Listen to “146: What We Can Learn From People With Spinal Cord Injury – Dr. Mitchell Tepper” on Spreaker.
Sex After Spinal Cord Injury
On this episode, Mitchell joins us to discuss the impact of a spinal injury on sexual function. Having experienced this type of injury personally, he shares his journey to teaching people about sexual health being one of the first people to have a sexual health domain registered in 1996. The website was intended to help people with disabilities with their sexual health but soon became a central source of sexual health information for all kinds of people.
The Importance of Trust
Setting myths aside, Mitchell explains that people with disabilities can experience sexual pleasure, erections, etc but some have difficulty expressing themselves. After research into this, he found that people need a partner they can trust to reach the point of sexual pleasure and comfort.
A critical part of this is relearning the truth about sex, departing from the limiting physical definition to experiencing trust, safety, and connectedness. Mitchell is a testament to breaking physical boundaries with this combination. He has found that even those with disabilities below their injury region have experienced an orgasm with the proper context and approach.
Sexual Self Esteem
In other areas of his research, Mitchell tells us about the effect of how much time has passed post-injury and sexual self-esteem on sexual health. His findings also point to people having higher sexual self-esteem if they were born with their disability as opposed to people who acquired their injury. This is based on the latter group constantly comparing their past sexual performance with their current ability.
These Ideas Apply to Everyone
In his process of helping people, Mitchell explains that he helps his clients understand how their new bodies work, as this is usually overlooked or taken for granted. In addition to this, he encourages people to make use of touch, sound, and sensation to help people reach sexual pleasure.
For people that aren’t struggling with a disability but want to explore a deeper and meaningful sexual experience, Mitchell advocates sensate focus. He further explains that this builds sexual communication and advocates touching for your own sexual satisfaction, allowing your partner to provide feedback. Mitchell also finds that Tantra a meaningful technique to deeper sexual experiences. The technique has three main factors: Stop, focus, and connect, which he digs deeper into.
Mitchell’s techniques are beneficial to able-bodied and disabled people, revealing that penetration is not at all the only means to orgasm. With dozens of examples of non-penetrative orgasms amongst his findings, he shares real cases with us that shed light on this experience.
Undoing learned habits is just as huge a part of the difficult journey to experiencing sexual liberation. Incorporating play into sex is also a great way to make it less serious.
Dr. Mitchell Tepper, author of Regain That Feeling: Secrets to Sexual Self-Discovery, brings a lifetime of first-hand experience with chronic conditions and disability to his work as a Sexuality Researcher, AASECT Certified Sexuality Educator and Counselor, Coach, and self-proclaimed Prophet of Pleasure. He has a Ph.D. in Human Sexuality Education from the University of Pennsylvania and a Master’s in Public Health from Yale. Dr. Tepper worked on ground-breaking research on orgasm in women with spinal cord injuries with world-renowned orgasm researchers Drs. Beverly Whipple and Barry Komisaruk. Over the last 14 years, Dr. Tepper has turned his attention to helping wounded veterans and their partners navigate intimate relationships. His forthcoming documentary, Love After War, tells the stories of intimate partners who have won the battle for love.
Links and Resources
Listen to “145: Sensate Focus – Linda Weiner” on Spreaker.
Sensate Focus Exercises
Sensate focus is a touching technique for couples or individuals that stimulates the primal part of the brain to enjoy a fully immersive experience with your partner. The technique starts with focusing on temperature, texture and pressure and uses a tactile sensation to move away from distraction.
Linda uses the technique for almost everything ranging from low/ no desire, sexual dysfunction, trauma, body image issues to rekindling connection between couples.
One Size Doesn’t Fit All
With each individual experiencing sensation differently, Linda highlights building up sexual tension with touch. From Linda’s experience, there is often a need to manage each level as it is approached. She removes conflict and pressure from couples relationships, by taking on the instruction/ control role. Her sessions help couples identify the difference between vulnerability and rejection.
How Do You Start With Sensate Focus?
With no hard and fast rule, couples can choose certain factors in their environment to ensure that they are at ease eg clothing (or no clothing). Linda’s rules include no kissing and no talking. She points out that talking uses the front of the brain and therefore brings individuals back to logic. Linda mentions that the toucher is supposed to touch for their interest while the person being touched, needs to experience the touch and provide feedback if something is not comfortable.
