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It’s Not a Vagina!

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 genitalia.

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Notice That

Bessel A. van der Kolk, a leading trauma expert, said, “As I often tell my students, the two most important phrases in therapy, as in yoga, are “Notice that” and “What happens next?” Once you start approaching your body with curiosity rather than with fear, everything shifts.”

Through my clinical work over the past 10 years, I have found the body to be one of the greatest teachers in helping clients to connect with, and heal from, trauma that is stored in the body. Stored trauma often manifests itself physically, such as with anxiety, panic attacks, nightmares, fear, and other “uncomfortable” emotions. Consequently, our bodies are often feared, rather than embraced as the wise teacher it is.

I have found one of the most powerful tools in helping myself, and my clients, stay in a state of curiosity, rather than fear, of these bodily sensations is the breath. When triggered by these bodily sensations mentioned above the body typically moves into the sympathetic, or fight or flight nervous system. Often, clients with trauma have learned to operate in this nervous system more often than is useful. The breath is a powerful bridge between the sympathetic and parasympathetic, or “rest and digest,” nervous systems.

Next time you find yourself filled with anxiety, I challenge you to take four deep “box” breaths, where you breathe in for four counts, hold for four counts, breathe out of four counts, and hold for four counts. After which, maintain the deep breathing pattern and notice what is happening in your body physically, and breathe into any tension you find. Then, remain curious and ask yourself what is needed to help you feel safe and secure in the present moment. At that point you may ask, “what happens next?” Take note of what inner child wounds or beliefs may be surfacing, and allow yourself to sit with that wound to find truth. Learning to become curious about thoughts that once seemed overwhelming, scary, or insurmountable can be an empowering exercise when you start unwinding unhelpful past conditioning.

Sometimes with trauma, clients may find themselves feeling stuck at certain points of traditional talk therapy. If that has been the case, it is helpful to explore other modalities to help release trauma on a cellular level, such as EMDR. Other movement based interventions such as yoga, tai chi, qigong, and dancing have also been found to be helpful in healing trauma. If you have found yourself stuck in processing past trauma, please feel free to reach out to see if we can explore some additional healing modalities. You can schedule by calling 801.944.4555.

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Flexible Thinking Part 1: Make and keep friends, romantic partners, and your job

What is Flexible Thinking?

Running a social skills group for kids ages 7-11 has taught me a lot about the benefits of flexible thinking. Flexible thinking in kids produces turn taking, transitioning smoothly to new activities, and the ability to adapt mentally, emotionally and behaviorally to a variety of situations.

Flexible thinking in adults also enables mental, emotional, and behavioral adaptability. It is the ability to consider situations from multiple perspectives, include context clues to inform decision making, manage rising emotional responses in appropriate ways, problem solve, and balance and prioritize competing desires and goals. Flexible thinking also allows for spontaneity in our romantic relationships that can increase excitement and deepen connection.

Flexible thinking looks like letting someone else pick the restaurant for dinner, cancelling plans to be with a friend or spouse who’s had a difficult day, finding solutions to problems instead of ruminating on the endless escalating spiral of “what if…” scenarios, truly listening to understand what others are saying, and not telling your boss what you really think of them when they take credit for your work during the company meeting.

Inflexible or rigid thinking in adults is often manifest in all or nothing (Black and White) perspectives and doesn’t allow for nuances and mitigating circumstances. Doing something because, “That’s how we have always done it” is an example of rigid thinking. Other examples include not listening to other’s ideas, struggling to consider the feelings and experiences of others, and obliviousness to opportunities around us because we are locked into our self-appointed expectations, rules or ideas about how something is “supposed to be.”

There is a popular Huffington Post article (“Reasons my son is crying will crack you up!”) that is unknowingly highlighting inflexible and rigid thinking. In each of these pictures, the child is having an emotional meltdown because they are stuck on one thought and the associated feeling so deeply, they become overwhelmed, abandon all reason and rebuff efforts to console them; for example, “He wouldn’t fit through the doggy door. Note the open-door right beside him.” With toddlers and adults alike, inflexible thinking can lead to unhelpful and stressful situations.

