How a Woman's Negative Body Image Can Affect 1ntimacy in a Relationship and How Therapy Can Help

Both men and women can be affected by a negative body image, but it's more common among women (see my article: Is a Negative Body Image Ruining Your Sex Life?).

What is a Negative Body Image For Women?

A negative body image refers to body dissatisfaction and a preoccupation with what women perceive as "bodily flaws" and "imperfections."

A Woman With a Negative Body Image

This means women are often unhappy about how they look, so they think they must change their body in terms of size and/or shape.  

How Does a Negative Body Image Develop For Women?

Western culture tends to value girls' and women's bodies that are young and thin.  

This is easily observed in social media, like Instagram, in magazines and many other forms of media (see my article: How to Stop Negatively Comparing Yourself to Others).

Girls and women get the message early on that, in order to appear attractive, they must strive to maintain a youthful and thin appearance or they won't be desirable.

A Woman's Negative Body Issues Can Start at a Young Age

Unfortunately, many girls get the same message in their homes where one or both parents, grandparents or siblings criticize them for not having what they consider the "ideal" body.  

Women's romantic and sexual partners might also be critical of a woman's body--even if they try to frame their criticism as "I'm just trying to help you."

All of this criticism about body image can cause self consciousness, shame and guilt as women strive to live up to a standard of beauty that is often unattainable for most people.

How Can a Negative Body Image Affect Mental Health?

Girls and women who feel unattractive because their body doesn't look a particular way are more likely to develop depression, anxiety, low self esteem and eating disorders.

They might develop anxiety about social situations where they fear they'll be judged.

A Woman's Negative Body Issues Can Affect Her Mental Health

They might also avoid going to the beach because they feel too ashamed of people looking at them critically in a bathing suit.

They might also avoid dating and/or sexual encounters because they fear their body will be judged.

All of this social avoidance can leave them feeling isolated and lonely.

How Can a Negative Body Image Affect Emotional and Sexual Intimacy in a Relationship?

A negative body image can have a negative impact on emotional and sexual intimacy in a relationship.

Women who feel ashamed of their body might avoid having sex for fear of being judged by their partner or, if they have sex, they might be too anxious and self conscious to enjoy it. 

A Woman's Negative Body Issues Can Affect Her Relationship

If they do have sex with a partner, they might just go through the motions and hope to get through sex as quickly as possible.

They might also project their dissatisfaction with their body onto their romantic and sexual partners, which can cause women to believe that their partner feels disgusted by their body when, in fact, this often isn't the case.

All of this can lead to poor relationship and sexual satisfaction for both partners. 

In many cases, the woman might be too ashamed to talk about her poor body image issues so that the partner might assume that her emotional and sexual avoidance is due to her finding him less attractive and desirable.

Clinical Vignette

The following clinical vignette shows the impact of a woman's negative body issues and how sex therapy can help:

June and Mark

When June was growing up, her mother would monitor everything that she ate from the time June was 10 years old.  

Her mother was also preoccupied with her own food consumption and weight. She would exercise several times a day to burn off the calories she ingested.

Her mother would often caution June not to eat too much, "If you eat too much and get fat, the boys won't like you."

June's older sister, Marie, who was tall and thin, would also criticize June when they were both teenagers, "You're too fat. You need to go on a diet."

Even though June's doctor told her and her mother that June was a normal weight for her age, June continued to hear criticism about being fat from both her mother and sister while her father remained silent on the topic.

By the time June was in her early 30s and in a serious relationship with Mark, she worried that he would find her unattractive--even though he reassured her many times that he found her very attractive.

Due to her negative body image, she never initiated sex, which was a source of contention between her and Mark. 

Even though she knew objectively that Mark wouldn't reject her because he never did, on an emotional level she feared that he wouldn't want to have sex with her if she was the one who initiated. She felt that if he initiated sex, she knew he wanted to be sexual and she wouldn't have to face his rejection, even though she knew this was irrational.

No matter how much Mark tried to reassure June that he loved her and he found her very attractive, she couldn't overcome her fear.

