NYC Psychotherapist Blog

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Wednesday, August 25, 2021

Sexual Wellness: Are You Distracted By Negative Thoughts About Yourself When You're Having Sex?

The sex researchers, Masters and Johnson, did groundbreaking work on the human sexual response.  As part of their work, they developed a term called "spectatoring" in the 1970s to describe the experience of self consciously watching yourself while having sex. 

Sexual Wellness: Are You Distracted By Negative Thoughts in Bed?

When you're spectatoring, instead of being present with your partner, you're both a participant and a spectator of the experience.   

Spectatoring often occurs when there is performance anxiety, which is a sexual inhibitor.  It gets in the way of being fully present and sexually aroused.  It can also turn sex into a performance rather than an intimate experience (see my article: What is Performative Sex?).

Spectatoring often comes with an anxious, self conscious, critical voice.  It's the opposite of being present with your partner.  It can include critical comments about your body image: "I wonder if my partner thinks I look fat" or negative thoughts about how you're interacting sexually: "Does my partner like how I'm touching her?" (see my article: Overcoming the Internal Critic).

Instead of being attuned to your partner's and your own sexual experience, you're making negative comments about yourself in your mind as if you're someone else. 

You might also be distracted by unresolved issues in your relationship or unresolved trauma (see my articles: How Trauma Affects Intimate Relationships and What is a Trauma Therapist?).

If you're spectatoring, you're distracted, so chances are very good you're not enjoying your experience.  Also, your partner probably realizes that you're not present, so the experience is less satisfying for him or her too.

How to Stop Spectatoring Using Mindfulness
One way to overcome spectatoring is to use mindfulness.

Mindfulness is a practice where you focus on what you're feeling and sensing in the moment without judgment or interpretation.  

Not only does it help you to focus, it also helps you to relax (see my article: The Mind-Body Connection: Mindfulness Meditation).

Before you use mindfulness during sex, I recommend that you practice mindfulness daily during everyday activities, like when you're walking, savoring a meal, smelling flowers, taking a shower or any other similar activity.  

You can also practice mindfulness during solo pleasuring (masturbation) to enhance your experience, get to know what you like sexually and be able to communicate this to your partner (see my articles: Women's Sexuality: Tips on Sexual Self Discovery and How to Talk to Your Partner About Sex).

By practicing mindfulness, you can develop the skill of being mindfully present in bed with your partner, which will make sex more pleasurable.

Getting Help in Therapy
Asking for help can be challenging, but struggling with unresolved problems is even harder (see my article: Overcoming Your Discomfort With Asking For Help in Therapy).

Everyone needs help at some point, so if you're feeling stuck, you're not alone.

A skilled therapist can help you to overcome the obstacles that are keeping you from living a fulfilling life.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR, AEDP, EFT and Somatic Experiencing therapist.

I work with individual adults and couples.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

Wednesday, August 18, 2021

Learning About Yourself in a Relationship

Although there are many ways to learn about yourself, including keeping a journal, talking to friends and family members, and going to therapy, being in a relationship can be very revealing (see my article:  Growing As An Individual While You're in a Relationship).

Learning About Yourself in a Relationship

Many people think they have to work out all their issues before they can be in a relationship, but there will always be issues and by waiting you could be missing out on a potentially good relationship. 

Being emotionally vulnerable is one of the keys to a successful relationship.  Although this can be difficult for some people because of their history of being hurt in their family of origin or in previous relationships, learning to be emotionally vulnerable helps you to discover who you are and enhances your relationship (see my article: Emotional Vulnerability as a Pathway to Greater Intimacy).