Linda shares that avoidance is one of the main issues that couples encounter. She reveals how she handles this delay tactic fairly. For clients that don’t like the technique, she reminds them about the basic three areas of focus temperature, texture and pressure. Partner pressure is an obvious obstacle that Linda notices with her clients. She uses a great analogy to help us accept our differences and move couples through the basic steps at their own pace.
Linda Weiner, MSW, LCSW, Owner of Sex Therapist St Louis, LLC is a Certified Diplomate in Sex Therapy, a Supervisor for Certification in Sex Therapy & Sexuality Counseling and a CE provider for the American Association of Sexuality Educators, Counselors and Therapists (AASECT).
She earned a B.A. in Psychology from American University and an MSW from the University of Missouri. Linda trained at Masters & Johnson Institute and was employed there for five years as the director of Training & Workshops and as a Research and Clinical Associate. Evolving into private clinical practice as a therapist specializing in sexual and relationship concerns, Linda later began publishing on Sensate Focus mindful and somatic touch techniques with co-author, Dr. Constance Avery-Clark. Following the publication of a number of journal articles and a book chapter, Sensate Focus in Sex Therapy: The Illustrated Manual was published in 2017.
For 15 years, Linda served as an adjunct professor at the Brown School, Washington University. Linda has presented nationally and internationally and has been interviewed by a number of media outlets including CNN. Her current interest is in transmitting information about the use of Sensate Focus techniques to physicians and Allied health professionals who represent the first contact with sexually distressed individuals.
Links and Resources
Listen to “144: What is Sex Therapy Like – Paula Leech” on Spreaker.
What is Sex Therapy Like
Paula shares that mindfulness plays a key role in sex therapy which ties in mind and body by focusing on sensate focus and behavior. The therapy is purely verbal and while it implies a physical element, that only happens in a clients home away from their therapy so that progress can be made. Paula emphasizes that a major part of her clients have underlying anxiety struggles. She points out that sex therapy is used to treat this before ever focusing on sex.
Who needs sex therapy?
With a degree in Family therapy, Paula thinks about the ‘who’ differently. Her approach includes her client’s partner/s to get better insight into her patients’ struggle.
Paula also helps single clients. She points out erectile dysfunction as an example of a problem she tackles with her single clients. Her work with these clients includes understanding their bodies and giving them tools to help themselves.
Working with Paula
Paula’s first sessions are honest consultations used to get to know each other as taking the first step into therapy can be daunting for clients. She moves on to providing the way forward and answering any questions around this. Obviously this varies with each clients unique situation since her clients experience a range of difficulties from sexual trauma to pelvic floor issues.
Paula’s direct communication and transparency is a different approach to this kind of therapy but welcomed by her clients as they find her more relatable.
In this type of therapy, clients are exposed to an extent and Paula reveals that fear is part of the process. One of the most common fears she finds with her clients is the fear of being judged. Another one is fear of loss of a relationship if a struggle is not overcome during the therapy.
Frequency of sex often comes up with Paula finding that couples need permission to not engage in sex. Her candid and simple reaction to this is based on whether the parties are happy.
Paula shares an interesting angle to look at things from when experiencing sexual struggles, highlighting that being too involved in your partners problem takes away from you focusing on you and helping from that point of view.
Finding a Sex Therapist
Legitimate sex therapists have an AASECT certification. Therapists do around 160 hours of courses and 300 hours with patients before being certified. Training ensures that therapists themselves are aware of their biases and comfort zones to better aid their patients.
Paula received her bachelor’s degree in Family and Human Development at Arizona StateUniversity and then went on to receive her master’s Degree in Family Therapy at the University of Massachusetts, in Boston. Post family therapy licensure, Paula became AASECT (American Association for Sexuality Educators, Counselors, and therapists) certified as a Sex Therapist and worked with individuals, relationships, and families in private practice in Boston, Massachusetts for ten years.
In that time, she received AASECT certification as a Supervisor of Sex Therapy and co-founded a sex therapy agency and training institute where we saw clients in addition to training therapists to become competent, confident sex therapists themselves. Paula continues to regularly present at various training institutes as well as Universities and therapy agencies across New England.
