As a clinician who frequently works with sexual problems, I talk about genitals a lot! A lot! As I embark on these conversations with my clients, I have noticed how many people either don’t use the correct words for their genitals, or don’t even say the words at all. One of the most common errors I see is that people commonly say men have a penis and women have a vagina. While this is true, they are not the equivalent of one another.
I see this error in common culture verbiage also, people
referring to the female genitalia only as her vagina. The vagina however is one
part of the female genitals. It is the canal that leads from the vaginal
opening to the cervix. This is an internal part of the female anatomy. I hear
many people use the word “vagina” to refer to a woman’s external genitalia.
This would be somewhat equivalent to calling the male external genitals a vas
deferens (male internal tube) instead of a penis.
What people mean to say is that men have a penis and women
have a vulva. Vulva is the correct term to refer to the external female
genitals. It is made up of the 2 sets of lips called the labia majora and
minora. It protects the internal components of the female reproductive system.
So, next time you say the word vagina, make sure you are
referring to the correct anatomy. If you have never even said the word vulva, I
encourage you to start using it as the appropriate term for female external
In my work with people from all walks of life and circumstances, the one thing I have found to be true in every case is that humility always aids in healthier interactions and higher quality relationships. Another observation, is that humility is not very easy to come by. We, as human beings, kind of stink at this humility thing.
So, what is this humility
thing? Well, in my personal and very unofficial definition it means not viewing
yourself (or anyone for that matter) as better than anyone else. It is throwing
out the right vs wrong, better or worse than mentality. I think that the
following two beliefs are an essential first step in maintaining humility.
Remember that every single human being on this
earth has had and will have an entirely unique experience. None of us can have
the exact same experiences and views as someone else.
Each one of those unique human experiences and
vantage points are valid.
Not only do these beliefs lay the
ground work for much kinder and constructive interactions, but it will ease you
of the stress that comes from expectations to be right or better than. Humility
might sound like this:
“I think it is like this, but I could be mistaken.”
“I want to try this, and I would love to hear what you would
like to try.”
“Can you tell me what that is like for you?”
“I was mistaken.”
“I am sorry about the pain you are feeling due to my choice.
Will you tell me more about it?”
I challenge you
to incorporate even one of these phrases into your conversations, perhaps with
someone you haven’t been getting along with very well, and see how the
relationship improves. Even if you don’t find the outcome you were looking for,
kindness and softness are never wasted.
While it is perfectly healthy and effective in therapy to
disclose any personal information about your life to your therapist that you
desire, here are some things you do not want to be sharing with them:
Media Accounts: That’s right. Therapists are bound ethically not to have
any relationship with a client outside of the therapeutic one. Social media is
something you share with family, friends, and co-workers (maybe). You likely
don’t want your therapist seeing everything you post, and your therapist likely
doesn’t want you to see what they post in their private life. This could alter
the therapeutic setting. If your therapist has a professional or business
social media account, these are okay to follow, but not personal accounts.
The therapeutic relationship is a unique one, and for that reason, some clients
I work with feel a sense of gratitude and they want to communicate that. Some
clients feel the need to give a gift or “return the favor” in some way. I
always reassure my clients, the work we do together is not a favor, it is a
business arrangement and you already paid me. Therapists have an ethical
obligation not to accept gifts from their clients.
Your therapist should never be related to you, even if it isn’t by blood. This
comes back to that multiple relationships thing we talked about earlier under
number 1. People in your family already have opinions about you and a serious
investment in you. This would drastically impair their ability to be
therapeutic and your ability to feel the comfort of unbias. I would extend this
rule to close family friends or other significant people in your life.
to personal events: Though many people want to share the exciting and proud
moments of their lives with their therapist, this is best done verbally in
session. There is no need to invite your therapist to your wedding, baby
showers, graduation, or any other personal event in your life. Rather, come to
your next session with all the wonderful details you want them to hear about. They
will be happy to hear about it!