During sex, June felt so ashamed of her body that she just wanted them to get through it as quickly as possible so she could cover herself up. 

After a while, Mark felt less inclined to initiate sex, so weeks and months went by where they weren't having sex.

When they began talking about moving in together, Mark brought up their nonexistent sex life and suggested they get help in sex therapy before they considered living together.

Although June felt hesitant to attend sex therapy because she didn't know what to expect, she agreed to attend these sessions with Mark to salvage their relationship.

During sex therapy sessions, their sex therapist told them how common it is for women to have a negative image of their body.

She also explained to them that sex therapy is a form of talk therapy and there would be no physical touch, nudity or physical exams during their sessions.

Their sex therapist worked with them as a couple and she also had individual sessions with June and Mark.

During June's family history session, June realized how her upbringing affected her perception of her body.  

Their sex therapist also helped June to challenge these views through Ego States Therapy, also known as Parts Work Therapy, by asking the critical part of herself to step aside and relax so that the positive parts of herself could be strengthened and help to affirm her body image (see my article: How Parts Work Therapy Can Empower You).

Their therapist also helped June to use mindfulness and self compassion to deal with her negative perception of her body (see my article: How Mindfulness and Self Compassion Can Help With Body Acceptance).

She also helped June to focus on sexual pleasure during solo sex and sex with Mark instead of focusing on her body as the couple resumed having sex again.

Gradually, June developed body self acceptance and a positive erotic self (see my articles: Keeping an Erotic Journal For Sexual Self Discovery and What is Your Erotic Blueprint?).

After a while, June felt comfortable enough with her body to initiate sex with Mark so that sex was more pleasurable for both of them.

The work was neither quick nor easy, but both June and Mark were motivated to attend sessions and make changes.

Over time, June and Mark's emotional bond and sexual relationship were strengthened.

Whenever June felt the negative part of herself that was critical of her body creeping in, she gently asked it to step aside so the healthier parts of herself could take precedence.  

After a while, the part of herself that was critical of her body came up less and less until it stopped altogether.

Mark also learned in sex therapy how to be more sexually affirming of June in the way he related to her.

Their successful work in sex therapy enabled them to move in together and have a satisfying emotional and sexual connection.

Conclusion

Men and women can have negative feelings about their body.  For men, this might include shame about penis size, height and other physical characteristics and distortions.

This article focuses on women's negative body issues, which can develop at an early age, because negative body issues are more prevalent among women.

A negative body image which is affecting emotional and sexual intimacy is a common issue  that is dealt with in sex therapy.

Getting Help in Sex Therapy

Whether you are single or in a relationship, if you're suffering with a negative body issue, you're not alone.

Get Help in Sex Therapy

If a negative body issue is having an impact on how you feel about yourself as a sexual being, sex therapy can be helpful.

Sex therapy is a form of talk therapy (see my article: What is Sex Therapy?).

There is no nudity, physical exams or physical contact during sex therapy (see my article: What Are Common Misconceptions About Sex Therapy?).

Many individuals and couples are helped in sex therapy for a variety of issues (see my article: 

What Are Common Issues Discussed in Sex Therapy?).

About Me

I am a licensed New York psychotherapist, hypnotherapist, EMDR, AEDP, EFT, Somatic Experiencing and Sex Therapy.

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.

Getting Help For Premature Ejaculation

As a sex therapist in New York City, I help individual clients and couples who are having problems with premature ejaculation, erectile dysfunction and other sexual related problems. 

Problems With Premature Ejaculation

What is Premature Ejaculation?

Premature ejaculation is a common problem. It's estimated that as many as 1 in 3 men suffer from premature ejaculation at any given time.  

Premature ejaculation is a treatable condition, so if you have been avoiding getting help, please reconsider this because you don't need to continue to suffer with this condition.

If you have premature ejaculation occasionally, it's usually not a cause for concern. However, you might be diagnosed by your doctor with premature ejaculation if:

• You always or almost always ejaculate within 1 to 3 minutes of penetration

• You're unable to delay ejaculation beyond 1 to 3 minutes after penetration

• You avoid having sex because you feel frustrated and ashamed of ejaculating too soon

What Are the Symptoms of Premature Ejaculation?

