How to Make 0ral S£x Great For Her

Oral sex can be one of the most pleasurable, exciting and intimate experiences between two people--whether it's cunnilingus for women or fellatio for men (see my article: Closing the Orgasm Gap Between Men and Women).

How to Make Oral Sex Great For Her

In this article I'm focusing on cunnilingus, which is oral sex for women, and I'll focus on fellatio, oral sex for men, in a future article.

There's a great book by Sex Therapist Ian Kerner, Ph.D., LMFT, called She Comes First, that provides excellent tips for cunnilingus.  If you're not familiar with this book, check it out. It's available wherever books are sold.

What is Cunnilingus?

Cunnilingus is oral sex for women.

It can involve the giver using their mouth and tongue to stimulate the vulva, vagina and, specifically, the clitoris. This means sucking, licking, and nibbling--depending upon what she likes.

Why is Cunnilingus Important For Most Women?

Cunnilingus is very pleasurable for most women to receive. 

It can also be very pleasurable for the person who is performing cunnilingus.

Most women need stimulation of the clitoris to have an orgasm and cunnilingus provides clitoral stimulation by the giver using their tongue, mouth and fingers.

Tips on What Makes Oral Sex Great For Women

Here are some tips that can help you:

Shower or Bathe Beforehand

• Shower or Bathe Beforehand: Being clean is essential for all sex. A shower or a bath will also help both of you to relax before sex.

Shower or Bathe Beforehand

• Be Generous: There are some people who enjoy receiving oral sex, but they don't want to give. Sex research indicates this is less likely to occur with lesbians or bisexual women.  So, if you're a heterosexual guy who likes to receive oral sex but you don't like cunnilingus, you need to rethink your attitude. While it's important that no one should do anything they're not comfortable doing, if you're unwilling to perform cunnilingus, don't expect to receive fellatio. It's that simple. This often occurs during casual sex, especially one-night stands where some guys are only focused on their own sexual pleasure (see my article: Can Casual Sex Be Safer and More Satisfying For Heterosexual Women?).

Communicate

• Communicate: Although many women love to receive oral sex, some don't, so you need to know whether your partner likes it or not. Having a conversation before you have sex will let you know your partner's preferences. In addition, if she's into oral sex, ask how she likes it. Many women prefer a slow build up with kissing, touching and attention to other erogenous zones before their partner stimulates their clitoris. Other women might like sucking as opposed to licking or alternating between the two, so find out what she likes beforehand. The conversation can be part of your foreplay. Also be open to feedback while you're performing cunnilingus to maximize her pleasure (see my articles: How to Talk About Sex With Your Partner - Part 1 and Part 2.

Communicate

• Help Her to Relax: Receiving oral sex makes some women feel physically and emotionally vulnerable. So, as much as you can, help her to relax if she's tense. This might mean giving her a massage beforehand, cuddling, talking or the two of you doing a breathing exercise together. Find out from her what helps her to relax. 

Help Her to Relax

Help Her to Relax

• Get Comfortable: Before you perform cunnilingus, make sure you're comfortable. Use pillows to get comfortable if you need them so you don't strain your neck or have to stop suddenly. 

• Use a Dental Dam: If you're in a monogamous relationship and both of you only have sex with each other, you can probably skip using a dental dam. But if you're not completely monogamous or one of you has a sexually transmitted infection or you don't know each other well, use a dental dam. Dental dams are available over the counter or online, so you shouldn't have a hard time finding them.  Also, if one or both of you hasn't been tested in a while, take precautions in the same way you would if one of you had an STI.

• Don't Go Right For the Clitoris (unless that's what she likes): Most women like a build up of sexual tension with kissing, caressing, touching other erogenous zones, and so on, before you focus on the clitoris. Also, be sure to include the labia (the folds of skin that surround the vaginal opening) when you use your tongue and mouth to stimulate her. 

• Vary Your Technique S-l-o-w-l-y: You don't want to ruin the moment if she's about to have an orgasm and you switch too quickly from one type of stimulation to another (like from licking to sucking). You need to be tuned in to your partner to get a sense of how turned on she is or if she is about to have an orgasm. 

• Don't Forget the G-Spot: The clitoris is the only part of a woman's body that is specifically for pleasure. It serves no other biological function, so it's important to understand what it is and how to stimulate it. The pea shaped clitoris that is visible to the eye is only a small part of the clitoris. The rest of the clitoris extends into the vagina. Stimulating a woman's G-spot, which is located about an inch or so inside the vaginal opening on the upper vaginal wall, can add a lot of pleasure. Combining cunnilingus with stimulating the G-spot with your finger at the same time can add a lot of pleasure (see my article: What You Need to Know About the G-spot).