Yep, we’re going there. For most people, this is well understood. However, some
people feel very close and connected to their therapist and in rare cases start
to develop romantic feelings for them. Under no circumstances should a client
and therapist ever share intimate or romantic relations. For my professional
license, this boundary still stands if I am no longer seeing the client in
therapy. There are plenty of fish in the sea. Don’t even consider this one.
There is someone out there who will understand you and make you feel safe that
is not your therapist.
While all of these boundaries were written to the client,
therapists have the ultimate responsibility to make sure that healthy
boundaries are taking place in their practice. If your therapist has breeched
any of these boundaries with you, it is time to have a conversation with them,
and likely seek a new therapist.
Though we live in a time where therapy is more widely utilized, and less stigma exists than in years past, I still hear from individuals who are very apprehensive about seeking out psychotherapy. Many of the clients that come in to meet with me, admit they have wrestled for years with the decision to come in before “finally reaching a breaking point.” On the tail end, it is common for me, as a therapist, to hear a client near the end of treatment say, “I wish I had done this years ago!”
I think part of the reason people are apprehensive to come to therapy is that they think if they go to therapy, something must be wrong with them. They must be flawed in some way or they should be able to figure out their problems “on their own.” We give very unreasonable expectations to ourselves regarding mental, emotional, and social health, that we don’t necessarily assign to medical health. This is why, I have developed an analogy I find very useful to squash the stigma of therapy. Here it is…
Everyone needs to go to the dentist. We all get tarter build up on our teeth and lack the tools, ability, or vision to reach and clean all the spots on our own. Most people go to the dentist for just a cleaning now and again, some for minor cavities, and far fewer for an abscessed tooth or root canal. If we avoid the dentist and the cleanings, then we are more likely to get a cavity, and more likely to need that root canal.
Well my friends, therapy is the exact same way. Most people benefit from therapy for the day to day grime that builds up in our personal lives and relationships, the things we all deal with like marital disagreements, parent-child conflict, grief and loss, and major life transitions. Some of us however, do need an extraction at times and therapy is equipped for depression, anxieties, trauma and all other kinds of struggles.
The reason I like this analogy is because I have yet to meet anyone who feels shame for needing to go to the dentist for a cleaning, however people attending therapy are frequently dripping in shame unnecessarily. I reassure them that I am just here to aid in their cleaning with my big lamp and some tools they may not have at home.
If you have been considering therapy as a tool that may help your family, don’t hesitate! Schedule your cleaning today 😉
As I continually work with couples on improving their sex lives, one concern I hear frequently is, “Are we having the normal amount of sex?” They worry that if they are having less sex than they did at other points in the relationship, that maybe their sex life is getting worse. The reality is, the number of times you are your partner have sex, isn’t the most valuable information about whether or not you have a high-quality sex life. It is very natural for the quantity of sex to eb and flow throughout a lifetime together. Here are some perfectly normal times to see some changes in the frequency, and perhaps quality of your sex with your partner:
Pregnancy: Though there are some changes in the body during pregnancy that can make sex more enjoyable for women, there are certainly some changes that do not. Some women report that fatigue and sickness during the first trimester of pregnancy, make them feel less sexual desire. Typically, women report the most enjoyable sex during their second trimester of pregnancy. During the third trimester, it is a fight for space in the female body! Additionally, after baby comes, there is no sex at all for at least 6 weeks.
Death and Grieving: Some people report that when they are grieving the loss of a loving one, they feel less desire to be sexually intimate. That being said, some don’t feel that way at all. You shouldn’t feel weird or guilty if you still do have a desire for sex after the death of a loved one. All of these responses fall under the normal umbrella.
Illness: Most people don’t feel like being sexually intimate when they are sick. When our bodies are fighting off illness, survival takes precedence over procreation. Luckily, illness usually only influences our sex lives for a week or so. However, when chronic illness is involved this can take a toll on a relationship. When a partner has cancer, or dementia, or kidney failure, sex becomes one of the last priorities, though sex can still be missed and longed for by both partners.
