart problems, circulatory problems and medications, especially blood pressure medicine, can all result in poor erections or lack of erections altogether. Aging is a factor that naturally causes softer erections and the slower process of getting an erection. If an erection fails to live up to a man’s expectations or his partner, the conditions are present for the cycle of performance anxiety to be generated in which erectile dysfunction becomes a pattern.  However, strong negative emotions can also eliminate the potential for a man to experience a solid erection.  Fear, anxiety, stress, pre-occupation, anger can all interfere with full erections. If a man is in conflict with his sexual partner or harbors resentment towards the partner, he may have difficulty or the inability to achieve an erection. Andrew Aaron, LICSW 

Erections and Aging

As a man ages, so does his penis. Age-related changes are viewed negatively by most men and represent a loss. The changes a man experiences in his erections vary from man to man, but the aging process includes changes that are typical, such as erections which are not as firm as decades earlier. The older a man is, the amount of time to become erect is greater. As age increases, the negative factors that had interfered with a full erection occasionally, will prevent an erection often and easily, such as anxiety, busy mind or tension between he and his partner. A young man may become aroused upon seeing something or someone erotic (which can be embarrassing for a young man) but for an older man, an erection is unlikely even though he may be mentally aroused. Older men required direct stimulation to get and maintain an erection, a fact that can be disturbing to some men.

Aging introduces many challenges as bodies experience tests to health.  A healthy older man, into his 70’s or 80’s may experience full sexual functionality and sexual interest if he has good health. However, the opposite is also true, if a man is physically unhealthy he runs a high risk of losing sexual function. Heart problems and the associated medicine are an enemy to good erections. High blood pressure treated with high blood pressure medications are literally erection-killers. Physical pain can routinely interrupt arousal reducing the likelihood of a good erection.  Indirect to physical health is relationship health; most older are in older relationships, which have had longer than younger relationships to accumulate sources of resentment, that if not resolved may prevent arousal and erections when very close to the romantic partner.   Andrew Aaron, LICSW 

See article entitled: “Pipeline to Pleasure”

Delayed Ejaculation

Few men talk about this problem, which is the limited or inability to reach orgasm.  Men suffering from this grow frustrated by their inability, and may be troubled by their partner's reaction, such as taking their lack of ejaculation personally, as an indication of undesirability and feelings of lack of love.  At its worst, sufferers are unable  to ejaculate ever when with their partner.  Delayed ejaculation may also result in negative effects to the sexual relationship between partners.  In their desire for orgasmic success, partners may make lengthy efforts mostly resulting in loss of arousal, soreness, disappointment and frustration. Andrew Aaron, LICSW 

Sexual Compulsion and Addiction

Sex is a powerful force, though most men are able to sufficiently control their sexual desire from becoming unhealthy, unwanted or risky sexual behaviors.  Men with sexual compulsion or sexual addiction do not possess the necessary control to curb risky, self-destructive sexual behaviors, thus create problems for themselves, their partners and families. These men struggle with self-esteem, anxiety often due to past trauma, such as childhood sexual abuse.

     For men sex is deeply tied to their sense of their selves, thus when a man experiences deep inner pain or shame, he is likely to express it sexually. Men will seek to address their woundedness, experienced by him as incessant and unrelenting sexual desire, causing him to attempt relief through repetitive and frequent sexual experiences, such as compulsive masturbating to porn, demanding a high frequency of sex with the romantic partner, initiating frequent sexual hookups, and even sex in situations that are dangerous and highly unhealthy without regard to the effect on those who will be impacted, such as a romantic partner, family and friends. Sex and orgasm pump up a sense of self-worth and orgasm provides good feelings due to the release of brain chemicals that decease depression, increase pain threshold and provide a sense of well-being, a positive alternative to his daily feelings.

     The man who is sexually compelled will experience his sexual drive as controlling him; that he has no choice about it and cannot stop. Though externally the out-of-control sexual patterns look a lot like addiction, they are actually an expression of an emotional need for inner healing, self-love. 

     Men get caught in a cycle of intensifying sexual desire. His need for sexual gratification does not heal his inner pain, shame and self-hate. On the contrary, the more he pursues relief through sex, the more he hates himself which energizes his cycle of compulsion. Andrew Aaron, LICSW 

High Sexual Desire

Some do not regard this as a problem but just a healthy sign of masculine virility. Not all sexual desire is related to emotional pain. The presence of high level of the hormone testosterone produces high levels of sexual desire. Many men are not sexually compulsive...they do not act out sexually and their sexual desire is not driven by a desire to heal shame. Some men just have high and unrelenting sexual desire. These men are the ones that are the prototype for female's myth about men and sex; men whose desire cannot be quenched.

     High sexual desire is multi-faceted; men like feeling virile and like fitting into the high sexual model of great masculinity, certainly men like the pleasure of sex and being close to a woman and pleasing her, but the chronic sexual desire is uncomfortable, is present even when no sexual opportunity exists or at inappropriate times the result of which is that sexual desire is a distraction. Even after a sexual experience culminating in orgasm, within minutes the sexual desire is back. Though rarely does a man complain, but secretly many men wish their strong desire would go away sometimes. Andrew Aaron, LICSW 

     See article about Sexual Desire and Men

      See article about Men and Their Eroticism

Discrepancy of Sexual Desire

When sexual partners differ on the preferred frequency of sexual activity, tension may build between partners and even be the source of arguments. Unresolved, discrepancy of sexual desire may result in significant damage to the relationship and connection between partners, well beyond the arena of sex. As relationships transition through developmental phases, differences in sexual interest will increase and decrease causing tension due to frequency or infrequency. Andrew Aaron, LICSW 

See article: Sexual Desire and Men

See article on: Discrepancy of Sexual Desire

See article: Battling Desire Discrepancy

Discrepancy of Sexual Interest

What each one of us defines as good or great sex varies from person to person. When sexual needs or interests vary widely, problems with sex are sure to follow.  Couples who easily and openly talk about sex may be able to resolve such a discrepancy, but most couples are not comfortable with talk of sex and do not engage in this kind of communication.  Unsolved, discrepancy of sexual interest may result in tension between partners, but also an accumulation of frustration, resentment and loss of interest in sex and infrequent sex. Andrew Aaron, LICSW 

See also article: Eroticism: What Turns Us On

See also article: Battling Bedroom Boredom

See article on: Curing the Sexless Marriage

Performance Anxiety

Performance anxiety is an emotional trap. Once a man has experience of failed sexual performance and reacts with horror, a pattern becomes entrenched in which he worries about his performance in each subsequent sexual opportunity. Because a relaxed and positive attitude supports good sex and successful male sexual performance and fear, worry and negative feelings undermine good sexual performance, his worry contributes to a re-occurring self-fulfilling prophesy in which failed performance is worried about so failed performance occurs.

      For maintained arousal, manifested by an erection, a man must be relaxed and  undistracted to enjoy the pleasure of excited feelings in his body. If anxious, he is less likely to maintain arousal and be unaware or insensitive to physical sensations of excitement; he will lose his erection. The cycle is then repeated.  

     Men who have experienced failed sexual performance may be beset with painful feelings of inadequacy. Such men have a tendency to avoid sexual encounters. 

     Performance anxiety is an anxiety-based emotional trap that may snare anyone at anytime high pressure for high performance is in place. Whether it be a student regarding tests, an athlete regarding competitive success, a woman regarding sexual arousal, all are prone to vicious cycles of performance anxiety. Andrew Aaron, LICSW 

Pornography 

The use of pornography is widespread. In many cases men and their partners incorporate sexual material into their sex play in creative and positive ways often times as an aid to arousal. Yet in other circumstances, pornography for some men is an expression of sexually compulsive behaviors.  For others, especially those in relationships where their partners are opposed to the presence of pornography, porn represents a destructive force to the relationship, a sense of infidelity, and the healthiness of a couple's sex life.  Andrew Aaron, LICSW has helped many men and their partners negotiate the treacherous waters surrounding the issues of pornography. Andrew Aaron, LICSW 

See article entitled: "Coping With the Porn Factor"

Sexual Avoidance

For many emotional reasons, including those mentioned above, many men avoid sex, contrary to the prevailing myth that all men possess intense and incessant sexual desire. Some men have low desire or lack of desire which may be caused by low testosterone, depression or lack of confidence brought on by experiences of failed sexual performance. Others suffer from depression or due to relationship complications seek to avoid being sexual with their partners.  The effect of sexual avoidance can be negative and profound, from continuous hurt to the partner to causing the end to relationships.


Therapy Frequently Asked Questions

THERAPY

How long does therapy last?

Each person or couple is different. Every situation is unique.  The capacity of each person to grow or make change varies widely.  However, the average length of time in therapy is about 5- 6 sessions. Couples take 5 to 12 sessions to resolve most problems.

Will I/we be in therapy forever?

No. Most therapy episodes are short-term and time limited. Some clients set a specific number of sessions to work on a specific issue. While some clients do participate in therapy on an ongoing basis, a vast majority do not.

What is your theoretical approach to therapy?

I guide my clients in the development of personal strength and empowerment as well as practice love and compassion for themselves, their partners and others. Love guides my method. Yet my approach to therapy is eclectic, meaning I utilize many theoretical models and blend them together. Cognitive/behavioral therapy is my core method, but in couples work I am influenced by Susan Johnson's emotionally focused therapy approach. I will often encourage insight by my clients into their own feelings and issues. I operate out of a deep reverence for the free will of each individual to make his or her own choices. Click here to visit my bio

PAYMENT AND FEES

Why is Andrew Aaron, LICSW not a provider for insurance companies?

Insurance companies have practices that interfere with ease and success both for this therapist and for therapy. They reimburse at a low rate. They may reduce their reimbursement rate unilaterally without notice. Insurance companies typically require an authorization processes which are paperwork intensive and require some of your personal information. Their requirements may interfere with the therapy process and with your relationship with me. Additionally to obtain payment from an insurance company billing procedures must be followed that are too costly and time intensive.

Do you offer a sliding-scale fee?

Sometimes I will make accommodations for special circumstances, but doings so is uncommon. A potential client who is strongly determined to succeed has a better chance of getting a reduced fee.  At times when therapy has begun and financial problems interrupt the process, I may adjust the fee to help a client achieve his or her therapy goals.

KINDS OF CLIENTS

Do you work with gay or lesbian individuals or couples?

Yes. I have had many male and female couples as clients through the years and am knowledgeable about the issues concerning gay men and lesbians.

Do you offer family therapy?

While I do not consider myself a family therapist, I have experience helping the families of my individual and couple clients when significant issues require support and intervention. I do not provide family therapy as a primary focus.

Do you just work with adults?

I primarily work with adults and sometimes older teens. There have been instances where an individual client or the child of a couple who are client will bring into a therapy session a small child to address a specific issue that requires a short-lived experience in therapy.

THERAPY WITH COUPLES

With couples, what is Andrew Aaron, LICSW’s success rate?

This is a difficult question to answer. After therapy has finished, success is often defined differently than it was prior to therapy. Many individuals and couples return to therapy with me even though therapy goals were not completely met in the first therapy episode. In many instances, the original goals were large and the therapy experience helped the couple advancing one or more steps in the direction of achieving their goals. Many couples enter therapy with unrealistic expectations.  A majority of couples enter therapy as “our last hope” and have destroyed trust and goodwill before therapy and have a low chance of success.  A majority of couples who seek help do so far too late and have destroyed the ingredients needed for a successful relationship. On average, couples would be wise to enter therapy when problems are still small instead of waiting until they are of crisis proportions.

Do most individuals and couples succeed in therapy?

Many achieve their goals, but some do not and the reasons vary from having unrealistic expectations, living an unstable life that interferes with treatment stability, insufficient commitment to the therapy process and finding that more strength is needed than what is possessed to create the desired changes.