As a caution, let’s be clear that not all rigid thinking is unhelpful. There are areas in life that being inflexible is necessary and protective. With regards to physical safety and personal and emotional boundaries, it is advantageous to be rigid.

Application

We all have times where we utilize both flexible and rigid thinking, the important part is to identify where we, as adults, teens or kids, could benefit from more flexible thinking.

  • Is there an issue with your friends or spouse that keeps coming up, how could you change your perspective or response in the situation to increase connection with that person?
  • What could be a different way to address the issue? What about that issue is the real problem?
  • Could any of these same questions be applied to work relationships and circumstances?

You need to be a pipe cleaner.

Here is a visual way to conceptualize flexible thinking. During one of my first weeks running the aforementioned social skills group I came across an activity highlighting the importance of and difference between flexible and rigid thinking using a popsicle stick, a pipe cleaner and a piece of yarn.

  • A popsicle stick is sturdy but rigid. Attempts to bend the popsicle stick typically result in it breaking. Not helpful. 
  • Pipe cleaners are soft and fuzzy on the outside, come in multiple colors, bend easily, hold their shape and have sturdy wire in the middle: the creative options are endless. They are so adaptable they can bend to whatever the situation requires while maintaining their inner core (read: personal values and goals).
  • A piece of yarn can barely hold any shape at all, it’s too flexible. It can’t stand up for itself or hold a boundary and can be easily manipulated with no resistance.

Thinking like a pipe cleaner allows flexibility, adjusting, shifting, adapting and changing as needed without compromising our values. What areas in your life are you like a pipe cleaner? Are there some relationships, situations or events where you are more like a popsicle stick? Which of these scenarios or people would benefit from you being more like a pipe cleaner?

Look for Flexible Thinking Part 2: Mental Health, where I will review how flexible thinking impacts and effects our mental health.

Emerald Robertson, M.S.Ed., ACMHC, NCC

Reference:

Halloran, J. (2015, February 9). Teaching flexibility to kids. https://www.encourageplay.com/blog/being-flexible

Khoo, I. (2015, April 29). ‘Reasons my son is crying’ will crack you up. Huffington Post Canada. https://www.huffingtonpost.ca/2015/04/29/toddlers-crying_n_7033472.html

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“Won’t You Be My Neighbor?”

Anything that is human is mentionable and anything mentionable can be more manageable. When we talk about our feelings, they become less overwhelming, less upsetting, and less scary. The people we trust with that important talk can help us know we are not alone.” – Fred Rogers

I love this quote from Mr. Rogers; it is the epitome of what I believe as a therapist and strive to achieve with my clients. We are all human and we have immense capacity for handling emotions, but sometimes those emotions feel completely and utterly overwhelming. Having a person that we can trust can make those emotions feel more manageable and we might, just maybe, even be able to talk about them more openly.

 We all want to feel like we matter and that someone cares about us; that is a universal human desire. No one wants to feel like they are all alone in this life, but often that is a feeling that we experience. How do we combat those feelings of being alone, isolated, not heard, or not cared for? Connection. Connection to someone or something that allows us to feel seen, heard, and understood. Connection requires vulnerability and vulnerability can be scary. Let’s be honest, we have all probably experienced a situation that we chose to bury, ignore, or deny an emotion rather than risk being hurt by being vulnerable and sharing.

Many of us grew up with Mr. Rogers as our introduction into learning about feelings. He didn’t shy away from talking about the hard topics either: death, divorce, pain, rage, and anger all featured on his show aimed at children. His forthright presentation of issues that we, as human beings, all struggle with was not typical for the time where children were, largely, encouraged to be seen and not heard. How refreshing to help children, and the adults that we became, to learn to recognize, identify, and name the emotions that we were feeling and that it was ok to be scared, it’s human. And if it’s human, then it’s mentionable and manageable with a little help from our friends in the neighborhood. In the words of Mr. Rogers, “Won’t you be my neighbor?”

Henley, Y., Saraf, P., Turtletaub, M., Holzer, L. (Producers), & Heller, M. (Director). (2019) A Beautiful Day in the Neighborhood [Motion Picture]. United States: Tristar Pictures.