The main symptom of premature ejaculation is not being able to delay ejaculation beyond 3 minutes during partnered sex or during masturbation.

There are two types of premature ejaculation:

• Lifelong: Lifelong premature ejaculation occurs all the time or nearly all the time since the first sexual encounter.

• Acquired: Acquired premature ejaculation occurs after a period of not having this problem.

What Causes Premature Ejaculation?

Premature ejaculation is often a combination of physical and psychological problems so each person needs to be assessed and diagnosed individually.

What Are the Psychological Factor That Can Contribute to Premature Ejaculation?

The psychological factors might include:

• Early sexual experiences
• A history of sexual abuse or trauma
• Depression
• Poor body image
• Worry or anxiety about premature ejaculation
• Guilt or shame that cause you to rush through sex
• Erectile dysfunction
• General anxiety
• Relationship problems

The biological factors might include:

• Irregular hormone levels or brain chemicals
• Swelling or infection of the prostate gland or urethra
• Inherited factors

What Are the Risk Factors for Premature Ejaculation?

The risk factors might include:

• Stress
• Erectile dysfunction
  

How Can Premature Ejaculation Impact Your Life?

Premature ejaculation can create complications in your personal life including:

• Stress
• Relationship problems
• Fertility issues

When Should You Seek Help From a Medical Doctor?

Problems with premature ejaculation can occur from time to time, but you should seek help from a urologist or a sexual health medical doctor if you always or nearly have problems with premature ejaculation.

Help from a Medical Doctor For Premature Ejaculation

You might feel embarrassed to talk to a doctor about your problem, but urologists and sexual health medical doctors have experience with this common problem, so don't allow embarrassment to keep you from getting help.

When Should You Seek Help From a Sex Therapist?

Since premature ejaculation is often caused by psychological issues, you could benefit from seeking help from a sex therapist to deal with these issues (see my article: What is Sex Therapy?).

Help From a Sex Therapist For Premature Ejaculation

A skilled sex therapist can help you to overcome the psychological problems that prevent you from having a satisfying sex life (see my article: What Are Common Issues Discussed in Sex Therapy?).

Rather than suffering on your own, seek help from a qualified medical doctor to rule out any physical problems and get help from a sex therapist for the psychological issues that might be contributing to your problem (see my article: What Are Common Misconceptions About Sex Therapy?).

About Me

I am a licensed New York City psychotherapist, hypnotherapist, EMDR, AEDP, EFT, Somatic Experiencing and Sex 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.

 

Overcoming Problems With Anxiety-Related Erectile Dysfunction (ED)

Anxiety-related erectile dysfunction is a common problem for men regardless of sexual orientation, age or race (see my article: What is Sexual Anxiety?).

What is the Link Between Anxiety and Erectile Dysfunction?

Most men experience occasional problems with maintaining an erection and most of the time these occasional problems aren't a cause for concern.

Anxiety-Related Problems With ED

Occasional problems can be related to not getting enough sleep, drinking too much or other factors.

Occasional problems are different from ongoing problems with erectile dysfunction.  

Assuming medical problems have been ruled out by a urologist or a sexual health doctor, erectile dysfunction (ED) is often caused by stress and anxiety, especially when men worry about their ability to please their partner (see my article: The 5 Most Common Male Sexual Insecurities).

Anxiety and stress-related ED can include one or more of the following problems:

• Problems with Body Image: For many men body image problems involve worrying that their penis is too small.  There can be a lot of variation in penis size, however, the average size of a flaccid penis is 3.5 inches and 5.1 inches for an erect penis.  Men who compare the size of their penis to male actors in pornography can develop a distorted view of what an average penis looks like, especially if they don't realize that male actors in porn are chosen for their unusually large penises.  

• Shame and Guilt About Sex: Shame and guilt can be related to many factors, including personal shame about sex, cultural shame or interpersonal issues with a partner.