Why do you meet with each relationship partner individually?

When beginning therapy with most couples,  I meet with relationship partners separately at least once before proceeding with the therapy process as a couple. I learn about different information and often highly important facts in the individual sessions. As a couples therapist, the more informed I am, there greater is my ability to help. All information shared in the individual sessions is kept confidential and not shared with the partner unless permission is given.

Will you tell us we should breakup?

No. I do not consider giving this kind of judgement part of my role as a couples therapist and it is decision of the couple’s partners.  If faced with very difficult problems, I may indicate whether the partners seem to have the capacity or not to solve the problems.

What if my relationship needs help but my partner/spouse refuses to come to therapy?

Relationship or marital problems may be helped through individual therapy, up to a point, but it is better than no help at all and can reduce some of the suffering caused by problems through the development of improved strength and loving and learning new and better ways to influence the resistant partner. Andrew Aaron, LICSW has had much success at engaging the resistant partner to come into therapy to work as a couple.

If I get started in therapy individually, may my partner join me later? 

This is not an uncommon scenario. Often couples therapy begins with one partner working individually. I have had much experience helping the newly engaged partner feel comfortable and that the therapist is unbiased and open to understand and support the newly engaged partner as well as the partner who has been in therapy for weeks or months.

Is there a chance that couples therapy will harm my marriage/relationship?

There is always some risk, especially when relationship problems have been unresolved for long time and much resentment has built up. However, I have worked with hundreds of couples, many of whom enter therapy with enormous tension between partners. On rare occasions when a couple comes into therapy, the choice to get help precipitates instability that leads to relationship break-up.  I work with great care to do no harm and am overwhelmingly successful at helping not harming.

SEX THERAPY

How does sex therapy differ from regular therapy?

Sex therapy is different only in that the focus is on solving sexually-based problems; otherwise it is the same. I have years of training in the subject of human sexuality and therefore understand how emotions and psychology effects sexual functioning.

I have never spoke openly with anyone about sex, will I feel embarrassed?

Probably at first. Throughout our society, because of attitudes towards sex, many people have guilt, shame and embarrassment about sex.  Because of this, strength and courage may be required to talk about sexual problems. When a problem is painful enough, the embarrassment seems small by comparison. My clients notice that shortly after therapy has begun, due to my accepting and non-judgement approach, embarrassment and discomfort about the subject of sex quickly fades.

My problem seems physical, can sex therapy really help with a sexual problem?

Universally sex is thought of as a physical activity, but in my opinion sex is 80% emotional.  Most sexual problems are emotionally centered but manifest physically. In my initial evaluation of your difficulty, I will attempt to rule out a strictly physical cause. If I cannot, I will recommend a physical evaluation with a medical doctor.

As a woman, can Andrew Aaron, LICSW understand my sexual difficulties?

Through over twenty-five years I have provided sex therapy to hundreds of men and women and understand the discomfort and embarrassment of having sexual problems and of talking with a man about sexuality.  Additionally, I have the advantage of having talked to hundreds of women about the most common sexual difficulties and understand a woman's perspective, feelings and needs. As a professional I offer compassion without judgment. Through the years women have expressed to me after working to resolve sexually-based problems that they no longer think of me as a man or woman, but as a safe helper.

I would be uncomfortable talking to a man about sex. Will this prevent me from getting effective therapy from Andrew Aaron, LICSW?

No. I have helped many women with sexual problems. An initial discomfort and embarrassment quickly fades after experiencing that the environment in therapy is accepting and nonjudgmental.

Will therapy make feel better right away?

It may. Many couples feel hope and relief very quickly. Many individuals feel better due to having opened up and shared about painful issues. Feeling understood can be uplifting. However, some people who have buried much painful emotion may have to feel what they have internalized and therefore feel discomfort before feeling better.

How will I know if I am succeeding in therapy?

Clients notice they have greater ability to handle situations more comfortable, with greater skills or with greater ability to cope than before. Others start to feel better and notice a greater comfort at talking about previously uncomfortable topics in therapy.

 


Orgasms, Real or Fake?

Probably one hundred percent of men believe that their female partners don't fake orgasms, but in recent studies, approximately fifty percent of women admitted to having faked at least one. Remember the famous scene in the movie When Harry Met Sally? It was when Meg Ryan's character debates with Billy Crystal's about whether or not a male partner can tell when a woman fakes an orgasm.

    Her command performance of a loud fake orgasm in the middle of a bustling cafe suggested that men can't.  Since most people think a female orgasm should look dramatic and loud like Meg Ryan’s, a male partner's ability to judge the difference between real and fake orgasms is somewhat disabled, because many women actually orgasm quietly.  The difference between reality and expectation creates a murky situation in which lovers have difficulty creating satisfaction.

    Is faking an orgasm a problem? Can be. It is deceitful and signals a breakdown in communication.  Without sincerity, the satisfaction of an intimate connection is limited. Yet a fake orgasm is a seemingly painless solution to a difficult problem, like a little white lie.  On the surface, faking an orgasm can be motivated by kindness, to help a sexual experience end gracefully while saving face.  It may spare a couple awkward moments of discomfort.  At first the situation appears comical, but under the surface, some harsher truths are hidden.

    The reality of sex is that it is complex and highly political.  Partners' sexual choices are informed by both realistic and unrealistic expectations.  Self-esteem is on the line in each sexual encounter making sex a highly charged cauldron of pressure.  When good outcomes seem unobtainable, something's got to give...and often that is a well-executed faked orgasm. Woman react to the high expectations placed on them by their partners.

     If sex were less burdened with expectations, a woman may feel freer to say she hasn’t had an orgasm or doesn’t desire one.  This would be a vast improvement.  Unexpressed expectations create pressure for a sexual drama to proceed along a pre-defined plot, otherwise hurt feelings ruin a well-choreographed experience.  A faked orgasm is a symptom that a problem exists

    Why would women do such a thing? Each woman's reasons vary.  Most women don't orgasm during intercourse, but believe they should, so faking an orgasm helps them to live up to their own “should’s” about sexual performance.  Other women make this choice to soothe their partner's sexual insecurities; many men worry that their female partner's failure to reach orgasm their signifies their own lack of sexual skills, a misplaced burden some female partners carry.  Some women, if ready for sex to end, may fake an orgasm to gracefully conclude it.  A faked orgasm also frees a woman from having to ask her partner for the stimulation she may really need to reach orgasm, a conversation many women prefer to avoid, especially if she fears the request would upset her partner or be rejected.

     Is it a victimless crime?  The partner may never know how real a woman's orgasm is unless she herself reveals it.  Openness is a relationship ideal and faking an orgasm violates it. If sex is troubled by emotional disconnection, a faked orgasm does nothing to address the problem, but only prolongs it.  In an emotionally safe relationship, a more vulnerable but sincere approach may include having an honest discussion about sex, expectations and sexual limitations.  Gaining more sexual information may be an important step. It takes a strong person to embark on such a journey. The results may lead to learning and increased sexual confidence that benefits the relationship and heightens the mutual satisfaction of sex.  

Andrew Aaron, LICSW


Women Describe Their Orgasms

Excerpts from The Hite Report by Sheri Hite

🔺 Some are just a quick hard rush that shoots through my body like a bolt of lightning. Others feel like a slow burn. They build up over time. They tease me. They float up and down my body, spreading out like concentric circles until there's a burst of release.

 

🔺 My orgasms feel like water shooting up through the top of a fountain, tickling all the way, then shooting out in electric vibrations through my body.

 

🔺 During masturbation or cunnilingus, there is a strong feeling of the clitoris expanding and filling and becoming unbearably pleasurable, after which at about the moment of orgasm there is a shift to the vaginal area and then strong contractions to the vagina, with me trembling and swooning.

 

🔺 For me, orgasm is often this very still point. There's lots of movement as I'm getting increasingly excited, but when I come, everything becomes intense and still.

 

🔺 Orgasm is the most intensely pleasurable sensation I have ever experienced. It varies from a simple, too-quickly-concluded genital jolt to a full body rush.

 

🔺 There is .an almost frantic itch-pain-pleasure in my vagina and clitoral area that seems almost insatiable, it is also extremely hot and I lose control of everything, then there is an explosion of unbelievable warmth and relief to the itch-pain-pleasure! It is really indescribable and what I've just written doesn't explain it at all!  WORDS!

 

🔺 Sometimes orgasm feels very concentrated in my genitals. Other times, it's totally diffuse throughout my body. Sometimes, if I'm stressed out, it just feels like a physical release. When I'm relaxed, I feel like I'm floating in a place where there is no time and space,"

 

🔺 Suddenly, after the tension built and built, I was soaring in the sky, going up, up, up, feeling the cool air rushing by. My insides were tingling and my skin was cool. My heart was racing in a good way, and breathing was a job.

 

🔺 Throbbing is the best word to say what it is like. The throbbing starts as a faint vibration, then builds up in wave after wave where time seems to stand still.

 

🔺 My orgasms feel like pulsating bursts of energy starting in my pelvic area and then engulfing my whole body. Sometimes I feel like I'm in freefall, and sometimes I feel like my body's an entire orchestra playing a grand crescendo.

 

🔺 "Before, I feel a tremendous surge of tension and a kind of delicious feeling I can't describe. Then orgasm is like the excitement and stimulation I have been feeling, increased, for an instant, a hundred-fold."

 

🔺 The physical sensation is beautifully excruciating. It begins in the clitoris, and also surges into my whole vaginal area."

 

🔺 Orgasm starts as a pressure from within and a tingling tension near the clitoris, which spreads to the vagina inside my abdomen.  There is a general stretching tension throughout until orgasm breaks.


The Ohhh! in Orgasm

At the pinnacle of each sexual experience, where the tension and high excitement release into pleasure-filled waves of bliss is an experience called orgasm. It is so highly sought after that many do not consider a sexual experience complete unless an orgasm included.  Both the rapidly growing multi-billion-dollar pornography industry and the thriving sex-toy industry both depend upon the value people place on heightening their orgasmic experience.

    People need ecstasy and bliss.  The experience of orgasm is one way to obtain these positive feelings. The need for these is so strong that many will crave them, and settle for self-destructive activities which provide only a hint of these peak states.  An ecstatic experience is one in which our ordinary awareness gets a boost from something much larger and deeper within us.  People drink alcohol and take drugs to satisfy their need for ecstasy. A bliss is experienced when makingan exciting purchase while shopping, or when tasting food that is just divine,” or “out of this world. When winning at a sporting event, or winning on a bet while gambling, these provide a little bit of bliss. Most of the unhealthy dependencies people form, are done so out of the desire for the ecstasy and bliss. Ecstasy is also experienced in orgasm, but the orgasm itself is very healthy.

   During an orgasm, physiological changes occur that promote our health and well-being. Serotonin, an important brain chemical, increases in the brain. It causes us to feel good and healthy, while also reducing depression.  The levels of the hormone, oxytocin, also known as the love hormone, increase within our body resulting in feelings of love, calmness and relaxation, while simultaneously reducing stress.  Endorphins are released upon orgasm, increasing our tolerance of pain. Studies show that men who have regular orgasms have a lower risk of prostate cancer.  While also feeling really good, orgasms are good for our health.

    Obviously, orgasms are different in men and women.  In men, orgasm is almost always linked to ejaculation, an essential event for the reproduction of our species.  With women, an orgasm has no direct link to any reproductive benefit.  Another large difference between the genders regarding orgasm is that men do not learn to have an orgasm.  Instead they usually experience it spontaneously, during puberty in what is called a wet dream.  On the contrary, women have no such spontaneous event and must consciously learn to become orgasmic.  While most are capableof learning, sadly, many women never do so, and the lack of orgasm negatively affects their self-esteem and quality of their love relationships.

    Orgasm is among the healthy ways to include the ecstatic experience in your daily life. Thepotential for orgasm is built within you.