What You Can Learn About Yourself When You're in a Relationship
Here are some of the key things you can learn about yourself when you're in a relationship:
  • Your Communication Skills:  How well do you communicate with loved ones? Are you open to expressing your feelings or do you tend to withdraw and bottle things up?  When you're in a relationship, there are many opportunities to talk about your feelings--both positive and so-called "negative" feelings.  Even if you enter a relationship lacking good communication skills, constructive feedback from your partner can go a long way to helping you to improve this skill.
  • Your Coping Skills: Every life has its inevitable ups and downs.  Most people can handle things when life is going well, but how well you handle challenges, including problems in your relationship, reveal a lot about your coping skills.  Whether you avoid problems or deal with them as they come up reveals your particular style of handling problems. Becoming aware of your coping skills and having self compassion is the first step towards changing them (see my article: Developing a Compassionate Attitude Towards Your Maladaptive Coping Skills).
  • Your Love Language: According to Dr. Gary Chapman, who wrote The 5 Love Languages, there are five different ways of expressing and receiving love in a relationship (and some relationship experts believe there are more than five ways):  words of affirmation, quality time, receiving gifts, acts of service and physical touch.  You can learn a lot about yourself and your partner in terms of each of your love languages. When you get to know your partner, you also learn to relate to them in terms of their love language (as opposed to relating to them based on your love language).  In reality, everyone has more than one love language, but there is often one that predominates.  Here are the love languages as outlined by Dr. Chapman in his book:
    • Words of Affirmation: People with this love language value verbal acknowledgements of affection (saying "I love you" frequently, compliments and words of appreciation, encouragement).
    • Quality Time: People with this love language feel loved when their partner wants to spend time with them.  This includes active listening, eye contact and being fully present.
    • Acts of Service: People with this love language as primary like it when their partner goes out of their way to make their life easier.  In other words, actions speak louder than words.  
    • Gifts: Visual symbols of love are what is most important with people who value gifts as their primary love language.  They like to know that their partner spent the time to think about getting them meaningful gifts.  The key is the meaningfulness of the gift.
    • Physical Touch: This includes physical signs of affection, including kissing, holding hands, cuddling and having sex.  Physical intimacy is very powerful for people with physical touch as their primary love language.  They value the warmth and comfort that comes with physical touch.
  • Your Values and Priorities: What do you value most in your life? What are your goals? How important are your familial relationships, friendships and your partner?  Even if you don't usually think a lot about your values and priorities, you can learn a lot about them in a relationship in terms of how you prioritize your partner and whether your partner's values and priorities are similar to yours.  
  • Your Strengths: Ideally, your partner and you bring out the best in each other and, if not, this is an important area to work on.  You might have strengths you're unaware of--until you see yourself in a relationship and become aware of them.  You might also realize that you and your partner complement each other (or not).
  • Your Shortcomings: You might be aware that, just like everyone else, you have certain shortcomings, but when you're in a relationship, these shortcomings become glaringly clear.  Although many people feel uncomfortable acknowledging their shortcomings, when you're in a relationship, you have an opportunity to improve them.  It helps if, to start, you have self compassion because it makes it easier to change (Self Compassion: Loving Yourself Even in the Places Where You Feel Broken).
Being in a relationship, especially after the "honeymoon phase," can be challenging, but if you're in a healthy relationship, the emotional rewards, including the opportunity for self discovery, outweigh the difficulties (see my articles: How Do You Know If You're in an Unhealthy Relationship? and Developing and Maintaining a Happy Relationship).

Getting Help in Therapy
If you've been struggling on your own, you're not alone.  Help is available to you.  

Taking the first step, which is contacting a licensed psychotherapist, is often the hardest one, but a skilled therapist can help you to overcome the obstacles to leading a more fulfilling life.

About Me
I am a licensed NYC psychotherapist,  hypnotherapist, EMDR, AEDP, EFT and Somatic Experiencing therapist.

I work with individual adults and couples.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during regular business hours or email me.

Saturday, August 7, 2021

Relationships: What is Rec-Relational Sex?