Distance: This one is obvious… You can’t have sex when you are miles apart. Many couples have to spend time apart due to work, deployments, etc. In these cases, couples should have a plan for how they will maintain intimacy and connection during the time apart.
Depression and Anxiety: Mental health issues can certainly influence sex. Specifically, anxiety and depression, somewhat highjack the mechanisms in the brain and nervous systems that influence our sexual reactivity and receptivity. With professional help and treatment of the illness, these concerns can be resolved or better managed, and couples can learn to have functioning sexual relationships.
Stress and Fatigue: Stress also interferes with some of the biological mechanisms that influence sexual receptivity. When our bloodstream is raging with the stress hormone Cortisol, our nervous system is not typically apt to engage in sex. High levels of fatigue can also decrease desire. You may be noticing a pattern. There is an order of operations in the body; survival first, everything else after. Since sex is not essential for survival, but sleep is, the body will prioritize accordingly.
These certainly aren’t all the reason sex may struggle in a marriage. They are however, some of the big ones. Men and women all report times when sex wains. There are stereotypes that men always want to have sex and that women are always the ones turn men down. That’ s simply not true. Men and women,though different, have many sexual similarities. For help with your sexual relationship, schedule an appointment today.
Most people are aware that eating healthy and exercising will result in a smaller waistline. I am not sure, however, that people understand the impact eating healthy and exercising have on your mental health. Think about it: your brain is a body part, right? If poor eating can make your heart suffer and not function properly, why wouldn’t poor eating make your brain suffer as well?
There is a lot of scientific research supporting the fact that eating a whole foods, plant-based diet can improve mood and decrease the occurrence of mental disorders such as anxiety and depression. In a study published in the 2012 Nutritional Journal, participants who decreased consumption of meat, fish, and poultry improved several mood scores in just a few weeks. In 2009 Arch Intern Med, Dr. Grant Brinkworth and colleagues found that a high carbohydrate, low fat, and low protein diet (plant-based) resulted in significantly lower rates of depression and anxiety. These are just a few of the many studies showing the mental health benefits of eating a plant-based diet.
Part of the benefit of eating plants is that there are thousands and thousands of chemicals and nutrients that our body uses on a cellular level to rebuild and repair itself. Scientists haven’t even identified all the advantages to these chemicals and nutrients there are so many. We need to trust our body to use nature to be in optimal health. The evidence is clear: our brain needs natural plant food to function the most optimally. Sadly, we are often misinformed on nutrition-related topics because there are a lot of people who make a lot of money if you eat poorly (there isn’t necessarily a lot of money for marketers to make off of you if you follow a plant-based diet).
When it comes to exercise, most people think of endorphins and all that jazz. This is all good and well, but I love exercise for my clients more for its ability to increase distress tolerance. Physical exercise is ALWAYS a mental exercise also. If I can push my body to a point of discomfort for my overall benefit, what else can I do that is hard? If you talk to avid exercisers, none of them say, “Yeah, I have been doing this long enough that it doesn’t hurt anymore. I feel only pleasure in mile 13.” Seasoned athletes still experience discomfort and pain (if not more) but have learned to tolerate it.
Your increased distress tolerance works as a shield against debilitating hardship. I have seen so many clients begin to exercise and all of a sudden, they have increased confidence and start to believe they can do hard things! While going to the gym may not seem like a big deal, it is a huge deal for your brain. The important key to implement this is to find an activity YOU love. If it isn’t running on a treadmill, then don’t do that. Walk your dogs or play frisbee or do something else entirely.
Some clients I have are weary of taking mood-altering pharmaceuticals, but are they bothered enough to get really uncomfortable and change their eating and movement patterns? I am not suggesting that research shows these changes to be a direct cure for mental health problems. Research can’t entirely do that. However, I am suggesting that it is certainly worth adding to the tool box and trying in order to have an overall better mood and mental health.