Don't Forget the G-Spot

• Take Your Time, Be Patient and Remain Attuned to Your Partner's Sexual Pleasure: A major mistake people make is thinking they only have to engage in cunnilingus for a few minutes and then they're done. Unless your partner tells you differently, take your time. A few minutes isn't enough time for most women to have an orgasm. Many women take up to 30 minutes or more. Pay attention to how she's experiencing pleasure and if she's close to an orgasm.

• Be Aware That Not All Women Orgasm During Cunnilingus and That's Okay: Women's experiences with cunnilingus varies. Some women have orgasms during oral sex and some don't. Some women need a combination of oral, fingering, G-spot stimulation and sex toys like a vibrator. It's all good. That's why it's important to communicate beforehand.

• Remember that Sexual Aftercare is Important: This could mean cuddling, kissing or whatever makes you both feel comfortable.

Sexual Aftercare

Sexual Aftercare

• Be Open to Feedback: Feedback can come from your partner at any time, so be open to receiving feedback from her to make the experience more enjoyable for both of you. You can talk about what worked and what could be improved upon. If feedback is given in a tactful, helpful way, it can ensure that sex will be pleasurable for both of you.

About Me

I am a New York 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.

Faking Orgasms Can Ruin Your Relationship

In a 2019 research study by Indiana University, researchers discovered that 58% of women admitted to faking an orgasm at some point.  However, it's interesting to also note that the vast majority of those women reported that they no longer fake orgasms.  

Faking an Orgasm Can Ruin Your Relationship

These findings raise interesting questions as to why women felt the need to fake orgasms in the first place and why many of these women stopped.

Why Do Women Fake Orgasms?

Women cited many reasons why they faked orgasms, including because they wanted:

• To make their partner feel better
• To prevent a partner they liked from feeling bad about sex
• To end sex because they were tired

Why Did Many of These Women Stop Faking Orgasms?

Women reported that they stopped faking orgasms because they now feel:

• More confident in themselves and their identity as women
• More comfortable with sex
• Secure enough in their relationship that they no longer feel the need to fake it

How Can Faking Orgasms Ruin Your Relationship?

There are many reasons why faking orgasms on an ongoing basis can be detrimental to your relationship:

• It's Dishonest: Faking orgasms is a form of deception. That might not be a woman's intention, but it's still a lie.

• It Creates a Barrier to Emotional Intimacy: When there is a lie between you and your partner, this creates an obstacle to emotional intimacy. Even if the partner doesn't know about the lie, the woman knows and this often makes her feel guilty and ashamed, which is a barrier to emotional intimacy (see my article: Vulnerability as a Pathway to Greater Emotional Intimacy).

• Sex Won't Get Better: If a woman's partner thinks the woman is having orgasms, there's no reason to make changes in the sex script to improve sex. That means that if the woman isn't experiencing satisfying sex, the sex will remain unsatisfying.

What to Do If You Want to Stop Faking Orgasms

• Stop Pretending You're Enjoying Sex That's Not Pleasurable to You: This decision is up to you. Both of you deserve to have pleasurable sex and, if you've been faking orgasms, you're not giving yourself to a chance to have good sex and your partner thinks you're enjoying sex when you're not. Once you stop faking, your partner is likely to ask questions and this would be an opportunity for you to get honest.

• Have an Open and Honest Conversation With Your Partner: Once again, this is your choice. You can continue faking orgasms, and nothing will change, which means that you'll continue to have less than satisfying sex. Or, if you decide you want to stop faking, you can get honest with yourself and your partner. Sure, it will be hard and somewhat humiliating to admit you've been faking it, but after you get over the embarrassment and your partner gets over their reaction, there's a chance to improve your sex life and your relationship (see my article: How to Talk to Your Partner About Sex - Part 1 and Part 2).

• Talk to Your Partner About Making Changes to Your Sex Script: Instead of remaining stuck in a sexual rut, talk to your partner about your sexual turn-ons as well as your turn-offs. Then, ask your partner about their turn-ons and turn-offs. There's a possibility that your partner might feel badly about doing things sexually that actually turned you off, but if you're in a otherwise stable relationship, there's also a chance the two of you can work things out so you can improve your communication going forward and sex will be more satisfying for both of you (see my article: Changing Your Sex Script).

• Seek Help in Sex Therapy: Two of the most common problems that bring couples to sex therapy is unsatisfying sex and discrepant sexual desire. When you get help from a sex therapist, you and your partner can learn to get comfortable with talking about sex and discovering new ways to improve your sex life.

Getting Help in Sex Therapy

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

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

As mentioned above, there are many reasons to seek help from a skilled sex therapist (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 have a more fulfilling sex 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.

 

Can Hookups Be Safer and More Sexually Satisfying For Heterosexual Women?

In my last article, Sex Research: Heterosexual Women Often Find Hookups Less Sexually Satisfying Than Men, I discussed some of the reasons why heterosexual women often feel less sexual pleasure during hookups than men. 

In this article, I'm focusing on how these hookups can be safer and more sexually satisfying for women.