In his book, Tell Me About the Last Time You Had Sex, Dr. Ian Kerner, couples/sex therapist in New York City discusses the three general categories of sex:
  • Procreative
  • Relational
  • Recreational 
  • Procreative Sex: Just like it sounds, when couples are focused on procreative sex, they're trying to get pregnant.  
  • Relational Sex: Couples who engage in relational sex are focused on intimacy, affection and emotional closeness.
  • Recreational Sex: The focus in recreational sex is fun, pleasure, adventure and play.
What is Rec-Relational Sex?
According to Dr. Kerner, many couples in committed relationships have either lost the recreational aspect of sex or they never had it from the start (see my article: Sexual Wellness: Overcoming Sexual Boredom in Long Term Relationships).

What is Rec-Relational Sex?

He indicates that for these couples, if they're having fun with sex at all, it's often when they're on their own when they're masturbating alone (also known as solo pleasure) with sex toys or porn.  

Alternatively, they might be having recreational sex as part of an affair because they crave the newness or novelty of these experiences.

Rec-relational sex, according to Dr. Kerner, is a combination of relational and recreational sex within a committed relationship.  

In rec-relational sex, couples finds ways to add novelty and excitement to their sex scripts (see my articles: Understanding Your Sex Script and Changing Your Sex Script).

One of the ways this can be done is by cultivating psychological sexual arousal, also known as psychogenic arousal (see my articles:  Enhancing Sexual Desire With Psychological Sexual Stimulation).

One of the challenges that many couples face in long term committed relationships is coming up with sexual activities that allow them to be erotic and sexually adventurous.  Often, one or both partners fear talking about their sexual fantasies because they think they will be rejected by their partner (see my articles: Exploring Sexual Fantasies Without Guilt or Shame).

Clinical Vignette: Rec-Recreational Sex
The following clinical vignette, which is a composite of many different cases without any identifying information, illustrates how a couple can develop a more satisfying sex life with the help of a couples therapist:

Tina and Bob
Tina and Bob agreed in their first session of couples therapy that, after 25 years of marriage, they were both bored with their sex life, but they didn't know what to do to spice it up.

During the history taking part of the couples therapy assessment, they told their couples therapist that their sex life was exciting and fun when they first met and during the first two years of marriage.  

But after they had children, everything changed.  They were often too tired to have sex and when they did have sex, it felt routine--like they were just going through the motions.  Now that their children were grown and out of the house, they knew they had an opportunity to improve their sex life, but they didn't know how to do it.

After Tina discovered flirty texts between Bob and a female colleague, she became concerned.  Eventually, Bob admitted to her that he had a brief extramarital affair with this colleague, but he broke it off long before Tina discovered the email.  He said he loved Tina and he was generally happy in their relationship.  He regretted having the affair and the hurt it caused Tina.  He knew he jeopardized his marriage.

Over the next few months, Tina expressed how betrayed she felt that Bob had the affair, and Bob listened.  He knew he needed to listen and really take in Tina's sadness and anger if they were going to repair their relationship (see my articles: Why Do People in Happy Relationships Cheat?).

Both Tina and Bob wanted to salvage their marriage, and Tina wanted to know what was at the root of Bob's infidelity.  At first, he wasn't sure, but as they continued to explore this in couples therapy, he realized that he no longer felt sexually desirable to Tina and he wanted to feel desirable again.  He said he wasn't trying to justify the affair, but if he was honest, this is what he was feeling (see my article: The Connection Between Infidelity and the Need to Feel Desirable).

Once Tina and Bob had made progress in repairing the emotional damage of the affair, their couples therapist asked them to talk about their usual sex script, and they admitted that it was almost always the same:  Bob would ask Tina if she wanted to have sex and, if she did, after a few minutes of foreplay, they would have sexual intercourse.  

With regard to their sex script, Tina admitted, reluctantly, there were times when she felt so bored that she couldn't wait for sex to be over so she could go to sleep.  She said she almost never had an orgasm, although she sometimes faked it so Bob wouldn't feel hurt (see my articles: Closing the Orgasm Gap Between Women and Men - Part 1 and Part 2).

Bob also said he wasn't satisfied with their usual sex routine, but he was afraid to tell Tina what he really wanted sexually because he feared she would laugh at him.

