Sex Therapist Tips and Topics

Affirmotive's Tips and Topics are designed with the view of giving brief answers and insights to frequently asked questions about relationships and sexual relationships, sexual functioning and dysfunctionig, sexual behaviours, sex addiction, sexual health issues, depression, and disordered eating.

We appreciate your feedback. Please call us on 02 9386 5656 during office hours, or email heide@affirmotive.com Thank you for your time and enjoy reading.
 

Useful Links

www.recoveroz.com.au

www.voicedialogue.org

www.impotenceaustralia.com.au

www.sexaddiction.com.au

www.seahorsesoc.org

www.gendercentre.org.au 

Do you know.......

Sexology is the scientific study of human sexuality. Human sexuality has been studied for centuries in the Eastern and Western world alike with a single focus on pro-creation and the outcomes of sex, rather than on re-creation and the experience of sexuality and pleasure.

Only more recently, modern studies have included human relationships into the study of sex; e.g. the study of love, sexual behaviours, sexual emotions and sexual response, sexual function and dysfunction, sexual pleasure, sex and aging, and the understanding of sexual orientations and gender. Sexual sciences have also included the study of criminal sexual behaviour.

Forensic Sexology

Forensic Sexology represents an aspect of criminology involving sex and sex crime, including;

• sex offenders and offenses
  
• assessments, profiling, treatment, processing
  
• survivors of sexual assault and treatment
  
• sexual law and sexual law reform
• forensics, forensic medicine, collection of evidence, materials, specimen
  

What is premature ejaculation

Premature or rapid ejaculation describes the condition where a man ejaculates (comes) too quickly. In its severe (and rare) form, the man comes before any direct stimulation of the penis occurs, just thinking about sexually stimulating situations triggers his ejaculation.

It is more common for the man to ejaculate either during or very soon after penetration into vagina or anus. Studies suggest the normal average time for the man to ejaculate is 3-5 minutes after penetration. Obviously some men regularly last much longer than this just as there are men who regularly ejaculate much quicker.

The most important criteria of rapid ejaculation are:

• That ejaculation occurs sooner than the man and his partner wishes
• And this is causing distress in their sexual relationship.

It is important to take the partner's wishes into account because what may seem rapid to the man may be already too long for the partner. Rapid ejaculation is a very common sexual problem affecting men. Most men experience rapid ejaculation on occasions. There is nothing to be worried about.

It becomes a problem only when it occurs during most sexual interactions. Studies show that about 40% of men are troubled by this problem on more then an occasional basis. The effects of rapid ejaculation can be detrimental on relationships. Usually rapid ejaculation has psychological reasons. Physical origins are rare.

The successful treatment of rapid ejaculation is usually achieved by seeking consultation from a professional sex therapist.

Source: Impotence Australia

What is vaginismus

Vaginismus is a condition which affects a woman's ability to engage in any form of vaginal penetration. The muscles in the vagina tense suddenly, and cannot be controlled by the woman, making any kind of vaginal penetration, including sexual penetration or medical examination either painful or impossible. Vaginismus can vary in severity.

Vaginismus is mostly a response to an earlier traumatic experience, e.g. a young woman's first experience of painful or violent penetrative sex, and a subsequent emotional development of an expectation that sex will be painful. If she then attempts to engage in penetrative sex, the muscle spasm will make penetrative sex painful. This, and each further attempt of sexual penetration confirms her fear of pain and contributes to worsen the condition.

Primary vaginismus

This form of vaginismus occurs when a woman has NEVER been able to achieve penetrative sex due to involuntary muscle spasm and pain.
Some of the things that may cause primary vaginismus are;

• sexual abuse 
• having been taught that sex is immoral or vulgar
• the fear of pain associated with penetration, particularly that of breaking the hymen upon the first attempt at sexual penetration

Secondary vaginismus

This form of vaginismus occurs when a woman, who has previously been able to achieve penetration, develops vaginismus.
Some of the things that may cause secondary vaginismus include; 

• physical causes such as a yeast infection
• trauma during childbirth
• sexual threat, violence, rape, pain
  
• psychological causes

 
Treatment by Affirmotive

Affirmotive chooses from a range of modalities, such as Sensate Focusing Techniques, Pelvic Floor Workouts, Cognitive Behaviour Therapy, Solution Focused and Person Centered Counselling, Voice Dialogue Facilitation and Professional Counselling. The sex therapist may also suggest the use of medical dilators, such as dildos or vibrators. A referral to a physiotherapist, or a medical treatment with Botox may also be considered.

Masturbation

Masturbation and the self-discovery of her own body can help a woman to make friends with her sexuality. She might eventually loose the fear of sex. Orgasm does not need be the goal of masturbation. Masturbation can simply be used to increase the comfort with her genital area, and to explore the various sensations through genital and clitoral touch, thus becoming aware of relaxing and pleasurable sensations. The masturbation exercise allows a woman to become more aware of her individual and unique sexual response.