Can Hookups Be Safer and More Sexually Satisfying For Women?

Let's face it: Regardless of how you feel about hookups, they're here to stay--for adolescents, college students and people in their 20s and beyond. 

So, for the purpose of this article, it's not a matter of stopping hookups or casual sex--it's more a matter of how to make hookups better for women who want to hookup.

Before going on, I want to clarify why I'm focusing on heterosexual women in particular. 

Based on sex research, compared to gay men, bisexual men, bisexual women and lesbians, heterosexual women have the least sexually satisfying sex, even in committed relationships, and even less satisfying during hookups and casual sex (see my articles: Closing the Orgasm Gap - Part 1 and Closing the Orgasm Gap - Part 2).  

More about this in the second half of this article.

Can Hookups Be Safer For Heterosexual Women?

Let's start by focusing on personal safety.

Personal safety is an important issue for heterosexual women who are much more at risk during hookups.  

According to the Centers For Disease Control and Prevention (CDC), 1 in 5 women are sexually assaulted in the United States.  

This is an astounding number.  It means that 20% of women in the US are sexually assaulted at some point in their lifetime.  

Considering that alcohol and drugs are often a part of hooking up, you can see where safety could be an issue when both people are impaired with regard to using good judgment and practicing consensual sex (see my article: What is Sexual Consent?).

    Tips For Safer Hookups

Although any hookup can be potentially unsafe, there are steps you can take as a woman to make them safer:

• Share Your Location With Trusted Friends: Before you meet with the person you're hooking up with, share your location so, in case of an emergency, people know where you are and how to find you. You can do this through your iPhone or using Google Maps.

• Keep Friends Informed: Share the first and last name of the person you're hooking up with and one of their social media accounts, like Instagram. Also, keep your friends posted with your whereabouts if you leave the place where you originally told them you would be.

• Practice Safer Sex and Carry Your Own Condoms: You can't always rely on your sex partner to have condoms, so bring your own to protect your health and theirs as well.  If your partner refuses to use a condom, don't engage in fellatio or have intercourse.

• Know Your Partner's Sexual Health Status: Even though it's good to use condoms, condoms aren't 100% safe when it comes to sexually transmitted infections and HIV. So, it's good for both you and your partner to get tested beforehand so you know each other's sexual health status.

• Be Aware of  Your Alcohol Consumption: Be mindful of how much you drink and what you drink. Never take a drink that wasn't given to you directly by the bartender, especially if you don't know your hookup partner well, because someone could easily slip a drug into your drunk that will impair you.

• Don't Walk Home Alone Late at Night: Make sure you have friends who can walk you home from wherever you were hooking up with your partner, especially if it's late at night or you're in a remote area.  If your friends aren't available, have enough money or a credit card with you to take a taxi or car service home.

• Trust Your Instincts: If you get the feeling that something is off, don't hang around just to be polite. Trust your gut and leave without feeling guilty. This is about your personal safety.

Can Hookups Be More Sexually Satisfying For Heterosexual Women?

Now that I've discussed the safety precautions, let's focus on how hookups can be more sexually satisfying for women, which is so important considering the orgasm gap.

    Tips For More Sexually Satisfying Hookups

Since women often leave hookups without experiencing an orgasm or without even feeling sexual pleasure, here are some tips:

• Know What You Like Sexually: Whether you discover what you enjoy sexually from experiences you've had with other partners or from solo sex, get to know your body and what you like (see my articles: Sexual Self Discovery With Pleasure Mapping and Keeping an Erotic Journal).

Know What You Like Sexually and Tell Your Partner

• Tell Your Partner What You Like: You can learn to get comfortable talking about sex with a partner by practicing. The more you're able to talk about what's pleasurable to you, the easier it can get.  Don't assume your partner knows or is even concerned about your sexual satisfaction, especially if you don't know each other well. You're entitled to sexual pleasure, so don't settle for less (see my article: Finding Your Sexual Voice).

• Take the Time to Get Sexually Aroused: Whether you experience spontaneous desire or, if you're like most women, you experience responsive desire, take the time to get aroused by kissing, touching, clitoral stimulation or doing whatever it is that gets you turned on (assuming your partner consents to it) before you engage in oral sex or intercourse. Don't allow your partner to rush you if you're not ready.

• Make Sure You Use Lube: Even if you're very turned on and already wet, adding lubrication can help reduce the amount of friction that can make penetrative sex unpleasant and even painful. Remember that oil-based lubricants break down latex condoms.

• Use Sexual Fantasies to Get Yourself Turned On: Sex starts in the brain, so if you want to get turned on, think about your sexual fantasies, including your peak erotic experiences.

• Feel Free to Use a Vibrator to Have an Orgasm: Depending upon whom you're with, your partner might have an orgasm before you do. Some partners can be more sexually generous than others, but if you're with someone who is mostly focused on their own orgasm, feel free to use a vibrator to have your orgasm. There are now so many varieties to choose from, including small bullet vibrators that are so convenient that you can carry one in your pocket.