Initially, Tina and Bob were hesitant to talk about their sexual fantasies as part of a discussion in couples therapy about psychological sexual arousal (see my articles: The 7 Core Sexual Fantasies).

Their couples therapist explained the meaning of rec-relational sex and she encouraged each of them to take risks in terms of sharing sexual fantasies with each other that they might never have shared before.  

Gradually, Bob opened up about wanting to try role play--something neither of them had ever tried in their relationship or in any previous relationships.  As an example, he said he wanted to role play being two strangers in a bar where he would pick up Tina and take her to a hotel for hook up sex.

Tina was intrigued by the idea of role play, and she said she would like to try it to spice up their sex life.  She also said she wanted to watch porn with Bob.

Over time, Bob and Tina experimented with watching ethical porn, reading erotica to each other, role playing and their fantasies about BDSM, which is bondage and discipline, dominance and submission and sadism and masochism.  They weren't ready to engage in BDSM and they weren't sure if they would ever be ready, but they both got sexually aroused by talking about these fantasies (see my articles: Destigmatizing Fantasies of BDSM).

As they integrated new and adventurous ways of relating sexually, their sex life became more fun and exciting and, at the same time, they also revived the emotional intimacy that had been missing from their relationship after the affair.

Rec-relational sex is a combination of relational sex and recreational sex.  

For many couples the combination of emotional intimacy with sexual excitement and fun helps to create novelty and sexual satisfaction in a loving relationship.

Getting Help in Therapy
Everyone needs help at some point (see my article: Common Myths About Psychotherapy: Going to Therapy Means You're Weak).

A skilled psychotherapist can help you to overcome the problems that are keeping you from living the life you want.

Instead of struggling on your own, seek help from a licensed mental health practitioner (see my article: Overcoming Your Fear of Asking For Help).

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR, AEDP, EFT and Somatic Experiencing therapist.

I work with individual adults and couples.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

Thursday, August 5, 2021

Women and Sexual Fluidity: A Clinical Vignette

In my previous article, Women and Sexual Fluidity, I began a discussion about sexual fluidity.  The article is primarily based on the work of Dr. Lisa M. Diamond, a sex educator and researcher, which states that cis-gender women are more likely to be sexually fluid than cis-gender men.  This doesn't mean that cis-gender men can't experience sexual fluidity (for the rest of the article, it's understood that whenever I refer to women or men, I'm referring to cis-gender individuals).

Women and Sexual Fluidity

In her book, Sexual Fluidity: Understanding Women's Love and Desire, Dr. Lisa M. Diamond tracked 100 women over a period of more than 10 years and she discovered that some women's love and sexual preferences are fluid over time and in different situations.

According to Dr. Diamond, these changes in love and desire can occur in women at different stages of their life and in different environments. In other words, for women who experience sexual fluidity, their love and sexual preferences are not exclusively heterosexual or homosexual.  

Although sexual orientation is unchanging for the vast majority of people, some women change their sexual orientation identity over time based on what's happening in their life at that time and their social circumstances.  This is a common and normal occurrence.

Clinical Vignette: Women and Sexual Fluidity
The following clinical vignette, which is based on a composite of many different cases with no identifying information, illustrates the concept of sexual fluidity in women:

Although Jane identified herself as exclusively heterosexual and only dated men throughout high school, when she went away to college, over time, she realized she was also emotionally and sexually attracted to women.

Her realization began as she got involved with political groups at her college and she met bisexual and lesbian women.  To her knowledge, this was the first time she had ever interacted with lesbian and bisexual women.  None of the women in her high school had ever outwardly identified as being anything other than heterosexual.  However, she realized that there might have been women in high school who weren't "out" to other students and, possibly, to themselves.

At first, when Jane began dating Nancy, who identified herself as a lesbian, Jane thought she was only interested in Nancy and not other lesbians or bisexual women.  She continued to think of herself as being heterosexual and that her attraction for Nancy was "an exception."  But as time went on and she discovered she was attracted to other women and less attracted to men, Jane realized that her attraction was not only for Nancy.  