Anxiety-Related Problems With ED

• Relationship Conflict: Stress and anxiety related to relationship conflict can be a contributing factor to ED and an inability to experience sexual pleasure. Relationship conflict can include frequent arguments, a history of emotional and/or sexual infidelity, financial infidelity, child-rearing disagreements, problems with one's own family or with in-laws, and so on.

• Unresolved Sexual Trauma: When there is unresolved sexual trauma, partnered sex can trigger trauma-related guilt and shame which often has nothing to do with the current sexual partner.  Trauma-related triggers occur in an instant without a person's conscious awareness.  Since trauma-related triggers often occur outside a person's awareness, a man might not understand why he feels so emotionally overwhelmed in the moment because he doesn't realize he is triggered and that the trigger has nothing to do with his current partner.  Anything can act as a trigger including a scent, a word, a gesture, a movement, a particular sexual position and hundreds of other things that were related to the original trauma (see my article: How Unresolved Trauma Can Affect Your Relationship and Overcoming a History of Sexual Abuse).

• Sexual Libido Differences in a Relationship: This is the #1 problem that brings couples into sex therapy.  Even though they can accept that they have differences when it comes to food or entertainment, most people find it difficult to accept that they experience sexual libido differences with their partner. This can create sexual pressure for a man or feelings of sexual rejection which, in turn, can lead to ED or sexual avoidance (see my article: Relationships and Mismatched Sex Drives: What is Discrepant Sexual Desire?).

• Lack of Sexual Experience: When a man worries he won't be able to "perform" sexually or that he won't be able to satisfy his partner, this can lead to "spectatoring" where a man becomes so self conscious that he becomes a so-called "spectator." Rather that enjoying sex with his partner, he is  "spectatoring" which takes him out of the sexual experience and can create a problem ED (see my article: What is Performative Sex?).

• Stress and Worry Unrelated to Sex: A little stress in the form of sexual anticipation can enhance sexual pleasure, but too much stress can lead to ED.  

• Other Mental Health Problems: Generalized anxiety, depression and other mental health problems that are not directly related to sex can also contribute to ED.

How Does Sex Therapy Help Men to Overcome Erectile Dysfunction?

Sex therapy is a form of talk therapy for individual adults and couples (see my article: What is Sex Therapy?)

Sex therapy is an effective treatment for sexual anxiety and other sexual problems.

During a sex therapy session, there is no sex, nudity or physical exams (see my article: What Are Common Misconceptions About Sex Therapy?).

Individuals and couples seek help in sex therapy for many reasons (see my article: What Are Common Issues Discussed in Sex Therapy?).

Regardless of the sexual problem, sex therapy usually begins with an assessment, including taking a family history, relationship history and sexual history to determine how the current problem might be related to the client's history.  This usually takes several sessions.

Sex therapy is an effective form of treatment for ED and other sexual problems (see my article: How Sex Therapy Can Help With Sexual Anxiety).

The underlying issues of erectile dysfunction are different for each person, so there is no one-size-fits all approach to overcoming ED.  

If a man is able to maintain an erection when he masturbates and if he experiences normal erections during sleep and upon waking up (also known as "morning wood"), ED is usually related to an underlying issue that he might have no awareness about before beginning sex therapy.

A sex therapist is a trained mental health professional who has special training in sexual-related problems, including erectile dysfunction.

Sex therapists give sex therapy clients assignments to do at home either alone or with a partner.  This can include (but is not limited to):

• Practicing Sensate Focus or other forms of touch exercises (see my article: What is Sensate Focus?)

• Reading assignments 

• Keeping a journal related to the sexual problem (see my article: Keeping an Erotic Journal)

• Practicing sexual communication with a partner (see my article: How to Talk to Your Partner About Sex)

• Other assignments between sex therapy sessions

If the ED occurs within the context of a relationship, it's considered a relationship problem and sex therapy is more effective if both partners are attending sex therapy sessions together.

In future articles, I'll explore, among other topics, how the penis is often a barometer of physical, emotional and sexual health.