Conclusion

Hookups aren't for everyone, but they're not going away any time soon.

Since heterosexual women are more at risk than men, it makes sense to take basic precautions to ensure personal safety.

In addition, since heterosexual women tend to have less satisfying sex than men, knowing what you like and being able to tell your partner can help you to have more satisfying sex.

Getting Help in Sex Therapy

If you're having a sexual problem, seek help from a licensed mental health professional who is a sex therapist.

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

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

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

Rather than struggling on your own, seek help from a skilled sex therapist so you can have a more fulfilling sex life.

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.

What Are the Most Common Issues Discussed in Sex Therapy?

Many people who have sexual problems feel too ashamed to get help in sex therapy or they don't know what sex therapy is (see my article: What is Sex Therapy?).

Common Issues in Sex Therapy

To shed light on some of the most common issues clients discuss in sex therapy, I'm writing this article to help reduce the stigma related to sexual problems and encourage people to seek help.

What Are the Most Common Issues Discussed in Sex Therapy?

The following are just some of the most common issues discussed in sex therapy in no particular order:

• Mismatched Libidos/Discrepant Sexual Desire Between Partners: The initial stage of a relationship is the limerence stage when people experience that heady in love feeling and sex tends to be passionate and exciting.  But it's a common occurrence that the limerence stage only lasts for a relatively short time and then the relationship develops into a more mature phase of love, which is often less exciting. This is normal, but many people think there's something wrong with their relationship when the excitement wanes. When this happens and one person desires sex more often than the other, there is a mismatch in sexual desire, which is called discrepant sexual desire. The mismatch can involve any type of difference. This mismatch can involve sexual frequency or the type of sex each person wants to have. Sex therapy can help couples to reignite the spark in their relationship (see my article: Relationships and Mismatched Sex Drives: What is Discrepant Sexual Desire?).

Common Issues in Sex Therapy: Sexual Desire Discrepancy

• Differences in Sexual Responsiveness in a Relationship: Related to discrepant sexual desire is a difference in sexual responsiveness.  This can occur at any stage in a relationship.  This means that each person in the relationship experiences sexual arousal in a different way.  One person experiences spontaneous desire and the other person needs more time to get turned on, which is called responsive desire.  Again, this is common and normal. Neither type of desire--spontaneous nor responsive--is better than the other. They're just different. Sex therapy can help people struggling with this issue, especially if both people are willing to work on getting to know their turn-ons and turn-offs, which are often referred to as sexual accelerators and sexual brakes (see my articles: Spontaneous Sexual Arousal and Responsive Sexual Arousal Are Both Normal and Understanding Your Sexual Accelerators and Brakes).

• Frustration About a Sexless Relationship: There are relationships where neither partner is bothered by the fact that they're not having sex because sex isn't important to them. If both people feel the same way, there's no problem. But in most relationships sex is important and if sexual frequency has dwindled down to several times a year or to nothing, one or both partners are often dissatisfied.  Sex therapy can help people to get to the root of their sexless relationship so they can enjoy sex (see my article: Have You and Your Partner Stopped Having Sex?).
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Common Issues in Sex Therapy: Frustration About a Sexless Relationship

• Loss of Trust and Sexual Desire After Infidelity: After one or both people in a relationship discover infidelity, they often find it difficult to reestablish trust so that they can enjoy emotional and sexual intimacy.  Even if the person who cheated is genuinely remorseful, the person who feels betrayed often associates sex with anger, resentment, sadness, betrayal and suspicion.  This can make having sex challenging. Sex therapy can help these individuals to work on regaining trust and intimacy (see my article: Learning to Trust Again After an Affair).

• Erectile Unpredictability: When medical issues have been ruled out, most cases of erectile unpredictability, including erectile dysfunction, premature ejaculation, delayed ejaculation, an inability to sustain an erection, are psychological in nature.  The man who experiences erectile unpredictability often experiences shame and guilt, and the significant other sometimes blames themselves or believes their partner doesn't find them sexually desirable.  However, sexual desirability usually isn't the problem.  The problem often involves anxiety about maintaining an erection or a self consciousness about sexual performance. Sexual anxiety often leads to spectatoring. Spectatoring, which can happen to a man or a woman, means they get stuck in their head and they lose focus of their own and their partner's sexual pleasure (see my article: Are Negative Thoughts About Yourself During Sex Distracting You?).
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Common Issues in Sex Therapy: Erectile Unpredictability

• Sexual Performance Anxiety: People who are preoccupied with performance anxiety during partnered sex often have problems with sexual self esteem.  Their preoccupation with their performance, body image issues, and other inhibitory factors often bring about the problems they fear in terms of erectile unpredictability (as mentioned above), problems with orgasms (for both men and women), and other sex-related problems. Rather than focusing on pleasure, they're focused on performance. Sex therapy can help these individuals to reorient their focus to sexual pleasure rather than on performing in a certain way (see my article: What is Performative Sex?).