 Andrew Aaron, LICSW


Anxiety Disorders

Anxiety is a fear-based emotion that ranges in intensity from mild to severe. In our fast-paced society, anxiety is suffered at epidemic proportions, thus unfortunately it is all too common. Stress plays a significant role in the development of anxiety difficulties. But it’s widespread presence in no way diminishes the discomfort and debilitating effect anxiety may have.

     At the mild end of the spectrum, anxiety is felt as an annoying discomfort which results in being on edge with a mild inability to relax in general or situationally.  In more severe experiences anxiety can disable a person from functioning and live a normal life. Panic is a brief but negatively intense experience of anxiety that may show up as an attack or acute episode.

     In families where parents have anxiety-based conditions, the behavior patterns, thought processes and values contribute to impressing an anxiety-based self and world-view upon their children. In this way, rather than an inherited genetic condition, though a propensity for anxiety may exist, parents and families teach their children to have anxiety and model anxiety for the children by example.

     Worrying is a thought process and a cognitive habit that is present in anxiety disorders. Worry is a non-productive thought pattern that is future-oriented with a focus on bad, negative, hurtful and even catastrophic events occurring.  Parents who have anxiety may express to their children countless times “be careful” or “watch out for bad people.” Such statements repeatedly warn of dangers and contribute to anxiety “training.” Worrying is part of an unhealthy anxious pattern not just because it inflates the size or likelihood of potential future dangers, but it tends to disable the worrier in anticipation of a dangerous developments rather than truly establishing proper preparation for such occurrences.

     A link exists between angry feelings and the development of anxiety reactions. When angry feelings are habitually repressed instead of expressed, they get indirectly expressed through anxiety in its many forms. As a result, should an anger provoking incident occur, anxiety may be triggered and linger at a high level for a duration afterwards.

     Avoidance is a pattern that may contribute to the onset of anxiety, but also is a behavior pattern in those who are anxious and seek to keep the level of anxiety low. It is a negative pattern that is limiting in nature. To avoid unpleasant or threatening situations, attempting to assert control over others or situations produces secondary negative results which harms relationships and discourages growth and strengthening.

In addition to psychotherapy, anxiety and it’s emotional sibling, depression, are also treated with doctor-prescribed medication. Natural methods to relieve anxiety and depression include Tumeric and Curcumin.

See category on anxiety

See article about challenging fear

     A variety of anxiety based disorders are identified by mental health professionals. Each varies from the other by how anxiety manifests. 

Generalized Anxiety Disorder (GAD) describes a condition in which a person experiences anxiety most all the time and and in most circumstances, though the anxiety may rise and fall based upon experiences and circumstances. Generalized Anxiety Disorder contributes to chronic discomfort and a poor quality of life with symptoms of an inability to relax, chronic worry, possible insomnia and other sleep disturbance, possible gastro-intestinal problems, possible somatic complaints such as headaches and physical pain, reduced immune system and auto-immune disorders.

Panic Disorder is a anxiety-based condition in which the afflicted person experiences occasional, repetitive or frequent episodes of extreme anxiety also called panic. For someone who has never experienced a panic attack (also sometimes called an anxiety episode or anxiety attack) an initial strong assault can feel like he or she is dying from a heat attack. It is not unusual that in reaction to this severe event the individual goes to the Emergency Department of the local hospital complaining of a heart attack. The event seems to be physical in nature though it's source is emotional. An initial panic attack may be profound and a life-altering experience and typically a first panic attack comes "out of the blue" in a relaxed moment. Many report a first panic attack when in a store or driving.

     The symptoms of panic vary from person to person, but share features such as fearing that one is going to die, terror, a heartbeat beating out of the chest, heat in parts of the body such as sweaty palms, tingling in parts of the body, a sweaty reaction, rapid cycling of thoughts and a belief one is going crazy. Once a panic attack has been experienced, the fear persists that it will happen again, potentially in the same location or during the same activity. A pattern of avoidance of precipitating situations or conditions which fear could cause a panic attack. The fear of an attack becomes a secondary level of anxiety; both levels then feed off the other in cyclic anxiety. 

Phobias are acute fearful reactions to very specific items or situations that provoke terror. Common phobias are of spiders, snakes, flying in an airplane, being in small spaces, heights, going over bridges, driving on the highway and germs. Someone who is phobic of of an item, situation or activity will avoid exposure to it at all cost due to the anticipation of terror.  For the phobic individual, exposure to the feared subject feels like he or she will be "scared to death." A phobia is highly irrational and as a result makes no sense to those who are not phobic, but is painfully real to those who suffer from phobias.

Health Anxiety is just as it's name suggests, a fear of and preoccupation with health threats, such as diseases and often severe as well as terminal conditions like cancer. People who have health anxiety obsess about the possibility of illness. Hypochondria is a related condition in which the fear exceeds the worry so that the feared health threat is imagined to be real when in fact it is not.

Obsessive/Compulsive Disorder (OCD) is a disorder characterized by both obsessive thoughts and compulsive behaviors. Obsessing is a powerful cycling of thoughts which cannot be slowed, despite efforts to do so. Compulsions are similar but are about behaviors.  Compulsions are repetitive behaviors which cannot be stopped; the behavior seems to have control over the person.

     Some who live with OCD have a pattern of ritualistic behaviors, such as checking doors and windows to make sure they are locked for safety, and obsessive worries that the last checking wasn't sufficient.  For someone with OCD may need for emotional comfort for items in their environment be ordered in a very specific way otherwise anxious distress will not cease. At its worst, OCD can be very limiting and highly distressing, such that it interferes with daily functioning.

PTSD (Post-Traumatic Stress Disorder) By experiencing an overwhelmingly frightening and/or painful experience some people are traumatized.  The word trauma gives meaning to an experience of a long-term distressing impact caused by the initial damaging event. In some cases traumatic events are of physical physical harm, such as injuries sustained in car accident, in other cases painful unexpected experiences render the traumatized individual powerless. When the negative effects of trauma linger in a person's life in an ongoing way for months and years, the condition is call PTSD or Post-Traumatic Stress Disorder.

     Unhealed trauma shows up as low self-esteem, a susceptibility to anxiety disorders, impulsivity, substantial mood changes and likely to be emotionally “triggered” unexpectedly by a variety of daily experiences. PTSD often coincides with Generalized Anxiety, Panic Disorder and chronic worry. See article about trauma 

Perfectionism is an expression of low self-esteem with OCD traits in which a person is unrealistically, ritually and obsessively determined to achieve perfection in all efforts and activities. The perfectionist's sense of him or herself as having worth is based upon his or her perfect success. Yet in all pursuits, despite producing excellence he or she will search in a detailed way to uncover imperfections. Upon finding them, no matter how small, will declared the efforts a failure and him or herself as a failure. Perfectionist are stuck in a negative cycle of self-imposed anxiety and dissatisfaction. See article about perfectionism

Jealousy and Insecurity at their worst can destroy a relationship or marriage. Due to a deeply held fear of loss combined with the insecurity of low self-esteem, some partners are chronically afraid they will be rejected or lose their loved one. Women worry and obsess that their beauty and desirability are insufficient, that their partner will be more attracted to another. Men fear that they are not strong enough, not sexually skilled enough, not funny enough...all symptoms of low self-esteem.

     Jealous partners are challenged with other anxiety disorders as well, Generalized Anxiety Disorder most likely. The jealous partner will express his or her insecurity through an inability to trust, chronic suspiciousness, investigating the partner and grilling the partner with questions to try and feel safe. These behaviors have the opposite of the desired effect. Rather than safety and security in the relationship, jealous partners drive the other away increasing the risk of loss or betrayal. See article about jealousy 

Performance Anxiety is an emotional trap. Once a man has experience of failed sexual performance and reacts with horror, a pattern becomes entrenched in which he worries about his performance in each subsequent sexual opportunity. Because a relaxed and positive attitude supports good sex and successful male sexual performance and fear, worry and negative feelings undermine good sexual performance, his worry contributes to a re-occurring self-fulfilling prophesy in which failed performance is worried about so failed performance occurs.

      For maintained arousal, manifested by an erection, a man must be relaxed and  undistracted to enjoy the pleasure of excited feelings in his body. If anxious, he is less likely to maintain arousal and be unaware or insensitive to physical sensations of excitement; he will lose his erection. The cycle is then repeated.  

     Men who have experienced failed sexual performance may be beset with painful feelings of inadequacy. Such men have a tendency to avoid sexual encounters. 

     Performance anxiety is an anxiety-based emotional trap that may snare anyone at anytime high pressure for high performance is in place. Whether it be a student regarding tests, an athlete regarding competitive success, a woman regarding sexual arousal, all are prone to vicious cycles of performance anxiety.

Anxiety and Love Relationships

Love and fear are opposites. When a partner in a love relationship suffers with fear-based anxiety, it directly neutralizes the quality of love shared between partners. Anxious people are afraid and defended, yet to love a partner needs to be relaxed and open. Anxious partners attempt to control their environment as a way to keep their anxiety low, but the way to love a partner is to accept him or her while accepting how the partner is.

Anxiety and Sex: the quality of a sexual experience is directly related to how relaxed are the partners. When anxious, partners are less available for connection, but also less able to become aroused, maintain arousal, less able to achieve orgasm...an anxious partner is less able to participate in a good and satisfying sexual experience.  Anxiety is detrimental to good sex.  An anxious partner, one who has experienced trauma may also be sexually inhibited, or withdrawn so they do not sexually “show up.”

Medication for Anxiety

For those with severe anxiety, medication can be helpful. Commonly anti-depressant medication is prescribed which is also effective at reducing anxiety, but with possible negative side-effects such as less sensitivity to emotions, flatter emotional experience, some cause weight gain, reduced interest in sex, and some cause inhibited or inability to achieve orgasm. Anti-anxiety medication can also be very effective at reducing the discomfort of anxiety. The risk of these medications is the possibility of addiction and must be used with restraint and care. They may also cause some sexual side effects. Andrew Aaron, LICSW 


The 36 Questions That Lead to Love

The 36 Questions That Lead to Love

By Daniel Jones

Jan. 9, 2015

Published in The New York Times

In Mandy Len Catron’s Modern Love essay, “To Fall in Love With Anyone, Do This,” she refers to a study by the psychologist Arthur Aron (and others) that explores whether intimacy between two strangers can be accelerated by having them ask each other a specific series of personal questions. The 36 questions in the study are broken up into three sets, with each set intended to be more probing than the previous one.

The idea is that mutual vulnerability fosters closeness. To quote the study’s authors, “One key pattern associated with the development of a close relationship among peers is sustained, escalating, reciprocal, personal self-disclosure.” Allowing oneself to be vulnerable with another person can be exceedingly difficult, so this exercise forces the issue.

The final task Ms. Catron and her friend try — staring into each other’s eyes for four minutes — is less well documented, with the suggested duration ranging from two minutes to four. But Ms. Catron was unequivocal in her recommendation. “Two minutes is just enough to be terrified,” she told me. “Four really goes somewhere.”

Set I

1. Given the choice of anyone in the world, whom would you want as a dinner guest?

2. Would you like to be famous? In what way?

3. Before making a telephone call, do you ever rehearse what you are going to say? Why?

4. What would constitute a “perfect” day for you?

5. When did you last sing to yourself? To someone else?

6. If you were able to live to the age of 90 and retain either the mind or body of a 30-year-old for the last 60 years of your life, which would you want?

7. Do you have a secret hunch about how you will die?

8. Name three things you and your partner appear to have in common.

9. For what in your life do you feel most grateful?

10. If you could change anything about the way you were raised, what would it be?

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11. Take four minutes and tell your partner your life story in as much detail as possible.

