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 “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
Listen to “135: Optimal Sexual Experiences – Dr. Peggy Kleinplatz” on Spreaker.
Optimal Sexual Experiences
On this episode, Dr Kleinplatz introduces her findings around “optimal sexual experiences” based on actual interviews she performed. After much research, she shares these eight components couples need to have to eventually reach an optimal sexual experience:
- Being totally absorbed in the moment
- Sharing a connection with your partner
- Deep sexual and erotic intimacy
- High levels of empathic communication
- Fun, laughter, exploration and good risk-taking
Her findings show that people begin to seek these experiences around their mid 50’s. Part of the process of discovery is unlearning much of what we know about sex growing up. Spontaneity arises as one of the behaviors to “unlearn “ as Peggy candidly shares her views on this.
Anyone can get there!
Peggy has found that people with chronic illness are enjoying magnificent sex! In an unexpected twist of events, Peggy’s co-workers proved that presumed stereotypes are false. She shares that consent is a major piece of the puzzle and contributes to empathic communication.
Peggy educates us about moving from good to magnificent sex explaining that getting to know each other on an ongoing basis builds trust to explore deeper levels of your relationship.
We learn about differentiation and how it impacts reaching optimal sexual experiences while identifying that therapy has to be customized to each individual.
To reach for the optimal sexual experience goal, Peggy highlights that respect for each other is crucial.
Resources and Links
Book: Magnificent Sex: Lessons from Extraordinary Lovers (routledge.com/9780367181376)
Peggy J. Kleinplatz, Ph.D., is a Professor in the Faculty of Medicine and Director of Sex and Couples Therapy Training at the University of Ottawa, Canada. She was awarded the Prix d?Excellence in 2000 for her teaching of Human Sexuality. She is a Certified Sex Therapist and Educator.
She is the Director of the Optimal Sexual Experiences Research Team of the University of Ottawa and has a particular interest in sexual health in the elderly, disabled and marginalized populations.
Kleinplatz has edited four books, notably New Directions in Sex Therapy:
Innovations and Alternatives (2012), winner of the AASECT 2013 Book Award,
Sadomasochism: Powerful Pleasures with Charles Moser, Ph.D., M.D. (2006)
Sexuality and Ageing with Walter Bouman, M.D. (2015).
She is the author with A. Dana Menard, PhD of Magnificent Sex: Lessons from Extraordinary Lovers
In 2015, Kleinplatz received the American Association of Sexuality Educators, Counselors and Therapists Professional Standard of Excellence Award.
Listen to “134: Senior Sex – Joan Price” on Spreaker.
Joan tells us that being a senior sex advocate is her third career. She lived as a high school English teacher until a car accident made her acutely aware of the privilege of being able to be and stay mobile. She tells us that insight inspired her to become a fitness trainer, group exercise instructor, and health and fitness writer. After falling into what she calls a “planet-shattering” romance at the age of 57, she understood that great sex was a crucial element of romance at any age. Her research into overcoming the challenges of senior sex and increasing the passion and intensity of senior sex revealed an empty market niche, encouraging her to jump into the market by sharing her own experiences and adding her own research to the topic of senior sex.
She explores the misconception that sex is no longer experienced in old. She says that many believe that when people are older, they give up their sex lives and take up crocheting instead. “I have nothing against crocheting,” she says, “but it’s not sex.”
Challenges of Senior Sex
Joan admits that senior sex is not the same as the sex people have in their twenties. Bodies age and change, and she suggests that our sexual history can impact our sex lives.
She tells us that many people presume their sex lives are irrevocably declining when their knee arthritis prevents their favorite position, they take too long to orgasm, their erections are unreliable, penetration can become uncomfortable or intercourse may not feel as good as it used to. Joan believes that hurdles like these can be overcome when they’re acknowledged out loud and discussed with our partners. She admits that sometimes these are medical issues, while others are best solved with creativity, research, and an enthusiastic partner’s work.
Joan mentions that many elderly men and women insist that their desire to have sex is gone. To combat this belief, Joan describes writing a blog post on hotoctopuss.com about the difference between spontaneous desire and responsive desire. Many people believe that if spontaneous desire goes away, they no longer want to have sex, but that’s inaccurate. Responsive desire, she explains, exists when your body begins to engage in sexual activities, and you slowly develop a real desire and passion for sex while you’re engaging in the act.