A range of emotions may surface during genital exploration and need to be addressed. The vaginistic woman may have formed some negative associations with her genitals in the past, these can include; fears that her genitals are inferior or abnormal, dirty, smelly, or ugly. These distorted beliefs can lead to intense feelings of shame, guilt and inadequacy. Vaginismus can be successfully treated in almost all cases. It requires the full commitment to healing and self healing, patience and focus.

When partners are different in experiencing sexual desire

Couples often believe that they should be sexually in tune with one another at all time they attempt to have sex. However the difference in sexual desire or DD (desire discrepancy) in couples is normal.

It would an unrealistic expectation to assume that both partners are always equally sexually interested at the same time.

Desire and arousal are not the same, but usually are closely connected. Desire is driven by some form of attraction to someone or something. Sexual arousal is the physical readiness for sex, the penis erection in a man and vaginal lubrication in a woman.

Desire discrepancy and/or lack of arousal causes many disruptions to a fulfilling sex life. The sexually more 'switched on' partner may believe they are unable to please their lover, or they might feel anger and rejection as their needs are not being met.

The sexually less responsive partner might feel increasingly under pressure, which rather leads to performance anxiety, frustration and avoidance.

Changing positions and other 'bed room acrobatics' usually do not help. The biology of desire and arousal involves the brain, the central nervous system, hormones, physical wellbeing, mental wellbeing, emotional fitness, and relationship wellbeing.

What is Lust

Lust is the memory of extreme pleasure and arousal. Lust is a biologically driven experience, caused by our sex hormones and/or by arousal of sensual memories stored in the brain. The brain is our primary sex organ.

Our unique sexual habits and preferences arise from the impact of our sex hormones and our memories, fantasies, wants and practice of sensual pleasure.
Sexuality is inborn and genital pleasures are discovered by children in their early years of life. Masturbation may begin well before puberty and continues well into old age.

What’s Love

The falling in love and lust experience, are both temporary and extreme states or memories of joy and pleasure.

Loving intimacy does not depend on extreme states but requires a shared trusting bond and physical connection. It requires 'growing together'. Intimacy between a loving couple are states of physical, emotional, mental and spiritual pleasures.

Longterm committed relationships require the art of balancing sensuality and sexuality with bond, responsibility, and domesticity.

What is depression

Many people suffer a major depressive episode in their life.

A major depressive episode is consistent with at least a two week period of severe sadness. The affected person is easily upset and often teary, with symptoms of depressed mood and may lose almost all interest and pleasure in their daily life activities.

This (depressive) state of mood represents a change from the person's normal state of mood. Important functioning is negatively impaired by that change in mood, in nearly all aspects of their daily life; e.g. social, sexual, relational, occupational or educational.

Note - a depressed mood caused by any abuse of substances such as drugs, alcohol, medication or a general medical condition is not considered a major depressive episode. But substance abuse may occur in response to a depressive mood, or may create or deepen a depressive episode.

A major depressive episode includes the following symptoms;

• depressed mood most of the day
• markedly diminished interest or pleasure in all, or almost all, activities
• significant weight loss or weight gain when not dieting
• decrease or increase in appetite nearly every day
• insomnia or hypersomnia
• fatigue or loss of energy
• feelings of worthlessness and hopelessness
• excessive or inappropriate guilt
• diminished ability to think or concentrate
• indecisiveness, irritability, lethargy
• recurrent thoughts of death, suicide, a suicide attempt or a specific plan for committing suicide
  

If you have recurrent suicidal thoughts it is important to immediately contact your doctor, counsellor or local hospital. Depression is a treatable disorder.

Dysthymia

Dysthymia in adults is characterized by a moderate chronic state of depression, with depressed mood for most days for at least a two year period.

The symptoms in this two year period with no more than a month of symptomatic absence include;

• poor appetite or overeating
• insomnia or hypersomnia
• low energy or fatigue
• low self-esteem
• poor concentration
• difficulty making decisions
• sadness and feelings of hopelessness

The symptoms may cause significant distress or impairment in important areas of a person's daily life, including; social, sexual, relational, occupational and educational functioning.

Depression is a treatable disorder. Professional counselling and psychotherapy are powerful methods and have been successfully used in the prevention and treatment of depression. Early intervention by a qualified professional counsellor is recommended.

What is sex addiction 

Sex addiction, like other addictions, does not happen overnight, but develops over time. Contributing factors to addiction can be of genetic, biological, emotional, environmental, and social origin. Faulty early care giving and abuse is commonly reported by affected individuals.

Typically, sexual addiction is characterized by compulsive and obsessive sexual thoughts and acts which progress in severity over time. The negative impact of the escalating behaviour has an increasingly destructive effect on the addicted person and on their family, as the disorder progresses.

As it is common to all addictions, the sex addict has to intensify the addictive behaviour over time in order to achieve the same results of satisfaction.

Most sex addicts will not progress their behaviour beyond compulsive masturbation, compulsive thoughts and fantasies, excessive use of pornography, phone or internet sex, compulsive use of sex workers, or repeated succession of lovers, who are experienced by the addict as things to be used.

For other sexually addicted persons the addictive behaviour can involve illegal activities such as exhibitionism, voyeurism, obscene phone calls and stalking, rape, molestation.