12. If you could wake up tomorrow having gained any one quality or ability, what would it be?

Set II

13. If a crystal ball could tell you the truth about yourself, your life, the future or anything else, what would you want to know?

14. Is there something that you’ve dreamed of doing for a long time? Why haven’t you done it?

15. What is the greatest accomplishment of your life?

16. What do you value most in a friendship?

17. What is your most treasured memory?

18. What is your most terrible memory?

19. If you knew that in one year you would die suddenly, would you change anything about the way you are now living? Why?

20. What does friendship mean to you?

21. What roles do love and affection play in your life?

22. Alternate sharing something you consider a positive characteristic of your partner. Share a total of five items.

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23. How close and warm is your family? Do you feel your childhood was happier than most other people’s?

24. How do you feel about your relationship with your mother?

Set III

25. Make three true “we” statements each. For instance, “We are both in this room feeling ... “

26. Complete this sentence: “I wish I had someone with whom I could share ... “

27. If you were going to become a close friend with your partner, please share what would be important for him or her to know.

28. Tell your partner what you like about them; be very honest this time, saying things that you might not say to someone you’ve just met.

29. Share with your partner an embarrassing moment in your life.

30. When did you last cry in front of another person? By yourself?

31. Tell your partner something that you like about them already.

32. What, if anything, is too serious to be joked about?

33. If you were to die this evening with no opportunity to communicate with anyone, what would you most regret not having told someone? Why haven’t you told them yet?

34. Your house, containing everything you own, catches fire. After saving your loved ones and pets, you have time to safely make a final dash to save any one item. What would it be? Why?

35. Of all the people in your family, whose death would you find most disturbing? Why?

36. Share a personal problem and ask your partner’s advice on how he or she might handle it. Also, ask your partner to reflect back to you how you seem to be feeling about the problem you have chosen.


Common Sexual Problems

Sexual functioning is effected by many influences, and that unfortunately means that healthy sexual functioning is highly susceptible to problems. Below is a list of commonly experienced sexual problems.

LITTLE OR NO SEXUAL DESIRE

The feeling of wanting sexual activity is a necessary part of a healthy person, but also of healthy sexuality. To have desire indicates a level of physical vitality. It is a problem when there is little or no desire for sexual

activity, especially when in a relationship with a partner who does have sexual desire. This discrepancy of desire between partners can lead to significant conflict and tension between partners. Lack of desire may

indicate an unhealthy physical condition, but also may be caused by numerous emotional conditions. Some people, but a small percentage, do, naturally, have little sexual desire without any accompanying health or emotional problems. Lack of sexual desire may also be accompanied by lack of sexual fantasies, lack of interested in others as sexual partners, and lack of a sexual response.

Some of the potential causes are:

▪️Relationship difficulties: If partners are not emotionally connected, it may lead to one or both partners having low desire.  Relationship conflict, lack of trust between partners, the build up of resentment, or feelings of anger between partners all can dampen or fully put out any flames of sexual desire.

▪️Stress, feeling overwhelmed, preoccupied, anxious and fatigued may all kill sexual desire.

▪️Having small children at home is one cause of reduced sexual desire in caregivers.

▪️Depression, which is often internalized anger or feelings of powerless usually will eliminate sexual desire.

▪️Anxiety, like it's brother, depression, may reduce desire and cause a person to avoid closeness.  In some people anxiety tends to heighten sexual desire.  People who have strong feelings of shame regarding their sexuality may have anxiety which negatively impacts the ability to have sexual desire.

▪️Medications often have a negative effect on sexual response and functioning.  Many medications also reduce sexual desire.  Anti-depressant drugs are notorious for the reduced sexual desire side-effect.  Birth control pills also tend to reduce the user's level of sexual desire.

▪️History of trauma or abuse tends to cause those traumatized to avoid closeness, and especially the intense closeness of sexual activity.

▪️Having had negative previous sexual experiences with the partner or previous partners that have caused frustration, disappointment or hopelessness about having a satisfying sexual experience.

▪️Physical causes may also contribute. There are many possible sources, of which I will not list here. If you suspect that a physical problem may contribute to your loss of sexual desire, consult your physician.

▪️Poor body image: if a person feels uncomfortable with their body, and thus would feel ashamed or embarrassed to reveal the body, this may result in having little or no desire to engage in sexual activity. This category can include feelings of shame associated with a person's genitals and breasts.

▪️A history of participating in sex when one does not wish to be sexual. This includes one’s needs and feelings being unknown to or invalidated by he partner.

▪️When sex with the partner is dissatisfying because of lack of sexual education, lack of communication, lack of skill and lack of desired outcome, such as good sexual performance, emotional connection or orgasm.

See article on Low Female Sexual Desire

See article on: Curing the Sexless Marriage

LACK OF PHYSICAL AROUSAL

After partners have already begun to engage in sexual activity, whether it be talking about sex, kissing or even stimulating each other's body or genitals, a physical arousal response is normal and healthy.  A distinction should be made between a physical and psychological arousal.  A person may feel aroused or turned-on, but not have the accompanying physical response. The opposite is also possible.

IN WOMEN this typically means an enlarging of her nipples, sometimes a red flush on her breasts, a swelling of her vulva due to a condition called vasocongestion and the presence of wetness, lubrication from within her vagina, which functions as lubrication for comfortable intercourse.  Lack of arousal may mean that the swelling of the vulva due to vasocongestion does not occur, the nipples do not enlarge, and lubrication is not produce within the vagina. The potential causes are several:

Physical causes which range from an unhealthy physical condition, hormone fluctuations, a past hysterectomy, or the onset or presence of menopause, which tends to reduce or eliminate the lubrication. If a women experiences pain during intercourse, or has in the past, this can prevent arousal. Such pain may or not be physical in nature.

Emotions may also interfere with arousal.  Any negative emotion such as anger, resentment, depression, anxiety, fear, etc.can have this effect. A history of trauma or abuse can result in reduced or absence of an arousal response.   

Medications or drugs may also eliminate arousal.

See article on: Tiny But Mighty: The Clitoris

IN MEN an arousal response usually creates a stiffening of the nipples, sometimes a red flush on the chest, and an enlargement of the penis in an erection. Loss of these physical responses may be caused by:

Physical causes which may include heart problems, low blood pressure,  problems with blood flow to the penis, the prostate and other conditions of poor health. For physical problems like these, consulting a urologist may be helpful.

Emotions related to anxiety and anger, especially if felt toward the sexual partner may prevent the arousal response which results in an erection.  One such emotional response is related to feelings of pressure to sexually perform well and results in the anxious condition called "performance anxiety" in which a man cannot achieve an erection due to the fear that he will not sexually please his partner.

Medications or drugs generally have a negative effect on sexual response and functioning including loss of an erection.

Lack of an erection may also be called erectile dysfunction.

See article on: Erectile Dysfunction

See also article: Pipeline to Pleasure

See article on erection medication: Viagra: Politics of the Little Blue Pill

PROBLEMS WITH AN ORGASMIC RESPONSE

Men and women can have difficulty with the achievement of orgasm.  The lack of an orgasmic response to stimulation during  sexual activity can cause frustration and disappointment, but also hurt feelings and conflict between sexual partners. Orgasm is an extremely pleasurable physical/emotional/spiritual reaction to enough stimulation in which physical tension is reduced and is accompanied by a pulsing of the muscles in the genital area.

WOMEN: As many as 30% of women have not yet been successful at achieving orgasm. Some women may believe that they are incapable of an orgasmic response. Unlike men, for whom an orgasm is a physical reflex for which no learning is required, women may have to focus their efforts to learn how to have an orgasm.  Some women may have orgasms, but may have difficulty achieving it, and the necessary amount of stimulation for orgasmic response may be significant require an half-hour or longer. For most women direct stimulation of the clitoris is essential for the achievement of orgasm. Roughly half of women do not achieve orgasm through the experience of intercourse.  Other factors may interfere with a woman’s ability to have an orgasm:

Physical conditions, such as health problems and physical discomfort may interfere with orgasm.

Emotions, which are mostly of the negative kind such as anger, resentment, fear or anxiety. A past which included experiences of physical, sexual, emotional, or verbal abuse and trauma may emotionally eliminate a woman's ability to have an orgasm.

Inability to focus, relax or concentrate have a negative impact on achievement of orgasm.  If a woman cannot relax, or if she has difficulty eliminating stray thoughts, orgasm may not be possible.  A woman who feels uncomfortable with her body may be unable to relax sufficiently to have an orgasm.

Knowledge and experience play a part.  A woman who does not have much sexual experience, or is not familiar with her own body, sexual organs, or sexual response, and has not "practiced," such as through the self-stimulation of masturbation to have an orgasm, may be unable to do so.

Medications or drugs commonly have a negative effect on a woman's ability to achieve orgasm.  Medicine may reduce the orgasmic ability, slow the orgasmic response or eliminate it altogether.

See also article: Eroticism: What Turns Us On

See article on: For the Love of the Female Body

MEN: can have orgasmic difficulties and it is related to a man's ability to have an ejaculation, or the expulsion of sperm from the urethra or opening at the tip of the penis.  Ejaculatory difficulties are problems with ejaculatory control in which a man may be unable to have sufficient control over the timing of the ejaculation. Some men have a problem of being unable to delay the ejaculation. Other men have a problem of delayed ejaculation.

Difficulties of ejaculating too soon, and of having no control to delay it are among the most common sexual problem, but for those men who experience this, feelings of inadequacy, shame, fear, embarrassment and powerlessness often are felt. Over time, sexual partners often grow very frustrated if this problem is not resolved. Learning to overcome this problem, and the painful associated feelings are often successful.

Causes may be related to use of medications or drugs, but often it is caused by inexperience, and the lack of opportunity to develop control.

Delayed or Inhibited ejaculation is a less publicized problem that some men experience.  This is problem some men have when they are unable to achieve ejaculation, or much time and much stimulation is required for ejaculation to be reached.

Causes of delayed ejaculation may be related to medication or drug use, but also physical health causes. Emotions can also play a part in inhibiting a man's ejaculation. If a man is anxious or angry he may be unable to reach ejaculation. The inability to concentrate and focus on the body rather than the mind also can have a negative effect.  Men who are overly concerned with their partner's sexual satisfaction, rather than their own are likely to experience delayed ejaculation.

See article on: Inhibited Ejaculation

See also article: Anatomically Different...Intimately

See article one: Men and Their Eroticism

PROBLEMS WITH PAIN

Women at times experience pain during intercourse, which is called dyspareunia. Pain is a problem and is not part of healthy sex. If pain is experienced routinely during intercourse, there exists a problem which is best addressed with a doctor or another professional. The feelings of pain may or may not have physical causes. Sometimes a simple solution may be the use of a lubricant, but this will only eliminate pain caused by dryness.  Physical causes may include yeast infections, the presence of a sexually transmitted disease (STD), skin irritations and possible a cut or tear in the opening of the vagina or the inner vaginal wall.  Such pain during intercourse may also have an emotional source.  Women who have experienced physical or sexual abuse may have painful emotions associated with sexual activity and may experience this as physical pain during intercourse.

A different pain-related problem is called vaginismus. This is also a condition that is experienced only by women. This occurs when the muscles surrounding the vaginal opening are tightly closed, and prevent penetration for sexual intercourse. Vaginismus may be caused by emotions often related to discomfort with sexual intercourse and possibly due to uncomfortable feelings such as anger, resentment, disrespect for the partner, or from emotions related to past trauma, such as sexual abuse or rape. A physical cause may be the consequence of a woman having experienced painful intercourse chronically for a long period of time. The vaginismus may be an anxiety reaction to the anticipation of pain.