Also, see my article: Is It True That "Real Men" Are Always Ready to Get It Up?

Getting Help in Sex Therapy

In addition to whatever underlying issues there might be, men often feel too ashamed to seek help in sex therapy.  This is often due to distorted stereotypes of what it means to "be a man" or to "be strong."

Getting Help in Sex Therapy

Sexual shame is often reduced or eliminated when men learn how common erectile dysfunction is for men regardless of age, sexual orientation, race and other identifying factors.

If you're experiencing ED, rather than struggling on your own or ignoring the problem, seek help from a licensed mental health professional who is a trained sex therapist.

Getting Help in Sex Therapy

Overcoming anxiety-related ED can lead to more satisfying sex and a more meaningful life.

About Me

I am a licensed psychotherapist, sex therapist, couples therapist, hypnotherapist and trauma therapist (EMDR, AEDP, Somatic Experiencing and other forms of trauma therapy) with more than 20 years of experience.

I work with individual adults and couples and I have helped many clients to overcome sexual problems.

My office is conveniently located in Greenwich Village, Manhattan where I provide in-person and virtual sessions.

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.

The 5 Most Common Sexual Insecurities That Heterosexual Women Have

Sexual insecurity is a common problem for both men and women.   In my prior article, The 5 Most Common Sexual Insecurities that Heterosexual Men Have , I focused on men's sexual insecurities.  

The Sexual Insecurities of Women

In the current article, I'm focusing on women's most common sexual insecurities.

The 5 Most Common Sexual Insecurities That Women Have

Women often seek help in sex therapy for many of the following issues:

• Insecurity About Weight: More than ever, women are bombarded in the media with culturally idealized images of women--specifically, white women. Based on these images, women should be white, young, thin, tall and beautiful. This creates a lot of insecurity and anxiety for most women who don't fit this image.  It creates so much stress that many women are undereating, over-exercising and spending too much time worrying about their appearance and whether they'll be sexually appealing for the male gaze (see my article: How Mindfulness and Self Compassion Can Help With Body Acceptance).

Body Image Insecurity

• Insecurity About Breast Size: Insecurity about breast size is part of problems with body image, but it's such a big problem that it deserves its own category. Most heterosexual women assume they will be more desirable with large breasts and, rather than being happy with their breasts, they worry about whether they should have surgery for breast augmentation. In reality, just like anything else, beauty is in the eye of the beholder so it's a fallacy that all men prefer large breasts. Also, focusing externally, rather than appreciating your body as is, is a psychological trap. In addition, bodies change over time as people age, so learning to accept your body will give you greater peace of mind.

• Insecurity About Their Vulva and Vagina: Also related to body image is the specific anxiety that many women have about their vulva and vagina. The vulva is the external female genital area. It includes the labia, clitoris, vaginal opening and the urethra. The vagina is the internal female genital area. It includes is a muscular canal that extends from the vulva to the neck of the uterus. Specifically, women worry about whether their labia are the right size and color and whether labia are uneven. In reality, labia come in all sizes, shapes, colors, evenness and unevenness.  And all of them are normal. Similar to male insecurities about penis size, pornography usually portrays culturally idealized images of vulvas. This sends the wrong message to women that if they don't have vulvas that look like the cultural ideal, they're not normal. This could result in women seeking unnecessary plastic surgery to get their vulvas to look like the cultural ideal, which has been happening more often in recent years.Women also worry that they smell during oral sex (cunnilingus), which can create stress during sexual activities if they're preoccupied with their scent instead of focusing on their pleasure. For many women this has been exacerbated by experiences with men who want to receive fellatio (oral stimulation to a man's penis) but who are unwilling to reciprocate.  Other women won't allow men to engage in cunnilingus because they have so much shame about their scent. Each woman has her own unique scent, which is normal. Women who are concerned about a strong scent that persists despite showering should consult with her gynecologist to rule out an infection.