For more tips and support changing your lifestyle to improve your mental health, schedule an appointment today!
Yes, we are going there. Though people come to therapy to talk about hard things, or things that take a lot of courage to say, the topic of changing physical attraction seems to be on the forbidden list. Try as I may to create a comfortable and safe environment for couple to discuss this very normal challenge, people won’t talk about it.
The truth is, ALL bodies change! Not one person is going to bed next to the same body that they initially married. We wrinkle, give birth, gain weight, lose weight, lose hair, lose body parts, get cancer, change skin tone and hair color, find stretch marks, get shorter, become less mobile, lose teeth, struggle becoming erect or lubricating, etc. I could go on and on. We are living organisms, and this earth breaks down living organisms over time. In fact, some estimates say that on average a person’s body is growing or developing only until around age 21, after which it is declining, breaking down, aging, and dying. The moral of the story; it is normal and it happens to all of us!
So, then the next question is, how does this impact your sexuality? For most of us, we need to re-evaluate what is physically attractive about our partner, or how much we value what our partner’s body looks like. Sadly, the solution I hear most people using to cope with these changes is to just turn the lights off. I don’t think turning a blind eye is the healthiest of solutions.
Might I suggest instead, changing your insides in tandem with those changing outsides.
Don’t have 1 dimensional sex. If you are hyper focused on your body or your partner’s body, you may be stuck in just the physical dimension of sex. Sex has the potential to be much more than that. According to Dr. Gina Ogden, sex should include body, mind, spirit and heart. Do you fixate on parts of your partner’s body during sex or have you ever thought about how much you love their kindness or nature or humility during sex? What parts of your partner are you currently neglecting to make love with, that may bring more satisfaction?
Within that physical dimension of sex, don’t focus on the parts of your own or your partner’s body that you are dissatisfied with. Rather, focus on the parts of their body you do enjoy. For instance, you could obsess about a fat roll, or you could admire their strong shoulders or beautiful eyes, or the sound of their voice.
Lastly, stop consuming large volumes of media that communicates inaccurate and unrealistic expectations of what bodies “should” look like. Research shows that our inaccurate interpretations of reality are directly related to how much media we consume. If you are going to bed expecting your spouse to look like the media version of a 21-year-old, 34-year-old, or 59-year-old, you will likely be disappointed. Comparing your partner’s body or your own body to anyone else’s body, is not going to serve your sexual relationship.
Work with your spouse to create new sexual expectations. I would guess that as you re-evaluate some of the expectations you have in your sex life, you will likely feel less shame and experience more connection and pleasure from sex.
If you and your spouse would like to create more meaningful and more pleasurable sexual experience, make an appointment today.
What does a blender have to do with communication you ask? Well, pull a chair up to the dining table, and I will tell you:
First, I want you to consider a scenario where someone prepared you a nice meal that you enjoyed. Envision that plate of food. What made it so enjoyable or delicious to you? How did it smell and taste? Were those sensations distinct from one another? How was it organized on the plate? Did your friend take your taste into consideration when making the dish? How much time went into preparing it?
Now, I want you to envision something entirely different. Imagine rather, that person took those same ingredients, piled them into a blender, sent them for a whirl, and poured you a nice thick glass full. As you take a big swig, can you distinguish clearly between all the ingredients? Does it slide down the throat nicely, or are your reflexes pushing it out? Are you feeling nauseous just thinking about it? What’s wrong? It’s the same ingredients, same food. Why not eat it this way?
It doesn’t take a world class chef to tell you why that wouldn’t be the same and why this concoction definitely would not be appetizing. Now, consider how communication is the exact same way as this meal. If we really want someone to digest what we are saying, we need to thoughtfully take our time, take their tastes into consideration, and plate it nicely for them. If we want someone to take in what we are feeding them, it needs to be palatable to them. Sometimes in communication, we take the haphazard route of throwing it all in the blender and serving a cup full of sludge. Then, without any consideration for the other, we can’t understand why they didn’t take in our cup of sludge.