At first, Jane was confused because she had never experienced these feelings before, so she attended sessions at the college counseling center.  She told her counselor that, unlike some of the lesbians she met at college, who said they always knew they were lesbians, she had never experienced these kinds of feelings before. That's when her counselor explained sexual fluidity to Jane. 

Knowing that she wasn't the only one who experienced these feelings was very helpful to Jane.  Gradually, she accepted that she preferred women at this stage of her life without denying that she had only ever been interested in men before.

In her sophomore year of college, Jane entered into a committed relationship with Ann, who, similar to Jane, discovered in college that she preferred women.  They were both involved in political groups at the college. They also attended bisexual and lesbian support groups, which they found affirming.

Over time, Jane identified herself as a lesbian.  She felt that her emotional and sexual commitment to women was of the utmost importance in her life.

In their senior year of college, Jane and Ann were each offered job opportunities in different states.  Ann was offered a teaching job in New York, and Jane was offered a community organizing job in rural Alabama.  They both agreed that these opportunities were too good to turn down, so they agreed to having a long distance relationship (see my article: Can a Long Distance Relationship Survive?).

Over the next year, they took turns visiting each other, but the demands of their stressful jobs and the challenges of a long distance relationship became burdensome.

Reluctantly, they agreed that it would be better not to be exclusive.  Soon after that, Ann met another woman, Betty, through her work in New York City and she told Jane that she wanted to be in a committed relationship with Betty.  Although it was hard for Jane, she wanted Ann to be happy, so she accepted that their relationship was over.

Adding to her unhappiness, Jane felt lonely in the rural part of Alabama where she was living and working.  She liked her colleagues and they often got together socially, but she missed having a lesbian and bisexual community for support.  She especially missed dating women.  With regard to lesbians, she had only met one woman, Alice, who identified herself as a lesbian, and Alice was in a committed relationship.

During her second year in Alabama, Jane met John at a community organizing meeting.  At first, they only met for coffee to discuss their work.  But as they continued to meet, Jane realized she was attracted to John and she sensed he was attracted to her too.  Soon they were meeting more often, having dinner together and going to the movies.

One night they talked about their mutual attraction for each other over dinner.  Although Jane admitted to John that she felt a strong attraction to him, she also told him that she continued to think of herself as a lesbian and her primary commitment was to women.  In response, John said he didn't have a problem with this if she didn't, and they became romantically and sexually involved.

A year later, Jane and John moved in together.  Although they were in a committed monogamous relationship and she didn't want to see anyone else, Jane realized that she was also attracted to other men, and she thought about her sessions with her college counselor where they talked about sexual fluidity.  

Jane began to think that she might be equally attracted to men and women at this stage in her life--although there were no other lesbians she knew of other than Alice, who had little time to get together with Jane.

Three years into their relationship, Jane and John were drifting apart.  They still cared deeply for each other, but they both agreed that their romantic and sexual relationship had run its course and they were living like roommates.  

At around the same time, Jane was offered a managerial position at a community organization in New York City and both she and John agreed the opportunity was too good to pass up.  So, Jane moved to New York City for her new job, and she also discovered lesbian and bisexual political and support groups in the area.

After her time in rural Alabama where there were no such groups, Jane loved the opportunity to get involved with women's groups again.  She also liked that she had more opportunities to meet other women to socialize with and date.  Occasionally, she dated men, but she knew she preferred women.

For some people sexual orientation identity and sexual responsiveness are not rigid or continuous throughout their life.  They can experience change or fluidity over time depending upon their life stage or the particular circumstances of their life.

Sexual fluidity does not inherently imply any negative emotional or mental health issues.  It's normal and common among many people, especially women, as a way they experience their sexuality over the course of their lifetime.

The experience of sexual fluidity in no way implies a need for conversion therapy, which is a harmful and dangerous form of therapy where unethical practitioners attempt to convert people to heterosexuality.