Sexual Insecurities of Women

• Insecurity About Taking Too Long to Orgasm: Rather than focusing on overall sexual pleasure, many heterosexual women tell their sex therapist that they worry they're taking too long to orgasm during partnered sex. They worry that men will get impatient or frustrated with them. The more they worry, the more difficult it is to have an orgasm. Many women are especially worried that men will get impatient with them during cunnilingus (oral stimulation of the vulva). This problem can be overcome during solo sex (masturbation) with either digital stimulation or stimulation with a vibrator or other sex toy. This allows women to know what they like and how they like it,which they can then communicate this to their partner. Also, getting comfortable with being more embodied, instead of being stuck in your head, can help a lot. In addition, although it can be great to have an orgasm, focusing on overall sexual pleasure, instead of orgasms, can take a lot of pressure off women (see my articles: Closing the Orgasm Gap Between Men and Women and Why You Shouldn't Fake Orgasms).

• Insecurity About "Low Libido": In their book, Desire: An Inclusive Guide to Navigating Libido Differences, the authors Dr. Lauren Fogel Mersey and Dr. Jennifer A. Vencill, make the point that desire discrepancy is relative to who you are having sex with. You can be in a relationship with someone where you're the higher desire partner and in another relationship where you're the lower desire partner. Also, many women who are falsely labeled as having a low libido aren't having sex that turns them on. They don't have low libido--sex with a particular partner just might not be satisfying for them.  So, as mentioned before, it's important to get to know what you like and don't like during solo sex so you can communicate this to your partner. In addition, TV, movies and other media tend to portray spontaneous sexual desire as being the norm. During spontaneous sexual desire, people are turned on immediately.  But, in reality, many men and women experience responsive sexual desire where they don't get sexually turned on until they have already begun sexual activities. So, if you experience responsive desire, it's often a matter of having the willingness to get started because you know you will get turned on. In addition, if there is a sexual desire discrepancy, just like any other difference in a relationship, it's normal for there to be one person who desires sex more than another. Desire discrepancy is the #1 issue that brings couples into sex therapy where they learn to negotiate these differences so both partners are satisfied.

Overcome Sexual Insecurity in Sex Therapy

Sex therapy is a form of talk therapy that focuses on sexual issues (see my article: What is Sex Therapy?).

Getting Help in Sex Therapy

There is no physical exam, nudity or sex during sex therapy sessions (see my article: What Are the Most Common Misconceptions About Sex Therapy?).

Many individual adults and couples seek help in sex therapy for a variety of reasons (see my article: What Are Common Issues Discussed in Sex Therapy?).

Rather than struggling on your own, seek help from a licensed mental health professional who is a sex therapist so you can lead a more fulfilling life.

About Me

I am a licensed New York City psychotherapist, hypnotherapist, EMDR, AEDP, EFT, Somatic Experiencing and Sex Therapist.

I am a sex-positive therapist who works 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.

The 5 Most Common Sexual Insecurities That Heterosexual Men Have

As a sex therapist in New York City, I have seen many clients struggle with sexual insecurity. In fact, sexual insecurity is a common experience for many people at some point in their lives.  

The current article focuses on heterosexual men's sexual insecurities (see my article: Overcoming Feelings of Sexual Shame and Guilt).

The Sexual Insecurities of Men

What Are the 5 Most Common Sexual Insecurities of Men?

• Fear of Rejection: Despite many positive changes in gender roles in the past few decades, unfortunately, the cultural expectation is still that men are the pursuers and women are the pursued, especially among traditional men and women. This places the burden on men to make the first move and risk rejection, which can create stress and anxiety. It also creates anxiety and frustration for women when they're in the passive role of waiting for men. With dating experience, over time, many men learn to deal with rejection, but many others never overcome this fear. They hope they'll be able to pick up on social cues from women who are interested, but these cues might be confusing or nonexistent in certain situations. If a man is especially fearful of rejection, he might feel his whole sense of self is on the line. Due to his fear, he might avoid taking the initiative--only to feel bad about himself later (see my article: Coping With Fear of Rejection).