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Five Tips for Navigating a Faith Crisis

Just Breathe

Really, right now take a few seconds to focus on your breath. Notice what it feels like as it goes in through your nose and out through your mouth.  A faith transition can be frightening and incredibly disorienting. Maybe you have that feeling of waking up in a strange place in the middle of the night, wondering where you are, only to remember you’re visiting a new town. Give yourself a moment to breathe, think, and become acquainted with this foreign land. Be kind to yourself. Sometimes you might feel excited or like you are on a new adventure. Sometimes you might feel hurt or betrayed. Sometimes you may feel lonely and out of place, but remind yourself that these emotions, like waves will go in and then go back out. Notice how you’re feeling without judgement. 

Start with What You Know

When your world feels turned upside down, it can feel like you don’t know what to think, believe, or know anymore. That’s ok. Start with what you do believe or what you do know. Maybe you believe in service or the power of good people to make a difference. Maybe you know how important your best friend is to you or that mint chocolate chip is still your favorite ice cream. What do you value? What is important to you? Make a list.

Reach Out

When you lose a community or separate from important people in your life, you may up feeling isolated or like no one understands. Despite that very real feeling, there are people who have gone through, or who are going through, a change in their Mormon lens too. Try looking for groups on Meetup, or Facebook groups. Network through people you already know or friends of a friend. 

Connect with Resources

“When Mormons Doubt” by Jon Odgen or “Navigating Mormon Faith Crisis” by Thomas Wirthlin McConkie are both two excellent books that are specific to Latter-Day Saints. Looking to people of other faiths, like Tova Mirvis in “The Book of Separation” can also be healing.

Slow Down

Take your time exploring the world through your new perspective. Be patient with yourself and give yourself the permission to say no and to take breaks. Find a therapist who can meet you where you are and support you wherever you decide your journey will take you. You’ve got this.

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Be Present: Enjoy the Silence

The world is full of noise and escaping that noise in important. Whether that is getting out running, hiking, walking, or enjoying any of your favorite activities. What is important in taking in the silences is that we are present. Taking the time to enjoy the silence is an act of mindfulness. Mindfulness has been shown to benefit us by:

·         Physical benefits including lowered blood pressure and improved sleep. 

·         Gaining more control of our thoughts.

·         Reduction of stress.

Remember yesterday is history, tomorrow is a mystery, but today is a gift. That is why it is called present. – Mastery Oogway Kung Fu Panda 

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Is Masturbation a Problem?

Sexuality is a charged topic for both adults and some children. Messages about what behaviors are appropriate and inappropriate are woven into the fabric of our cultural traditions, moral codes of conduct, and family systems. Negative messages cause a great deal of harm, mainly when the message contains sexual shaming. Masturbation is one of these topics.

Masturbation is extremely common, yet because it is private, we don’t talk about it with our children or a spouse. According to research, self-stimulation is a normal activity experienced by nearly all people starting at very young ages and can be observed in utero (Yang et al., 2005). Masturbation (like any behavior) can be both healthy and problematic; it is also experienced differently based on age. It well understood that nearly all males and most females will, at some point in their lifetime, masturbate.

When is it Healthy?

Nearly all professionals agree age-appropriate stages of self-stimulation is healthy. For example, exploring one’s body and how it responds sexually is a beneficial aspect of maturation. Men and women can learn what an orgasm is, so they are better equipped to educate their spouse on what types of sexual touch they enjoy. Also, individuals can use masturbation to self-sooth as a coping mechanism for mood regulation. For many people who (for whatever reason) are not in an intimate relationship, masturbation can be a healthy outlet to release sexual tension. Many relationships do not have an equal balance of libido. For some “higher libido” partners, masturbation can offer a method to balance sexual needs.

When is it Not Healthy?