• Unresolved Sexual Abuse That Has a Negative Impact on Solo and Partnered Sex: Unresolved sexual abuse trauma can get triggered during solo or partnered sex. Individuals with a history of sexual abuse, which include women and men, can experience anything from flashbacks to overall feelings of revulsion when they have sex. Some people are aware of their history of sexual abuse. Others might have fleeting memories or fragments of memories.  Others might have no conscious memories of it, but they have a sense of it. These individuals can be helped in sex therapy with a therapist who also specializes in psychological trauma (see my article: Overcoming the Trauma of Sexual Abuse).

Common Issues in Sex Therapy: Sexual Abuse

• Painful Sex For Women: Even though as many as 1 in 5 women suffer with some form of pain during sexual intercourse (penis in vagina sex), many of these women don't know that this is a common problem. They suffer in silence or they avoid sex altogether.  They also don't know that sex therapy can help them (see my article: Getting Help For Painful Sex in Sex Therapy).

• An Orgasm Gap Between Heterosexual Women and Men:  The orgasm gap refers to differences experienced by heterosexual women as compared to heterosexual men in terms of having an orgasm during partnered sex.  Many women are able to have an orgasm during solo sex (masturbation), but they're unable to have an orgasm during partnered sex with men.  This is usually due to the fact that many women don't have an orgasm from sexual intercourse alone.  They need clitoral stimulation, and many men and some women are unaware of this. Unfortunately, there's also still a double standard when it comes to sexual satisfaction: Some men don't value a woman's sexual pleasure as much as much as they value their own. In addition, some women are also focused more on their male partner's sexual satisfaction.  Or, sex is so unsatisfying for some women that they just want to get it over with as quickly as possible. Often poor sexual communication between the man and the woman having sex is an issue.  In addition, poor sex education in the United States is a contributing factor (see my articles: Closing the Orgasm Gap Between Men and Women - Part 1 and Part 2).

• Compulsive and Out of Control Sexual Behavior:  Sexually compulsive behavior includes an excessive preoccupation with sexual thoughts, urges or behavior. These compulsive thoughts, urges or behavior are disruptive. They often have a significant negative impact on a person's health, relationships, work and other important areas of their life. Compulsive or out of control sexual behavior is not the same as feeling ashamed or guilty about sex in general.  Sexually compulsive behavior can be treated in individual sex therapy or in couples sex therapy (see my article: Treating Sexually Compulsive Behavior in Sex Therapy).

• Lack of Sexual Experience: There are men and women who, for a variety of reasons, have either limited sexual experience or no sexual experience as adults. Shame and guilt are often at the root of this problem, including poor body image.  There might also be cultural factors. Sex therapy can help adults overcome shame and guilt so they can have a healthy sex life (see my article: (see my article: Is a Negative Body Image Ruining Your Sex Life?).

Common Issues in Sex Therapy: Lack of Sexual Experience

• Unrealistic Expectations About Partnered Sex: Due to the inadequacy of sex education in the United States, many people, especially those in their 20s and 30s, get their so-called "sex education" from mainstream pornography. Unfortunately, mainstream pornography gives false and misleading information about sex. People, who rely on mainstream pornography to learn about sex, forget they are watching actors in scripts. They forget that these sexual portrays aren't real.  Not only are these portrayals unrealistic, but the scripts are often very misogynistic in terms of how women are portrayed. Sometimes porn uses women as well as children who have been coerced into working on these films due to sex trafficking.  Pornography also has misleading information about what gets a woman turned on.  This is especially unfortunate because there are sources of ethical pornography that don't have these problems.  Sex therapy can help people, who have false and misleading information about sex and unrealistic expectations, to learn how to have healthier solo and partnered sex.

Common Issues in Sex Therapy: Exploring Kink or BDSM 

• Individuals or Couples Who Want to Explore Kink or BDSM: There are individuals and couples who want to explore kink or BDSM (Bondage, Dominance, Sadism, Masochism), but they might not know where to start. Or, one person in a relationship wants to explore kink and the other is hesitant. Sex therapy can help individuals and couples to start with their sexual fantasies as a way to explore their sexual turn-ons. From there, they can decide if they want to act on their fantasies or if the fantasies are enough without engaging in the behavior (see my articles: Destigmatizing Fantasies About BDSM and What is Power Play?)

• Disagreements About Opening Up a Relationship: Many people who are currently in monogamous relationships would like to have an open relationship, but their partner doesn't want it.  Couples who have a conflict around this issue could benefit from sex therapy where this issue can be negotiated. Other couples both want to open up the relationship, but they don't know how. There are many forms of consensual nonmonogamy. A couple can work out an agreement that suits both of them or they can acknowledge they're not compatible and end the relationship amicably. Sex therapy can help with all of these issues (see my article: What is Consensual Nonmonogamy?)