• Fear of Not Pleasing Their Partner in Bed: There's an unfair stereotype of men being mostly focused on their own sexual gratification. This stereotype is amplified in most male-oriented pornography which focuses primarily on men's pleasure (the exception to this is ethical porn).  Although this might be true for some men, especially in hookup situations, many men worry about whether they're pleasing women in bed. And, while it's important not to be selfish in bed, the misconception that men are responsible for "giving" women orgasms puts a lot of pressure on both men and women. It also casts women in a passive role as if they're only the recipients of sexual pleasure and not capable of generating their own pleasure.  Unfortunately, many men also base their sense of masculinity and sexual self esteem on whether or not their female partner has an orgasm instead of whether she enjoyed sex.  If their partner doesn't have an orgasm, they feel inadequate.  In some cases, due to a man's existing feelings of inadequacy, he can become so worried about his partner's pleasure that he loses sight of his own pleasure,. This can lead to other problems, including erectile dysfunction (see my articles: What is Sexual Anxiety? and What is Sexual Self Esteem?).

The Sexual Insecurities of Men

• Fear of Having a Small Penis: Another common male insecurity is fear having a small penis. This is especially true of men who watch a lot of pornography and who compare their penis to the penises they see in porn. What many men don't know is that male porn actors are specifically chosen because they have unusually large penises as compared to the average penis, which is about 5.1-5.25 inches long. Fear of having a small penis also creates a lot of shame, which can affect a man's ability to initiate sex or create anxiety about maintaining an erection.  In reality, size doesn't matter with regard to sexual pleasure, and most women don't care about penis size. Also, even a man with a micropenis, which is about 3.67 inches or less, can be give and receive pleasure.

• Fear Related to Overall Body Image: Body image issues are usually associated with women. But, even though women are mostly the ones who are negatively impacted by unrealistic body images portrayed in the media, men are also affected by unrealistic images of having "six pack" abs or a muscular build, which often creates anxiety about taking off their clothes during sex.  Other body image insecurities can include hair loss, weight, height and so on.

• Fear of Erectile Dysfunction (ED): All of the above fears can result in problems with erectile dysfunction, which most men dread. The cause of ED is often psychological due to stress, anxiety, lack of sleep, alcohol consumption, smoking cigarettes, drugs and so on. There are also some medical problems, like diabetes, high blood pressure, prostate problems that can cause ED.  If ED, premature ejaculation (PE) or delayed ejaculation (DE) is a problem, a man should see a urologist to rule out any medical problems first and then see a sex therapist to deal with psychological issues. Erectile problems can also be a combination of physical and psychological problems so that a urologist and sex therapist would collaborate in treatment.

See my article: The 5 Most Common Sexual Insecurities That Heterosexual Women Have

Overcoming Sexual Insecurities in Sex Therapy

Sex therapy is a form of talk therapy that focuses on sexual issues (see my article: What is Sex Therapy?)

Getting Help in Sex Therapy

There is no physical exam, nudity or sex during sex therapy sessions (see my article: What Are Common Misconceptions About Sex Therapy?).

Many individual adults and couples seek help in sex therapy for a variety of reasons (see my article: What Are Common Issues Discussed in Sex Therapy?).

Rather than struggling on your own, seek help from a licensed mental health professional who is a sex therapist so you can lead a more fulfilling life.

About Me

I am a licensed New York City psychotherapist, hypnotherapist, EMDR, AEDP, EFT, Somatic Experiencing and Sex Therapist.

I am a sex-positive therapist who works 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.

Overcoming Feelings of Sexual Shame and Guilt Due to Personal Issues

In my prior two articles, I discussed sexual shame and guilt from an interpersonal perspective and from a cultural perspective.

Sexual Shame and Guilt

See my prior articles: 

Overcoming Feelings of Sexual Shame and Guilt Due to Interpersonal Issues 

Overcoming Feelings of Sexual Shame and Guilt Due to Cultural Issues

In the current article, I'm looking at how personal issues can affect sexual guilt and shame.

There's a lot of overlap with personal, interpersonal and cultural issues.  

If you haven't read the prior two articles, I recommend that you read them first before reading this one because those articles have more detailed descriptions about many of the problems outlined below.