See article on female problem with intercourse: Vaginismus: Painful and Harmful to Inctimacy

DISCREPANCY OF SEXUAL DESIRE

When sexual partners differ on the preferred frequency of sexual activity, tension may build between partners and even be the source of arguments. Unresolved, discrepancy of sexual desire may result in significant damage to the relationship and connection between partners, well beyond the arena of sex. As relationships transition through developmental phases, differences in sexual interest will increase and decrease causing tension due to frequency or infrequency.

See article: Sexual Desire and Men

See article on: Discrepancy of Sexual Desire

See article: Battling Desire Discrepancy

DISCREPANCY OF SEXUAL INTEREST

What each one of us defines as good or great sex varies from person to person. When sexual needs or interests vary widely, problems with sex are sure to follow.  Couples who easily and openly talk about sex may be able to resolve such a discrepancy, but most couples are not comfortable with talk of sex and do not engage in this kind of communication.  Unsolved, discrepancy of sexual interest may result in tension between partners, but also an accumulation of frustration, resentment and loss of interest in sex and infrequent sex.

See also article: Eroticism: What Turns Us On

See also article: Battling Bedroom Boredom

See article on: Curing the Sexless Marriage

SEX ADDICTION AND COMPULSIVE SEXUAL BEHAVIOR

As with any activity that is pleasurable, sex for some people becomes a preoccupation.  These people find that their desire and interest in sex is uncontrollable; that their impulses to be sexual are difficult if not impossible to resist. The severity of this problem ranges from mild to severe., Mild cases involve individuals who have difficulty controlling the frequency of their masturbatory experiences; or a person who has difficulty controlling online viewing of pornography. These people take mild risks, but do not damage their lives significantly. More extreme examples are individuals who, despite their better judgement, become involved in incessant risky, reckless sexual hook-ups, without regard for the spouses they hurt, the financial problems they create, the jobs they lose, etc.

While people with these kinds of sexual problems often regard their challenge as an addiction, and treat the problem through an addiction model of treatment, risky and impulsive sexual behaviors can also be viewed as a type of obsessive/compulsive disorder commonly associated with anxiety problems. Some argue that people who cannot stop themselves from behaving sexually are addicted to the pleasure and increase in the brain chemicals, endorphins and serotonin, or "feel good" chemicals.

Those who regard this problem as a problem of compulsivity address it by noting that people who seem unable to control their sexual impulses also have a need for love, acceptance, connection and intimacy; qualities usually absent within their lives when young.

Difficulty controlling sexual behaviors, and engaging in sex without any emotional connection, are actions of many people who have been sexually abused and sexually traumatized.

See article: Sexual Desire and Men

PORNOGRAPHY

In recent years, pornography has grown more common, accepted and mainstream.  Some regard this as objectionable while others embrace this change as evidence of a greater acceptance of sexuality.  Irregardless of how you view pornography, its increased availability is a reality with significant effects. While pornography is not a biologically or emotionally based sexual problem, its use may cause significant distress both in terms of perspective on sex and sexuality, sexual expectations, sexual values, and conflicts between sexual partners who have differing views on pornography's place in their relationship. Pornography also may be used by those who embrace it positively as an opportunity and resource with which to explore individual and relational eroticism and sexual adventurousness.

The presence of pornography in a relationship in which both partners do not view it in a similar positive perspective may be extremely destructive.  Partners who do not embrace pornography as a sexual resource, but as an immoral sexual perversion, are often threatened by its use and presence, resulting in feelings of hurt and betrayal, which do cause the destruction of relationships.

Because the openness, sharing, honesty of intimacy are emotionally difficult, it is easier for many to seek their sexual gratification in less threatening ways, such as with the solo use of pornography along with masturbation. Pornography in many cases is used as a tool with which for one partner to distance him or herself, and his or her sexuality from the partner. If used in this fashion, pornography can be seriously destructive to the relationship and hurtful to the partner.

When used in this manner, another facet of it use is secrecy. It is common that pornography is hidden and use surreptitiously. The need to hide its use is a reaction to the anticipated, and usually correct, negative reaction to it by the partner.  But while the presence of the pornography is cause of distress, the secrecy employed creates a secondary level of damage to the relationship; betrayal and distrust.

See also article: Coping With the Porn Factor 

See article on: Erotic Material, AKA Porn

FETISHES

A fetish is an inanimate object or body part given tremendous erotic value, to the point of being an obsession, which is used as a sexual turn-on.  Someone with a specific fetish, such as feet, certain articles of clothing, clothing of the opposite sex, etc., is generally unable to achieve sexual satisfaction without that object being present. Given the great value placed upon the object by the person with the fetish, the partner may feel of secondary value, and that the fetish object comes first. This can produce negative feelings between partners and even result in relationship break-up.

TROUBLESOME TURN-ONS

What we each find erotic differs from person to person. What is erotic is that which causes arousal, and it can be the source of fascination, curiosity and even obsession.  But for some, what is erotic is also problematic, such as when an erotic interest is unappealing or offensive to the partner.  Such a situation may cause relationship distress.  For others, the source of eroticism is more extreme, including interests that violate ethics, morals and laws. Erotic interests that cause unhealthy risks or problems is referred to as troublesome turn-ons.

See also article: Eroticism: What Turns Us On

Andrew Aaron, LICSW


Failure to Rise: When an Erection Disappoints

In that awful moment, he is flooded with dread.  Instead of being capable of fulfilling, he shrinks to limp in faded glory.  Sometimes eyes meet with questions and with fear, but more often eye contact is avoided.  It's just too uncomfortable.  The answers sought are unavailable so he offers equally limp excuses.  It is an awkward drama when he cannot perform.  Erectile dysfunction may have physical or emotional causes.  This article focuses upon erection loss when its source is emotional, an event most men will experience at some point in their sexual lives.

    The lingering memory after this kind of experience haunts men.  They recall the embarrassment and feelings of inadequacy whenever they sniff a hint of a sexual opportunity.  Without the confidence that good sexual performance provides, some men even avoid the closeness of affection, because it is a precursor to sex.  Even men with formerly high sexual desire suddenly have none.  Their partners may not understand why he is suddenly so distant.  A single man with a history of failed erections may avoid dating.  In fear, he mistakenly believes that every potential partner will want him to pass the sex test on the first date, one in which he will certainly crash and burn.

    Because most men have minor awareness of their emotions, they may be unable to identify the negative emotions responsible for a sudden loss of arousal and erection.  Confusion reigns in that moment when for the first time his penis isn't doing what he wishes; men often can't figure out why.  Facing a partner's questions is a second loss of control. 

      A female partner when together with her male partner who is not performing, is thrown into a predicament for which there is no easy scripted response.  She may feel it necessary to mask her disappointment, yet in doing so, she will be insincere, despite her wish to kindly reassure him. A less secure woman may believe his loss of erection is a statement about his feelings for her; that she is not desirable enough, or that her sexual skills are lacking.  None of these are are probably true. Each assumption heightens discomfort while fueling disconnection between partners. If the sexual opportunity is not salvaged, its memory may be as the proverbial elephant in the corner; obvious, awkward and unaddressed.

    Anxiety, stress and pressure are the most usual suspects; they kill arousal.  Anger and emotional disconnection between partners do this too.  As men age, they are increasingly vulnerable to the deleterious effects on sexual performance, though young men are not immune.  If anxiety is a common emotional feature of a man's personality, he is even more susceptible to suffer erection loss when the pressure of performance is on.  Good health protects men's erections while poor health makes erections less resilient if it does not destroy his sexual functioning completely.  Medications, such as blood pressure pills, can eliminate erections altogether.  Pro-erections medicines are helpful to make an erection more confident, and can also be a useful ally to destroy a negative, emotionally-based cycle of performance anxiety.

      Once it has happened, erection loss is an event that tends to re-occur.  The experience of failure to perform is strongly anxiety-provoking, turning each subsequent sexual opportunity into a fear-producing event.  Thus the climate is perfect for re-occurrence.

        When there is not so much pressure upon a penis to produce results, it is better able to perform.  Once successes are achieved, couples can practice and develop the skill of repair, regaining arousal even after it has been lost.  When sexual partners are able to talk about their relationship, feelings and sexual play, they are enabled to engineer low-stress, low-expectation sex, the right environment for erections to last.  With moments of closeness, acceptance and connection, in a team effort, partners can slow and ultimately defeat the negative cycle of fear and failure.  Andrew Aaron, LICSW


Trauma: Never Quite the Same Again

In a split second an unexpected event triggers a cascade of terrible feelings; transforming a loving person into someone darker, afraid, angry and out-of control. A sight, a sound, a few insensitively-chosen words may unleash the inner terror; the eruption of painful feelings from remnants of unresolved trauma long past. Too many have been hurt. The after effects of violence and terrorizing threat may linger for a lifetime. 

What is trauma and why do it’s effects linger so long? Trauma results from life altering experiences in which one loses control and at the same time anticipates or sustains painful harm. Soldiers live through it in war.  Car drivers experience it in a major accident. Victims survive it in horrible moments of violence. This is the stuff of nightmares, beyond the suffers’ ability to cope. During a traumatic experience extraordinary psychological measures are taken to endure; measures which forgo future well-being in exchange for survival. Not all violent, terrifying or injury-sustaining life experiences result in what is known as PTSD, an acronym for Post-Traumatic Stress Disorder. The disorder is a bundle of painful fear-based symptoms that linger far after the traumatic event has passed. What causes PTSD to one person may not in another. 

     To escape the intense fear and pain during a traumatic event, survivors psychologically retreat inwardly. The victim literally splits off from his or her body to create safety. But the extraordinary measure has an extraordinarily high cost; the psyche and the body long after remain split apart. Thereafter the body is the holder of the horrible memories and is perceived as toxic to the psyche. Rejoining the two is a difficult healing process for most and seemingly near impossible for others. The name PTSD, indicates that this emotional condition is a disorder when in fact the condition is a normal response to a very abnormal experience.

     Rough estimates indicate that one in three women and one in four men experience abuse-related trauma, many of these people were harmed as children. To cope with enormous pain some trauma survivors repress painful memories in an effort to bury the painful and often shameful traumatic memories in the subconscious so it will not be experienced during daily life. The traumatic event just seems gone. Common symptoms of PTSD may include anxiety, panic episodes, nightmares, chronic heightened vigilance, sudden intense and disturbing memories, episodes of rage, obsessive and compulsive thoughts and behaviors, being startled easily, an avoidance of situations similar to the one in which the trauma occurred and distancing from vulnerable closeness.

     Relationships which include a traumatized person suffer from old trauma as well. The emotional openness needed for a strong love relationship can be fear-provoking for someone who has experienced deep hurt. Also the self blame and shame felt by most PTSD sufferers as well as an attraction to risky behaviors complicate romantic connections. Certain situations normal to a loving partnership can trigger strong emotional reactions such as panic, flashback memories or avoidance. It is not unusual for traumatized individuals to be unclear as to the cause of his or her strong emotional reactions. Linking confusing behaviors and attitudes with old trauma is not obvious. In some instances previously repressed memories of old trauma abruptly surface into a partner’s consciousness, like a bubble rising from the deep. They can thoroughly transform a personality into someone troubled and significantly different. 

     The intensity common to love relationships can also traumatize a partner or re-awaken old trauma. Large conflicts and obviously those that escalate to violence may be traumatic. Partners with traumatic sexual abuse histories may dissociate in intimate moments, a way of mentally “going away” to avoid discomfort associated with the past. Threats of abandonment, insensitive dominance, aggression, cheating and breakup all may traumatize a partner negatively impacting a relationship for years.