Links and Resources
Webinar: How to make Sex easy without making it feel like an obligation
Surrogate Partner Therapy
Listen to “143: Surrogate Partner Therapy – Brian Gibney” on Spreaker.
What is Surrogate Partner Therapy
Surrogate Partner Therapy offers a unique, tailored space in which to safely explore trust, communication, emotional intimacy, sensuality, and sexuality. Each of these pieces is important in their own right and essential in how they interconnect to influence healthy relationships.
It facilitates the therapeutic process and focuses on physical limitations, personal history, poor self-image, communication and other broad areas in relationships. Unlike a therapist, a surrogate partner is in the relationship with you and shows you what something would feel like, lending itself to people not currently in relationships.
Surrogate Partner Therapy is a Process
Just like any type of work required on a relationship, the process may take some time. Early on in the process, Brian ensures that his clients are aware of what can be expected during the sessions. The session involves the client, the therapist and the surrogate partner working parallel with each other.
Initially, Brian assesses his clients to see if they are a good fit for the sessions. He discusses mental disorders and active abuse as an example of clients that would not be a good fit for the therapy.
Consent is Crucial
Brian opens up the consent conversation and how critical it is to measure if his clients understand consent. He takes us through the exercise he uses throughout his sessions, to ensure that his clients understand consent and know how to identify it.
Specialized Training is Important
While this type of therapy is not offered by therapists, Brian discusses the process of involving his clients’ therapists and ensuring that they too are not overstepping personal or professional comfort boundaries.
To ensure you are getting a certified surrogate partner, Brian suggests getting recommendations and getting a feel for how your therapist works. The typical way a surrogate partner works is within a triad. Communication is usually a main area of discussion while sexual focus comes in as a client requires it.
Brian mentions the certifying organizations available that you can use to check if your surrogate partner is certified.
Over the course of his adult life, Brian has worn many hats: research scientist (BA, Molecular biology; Masters, Microbiology), teacher, professional artist, performer, and parent. The common thread that has run through all of those vocations has been the joy of learning, discovery, and improvement.In parallel with his professional life, he has also been keenly interested in interpersonal interactions, intimacy, and authenticity. These two facets have merged in his practice as a Surrogate Partner.
Brian received his training in Surrogate Partner Therapy from IPSA (the International Professional Surrogates Association) in 2016. In addition to being a member of IPSA, he is also a surrogate partner member of IMBT (Institute for Mind-Body Therapy), AIHG (Ananda Integrative Health Group), and AASECT(American Association of Sex Educators Counsellors and Therapists).
Brian is a founding member of the surrogate Partner Collective and Chair of AASECT’s Somatic Sexuality Professionals Special InterestGroup.In his practice, Brian seeks to help clients create foundational self-knowledge that enables them to effectively navigate healthy and fulfilling intimate relationships. Motivating this is the core belief that sharing intimacy with others is an essential part of the human experience. While it is important for everyone to have the option to feel connected with others, many find it difficult (or impossible) to make this connection.
In helping clients achieve their goals, Brian strives to maintain high professional and ethical standards and promote accessibility of Surrogate Partner Therapy to ensure those in need may receive the most successful treatment. In addition to his work with clients, Brian has been advocating for his profession by education therapeutic professionals and the broader public.
Drawing from his experience as an educator, he has presented at a range of professional conferences, workshops, therapeutic practices, and professional groups. In discussing his work, he hopes to encourage dialogue about a variety of topics–intimacy, sensual awareness and embodiment, and communication–that is so desperately needed in our society.
Resources and Links
Listen to “142: Birth Control – Emily Aytes” on Spreaker.
On this episode, we hear from birth control expert, Emily Aytes. She uncovers some of the most common questions she receives. Interestingly, Emily shares that both young and older people ask her about birth control as it isn’t widely discussed from her experience. Her personal opinion is that having a birth control conversation with your partner early on allows you to enjoy sex and delve into other parts of your relationship.
Long acting reversible contraception
If you have ever wondered what a LARC is, Emily explains the acronym to us : LONG ACTING REVERSIBLE CONTRACEPTIVE. This includes IUDs which can last between 3-12 years. Emiiy shares the side effects of the IUD and unpacks NEXPLANON, the copper and plastic iud. Benefits of this include not having to remember anything as these methods provide protection without any further human intervention once they are implanted. If you change your mind and decide to remove the device, rest assured that it’s relatively easy to continue where you left off.