Sexual Shame and Guilt

As a recap from my prior articles: The difference between sexual shame and guilt is:

• Sexual shame is a worry about being rejected for an aspect of who you are as a sexual being. 

• Sexual guilt is a worry about being rejected for your sexual thoughts, feelings or behavior. 

Personal Issues Related to Sexual Shame and Guilt Include (but are not limited to):

• Problems with body image (feeling too fat, too thin, breast size too small, penis too small, etc.)
• Discomfortable with undressing in front of a partner
• Insecurity with being a sexual person
• Lacking sexual self esteem
  
• Chronic stress related to sex
• Sexual anxiety
  
• Depression before, during or after sex
• Negative self talk about sex
• Harsh self judgment about sexual thoughts, feelings or behavior
• Fear of having sex
• Lacking sexual self awareness
  
• Inability to identify what is sexually pleasurable to you
• Arousal or orgasmic difficulties (assuming sexual activities are unrelated to a sexually inattentive partner)
• Isolation
• Problematic or compulsive sexual behavior
  
• Substance misuse or abuse
• Severe discomfort with sexual topics
• Difficulty talking about sex with a partner, medical professional or sex therapist
• Avoiding sex
• Limited or no sexual experience as an adult
• Worrying about smells or taste related to sex even though you and/or your partner are clean
• Avoiding masturbation
• Feeling ashamed and guilty about masturbation
• Discomfort with your own sexual fantasies or repressing your fantasies
• Discomfort initiating sex with a partner
• Feeling guilty after having sex with a partner
• Engaging in "duty sex" with a partner out of a sense of obligation
• Approaching sex with a partner as if it is a "chore"
• Fear of expanding your sexual repertoire to try to new sexual activities
• Believing sexual pleasure is only for heterosexual men and not for heterosexual women
• Repressing LGBTQ sexual orientation or gender issues
• Inability to set boundaries with others because you don't know your own sexual boundaries
• Experiencing physical discomfort during sex
• Severe body tension during sex
• Pain during sexual intercourse, including dyspareunia, vaginismus, phimosis (uncircumcised man's foreskin gets stuck so it cannot be pulled back)
• Fear of telling a partner you're experiencing sexual pain (related to "duty sex")
• Erectile difficulties (erectile dysfunction, premature ejaculation, delayed ejaculation, erectile unpredictability)

Overcoming Feelings of Sexual Shame and Guilt

The following strategies may be helpful:

• Journal your thoughts about sex

• Get to know your body:

• Look at yourself in the mirror several times a week either without clothes or with minimal clothing, and pick one thing you like about yourself (no matter how insignificant it feels to you).

• If you're wearing clothes when you look at yourself, gradually wear less clothing over time to get comfortable with your naked body.

• Engage in solo pleasure/masturbation

• When negative thoughts about yourself as a sexual being arise, counter them with positive thoughts you genuinely feel

• Educate yourself about sex through reputable sex education podcasts like Sex and Psychology with Dr Justin Lehmiller

• Educate yourself about sex by reading books by sex therapists or sex educators, including Come As You Are By Dr Emily Nagoski

• Try to have conversations with your partner (if you're partnered) about sex (start small until you gain confidence)

Get Help in Sex Therapy

Overcoming sexual shame and guilt on your own can be daunting and you might need professional help from a sex therapist.

Get Help in Sex Therapy

Sex therapy is a form of talk therapy (see my article: What is Sex Therapy?)

There are no physical exams, nudity or physical touch during sex therapy sessions (see my article: What Are Common Misconceptions About Sex Therapy?).

Individual adults and couples seek help in sex therapy for a variety of issues (see my article:What Are Common Issues Discussed in Sex Therapy?).

Rather than struggling on your own, seek help in sex therapy so you can overcome your guilt and shame and lead a more fulfilling life.

About Me

I am a licensed New York City psychotherapist, hypnotherapist, EMDR, AEDP, EFT, Somatic Experiencing and Sex Therapist.

I am a sex-positive therapist who works 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.