Common Issues in Sex Therapy: Disagreements About Consensual Nonmonogamy

The categories listed above are just some of the most common reasons why people seek help in sex therapy.  There are many other sexual issues that bring individuals and couples to sex therapy.

Why Couples Therapy is Often Not the Right Therapy for Sexual Problems

Many couples therapists aren't trained sex therapists.  

Worse still, many couples therapists, who were trained in more traditional or outdated forms of couples therapy, don't know how to talk about sex with their clients. Many others collude with couples by avoiding the topic of sex altogether. In cases like this, a couple can go through an entire couples therapy with neither the couple nor the therapist bringing up anything about sex.

Couples therapists who weren't trained in sex therapy believe that if they help the couple to fix romantic problems, sex will naturally improve.  And while this might be true for many couples, it's definitely not true for all couples.  

In fact, there are lots of couples, who love each other and get along well, but there are problems in their sex life.  If a couples therapist doesn't know this, the sexual problems either never get addressed or the couples therapist unintentionally gives misleading or false information.  

In short, many couples therapists, who have no additional training in sex therapy, don't know how to help individuals with contemporary sexual issues.  This often leads to more harm than good.

When to Seek Help in Sex Therapy

Sex therapy is a form of psychotherapy, also known as talk therapy. 

There are no physical exams, no touching and no nudity in sex therapy (see my article: Common Misconceptions About Sex Therapy).

If you have attempted to resolve sexual problems on your own without success, you could benefit from working with a sex therapist.

Rather than allowing hurt, shame and resentment to grow, seek help in sex therapy so you can have a more fulfilling sex life.

About Me

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

I am also a trauma therapist who has helped clients to overcome problems related to sexual abuse (see my article: What is a Trauma 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.

Rethinking Foreplay as More Than Just a Prelude to Intercourse

Foreplay is commonly thought of as sexual activity that precedes sexual intercourse.  As such, it's often considered secondary to sexual penetration, including penis in vagina or penis in anus penetration (PIV or PIA).  Unfortunately, for many couples foreplay can last only a few minutes or it can be completely nonexistent (see my article:  What is Good Sex?)

Rethinking Foreplay as More Than Just a Prelude to Intercourse

In his books, She Comes First: The Thinking Man's Guide to Pleasuring a Woman and So Tell Me About the Last Time You Had Sex: Laying Bare and Learning to Repair Our Love Lives, sex therapist Ian Kerner, Ph.D. emphasizes that sexual foreplay is more than just a prelude to intercourse, especially for women.  He indicates that what we normally think of as foreplay should be considered "coreplay" because it's an essential part of sex and, in particular, core to women's sexual pleasure.

Human sexuality professor Laurie Mintz, Ph.D. stresses in her book, Becoming Cliterate - Why Orgasm Equality Matters and How to Get It, that a focus on the penetration model of sex (PIV or PIA) is shortchanging women of the sexual pleasure they seek and deserve.

According to a 2016 sex research study with over 52,500 participants published in the Archives of Sexual Behavior, 95% of heterosexual men usually or always have an orgasm during sex as compared to only 65% of women.  The discrepancy between men's and women's response is known as the orgasm gap (see my articles: Closing the Orgasm Gap Between Women and Men - Part 1 and Part 2).  

Dr. Mintz, who is a sex positive advocate for closing the orgasm gap between men and women, emphasizes that the main reason for this gap is cultural ignorance about what most women need to experience an orgasm, specifically ignorance about the clitoris and the importance of clitoral stimulation.

Accordingly, based on sex research, Dr. Mintz challenges the idea that sexual intercourse is the best (or only) way for heterosexual women to have a climax (see my article: Women's Sexuality: Tips on Sexual Self Discovery).

According to current sex research, a whopping 75% of women don't experience orgasm through sexual penetration alone (PIV or PIA). As previously stated, most women need clitoral stimulation.  However, many women, who lack access to good sex education about this issue, believe there's something wrong with them if they don't experience orgasms through PIV or PIA alone.

Even for couples where they're knowledgeable about the importance of clitoral stimulation, many men in those relationships approach pleasuring their female partners with oral sex as if it's a chore.  These same men often like to experience receiving oral sex but, for a variety of reasons, they don't want to reciprocate with their partner.  Needless to say, this is selfish.

When women sense that men don't like to reciprocate with oral sex, they're often hesitant to ask their partner to "go down" on them.  As a result, it's not unusual for these women to approach sex as something they have to "get through" because it's not pleasurable for them, but they don't want to annoy their partners.  In many cases, they also don't feel like they deserve sexual pleasure.