If you are interested in finding out more about sexual fluidity, I highly recommend that you read Dr. Lisa M. Diamond's book, Sexual Fluidity: Understanding Women's Love and Desire (see the link at the beginning of this article).

Getting Help in Therapy
Everyone needs help at some point in their life.  

If you have been struggling with unresolved problems, you're not alone.  Help is available to you.

Working with a licensed mental health professional can help you to overcome the obstacles that are getting in the way of living a meaningful life.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR, AEDP and Somatic Experiencing therapist.

I work with individual adults and couples.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

Wednesday, August 4, 2021

Women and Sexual Fluidity

Sex researchers have found that sexual responsiveness can change over time, and they identify this concept as sexual fluidity.  While sexual fluidity can apply to both men and women, it's more common in women.  

Women and Sexual Fluidity

For instance, the Binghamton Human Sexualities Lab in New York has been studying sexual behavior for almost 10 years, and their research reveals that between 2011 and 2019 college age women have been moving away from defining themselves as exclusively heterosexual.  

Whereas 77% of women identified themselves as being only attracted to men in 2011, that number declined in 2019 to 65%.  

At the same time, men's sexual attraction to women remained about the same during that same time period (between 85-90%).

What is Sexual Fluidity?
Dr. Lisa M. Diamond, sex educator and author of the book, Sexual Fluidity: Understanding Women's Love and Desire, defines sexual fluidity as the capacity for situation-dependent flexibility in sexual responsiveness.  This flexibility allows individuals to experience changes in same-sex or other-sex desire across long term and short term time periods.

According to WebMD, sexual fluidity involves multiple aspects of sexuality:
  • Sexual Orientation: The pattern of your sexual attraction and preference
  • Sexual Identity: How you define yourself with regard to your orientation
  • Sexual Behavior: The sexual activity that you engage in 
When any of the abovementioned aspects change over time, you can consider yourself as being sexually fluid.

At one time, the main categories for sexuality were either gay or heterosexual.  However, sex experts in the field now recognize many other categories, including (but not limited to):
  • Heterosexual: Attractions to people of the opposite sex
  • Bisexual: Attractions to both men and women
  • Gay or Lesbian: Attractions to the same sex
  • Pansexual: Attractions to people of all gender identities
  • Demisexual: Attractions are based on already having established a strong emotional bond
  • Asexual: An umbrella category that encompasses a broad spectrum of sexual orientations (some people experience no sexual or romantic attractions and others might experience varying degrees of attraction to people).

Sexual Preferences on a Spectrum:
Most sex experts agree that sexuality exists on a spectrum.

The Kinsey Scale, originally published in 1948, suggested that many people don't fit neatly into either heterosexual or homosexual categories.
The scale has six ratings with an additional category:
  • 0: Exclusively heterosexual
  • 1: Predominantly heterosexual, only incidentally homosexual
  • 2: Predominantly heterosexual but more than incidentally homosexual
  • 3: Equally heterosexual and homosexual/bisexual
  • 4: Predominantly homosexual but more than incidentally heterosexual
  • 5: Predominantly homosexual, only incidentally heterosexual
  • 6: Exclusively homosexual
  • x: No socio-sexual contacts or reactions
The concept that sexual orientation does not fall neatly into heterosexual or homosexual was groundbreaking at the time.  However, many current experts in the field also recognize that the Kinsey scale doesn't address all the possible sexual orientations and identities. 
This article is meant to be an introduction to this topic.
I'll continue to explore this important topic in my next article: Women and Sexual Fluidity: A Clinical Vignette.
Getting Help in TherapySeeking help in therapy doesn't mean that you're weak.  It just means that you're human and everyone needs help at some point.  
If you have been unable to resolve problems on your own, you could benefit from seeking help from a licensed mental health professional.  
About Me:  I am a licensed NYC psychotherapist, hypnotherapist, EMDR, AEDP, EFT and Somatic Experiencing therapist.
I work with individual adults and couples.
To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.
To set up a consultation, call me at (917) 742-2624 or email me.