So, does this mean for effective communication we should just serve up cake every meal? No! We all know that would lead to a sick or even dying body (or relationship). Like it or not, sometimes we need to eat things that aren’t our favorite in order to be healthy. Are you willing to take the time to find the preparation of that ingredient that tastes the most palatable for your partner, child, etc.? Some people like broccoli cooked and some like it raw. Some like it covered in butter with salt and pepper.
In my experience as a therapist, I’ve watched countless hours of couples serving one another “meals.” As they progress in the therapy process, they learn to put the blender away and begins plating beautiful meals for one another, after which no one has a problem listening or digesting.
For help putting your blenders away and plating some really nice dishes, consider making an appointment today.
Complicate Everything: In order to create the perfectly stressful holiday, make sure that you make everything as complex as possible. There is zero room for simplification if you want to achieve high stress. Don’t just serve one kind of pie; make sure you make everyone’s favorite kind. Tablecloths, napkins, place settings, and your outfit should all match for ambiance. Additionally, all recipes should be great great great aunt Emm’s, passed down from generation to generation or the holiday just won’t be stressful enough. Remember that 12-step process so the homemade rolls are the right kind of fluffy.
Do NOT Delegate: Make sure for the ultimately stressful holiday, that you do everything yourself, and I mean everything. This should include loss of sleep, not actually participating in the activities you prepared for everyone else all night and day, and never accepting help of any kind. This will be tempting when others offer, but don’t give in. No one else can do it as well as you anyway. The stress is just an added bonus.
Have High Expectations: After all, these holidays come only once a year, so it must be perfect or you have ruined it for everyone and can’t try again for a whole year and everyone will be completely distraught until then. That is, unless you mess it up next year too. Make sure you are as rigid as possible. There is no room for flexibility this day. Do not tolerate anything that doesn’t go according to that wondrous magical plan you created in your head. For an added stress-filled bonus, make sure you meet everyone else’s too high expectations also!
Focus on Commercialism: As these holidays roll around, make sure to focus on the true meaning of each holiday. Everyone knows that is commercialism and aesthetics only. Nothing else. As long as the way you did the holiday makes you look good to everyone else and you spent a ton of money, then you did a perfect job at creating a stressful holiday. Don’t get distracted with all that family love stuff and gratitude crap. This is game time. You have waited all year to be this stressed out. Stay focused.
O yes, we are talking about the big O. A little too big, if you ask me. As I sit with couples and discuss the tender issue of sex and the vulnerabilities it uncovers, I notice that a lot of people make a HUGE deal about orgasms. Now, I get it, orgasms are great! However, sometimes when couples make an orgasm the determining factor as to whether or not a sexual encounter was good or bad, they may discredit a lot of other good things that happen during sex.
The truth is, not everyone orgasms every time they have sex. This varies widely from individual to individual. Some people have orgasms frequently, hit or miss, or rarely at all. Some people are distressed by a lack of orgasm, and some are not. Some people are distressed by having an orgasm. Individual experiences and contexts influence what meaning we attach to things such as orgasm.
This being the reality, you can see how much pressure it can add to a sexual encounter to make orgasm the primary goal. While orgasms feel spectacular for most, connection is a good goal for sex. In fact, when someone is feeling pressure or anxiety about “making someone orgasm,” or, “I need to orgasm so my partner feels like a good enough lover,” it actually interferes with the mechanisms in the body that make orgasm the most likely. Ironic, right?
This is why I tell couples to think of orgasm as the side dish, and connection as the main dish. It is okay if you want to orgasm more and take healthy steps to work toward that with your partner. This is best achieved in a mind set of “if it happens great, but if not, we will keep practicing,” rather than a pass or fail mentality. My advice is to relax, communicate, focus on your love for your partner, and enjoy the sensations you feel.
To schedule an appointment with Kathleen Baxter, call Wasatch Family Therapy at 801-944-4555.