Similarly, Esther Perel, Ph.D., who is also a sex therapist, emphasizes that we need to reconsider foreplay as "more than just a warm up act" to intercourse.  She indicates that foreplay is an atmosphere a couple creates and it can run through the entire relationship.

Dr. Perel says foreplay is the art of anticipation which builds sexual tension between two people.  From her perspective foreplay is essentially about playing.  It can include a look, a gesture, banter, a text, and so on (see her book, Mating in Captivity: Reconciling the Erotic and the Domestic).  

There is more information available today from books and podcasts about enhancing sexual pleasure than ever before, but there's still not enough.  Complicating the matter, most sex education programs in the US are only focused on prevention and disease.  While this is important information, a comprehensive sex education program needs to include education about sexual pleasure--not just the potential problems that can occur during sex.

Due to the lack of information about pleasure in sex education programs, many people, especially young men, get most of their information about sex from watching porn, which gives a distorted perspective about sexual pleasure.  For instance, in heterosexual porn the woman is usually shown as being ready to have sex immediately without any prior sexual stimulation.  

Another important contributing factor is that many women don't understand their own anatomy.  This isn't women's fault.  Again, it gets back to the lack of information in sex education programs and taboos around women discovering what gives them sexual pleasure (see my articles: Sexual Pleasure - The Erotic Self - Part 1 and Part 2).  Also see Betty Dodson's book, Sex For One: The Joy of Selfloving).

In addition, many women suffer with dyspareunia, which is painful sex during intercourse due to physical and/or psychological issues.  Dyspareunia often goes untreated because women are too ashamed to get help and/or the medical community sometimes, unwittingly, sets up obstacles to appropriate medical treatment, which often consists of seeing a physical therapist who specializes in pelvic floor issues (see Heather Jeffcoat's book, Sex Without Pain).

Another problem is that many couples feel too ashamed to talk to each other about sex.  Many of these problems, including the most common one, discrepancies in sexual desire, could be overcome if couples learned to discuss what they like and don't like sexually (see my articles:  How to Talk to Your Partner About Sex - Part 1 and Part 2).

Conclusion

There needs to be a rethinking of sexual foreplay as more than the preclude or the "opening act" to intercourse but as an essential part of sex.

To improve sex between heterosexual men and women there needs to be: 

• More and better sex education, including cliteracy, about sexual pleasure for women and men

• Psychoeducation for women about their bodies and that they are deserving of sexual pleasure

• Improved communication about sex between heterosexual men and women

• Improved access to appropriate medical and psychological care for women who experience sexual pain or other sexual problems 

• Men who are willing to prioritize their female partner's sexual pleasure

• A willingness for couples to talk openly about what they enjoy sexually

Getting Help in Therapy

The psychological and emotional toll that sexual problems cause can exact a big toll for individuals and people in relationships. 

Many relationships end unnecessarily because couples don't know how to talk about sex with their partner.  As a result, longstanding problems go unaddressed, resentment builds and people feel they have no other option but to end the relationship.

If you're struggling with unresolved issues, you're not alone.  Reach out for help.  

A skilled psychotherapist can help you to work through these issues so you can have a more fulfilling life.  Help is a phone call away.

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.

Women's Sexuality: Tips on Sexual Self Discovery

In my prior articles, The Orgasm Gap Between Woman and Men - Parts 1 and 2,  I discussed the sexual satisfaction gap between men and heterosexual woman.  One of my recommendations in Part 2 was that, in order for women to experience more sexual satisfaction, they can explore their own body and discover sexual pleasure for themselves.

Women's Sexual Self Discovery

Women Overcoming Guilt and Shame About Their Sexual Pleasure

For many women this is easier said than done because shame and guilt about their body and their sexuality gets in the way.  Part of this can be culturally induced because women still get mixed messages about enjoying sexual pleasure.  In some cases, the shame and guilt can be related to unresolved sexual trauma (see below: Getting Help in Therapy).

On the one hand, heterosexual women are told they should be sexually alluring to men.  But, on the other hand, they're still stigmatized for being sexual or experiencing sexual pleasure, especially if it's for themselves and not for men.

There is so much misinformation that it's no wonder many women feel confused, ashamed of their bodies, and they feel they have no right to their own sexual pleasure. 

There's still double standard that it's okay for men to be sexual but not for women.  And many  women are still told, if not explicitly then implicitly, they should wait until they're married to be sexual (you might think this is a thing from the past, but I still hear many women tell me in their therapy sessions that they grew up with these cultural or religious taboos).

The expectation in these families is that women will just know somehow how to be sexual with their partner or spouse "when the time comes."  But the reality is that this stigma against women's sexuality in these instances often carries over into marriage because these women haven't discovered their own sexuality beforehand.  

Women's Sexuality: Tips on Sexual Self Discovery:

• Make a Decision as to Whether You're Ready to Get to Know Yourself Sexually: As a woman, whether or not you want to discover your sexuality is up to you and only you.  While it might feel daunting at first because of cultural or religious taboos, if you're ready to get to know yourself sexually, it can be an adventure in self discovery.  Try to be as open and curious as you can.