     Regular talk therapy alone is usually not effective at healing the deep injury. If it includes a re-living of the traumatic event it may actually re-traumatize the sufferer. For a treatment method to be effective, it must delve deeper than the conscious mind and into the more primitive body-consciousness where traumatic emotions are stored. Healing is possible, however, it is not easy. Offering a trauma sufferer patience and compassion is always a loving practice while individuals and couples travel the journey to healing. Andrew Aaron, LICSW


Let the Games Begin: Games of Courtship

LET THE GAMES BEGIN...the games of courtship

In the beginning of a new romantic connection, the negotiation between potential partners can feel an awful lot like playing games, or playing mind games.  What is actually happening is that negotiations are underway as to how the relationship should proceed.  Each person is also being careful to present as positive an image of themselves as they can so as to increase their power of choice while decrease their chance of rejection. This negotiation is about stuff like power and control, who accepts what responsibility, what understandings will be in place for behavioral expectations in the future.

This is the development of the "invisible unspoken contract." (See article on Invisible Unspoken Contract).  Be aware that your choices and behaviors at this early point in the relationship determine how it will go later on should it last.  So if interactions are not to your liking,  or if this other person does or says things which make you uncomfortable, this is the easiest and most effective time to speak up in terms of making changes.

In the beginning of a new romantic connection, the negotiation between potential partners can feel an awful lot like playing games, or playing mind games. What is actually happening is that negotiations are underway as to how the relationship should proceed. This negotiation is about power, control, who accepts what responsibility, what are the expectations for interactions in the future. This is the development of the invisible unspoken contract. Be aware that your choices and behaviors at this early point in the relationship determine how it will go later on should it last. So if interactions are not to your liking, or if this other person does or says things which make you uncomfortable, this is the easiest and most effective time to speak up in terms of making changes.

Early on, after meeting someone to whom you are attracted, it is wise to keep in mind various
important considerations:

1.  Be aware of any old relationship patterns or patterns in the choices you made for previous partners. Note also any patterns within those relationships. Be aware that the one to whom you are now attracted, will also be part of this pattern. Attempt to determine which problems occurred in past relationships, and how you may have contributed to their formation.

2.  Deliberately slow the relationship's development. The faster your relationship is going, the less control you have. Imagine yourself in a car, speeding down the highway at eighty miles per hour. The view along the side of the road is a rushing blur. So if there is a beautiful flower on the side of the road, you will not notice it, let alone appreciate its beauty. Now image yourself walking along the road. It would be unlikely that you will not notice the flower. It is much easier to stop and appreciate its beauty when you are going slowly.

There is no need to rush; you have the rest of your life to get to know this person and determine if he or she is the right one for you. The beginning of a love relationship is among the sweetest times of your life; savor it slowly the way you would delicious food. If you take it fast, and allow sex to begin quickly, this sweetness will be over too quickly. Taking it slow will give the relationship the best chance of being healthy. Going slow helps you to notice and address problematic situations early in their growth when they are still small and more responsive to change.

3. Keeping the relationship's development slow prevents your destructive unconscious patterns from asserting themselves. If they do, the old negative patterns which had contributed to the problems in your past relationships are more likely to be repeated once again. These are your choices which either cause you to behave in destructive ways, or cause you to accept destructive behaviors by your partner. Take it slow! Make your actions and choice conscious, not unconscious!

4. Determine your potential partner's intentions. Ask lots of questions. Consider this metaphor: You are traveling to a distant location. You go to the train station to catch a train to take you to where you want to go. You quickly board the nearest train. The train is about to roll. Then you realize that you are uncertain if the train is going to your desired destination or not. Isn't it best to determine if it is the right train as soon as possible, so you will have the opportunity to get on the right train? When a new person is invited into your life, make sure the new person wants what you want, so you avoid becoming attached only to break-up because the two of you want a different kind of relationship.

5.  Look for “red flags.” While getting to know a new person, it is wise to keep yourself alert. Pay attention to all your senses, your thoughts and feelings. Do not let this other person talk you out of  your feelings...value them as you would a message from your most wise advisor. Your feelings are your antennae in a love relationship. If you have feelings of discomfort, disrespect, some things just don't add up to you, or if something confuses you...trust these feelings! These are warning signs that all may not be right with this person. Proceed with caution. Be on the lookout for red flags: characteristics, situations, occurrences that do not fit with your values, which reveal character flaws or weakness in your potential partner. After weeks or months, if there are no “red flags,” or very few, but only minor ones, then you are probably safe.

It is wise to be cautious if this new person has financial troubles. If they ask you for money, let this be a strong warning to eliminate this person as a potential partner. A good partner is one who can be strong, self-sufficient and responsible. If this person seems to be in a financially bad position and does not ask for money, do not lend them any. To do so is to encourage a dependency, which would prevent him or her from learning a lesson, and it will put destructive pressure on the relationship. If  you have grown to value this person and they do have financial problems, let them know that this is a problem, as soon as you are aware of it, and suggest ways they may learn to fix them.

If he or she is not receptive to your observation or does not take action, you may consider moving on to find someone who is strong enough to be in control of their finances and their life.  Finances are one of the issues about which couples argue most. Lack of integrity is a major red flag. A good partner's words and actions must match. If a person makes a promise, they must keep it, unless there are reasonable extenuating circumstances. If these kind of extenuating circumstances seem to occur frequently, then this is a red flag that hidden problems exist.  You probably should stay away. You must practice integrity as well. Lack of honesty and lack of respect for you and others are major red flags.

6.  Ask lots of questions. If your potential partner does not want to give you answers to your questions, his or her silence should be a red flag of caution. What is this person looking for in a relationship? What needs do you want met in a relationship? Are you ultimately looking for someone to share with you a committed marriage, or something more casual? It is of utmost importance that  you ask this person about this early on. Ask about the person's past. Learn about his or her past relationships and struggles. How did they solve problems in the past? A good problem-solver will be good a “teammate” for you. What kind of persons does this potential partner choose as friends? Do these people share your values? How open is this person to seeking outside help should a difficult problem develop? If the two of you do create a long-term relationship, how willing is he or she to fix the problem, no matter what it takes? How do they treat the friends and family members? How does this person handle money? Is this person willing to be influenced by you and your needs?  If not, this is a red flag. Questions, questions, questions!

They do not need to be answered all at once, but these answers are vital to your safety and to your success at choosing a good partner.  The process is challenging, but no more challenging than being in a bad or dangerous relationship! Consider the kind of life this person leads. If they have many problems, be aware that by joining your life with theirs, their problems become yours.

7.  Arrange so that the first times spent together are safe and highly informative.  Your first few dates are probably best spent in public settings until you have determined that the candidate is trustworthy and safe.  For men, realize that female partners may be fearful of spending time with you in ways in makes it easier for her to feel safe and to say yes to your invitation.

Talking is nice, but words deceive more than actions can; you will learn more about this person through their behavior than their words. In a just-getting-to-know-you situation, each person is on his or her best behavior, which limits your ability to know his or her true self. Choose an activity which allows you to learn as much as possible about the way a person him or herself. People are more likely to relax in situations in which both people are able to focus on a shared activity rather than a more direct face-to face situation. Physically active and challenging past-times such as bowling, tennis, miniature golf, going to walks in a pleasant public place, eating messy foods, challenging activities.

Activities in which are new to the candidate, allows you to see this person when they feel awkward or frustrated. While it may be slightly uncomfortable for that person, it allows you to see how they behave when they are not at their best…a predicament in which they will often be if your relationship should last a long time. But also this kind of together time can provide ample opportunity for laughter and fun, as opposed to an interview-style restaurant dinner. If a person refuses to enter a new kind of situation, consider why; if they cannot handle their anxiety, how will this person be able to handle the anxiety provoked by deep intimacy, an essential to a good relationship.

8.  Delay sex as long as you can; this helps to rule out potential mates whose main interest in you is motivated solely by gaining sexual gratification. You should not be having sex with a new person with whom you are still uncomfortable talking about sex, asking about his or her sexual history, and asking if he or she has a sexually transmitted disease. If you would be uncomfortable sharing with this person your sexual history then you probably do not know them well enough. Remember, the two of you can talk about sex without being sexual. Doing so can add deliciously to the exciting build-up of sexual tension. Sex can be talked about as a way of determining if and this new person may be sexually compatible and share similar sexual values.

While being single, and while exploring the possibility of a relationship, masturbation can be not only a pleasurable relief from the build-up of sexual tension, but also it can be valuable practice to know your sexual response more fully. This will better enable you to teach your future partner how to please you. During your single days, to be the best lover you can for when that time arrives, if you are a woman, you might practice Kegel exercises so as to improve your sexual responsivity. If you are a man, you might practice developing strong ejaculatory control.

If sex occurs too early, the relationship will speed up dramatically in its emotional intensity, reducing your ability to choose what happens. Once sex has been experienced, your emotions will become more fully involved causing you to be much less rational, and therefore less able to be aware of all that is happening. Old unconscious patterns more strongly assert themselves after sex has become part of a relationship. If your partner wishes to be sexual and you are not ready, this person will demonstrate the depth of his or her of love for you by waiting. If all seems right between you and this special person, let the sexual tension between the two of you build until it is driving the both of you crazy. Let it build to fever pitch.

Undoubtedly after the relationship is much older, you will look back and view this sweet, early time as all too brief. There are many exciting ways to show you care without including your genitals. If this person is truly great, and the two of you make a good match, there will be plenty of opportunity for great sex in the future!

Good luck at loving yourself, loving life and being loved by others!

Andrew Aaron, LICSW 


Being Single is an Opportunity

BEING SINGLE IS AN OPPORTUNITY...treat it as one.

1.  It may not initially console you, but while single you have an abundance of the commodity which most people in a relationships value the most, freedom. At first glance this may seem obvious, and perhaps having too much freedom may be the source of your discomfort, but if you choose to value this, you have the opportunity to utilize the time while you are single to a greater advantage.

2.  While single, you have the opportunity to grow in ways that you will be unable to do when you are paired up. This includes inner emotional work. It includes trying new experiences, in which your future partner may have little interest. This is a great time to explore new activities and experiences; to learn new skills. Expand your horizons, and in fact, while doing so, your chances of meeting someone new is increased.

3.  While single you have an opportunity to learn more about yourself in ways you cannot while in a relationship. If you put much effort into living a full and satisfying life while single, it will boost your chances of 1) being the kind of person another would want as a partner. 2) you will be growing stronger and be in a better position to make a good choice of future partner, and 3) you will be a satisfied and complete person, the kind others find most attractive. Remember, a happy, strong person is the most attractive kind of person.

4.   Do not force your journey while single to be a desperate and obsessed search for a new partner. It is a well-known adage that says the person you desire to meet will appear at a time you least expect. Forget about finding a partner. Instead, make the effort to find out who you are and what kind of life satisfies you the most. The more you know yourself and know your values, likes and dislikes, the greater chance that you will be able to establish a healthy relationship when the opportunity arrives.

5.   Be involved in activities from which you get the most pleasure. When you are doing what you love, you are at your best; it is then that you shine. If you are doing what you love, then the people you are likely to meet will be those who share at least one of the activities you love. These people are also likely to share some of the values you have, because they enjoying doing what you also enjoy.

6.   Being single is an opportunity to make yourself strong. Practice to learn to be strong in asserting yourself. Practice respecting the feelings and choices of others. If you are solely focused upon finding a partner, you are ignoring the relationship you need with yourself. If you feel desperate to be in a relationship, then you are likely to make the choice of a partner mostly because that person's availability and not their qualities; a recipe for choosing the wrong person resulting in a disappointing experience. If you feel desperate to be in a relationship, then you probably have a poor relationship with yourself. Work at improving that. No relationship you have will ever be healthy if you are weak, insecure or have low self-esteem. It takes two strong people to make one strong relationship.

7.    Being single is an opportunity to get your life in order without the complications another’s influence, input and demands. Straighten out those troubled areas in your life. Get stronger in the areas of your life you are less strong. Be the kind of person who posses the attributes to whom you would be attracted. It is best that you work to possess the qualities you want in your partner.