Behaviors become problematic when they negatively impact, work, school, or one’s social life. Like all sexual behaviors, masturbation may conflict with religious values. In a recent study from students at Brigham Young University, researchers reported the perception of pornography (a common corollary with masturbation) is the primary predictor of negative outcomes, not the pornography use itself (Leonhardt, Willoughby, Young-Peterse, 2018). It is important to inventory what our values are and why we have them. It can be helpful to challenge what we believe, while still honoring our values and the values of others. In many situations, individuals with strict religious tenets regarding masturbation find themselves in harmful shame cycles leading to increased rates of depression, compulsivity, or suicidal ideation (Beagan & Hattie, 2015). Researchers don’t diminish the value of traditional moral values. However, they do suggest creating a healthy relationship with our values within the normal range of human experiences.

Myths about Masturbation

We tell stories and create myths to justify attitudes about sexuality. Some common myths include masturbation causes homosexuality, is an addiction, leads to infidelity, will lower sexual desire, create hypersexuality, may cause you to go blind, and causes cancer in men. These things are not true. However, there are things that do occur. For example, a partner may feel betrayed when they learn their spouse masturbates.  Couples can contract what cheating is, and what betrayal is. Feelings of betrayal are especially common when erotic material is involved. People engage in negatively impacting habit-forming behaviors with all sorts of things, including masturbation. Also, some coping mechanisms prevent healthy attachment in relationships.

Talking about Masturbation to our Children

It’s helpful for parents to have discussions with their children about masturbation in age-appropriate ways. For example, 5-year-old children don’t typically need to learn about orgasm mechanics, but talking about what “feels good” is more appropriate. Also, shaming a child by saying, “don’t touch that,” could be replaced with useful comments such as “that feels good, maybe you should do that in private.”. Children without parental guidance will learn about masturbation from friends or erotic material. Pornography doesn’t typically represent healthy sexual education. It is also beneficial to create safety for children, so as they begin to explore their sexuality (in person or with others), they feel safe to engage a parent about their experiences. Normalizing sexual desire, response, and anxieties create wellbeing for developing children. Lastly, it’s helpful to remember that not all children have the same sexual interests, levels of desire, or attractions at the same age as other children. It’s important to meet our children where they are at.

Talking about Masturbation to a Partner

An important aspect of contracting between couples includes the topic of masturbation. As a part of healthy sexual practices, discussing what is acceptable (or not) is essential. While there are many options, some couples will incorporate self-pleasuring behaviors into their relationship as a method to balance sex-drive differences. Often one partner may feel betrayal if they learn their spouse masturbates. When couples talk openly with each other about their feelings and attitudes regarding sexuality, it usually removes the stress in these situations. A good place to start is becoming aware of your own sexual biases and perspectives. Some couples find it helpful to discuss these feelings with a competent therapist. It’s important to remember masturbation doesn’t constitute cheating. Marriage isn’t the antidote for fulfilling all sexual needs. Many married people masturbate. Much of the time, masturbation creates better sexual experiences for couples.

Talking about Masturbation to Church Leaders

In many faith traditions, ecclesiastical leaders counsel parishioners regarding sexual behavior. Not all religions have sex-positive perspectives. In many cases, such leaders have no training regarding sexuality, trauma, or psychological situations. A lack of training can be problematic. This doesn’t suggest the support of an ecclesiastical leader cannot be helpful. Individuals seeking counsel from their church leader should remember boundaries are essential. It’s okay to tell a church leader what questions or statements are inappropriate or feel uncomfortable. This is especially true for parents whose children may be questioned regarding their sexual behavior, to communicate what forms of communication are acceptable and what is not.

References

Leonhardt, N. D., Willoughby, B. J., & Young-Petersen, B. (2018). Damaged goods: Perception of pornography addiction as a mediator between religiosity and relationship anxiety surrounding pornography use. The Journal of Sex Research55(3), 357-368.

Beagan, B. L., & Hattie, B. (2015). Religion, spirituality, and LGBTQ identity integration. Journal of LGBT Issues in Counseling9(2), 92-117.Yang, M. L., Fullwood, E., Goldstein, J., & Mink, J. W. (2005). Masturbation in infancy and early childhood presenting as a movement disorder: 12 cases and a review of the literature. Pediatrics116(6), 1427-1432.