• Create a Time and Space For Privacy and Relaxation: Once you have decided to get to know yourself better sexually, look for a time and place when you'll have privacy and you won't be interrupted.  Some women like to set the mood by creating a private and relaxing environment for themselves in the bath and engage their senses: candles, incense, a favorite bubble bath, relaxing music and whatever else helps to create the right mood.

• Take a Look at Your Body: Many women have so much shame about their body that they can hardly stand to look at themselves in the mirror--even when they are fully clothed.  It's understandable why they feel this way because social media, movies, TV programs and magazines give women messages that they should look a certain way--usually thin or curvy or some other particular way.  

• Accept Your Body As It Is Now: This might be one of the hardest steps to take because there are so many negative messages  for women about body image.  Even if you want to change your body for health-related reasons, one of the best ways to change is to start by accepting yourself as you are now.  Acceptance doesn't mean you're not going to try to change if that's what you want.  It just means that you acknowledge that you are where you are right now and you love yourself regardless of how you look.

• Take a Hand Mirror and Look at Your Vulva:  The vulva is a woman's external genital area. It's normal for vulvas to come in all different shapes and sizes.  The vulva contains the vestibule (vaginal opening), the labia majora, the labia minora, and the clitoris.  By being curious and looking at yourself, you can discover your own unique beauty.  Holding onto the hand mirror, look at the:

• labia majora: outer lips

• labia minora: the smaller, inner lips

• vulval vestibule (vaginal opening): is the part of the vulva between the labia minora into which the urinary meatus (urethra opening) and the vaginal opening open.

• clitoris: the tip of the clitoris is slightly above the urethra and at the top of the vestibule.  The rest of the clitoris is covered by the clitoral hood. It extends into the body and wraps around the vaginal canal (the vagina is a woman's internal reproductive area). Sexual pleasure is the clitoris' primary purpose.  It is the most sensitive erogenous zone. The glans of the clitoris has 8,000 nerve endings, which is twice as many nerve endings as the penis. This erogenous zone spreads the feeling to 15,000 other nerves in the pelvis, which is why it can feel like your whole body is experiencing an orgasm.

• Spend Time Discovering What's Pleasurable to You Through Solo Pleasuring: Solo pleasuring (also known as masturbation) is a safe and pleasurable way to:

• discover what turns you on sexually
• have fun
• release sexual tension
• improve your sleep through the release of tension

• Understand That Your Brain is Your Biggest Sex Organ: Your thoughts and beliefs affect how you feel sexually, so your personal psychology matters just as much as your physiology.  There are two types of sexual stimulation: 

• psychological stimulation: Visual cues or sexual fantasies can include your own fantasies, fantasies from erotica, ethical porn, sexy movies or TV programs, and so on.  Don't overthink or overanalyze it--fantasies aren't real, so you don't necessarily want to act on them.  But maybe you do.  It's up to you.  

• physical stimulation: Your hand, a vibrator or sex toys can be used to get sexually aroused.

• Explore Your Erogenous Zones: Your erogenous zones include your nipples, thighs, vulva, clitoris, and any other areas that might turn you on.

• Don't Pressure Yourself to Have an Orgasm: Rather than focusing on having an orgasm, focus on what feels pleasurable to you without pressuring yourself to have an orgasm.

• Ready to Have an Orgasm? Aside from the fact that everyone is unique in terms of what turns them on, one article isn't sufficient, but there are good books that provide can you with some guidance, including:

• Book Recommendations:
• Come As You Are: The Surprising New Science That Will Transform Your Sex Life - by Dr. Emily Nagoski

• Sex For One: The Joy of Self Loving - by Betty Dodson

• Becoming Cliterate - by Dr. Laurie Mintz

• She Comes First - by Dr. Ian Kerner

• Tell Me What You Want: The Science of Sexual Desire and How It Can Help You Improve Your Sex Life - by Dr. Justin J. Lehmiller

Feeling Pain?  Get Medical Help

If you are experiencing vaginal pain, seek help from your doctor immediately.  Pain can be related to any one of a number of problems, including vaginal infections, vulvodynia, cysts, pelvic floor problems or other medical problems.

Getting Help in Therapy

We all need help at sometimes.

Unresolved traumatic experiences can affect your ability to be sexual whether it's on your own or with a partner.  The effects can include (but are not limited to): emotional numbing, physical pain, flashbacks, getting triggered, panic attacks, feeling disconnected from your body, and other related symptoms.

If you have been unable to resolve your problems on your own, you could benefit from working with a licensed mental health professional.

A skilled psychotherapist can help you to overcome the obstacles that keep you stuck, so rather than suffering on your own, seek help from a licensed therapist.

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.