8.  Delay sex as long as you can; this helps to rule out potential mates whose main interest in you is motivated solely by gaining sexual gratification. You should not be having sex with a new person with whom you are still uncomfortable talking about sex, asking about his or her sexual history, and asking if he or she has a sexually transmitted disease. If you would be uncomfortable sharing with this person your sexual history then you probably do not know them well enough. Remember, the two of you can talk about sex without being sexual. Doing so can add deliciously to the exciting build-up of sexual tension. Sex can be talked about as a way of determining if and this new person may be sexually compatible and share similar sexual values.

While being single, and while exploring the possibility of a relationship, masturbation can be not only a pleasurable relief from the build-up of sexual tension, but also it can be valuable practice to know your sexual response more fully. This will better enable you to teach your future partner how to please you. During your single days, to be the best lover you can for when that time arrives, if you are a woman, you might practice Kegel exercises so as to improve your sexual responsivity. If you are a man, you might practice developing strong ejaculatory control.

If sex occurs too early, the relationship will speed up dramatically in its emotional intensity, reducing your ability to choose what happens. Once sex has been experienced, your emotions will become more fully involved causing you to be much less rational, and therefore less able to be aware of all that is happening. Old unconscious patterns more strongly assert themselves after sex has become part of a relationship. If your partner wishes to be sexual and you are not ready, this person will demonstrate the depth of his or her of love for you by waiting. If all seems right between you and this special person, let the sexual tension between the two of you build until it is driving the both of you crazy. Let it build to fever pitch.

Undoubtedly after the relationship is much older, you will look back and view this sweet, early time as all too brief. There are many exciting ways to show you care without including your genitals. If this person is truly great, and the two of you make a good match, there will be plenty of opportunity for great sex in the future!

Good luck at loving yourself, loving life and being loved by others!

Andrew Aaron, LICSW 


Fair Fighting Makes Togetherness Safe

 

If it weren’t for marriage men and women would fight with total strangers.

                                                        —Anonymous

    A relationship without conflicts is unusual, and may even be unhealthy.  While conflict is uncomfortable, it is also normal.  It signifies that each partner in the relationship is strong enough to assert his or her own will.  Of course this is all a matter of degree.  There are various patterns of relating in which conflict is avoided or reduced, but often at a high emotional cost: where one partner gives up on equally sharing control or power in order to keep the peace.  

    Each couple has its own unique way of beginning and engaging in a conflict.  The amount of resentment built up and personal individual history determines the “temperature” of that personal connection.  There are couples that are hot and only a small spark detonates an explosive confrontation; whereas other couples seem only to smoke and smolder without ever entering a real argument.

Conflict generates is anger; anger does not need to be hurtful.

     The challenge is to have a conflict where the opposing positions are clearly stated; a resolution is reached with some degree of compromise and no permanent damage is done to either person or the union between them. Each healthy conflict is like a single word in an ongoing negotiation between partners, ever re-arranging their togetherness as they change and hopefully mature.  So controlled conflicts should not be avoided; they propel couples forward in growth provided the conflicts are safely resolved.  

    The following 11 rules, if followed, help to keep arguments constructive, safe and under control:

1. No name calling, threatening remarks, or violence is allowed.
2. No put downs or personal attacks are allowed.
3. No threats of ending the relationship are allowed.
4. Take turns. Listen attentively without interruption when the other is talking.
5. Try to enter into conflict when the problem is still new and small.
6. Stay focused only on the issue that caused the conflict.
7. Stay in the present without bringing up past events. One issue at a time.
8. Stick to positive, constructive language that expresses what is wanted or needed.
9. State what you want to be different.
10. Develop a plan of action.
11. Create a standing agreement that if things get too hot, you two will separate for a predetermined length of time.  This should be no longer than an hour. Return precisely at that time ready to discuss the issue more calmly.

Enter conflicts boldly. To become skilled at fair fighting takes practice.

Andrew Aaron, LICSW 


The Blind Spot

As the evening had been growing long, the gathering was winding down.  Some couples had left but still many talked enthusiastically so that a chorus of voices filled the house.  Michelle was chatting with a small group of her girlfriends.  Her husband, Steve, approached the group having already grown tired of the get together.  Without waiting for a gap between their words, he forcefully injected towards Michelle that he'd be sitting in the car. One friend's face displayed obvious amazement.  Another's jaw fell agape. A third, Sarah, watched Steve, who didn't wait for a response, turn and walk unthinkingly out the front door. The storm door slammed shut behind.  She looked to Michelle and asked, "What was that about?  Michelle responded in a nonchalant tone, "That's just how he is. He's ready to go," suggesting that his abrupt social insensitivity is just normal. "Wow, that would drive me crazy," Sara offered without hesitation.  Michelle explained, "Yeah, a few people have said that to me.  Steve doesn't think there's anything wrong with it. I've tried to explain it to him. He just doesn't get it." An ache surfaced in her heart.

     We all know someone like Steve, and we all are, in some degree like Steve. Parts of ourselves, emotions and behavior patterns are expressed in automatic and unconscious ways.  Their impact, consistently negatively, is felt most by our romantic partner, also by others in our social sphere but to a lesser degree. These are the behaviors, attitudes, personality nuances that drive our partners crazy. And just like Steve, such troublesome characteristics are not within awareness; they reside in the emotional blind spot.  If asked about his social insensitivity, Steve would probably respond, "Michelle complains about it, but she doesn't know what she is talking about," or "People are too sensitive.  Why don't they focus on something really important like world hunger!" When a blind spot is threatened with vision, the defensive response includes denial or dismissal. Just like the dangerous spot behind a driver's left shoulder which cannot be seen, this an emotional "place" into which it's owner cannot see and thus to him or her does not exist.

     Most of us have such a blind spot, and few of us are aware of it. Yet this blindness is a large obstacle preventing our love relationships from reaching a higher level. It is an area within our psyche and emotional world about which we don't know that we don't know.  It is an area of complete blindness like an intense darkness that an ordinary flashlight will not penetrate.  Unconsciously, we prevent ourselves from becoming aware of our own blind spot, but each one of us is clearly aware of others'. We are an expert about our romantic partner's blind spot, whose behavior and attitude tempts us to judge and criticize.  In reaction to a behavior that reveals another's blindness it is easy to comment, "What were they thinking?" Holding back on judgement is wise, just as it is best that people who live in glass houses should not throw stones.

     The variety of personal blindness all fall within the negative range; the ways we unknowingly negatively effect others.  One wife, exasperated by her husband's blindness, causing her to often feel invisible, put her socks in the kitchen silverware drawer as a test to see if he would notice the item that did not belong...but he did not. A husband complained to his wife that every time they come together she emphatically lists her frustrations and complaints, preventing him from having a pleasant conversation with her.  She denied it upon being confronted. An oblivious husband leaves a trail of used items: dirty socks, empty drinking glasses, wet towels behind him after he leaves a room without regard for his wife who prefers an orderly house.  A wife who regularly but unknowingly speaks too loudly, hurting her husband's ears, despite years of requests for a lower voice.  A girlfriend who has a pattern of being consistently late for every meeting. The boyfriend who unconsciously turns every conversation around to himself.

      The behaviors that are performed without awareness are typically minor.  If not for their repetitive pattern, creating a negative snow-balling effect, such unconscious behaviors would matter little. They represent an insensitivity to the social world, just like littering; it may not devastate the environment but unchecked, it contributes ugliness.  No one is more influenced than the romantic partner, whose annoyance is likely to grow into resentment and peak in bitterness should cessation of blind behaviors not occur.  Our blind spot behaviors unconsciously contribute to the gradual decline of passion in our relationships, providing an example of how so many loving connections die a death of a thousand tiny paper-cuts.

     A romantic partner who tries to shine light into the other's blind spot risks strong opposition formed of denial, dismissal, invalidation and possibly counter-attack, while coming away little success of change. Taking off the emotional blinders may be slow in arriving. To rid the blind spot of its blindness requires an emotional awakening.  Ultimately each one of us has complete control of our actions and choices.  We have the power to limit any behavior pattern we choose, but the momentum of habit and personality make many behavior changes unpalatable.  Many only choose to change when circumstances force change.  For individuals and partners who are ready, growing aware where previously blind empowers a soul with new eyes and a world of fresh possibilities. Andrew Aaron, LICSW


For the Love of the Female Body

For heterosexual men, women’s bodies are the source of fascination and erotic nourishment, but the relationship between women and their bodies is a war zone.  In my capacity as a sex therapist, I recall treating an eighteen-year-old female patient whose body would elicit drools from most men and envious contempt from most women. Despite her actual shape and proportions, she could only express criticisms of, and contempt for her body. She shared harsh words about her thighs; she verbally attacked her behind, and when she mentioned her tummy, her face contorted into an expression revulsion. If the sampling of women I have had the honor to treat is representative, this eighteen-year-old is typical of how many women feel, irregardless of the shape, about their bodies.  

     It has seemed odd to me that many of the women’s male partners do not share this negative perception. Most men say, “I like her body.  It isn’t perfect, but that doesn’t matter to me as much as her ability to relax so that we can enjoy closeness and pleasure.”Unfortunately, the negative relationship between a woman and her body has a direct and negative effect on the healthiness and quality of her sex life with her partner.  Good lovemaking requires the ability to relax. A woman who dislikes her body cannot relax during sex.

    Beauty is a primary feminine value; just as power is a primary masculine value. To possess beauty is to own a potent source of a kind of power, but because beauty has grown into an unhealthy societal obsession, many of us have been deluded into believing that unless we have high physical beauty, we have no value.  This is not true.  The media constantly pushes the beauty/sexy button knowing that it can elicit a spending response, but this unintentionally fuels women’s shame and insecurity about their bodies.

     Some men and woman received the gift of physical beauty, but, to be honest, most of us have not.  Especially as we age into our middle or later years, if we have not given up on our need to have magazine looks, our vanity and our disappointment damages the beauty of what inner gifts we do possess. Perfection is an unrealistic goal.

Not evident in her experience is that the rejection women subject their bodies with is a little more than an expression of negative self-esteem and shame.  When women feel bad about themselves or emotionally uncomfortable, this is likely to be expressed in the form of physical self-criticism...experiencing one self and one’s body as ugly and unacceptable. Women self-talk when naked in front of the mirror can be cruel and harsh...language that she would never allow another to say to her daughter. While none of us are perfect, no one deserves to be verbally abused. Instead the practice of kindness, acceptance and gentleness may gradually replace self-hate with self-acceptance.

    It is wise for women to set a goal of physical, emotional, sexual and spiritual health rather than perfection in physique or beauty. This can be accomplished by making friends with your body, despite its limitations. Do you end your friendship when your friend demonstrates an imperfection?  Be just as forgiving with your body. If you harbor negative emotions, your body’s health will be harmed. To feel badly about your body is to be less than your best; it is unkind to rob your partner of access to all of you. Do make the most of your physical assets, but don’t let that be the source for obsession or self-hate.If you make it your friend, and if you can let go of negative emotions, your body is still capable of providing you and your lover with great pleasure; that is truly beautiful! Andrew Aaron, LICSW


Tiny But Mighty: The Clitoris

Far down through the dense and deep forest thicket, into the canyon cleft, there is a rise.  Under that rise and hidden beneath a protective layer rests a silver pearl.  She is the princess, waiting to be awakened.

     She is the clitoris, the tiny little secret, and the main organ of female sexual pleasure. No other quarter inch spot on a human body, male or female, is more tightly packed with nerve endings. The clitoris is intensely sensitive and capable of providing a woman with great sexual pleasure.  Because of her location on a woman's body, the clitoris has no direct reproductive purpose, unlike a man's penis.  Stimulation of the clitoris in the right way leads to female arousal and orgasm.