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Having Courage to Slow Down

I, like many of you, spend a lot of time in my car. I always feel like I’m rushing from one thing to the next and I never have enough time for anything. As I was driving to work the other day there was a car that I ended up behind in the turning lane that didn’t increase its speed once it turned. At first, I found myself annoyed and thought “Are you kidding me? Come on, GO!!” I was looking in my side and rear-view mirrors to try to change lanes but there was a steady stream of cars in the lane next to me. I, then, realized that I didn’t need to rush, I was going to have half an hour in the office before my client’s appointment and I calmed down.

I thought to myself as I paid more attention to the car in front of me that it was probably someone old driving the car because I couldn’t see the driver’s head above the head rest. When I was finally able to change lanes and go around this car, I looked over at the driver as I passed. Sure enough, it was a little old lady, hunched over and barely seeing over the steering wheel. A smile came to my face as I thought of this woman who likely had slowed down in many aspects of her life, only one of which was driving, and how I am always in such a rush. It made me wonder how often I missed things from not paying attention and always rushing from one thing to the next.

We live in such a fast-paced world with so many things demanding our attention at once. I find myself getting lost in the mundane routine that is my life as crazy and busy as it is right now. But when I can slow down and just be present in the moment, I find that while there are parts of my life that are mundane, there are also pretty amazing things that happen around me and inside of me every single day. If we are constantly chasing the next thing, we can never truly just be with ourselves. But maybe that is part of why we don’t slow down.

Slowing down can be vulnerable. When we allow ourselves to be still, things can surface that we’ve been avoiding. We constantly measure ourselves by what we do and what we accomplish, so who are we when we slow down? Maybe we aren’t enough, maybe we are too much, maybe our emotions are too overwhelming, maybe it will be too vulnerable. Brené Brown has dedicated her life to studying vulnerability, authenticity, and courage. It takes courage to be still, to allow vulnerability, and to show up authentically. She says, “authenticity is the daily practice of letting go of who we think we are supposed to be and embracing who we are.” Slowing down, embracing who we really are, and being still with whoever we are right now can be scary but can also be powerful.

So how are you going to demonstrate your courage to slow down, be still, and embrace that you are enough?

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The Power of Humility

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.

  1. 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.
  2. 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.

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Dancing, Digestion, and Female Sexuality

A 1999 study (Berman J, Berman L, Goldstein I. Female sexual dysfunction: incidence, pathophysiology, evaluation, and treatment options. Urology. 1999;54:385–391) found that 43 percent of women suffer from some type of sexual dysfunction.  That’s nearly half of all women!  There is a lot of history and research behind how we got to this 43 percent number, but simplifying it comes down to the medicalization of female sexuality.  

Dr. Leonore Tiefer is an author, researcher, educator, and therapist who has spoken out against the problems she has seen in viewing female sexuality through a medical lens.  Dr. Tiefer uses the metaphors of dancing and digestion.

Dancing is something we learn, a skill that is built over time.  Dancing has history and culture that informs it.  Our enjoyment of dance, and our participation in it can change throughout our lives.  People experience differently, but it is often something we share.  

Digestion on the other hand is a process that happens to us.  It is something that is consistent over the course of our lives, and deviation from the standard is a problem requiring treatment of some sort.  We have healthy digestion and unhealthy digestion.  Unless there are problems, we don’t spend much time considering our digestion, and sometimes we feel uncomfortable talking about when things aren’t working the way they’re supposed to.

Dancing is a helpful metaphor for looking at sexuality through a behavioral lens, and digestion is more applicable to a medical model.  Both approaches have their place, and certainly those experiencing sexual concerns would be wise to rule out obvious medical issues, but Dr. Tiefer suggests we spend more time considering the cultural, educational, behavioral and relational issues that impact female sexual health.  

For more information on Dr. Tiefer’s approach to healthy sexuality, see her presentation at Indiana State University in 2016, here: https://iu.mediaspace.kaltura.com/media/Tiefer+Talk+IU/1_wiqs4bjz

If you are experiencing sexual concerns, schedule an appointment with Alice at 801-944-4555 today.

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