Please note, that in providing counselling treatment it is mandatory for clinicians to report persons who engage in acts which seriously harm others including all acts against the interests of children. A child is a person under the age of 16 years. 

It is important to know that not all sex addicts become sex offenders, and not all sex offenders are addicts.

The US National Council on Sexual Addiction and Compulsivity has defined sexual addiction as 'Engaging in persistent and escalating patterns of sexual behaviour acted out despite increasing negative consequences to self and others.'

This means that the sex addict will continue to act out in their destructive sexual behaviours despite devastating consequences to their health, relationships, work, social status, finances or even facing arrest.

Sex adddiction is a treatable disorder. Please also refer to page sex addiction for detail and treatment information.

What are eating disorders

Eating disorder can affect anyone, men and women from across various age groups, cultures and socio-economic backgrounds. Eating Disorders can develop from a variety of factors including genetic, environment, family, social, trauma, life experiences, relationship difficulties and personality. The condition of eating disorders include a multitude of psychological conditions; thoughts about body shape, weight, beauty, eating behaviours, dieting, all can become a distressing singular focus of an affected person's every day life.

Untreated eating disorders can become habitually entrenched and very difficult to overcome. The health toll can be devastating to emotional and physical wellness, and sometimes lead to death.

Types of eating disorder treated by Affirmotive

Anorexia Nervosa

Individuals with anorexia nervosa suffer extreme fear of any form of weight gain. Even very thin individuals with anorexia nervosa may perceive themselves as 'fat', and may do anything to loose more weight. Extreme dieting or compulsive and excessive physical exercise are typically employed. In order to stay thin, a strict control over certain foods considered 'safe to eat' may be executed. Weight gain may also be prevented by self-purging. Some sufferers accept that they are thin, but cannot escape the compulsion of loosing more weight.

Anorexia nervosa is not about food and weight, but low self-esteem, perfectionism, high levels of competitiveness, and severe feelings of worthlessness and inadequacy. Individuals fight an everyday battle of coping with the pressures of how these feelings interfere with their daily life performance.

Associated physical symptoms of anorexia nervosa include;

• loss of menstrual periods 
• intolerance to cold temperatures
• lowered heart rate and blood pressure 
  
• weakening of bones, poor hair, poor nail conditions

Psychological symptoms of anorexia nervosa include;

• depressed mood
• obsessional thoughts
• perfectionism
  
• negative self image, feelings of guilt and unworthiness
• inability to concentrate on anything but on food, dieting and disorder-rerlated issues.

Bulimia Nervosa

Bulimia Nervosa typically involves a cycle of binge eating, followed by behaviours used to avoid weight gain. The weight gain avoiding behaviours can include rigid dieting which may lead to inadequate nutrition, hunger, fatigue, then followed by strong urges to binge. Intense fear of weight gain, self-disgust, shame and guilt causes individuals with bulimia to purge themselves, using self induced vomiting, laxative abuse, fasting, and excessive exercise.

Due to intense feelings of failure, shame and guilt, sufferers may become masters of disguise, hiding the illness from friends and loved-ones, sometimes for years.

Psychological and behavioural symptoms of bulimia nervosa include;

• intense feelings of being 'out of control before or during a binge
• extreme concern with body image 
• in excess exercising, exercise binge
• lowered mood
• unstable emotions
• feelings of hopelessness, shame and guilt
  
• social withdrawal
  

Physical symptoms of bulimia nervosa include;

• gastrointestinal problems - reflux or constipation
• rapid tooth decay
• glandular swelling
• fatigue
• dizziness
• increased risk of cardio-vascular problems
• cardiac arrest 

Binge Eating Disorder

Binge eating disorder is characterized by compulsive overeating without compensatory behaviours such as purging, fasting or compulsive exercising. During binge eating episodes, the amounts of food eaten can be very large, and eating is more rapid than usual. Eating may even occur when the individual is not physically hungry.

• several failed attempts to weight loss
• buying and preparing more food than needed
• eating while preparing food
• eating between meals, and eating when not hungry
• avoiding eating away from home 

Psychological symptoms associated with binge eat disorder include;

• low self-esteem
• difficulty to asserting or communicating needs 
• social withdrawal or isolation
• self-disgust
• depression
• anxiety 
• obsessional thoughts about weight and food  

A referral to a medical professional may be necessary in severe cases of eating disorders.

What is impotence 

Impotence can be classified as primary or secondary.

• Primary Impotence: a man has never had successful intercourse with a partner but may achieve normal erections in other situations.
• Secondary Impotence: despite current impotence problems, there is some history of success with completing intercourse in the past.

How common is Impotence

Most men will experience occasional impotence, usually resulting from stress, tiredness, anxiety or excessive alcohol or drug consumption. Worrying about impotence may set the scene for a more persistent problem due to 'fear of failure' or performance anxiety. Research has established that the prevalence of impotence in Australian men range from 3% of 40-49 year olds to 42% in 60-69 year olds and increased to 64% of 70-79 year olds. Unfortunately, many men to not receive treatment or wait a long time before seeking treatment.