The shot is another commonly taken contraceptive in this category and contains Progesterone. Again, Emily discusses the side effects and notes that this method too is pretty effective.
Other Birth Control Methods
The pill has proven to be a highly effective method from Emily’s findings, however she notes the side effects and the fact that human intervention is required everyday, opening up a window for error and loss of effectiveness.
Touching on condom use, Emily explains how human error can result in a lack of effectiveness while doubling up on methods eg IUD plus a condom, can increase effectiveness. On the positive side, condoms are accessible without prescription and offer a wide range to suit your personal preference.
Planned Parenthood website is recommended if you are interested in a more natural method that does not require any external intervention.
One of the most common questions Emily gets asked is around how pregnancy occurs. For this reason, she explains the biological process for us in an easy to understand way.
We learn more about emergency contraceptive including the morning after pill : Plan B ( no script required) and Ella ( which requires a script) and the Copper T which is extremely effective.
Another common question Emily gets is whether you can get pregnant during your period. While it is possible, she explains it is not likely. For a more behavioural method of contraceptive, Emily discusses withdrawal which is only 78% effective.
Emily Aytes (she/they pronouns) is a community outreach educator with Planned Parenthood in Indiana state. As an educator, her role includes offering comprehensive, inclusive, and medically accurate sexual health information to her local community and beyond.
The majority of her work in the community is with young people in middle and high school classrooms teaching about relationships, consent, birth control methods, STIs, gender, and communication skills.
Emily is passionate about all folks having access to sexual health information so that they can make their own informed decisions. She also enjoys teaching about racial and social justice, LGBTQ+ identities, and sexual pleasure
Resources and Links
Listen to “141: Doing Non-Monogamy Well – Tristan Taormino” on Spreaker.
Doing Non-monogamy well
On this episode we dig into non-monogamy with Tristan Taormino. She discusses how the processing of both parties feelings is a crucial element to open relationships. Interestingly, she shares how working on yourself is a big part of the open-minded approach required to make this type of thing work.
The Importance of Boundaries in Consensual Non-monogamy
Tristan recommends a slow start and provides clear guidelines and examples on how to do this. Knowing what you want and need makes setting boundaries easier. These boundaries include whether or not you and your partner wish to keep your non-monogamy close to home or not. This ultimately bleeds into how much time you will be investing in non-monogamy and the depth of the relationships you will be seeking. Tristan shares the types of boundaries that could come up.
Decisions to make regarding non-monogamy
Tristan’s advice for couples with different feelings about non-monogamy is to go at the pace of the slower partner. Ultimatums are not encouraged especially if your partner agrees to give it a try.
Tristan adds valuable advice about making decisions during the heat of a moment, advocating a more thought-through approach when put in these situations. People trying non-monogamy also struggle with certain behaviours including jealousy. We learn more about this and how to constructively handle this.
The Common Pitfalls of Consensual Non-monogamy
Time management is considered one of the pitfalls of non-monogamy. With many tools available at our disposal, Tristan unpacks the subtle and obvious scenarios that eventually lead to your time being consumed and the negative impact it can have if not managed.
We hear about emotional privacy and how it involves considering the preferences of all the parties included in your non-monogamous arrangement. Tristan’s suggests the ‘don’t ask, don’t tell ‘ method if all parties can agree to it. Vito power comes into play here and we hear about how it can be used fairly.
Considering the Past
Trauma and negative childhood experiences eventually manifest in our relationships. Tristan urges us to investigate these issues so that we are informed when entering a relationship and acutely aware of our partner’s triggers and understand why they exist.
Tristan Taormino is an award-winning writer, sex educator, speaker, filmmaker, and radio host. She is the editor of 25 anthologies and author of eight books, including Opening Up: A Guide to Creating and Sustaining Open Relationships. She lectures at top colleges and universities and teaches sex and relationship workshops around the world for nearly 20 years.
Tristan hosts Sex Out Loud, a weekly radio show on the VoiceAmerica Network and is the creator of Sex Educator Boot Camp, a professional training program while still running a coaching and consulting business for sexuality and creative professionals.
Links and Resources
Sex Out Loud