Spontaneous desire, where a person knows they’re aroused and wants to have sex actively, often fades with age due to the hormones encouraging sexual reproduction declining. People who only experience responsive desire claim that they never really care about sex until they’re actually doing it—at which point they care very much! Joan argues that this responsive desire is just as intense and valuable as spontaneous desire, it just appears during instead of prior to sex.
Joan’s webinars talk about communicating needs, knowing your needs, as well as scheduling sex and creating responsive desire. She says that her books, blogs and webinars help people respond to and understand their current needs and abilities, and guides people through the conversation.
Benefits of Senior Sex
Joan assures us that senior sex can be better than the sex young people have because the elderly know what they like sexually and in other areas, they’ve learned to communicate very well, and they’ve gained the perspective to understand many problems as easy to overcome or as entirely unproblematic. She implies that elderly men and women have outgrown the shame and reticence most young people feel about sex. In her work, she notices older people are better at truly focusing on the pleasure their bodies are capable of creating, while young people are often fretting about minor bodily imperfections or other insecurities instead of being fully in the present moment.
That isn’t to say no seniors have hang-ups about sex. Jane describes the prejudices her generation internalized about the topic. She informs us that her generation was told not to talk about or have sex until you’re married and that women who don’t have orgasms during intercourse—as most women can’t—were called frigid. She says she is currently working on a webinar to work through this process and help seniors find the words to talk about attaining great sex.
Joan believes that especially for couples without spontaneous sexual desire, it can be sexually rejuvenating to set a date for sex. She explains that seniors can see that date on the calendar and that will cause them to think about sex more often. Scheduling sex also allows for planning the event with special underwear or a romantic setting or any number of other, enjoyable ways to improve sex and foreplay.
Joan suggests scheduling time to talk about sex and the physical and emotional changes that occur as people age. She insists that this can’t be accusatory. It’s meant to inform your partner about your changing body and needs and to invite your partner to do the same.
Sex Surveys and Seniors
Joan has been disappointed by surveys surrounding sex, because they often don’t poll the elderly about their sex practices at all. When they do include the elderly, she mentions that they don’t ask the right questions. Usually, she says, they ask whether you’re sexually active, which is a nebulous term.
She believes it would be illuminating if people writing surveys would ask what kinds of sexual activities people are utilizing at different ages. On air, she considers that she could do some of this research herself.
Another worthwhile survey question Joan suggests is, “What is interfering with your sexual pleasure?” Joan suggests that trouble reaching orgasm, not having a partner, and not having a vibrator could all be included in such an open-ended question.
Losing a Partner
She says her book, Sex After Grief was written after she lost her great love. Joan found herself trying many, many things to try to come back to her sexuality after losing her husband. She recounts her journey and shares the methods others used to overcome grief. She explains that there are many ways to regain your sexuality after the death of a partner, and though no single path exists, this book will help you navigate the loss of your partner and the return to your sexual self with insight and compassion.
Sex in Nursing Homes
Joan has written some about sex inside nursing homes, where you’re kept apart from others, cannot lock the door, and are given no privacy. She says there are a few nursing homes where sexual rights are a priority, based upon the belief that assisted living home residents should not be treated as prisoners. She says that it’s important to research nursing and assisted living facilities to determine whether they have policies in place to enable sexual activity in their facilities.
She explains that it’s important for the elderly to discuss what sexual rights their partners have before their mental state deteriorates or their body becomes too infirm to allow sexual activity. She says that if their partner can’t provide sexual or romantic love, or they themselves are too senile to remember their spouse, it’s important to make decisions about whether their partners finding love elsewhere is blessed or discouraged.
Joan Price is an advocate of ageless sexuality encouraging seniors to reclaim and rejuvenate their sex lives. A public advocate of senior sex since 2005, Joan has written five books to help and sexually engage seniors: Sex After Grief: Navigating Your Sexuality After Losing Your Beloved, The Ultimate Guide to Sex After Fifty: How to Maintain—or Regain!—a Spicy, Satisfying Sex Life, Naked at Our Age: Talking Out Loud about Senior Sex, Better than I Ever Expected: Straight Talk about Sex After Sixty, and Ageless Erotica.
Joan narrated and collaborated with Jessica Drake on her award-winning, explicit educational film “Jessica Drake’s Guide to Wicked Sex: Senior Sex.” Joan maintains a newsletter and a blog on senior sex, and she created an entertaining, free webinar to encourage safer sex among the elderly.
Resources for Joan Price:
Listen to “132: The Pleasure Gap – Katherine Rowland” on Spreaker.