     Misinformation and myth cloud the reality of the clitoris.  Even in mid-life, some women are unaware of the clitoris as the center of their body's capacity for sexual pleasure.  Many male partners are uninformed about the role of the clitoris in female pleasure and arousal.  Both partners are often uninformed as to the vital role of the clitoris in reaching climax and it's lack of involvement during intercourse.  The costs of these missing pieces of sexual education is success-preventing unrealistic sexual expectations, as well as disappointment regarding pleasure and orgasm.

At left is a model of the complete internal structure of the clitoris. Notice that a man’s penis and testicles look similar. The very tip of the clitoris at the top of the picture is the part of the clitoris that is on the surface of a woman’s body in the top of the vulva and available for pleasurable stimulation.

     Outside the body the clitoris is tiny, but internally, it's size rivals that of a man's penis.  The clitoris and the penis share the same beginning.  Influential gender hormones determine whether the responsible cells will grow into a penis or a clitoris. Both organs are equally capable of providing it's owner with great pleasure, but there remains huge differences between how each functions reproductively. This further causes misunderstandings about the clitoris.  

     Many men assume that the clitoris, or something similar resides inside a woman’s  vagina, causing intercourse to be equal in experience and pleasure for the female partner.  This is not so, and is proven when comparing to men the number of women who regularly orgasm during intercourse, which is about 100% to 30%.  For most women, intercourse does not lead to orgasm, because the clitoris is located outside their vaginas.  The clitoris’ purpose is pleasure, not reproduction.

     The experience of pleasure a woman will feel when stimulated, despite the clitoris' thousands of nerve endings, may still vary. When using a light with a dimmer switch, the brightness of a light will vary depending upon the setting of the dimmer.  Similarly, the sensitivity of the clitoris varies depending upon many factors. Negative attitudes towards sex, the presence of negative emotions, and preoccupying worries will all reduce a woman’s clitoral sensitivity.  If she has a busy mind, is unable to relax, or is feeling badly, her clitoral sensitivity may be "dimmed" or potentially even unresponsive. Stimulating an unaroused clitoris may cause a woman discomfort and interfere with her becoming aroused.

      Unlike men, whose sexual response is more consistent because they are less influenced by their emotions, women’s responses may vary greatly.  The fickle nature of what kind of clitoral touch pleases a woman can be confusing to male partners. Being so small and changeable in its sensitivity, some partners are challenged to locate the clitoris and provide touch that is pleasing.

     Giving your female partner intense pleasure is one way to show her love; her tiny but mighty clitoris is the way.  It is wise for a woman's partner to be receptive to her gentle, but essential guidance and instructions, on how she likes to be touched, rubbed and stroked. It is a brave and kind woman who fosters her partner’s success by offering this guidance.  Andrew Aaron, LICSW


Anatomically Different...Intimately

In the most essential sexual act, men and women are unequal and different. Expectations about how intercourse should go differs from reality, interfering with the satisfaction of lovers.  Many partners expect that intercourse should lead to orgasm, that all-important blast of bliss. Most men believe that during intercourse, if they are physically adequate and sufficiently skilled, their female partner will reach orgasm. Most female partners, too, believe that this is how it should go. When sex differs from expectations, problems are not far off.

   The myth that women orgasm during intercourse persists despite the reality suggesting that this is largely untrue.  The statistics show that roughly 30% of women orgasm during intercourse but most of these women most do not climax consistently. The expectations that women "should," complicates a potentially joyful act with tension.

    With men there is little problem or question; almost all men reach orgasm during intercourse. Responsible for such a large difference in response between men and women, is that during intercourse, a man's penis is directly stimulated.  The female organ analogous to a man's penis is the clitoris, similarly loaded with pleasure-giving nerve endings, but located outside of a woman’s vagina. The clitoris is not directly involved in intercourse. In a strange choice of nature, the experience of intercourse is far different for women than for men.  A woman's vagina, which is fully involved in intercourse, has far fewer nerve endings than does her clitoris. Most women are orgasmic, but just not from intercourse.

    To more clearly illustrate the point, let's reverse the genders.  If a man's lower belly were to be stroked, few men would reach orgasm.  Most men would react by saying, "It's not going to happen, because touching my belly won't produce an orgasm." Exactly, and that is true for women as well.  Yet the erroneous myth of female orgasm persists. Women, who seek to enjoy an orgasm when alone in private, overwhelmingly stimulate their clitoris for pleasure, arousal and orgasm.  Far fewer mimic intercourse by involving their vaginas in the experience.

    But what about the roughly 30% of women who do have orgasms during intercourse?  Such women are successful by being deeply relaxed, achieving high arousal and experiencing intercourse as highly erotic. Their successful strategy is less body-based and more mental, emotional and through the proper flow of sexual energy. Some people are able to orgasm without any physical stimulation at all but solely by thinking erotic thoughts.

    To reach orgasm despite the anatomical disadvantage some women choose to stimulate their  clitoris during intercourse. Other women are too embarrassed to attempt it. But this work-around comes with some risk since some male partners feel threatened by a female partner's self-stimulation. He may interpret her actions to suggest that he is "not enough for her." Women who believe that orgasms should occur during intercourse, but are unsuccessful, may struggle with feelings of sexual inadequacy.  If her partner also subscribes to this erroneous belief, a woman is susceptible to concluding that “something is wrong with me.” Couples who try hard to force an orgasm in their quest to correct the problem complain that “she takes too long.”

    The long-held ideal of simultaneous orgasms causes more disappointment and pressure than it does satisfaction.  As the "Holy Grail" of sexual experiences, simultaneous orgasm is a bar set too high and functions as a case of perfection preventing good enough.

    Yet if a woman does desire to become orgasmic during intercourse, she may develop this ability.  Some women are successful at learning to relax, focus and redirect the flow of sexual energy within her body to increase her capacity for pleasure and orgasm both during intercourse and beyond.  However, it may be simpler to let go of the myth that women need to orgasm during intercourse by instead seeking to more fully enjoy the relaxed pleasure that is more easily obtained.  Andrew Aaron, LICSW


Delayed Take Off: Inhibited Ejaculation

The plane sat still on the tarmac. Inside the passengers waited restlessly for long, impatient minutes, hoping that take-off will be soon. Hundreds of details, many minor, must all line up perfectly in completion for the plane to take off. What will it take for the air traffic control tower to finally send the message, "Cleared for takeoff?"
Some men are like that...they do not take off, or take a very long time to do so. Other men cannot finish no matter how hard they try. Just like the passengers on the plane, if that plane doesn't take off, irritability and frustration will result. For the men when with their partner, if not corrected, the difficulty or inability to ejaculate can have deep and harmful effects on the man, the partner and the relationship.
Delayed ejaculation is a sexual problem that doesn't get much press. Premature ejaculation, which is now formally called an ejaculatory control problem, is more common and more well known. It troubles many male lovers and is the opposite of delayed ejaculation because men have difficulty stopping ejaculation, especially when the timing is inopportune. Men in general are challenged to last long enough before ejaculating to fully please a female partner. Because of the value of being a lover who can last a long time before ejaculating, at first glance, this problem can seem like a blessing...one of endurance. Men are not likely to announce this problem, especially when he can view the problem through the lens of machismo, "I can last for hours!"
Deeper within, he knows that he cannot easily finish the job. Feelings of embarrassment, shame, and inadequacy accelerate once the partner identifies the issue as a problem. A cycle of performance anxiety commences in which during intercourse a man tries increasingly hard to succeed. Increasingly vigorous effort is not always welcome to a female partner whose arousal is declining. The unfortunate paradox is that the harder a man tries, the more elusive success will be.
The knot of this problem grows tighter when the partner reacts in hurtful or defensive manner. When a man ejaculates, many female partners receive his orgasm as a sign of attraction which confirms her desirability and skill as a good lover. But when his orgasm dos not occur easily, the female partner will conclude that she does not turn him on. She may worry that she is not doing sex well. The partners' feelings and reactions may cause both the problem and arriving at a solution to grow exponentially more complex.
Because sex happens in many episodes or sessions, the impact of a problem influences the sexual togetherness incrementally. Consider a bicycle wheel that is out of round. The more the imperfect wheel is used, the more out of round it becomes. Similarly, sexual partners react to each other by making adjustments to avoid discomfort and also to fix the situation accord to each partner's diagnosis of the problem. If the diagnosis is incorrect, which may occur due to limited communication, the problem worsens.
As with many sexual problems, relaxing is the solution. Many women who cannot climax, or who have to work hard to get there are in a similar boat. Relaxing is a very simple thing to do, but finding the obstacles to relaxing is not always so simple. The sources of anxiety are many. They may be hidden. They may be very old issues, long forgotten. Not to despair, however, because once uncovered, the obstacles to overcoming delayed ejaculation are not hard to remove. As always, applying loving efforts to the problem by both partners will help to travel more quickly the road to success. Andrew Aaron, LICSW


The Avoidant Partner

Some people avoid intimacy.  Strangely, these people still form intimate relationships, and in a pattern that defies logic, they engage in lovemaking during the relationship's initial months.  What happens next can be the source of confusion, frustration and finally out-right anger for the partner.  After intimacy deepens, the avoidant partner loses interest in being sexual, in hugging, kissing, and perhaps even holding hands.  Some avoidant partners will seem to actively limit physical proximity, such as sitting closely together on a couch where contact may be possible. Most avoidant partners do not possess conscious intent to cause hurt but chronically rejects the other without awareness. Even if asked directly, the avoidant partner will deny any avoidance because it is not a part of his or her conscious awareness.  Avoidance of intimacy falls along a spectrum from mild to extreme.

     The sting of rejection is sharp if it is discovered that an avoidant partner has been taking his or her sexuality away by having self-pleasure in private or has been having an affair.  Yet it is almost impossible for the hurt partner to embrace the reality that this is not a personal rejection.  Avoidant partners are uncomfortable with closeness and real intimacy, which is what is really being avoided.  Affairs are really far less intimate than long-term relationships and masturbation involves no risk of emotional intimacy.  Hurt partners' patience may be exhausted by such exclusionary sexual behaviors in conjunction with chronic emotional deprivation and choose to end the relationship.

     Those in relationship with an avoidant partner commonly take the avoidance personally; it feels like rejection. They may question if the avoidant partner is angry with them or if they are no longer found attractive. Reactionary efforts such as going to the gym to get fit or experimenting with a new hair style to increase appeal are unlikely to alter the avoidant partner’s low level of engagement, and will fail to increase the amount of emotional or physical closeness in the relationship.  A female partner may suspect that an avoidant male partner  is gay or is having an affair due to the prevailing myth that all men want lots of sex. The negative effect deprivation of warmth has on the other partner can be significant ranging from anger to low self-esteem and even depression. The lack of closeness and sex may raise the importance of sex to an extreme make-it-or break-it status where threats such as, “Have sex with me or we’re through!” are not unusual; even if sex has never before been that important.

     When confronted, an avoidant male partner is likely to say, “I am just not a sexual person;” words which contradict his or her active sexual behavior from the honeymoon phase of the relationship.  If the avoidant partner is female she is likely to say, “Sex is not that important, why are you so obsessed with it?..I think you are a sex addict…you need to get help.” It is normal when deprived of affection and sex to desire these firms of nourishment to increase, just as someone starved of food cannot get thoughts of food out of their minds. This differs from an unhealthy obsession. 

     Avoidant partners developed this pattern in reaction to a childhood history which typically included some form of abuse or lack of emotional nourishment, even though the avoidant individual is likely to describe their upbringing simply as normal.  Some families do not recognize or value emotions or emotional expression.  In such families, emotional needs go unmet.  A general and recurrent disregard for a child’s feelings can produce in them avoidant patterns as an adult.  Work in therapy can help an avoidant individual outgrow these tendencies; however, their strong motivation to do so is a vital ingredient for successful growth and change. Why a partner was attracted to an avoidant individual may also be a useful direction for exploration. Andrew Aaron, LICSW