The Pleasure Gap
Katherine explains her initial interest in sexual pleasure gaps began with her journalistic coverage of the search for a female version of Viagra. She describes being intrigued by the prevalence of the notion that there is something fundamentally wrong with women’s level of sexual desire.
She argues that feminine sexual desire is an ephemeral state that stems from myriad sources and appears as a final state that is or isn’t reached. She says it’s not a single trait that can be manipulated directly. Upon seeing this attempt to manipulate female sexual desire, Katherine began to interview women about their own sexual desires and what brings them sexual satisfaction.
Men and Woman Experience Sex Differently
In broad strokes, Katherine explains the Pleasure Gap is a measure of social inequality. She explains three intersecting ideas, the first being the differences men and women give in the accounts of sexual experiences. She says men report higher levels of sexual satisfaction than women, they achieve orgasm more readily, and are happier with their sex lives overall. She also informs us that men feel less stress, pain, and anxiety related to sex.
By contrast, she tells us women commonly report low desire, absent pleasure, muted or unfulfilling orgasms, sexual aversion and disinterest. She points out that women beat themselves up for feeling that way about sex. Katherine reiterates that these are common female experiences of sex, but woman are prone to blaming themselves for their problems.
She suggests that even women who report some satisfaction during sex may not be experiencing the event completely. Katherine mentions one study in which 50% of female participants reported having an orgasm when the scientific monitors for orgasms indicated no orgasm had occurred. She says this suggests that women’s education about their bodies and their possibilities is distressingly subpar.
Female Sexual Dysfunction
Curious about this disparity in human feeling, Katherine shares that many women express sexual dysfunction, asserting that their genitals feel numb or dead, all while lab tests report ordinary, healthy function of those organs. In other words, she noticed that women were responding physically to sex without any pleasure or intimacy being experienced in their brains. She suggests that because the mental and emotional aspects of sex are so important to women’s pleasure, that medications that aim to help women enjoy sex by affecting their genital performance miss the mark.
Sex in Media vs. Sex in Life
The third gap Katherine mentions is the gap between the sex we’re sold in the media and the sex we actually want and find fulfilling in life. She suggests that our modern notions of a liberated identity suggest that women should want and exude sex constantly, but real women often experience the opposite reality. She suspects that the problem is rooted in the lack of education women receive about sex and pleasure.
Ms Rowland also cites the stereotypes that men, the socially dominant sex, are supposed to desire lots of sex, while women are limited to being a gatekeeper restricting sexual access. Katherine believes that women need to be taught that pleasure is worthwhile and healthy so that they can feel comfortable exploring what gives them pleasure and allows them to enjoy sex.
What genuinely leads to satisfying good sex is intimacy, freedom of expression, creativity, safety, and being empowered to explore what genuinely turns you on.
The Effects of Sexual Trauma
Sexual trauma and abuse can also hinder women’s experience of their bodies according to research. She explains that women with this history may feel numb and distance themselves from the experience of sex or be hyperactive and hypervigilant during sexual encounters, leading to them feeling too stressed to enjoy sex. Women Katherine talked to also noted that women are inevitably objectified in pornography, which can lead to women objectifying themselves, instead of seeing sex as an avenue to express their own desire.
What Woman Want
She tells us that the scant research available on what makes good sex suggests that sexual satisfaction has nothing to do with the physical aspect of genitals coming together.
Feeling fully present in the moment—often achieved through mindfulness and the like—and feeling overwhelmed and encompassed by their experience to the extent of forgetting about daily obligations are markers Katherine found in women’s reports about good sex.
Katherine also found women asserting a need for safety, and the need to feel confident exposing the full extent of their sexuality with their partner. She mentions that many women who discuss transcendent sex often describe it in spiritual terms – as if sex is a way to break into people’s spiritual interiors as a homecoming in the other person.
What Women Can Do to Improve Their Sex Lives
Katherine asserts that her book is not proscriptive, though she does provide resources for self-inquiry and erotic amplification. Katherine does suggest that women can try to shut off the external noise distracting them from sex as much as possible to increase sexual immersion. She also suggests that they can explore their bodies and fantasies to enhance their knowledge of their bodies and their sexual experiences.
Katherine Rowland holds a masters in Sociomedical Sciences from Columbia University. At the same university, she was a National Science Foundation Graduate Research fellow in medical anthropology. In the past, she published and served as the executive director of Guernica. She’s contributed to Nature, the Financial Times, Green Futures, the Guardian, the Independent, Aeon, Psychology Today, and more. She is the author of the Pleasure Gap.
Resources for Katherine Rowland: