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.

How to Overcome Shame Spiraling

In the current article, I'm focusing on how to overcome a shame spiral.

Also, see the list of my prior articles about shame at the end of this article.

What is Shame Spiraling?

Shame spiraling can occur when someone feels intense guilt or shame which leads to negative thoughts, feelings and behaviors.

Overcoming the Shame Spiral

Shame spiraling can occur in any area of your life.

Shame spiraling is common among people who have experienced trauma, especially developmental trauma, which is ongoing trauma during childhood (see my article: How Unresolved Trauma Affects How You Feel About Yourself).

How Does Shame Spiraling Occur?

Shame spiraling can occur in many different ways. 

It often happens when an individual feels they have failed in some way or they feel rejected.

Current feelings of shame trigger old feelings of being inadequate in some way, including feeling powerless or unlovable.

This leads to negative thoughts where a critical part of you engages in negative self talk.

These thoughts and feelings can become so overwhelming that you want to shut it all down as quickly as possible, so you might look for an escape with anything you think will bring relief (or, at least, a distraction) as quickly as possible.  

This behavior could include alcohol or drug abuse, gambling, overeating, out of control sexual behavior, and so on.

How to Recognize a Shame Spiral

Here are some telltale signs that you might be in a shame spiral:

• Feeling intense shame or humiliation
• Feeling intensely unworthy, unlovable or powerless
• Feeling isolated and alone (even if you're around people)
• Experiencing difficulty with regulating your emotions
• Acting out destructively

Examples of Shame Spiral Triggers

Shame spiral triggers can occur in many different situations.

Some of the most common situations are:

• Comparing Yourself to Others: When you compare yourself to people you think are more successful, more attractive, happier or wealthier, you set yourself up for a shame spiral trigger (see my article: The Problem With Comparative Suffering).

• Receiving Criticism or Negative Feedback: Criticism and negative feedback can trigger a shame spiral when it leads to self doubt.  Even when criticism or negative feedback are in the context of overwhelmingly compliments and positive feedback, if you're prone to shame spiraling, you might focus only on the negative feedback.

Overcoming the Shame Spiral

• Feeling Rejected: Whether it's an actual rejection or a perceived rejection, feeling rejected can lead to feeling unworthy, which can bring up earlier feelings of rejection. The real or perceived rejection can feel like a confirmation that you're unworthy.

• Making Mistakes or Feeling Like a Failure: Even though you might know intellectually that everyone makes mistakes and everyone fails at something at some point, when it happens to you and you have an early history of related trauma, the recent episode can trigger a shame spiral (see my article: Overcoming Your Fear of Making Mistakes)

• Experiencing Trauma or Abuse: Current experiences of trauma or abuse can trigger earlier feelings, which can lead to a shame spiral.

• Experiencing Perfectionism: If you feel you have to be perfect, you're setting yourself up for a shame spiral. The need to be perfect usually begins at an early age when one or both parents have unattainable standards (see my article: Overcoming Perfectionism).

Steps to Overcome Shame Spiraling

• Get Grounded: This can be as simple as noticing your feet on the floor, taking relaxing breaths or looking around you and orienting yourself to your environment (see my article: Staying Grounded During Stressful Times).

• Acknowledge Your Feelings: Rather than trying to suppress your feelings, acknowledge them.  This can be challenging because you might want to get rid of those feelings, but you suppressed feelings come back stronger than before.

• Feel Compassion For Yourself: This might be difficult to do when you're in a shame spiral, but if you make a habit of talking to yourself compassionately, as you would to a friend you cared about, you can learn to do this (see my article: Acceptance and Self Compassion).

• Write in a Journal: Being able to concretize your feelings in writing, as opposed to these feelings swirling and escalating in your head, can be helpful. Not only can it help you to discharge your feelings, writing in a journal can also help to make these overwhelming feelings more manageable and contained (see my article: Journal Writing to Relieve Stress and Anxiety)

• Get Emotional Support: Shame thrives on secrecy and isolation. When you get emotional support from someone you trust, you break the cycle of secrecy and isolation. You can also get a different perspective on your situation (see my article: Tips For Overcoming Your Fear of Asking For Help).

Get Help in Trauma Therapy

As mentioned above, shame spiraling is usually indicative of unresolved trauma.

If you have been unable to overcome shame spiraling, seek help in trauma therapy (see my article: Mental Health Awareness: Reducing the Shame of Getting Help in Therapy).

Getting Help in Trauma Therapy

A skilled trauma therapist can help you to overcome unresolved trauma and build self confidence (see my article: What is a Trauma Therapist?).

About Me

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

As a trauma therapist, I have helped many individual adults and couples to overcome trauma.

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.

See My Other Articles About Shame

Overcoming Shame

Overcoming Shame in an Enmeshed Family

Overcoming Shame in a Disengaged Family

Feeling Sexual Shame and Guilt

Is a Negative Body Image Ruining Your Sex Life?

Slut-Shaming Girls and Women is a Form of Sexual Harassment

 

Relationships: Getting Curious About Your Own and Your Partner's Turn-0ns

As a sex therapist, when I'm working with individual clients or couples who want to work on their sex life, I often hear clients say they're bored or they're not turned on by what their partner wants to do sexually or the idea of doing something new makes them uncomfortable (see my article: What is Sex Therapy?).

Getting Curious About Your Own and Your Partner's Turn-Ons

These are a common problems, which is understandable because no two people are exactly alike and each will have their own preferences when it comes to just about anything--whether it's food, sex, types of entertainment they enjoy and so on.

Aside from the fact that many people don't know how to talk about sex with their partner, talking about sex when two people don't want to engage in the same sexual activity can be especially fraught (see my articles: How to Talk to Your Partner About Sex - Part 1 and Part 2).

The partner who is making him/herself vulnerable by asking for a sexual activity that is outside of their usual sexual repertoire often feels rejected when the other partner doesn't want to even considerate it. 

In most cases, the other partner isn't rejecting their partner--they're rejecting the activity.  But in the moment, it can feel like a personal rejection (see my article: Coping With a Sexual Rejection From Your Partner).

This often shuts down any more talk about sex due to fear of rejection. In many cases, this sets up a dynamic where sex becomes routine and boring over time because there's nothing new and each person is reluctant to talk about it.

Sexual shame and guilt often get in the way of partners being able to talk about sex.  If shame and guilt are worked through in therapy, a reluctant partner can get curious about their partner's and their own sexual interests.

How to Get Curious About Your Own and Your Partner's Turn-Ons

As I've said in prior articles, no one should do anything they don't want to do.  

Consent means more than just going along with your partner's wishes when you don't want to do it.  

But when you're in a relationship with someone you trust, your response doesn't have to be either Yes or No.  Instead, you can get curious about what turns your partner on about the particular sexual activity they're interested in and get curious about your own erotic preferences.

Even if you both decide not to engage in any of these activities, your curiosity and the discussion with your partner can open up other possibilities that you're both interested in.

Are There Sexual Brakes Getting in the Way?

Even more important than understanding your own and your partner's turn-ons is understanding each of your turn-offs.  

According to Sex Educator Emily Nagoski, Ph.D., when a couple is experiencing sexual problems where they're out of synch with regard to sexual desire, it's important to pay attention to whether one or both people are dealing with "sexual brakes."  

The sexual brakes need to be addressed first before looking at the sexual accelerators (turn-ons).  To paraphrase Dr. Nagoski: You have to turn off the offs before you turn on the ons.

This is an issue I discussed in detail in the article listed below, so I won't go into it in more detail here:

Getting to Know Your Own and Your Partner's Sexual Accelerators and Brakes

Clinical Vignette

The following clinical vignette illustrates how to use curiosity and an open discussion to bring a couple closer together emotionally and sexually:

Nina and Tim

Nina and Tim, who were both in their early 40s, were married for several years when Tim told Nina that he felt their sex life had become too routine and he would like to spice it up a little.

Prior to dating Tim, Nina was only in one other long term relationship so she didn't have a lot of prior sexual experience.  

She was also bored with their sexual routine, but she didn't feel sexually confident, so when she heard Tim say he wanted to spice things up, she felt embarrassed and apprehensive.  

Sexual Boredom is a Common Problem in Long Term Relationships

In addition, due to her religious and cultural upbringing, talking about sex brought up guilt and shame for her (see my article: Overcoming Feelings of Sexual Shame and Guilt Due to Cultural Issues).

Even though she felt uncomfortable, she wanted to be a good partner to Tim, so she asked him what he had in mind.  

Tim knew talking about sex made Nina feel uncomfortable, especially talking about trying something new, so he reassured her that he wouldn't try to get her to do anything she didn't want to do.  He only wanted to expand their usual sex script (see my article: Changing Your Sex Script).

Tim told Nina he wanted to try doing role plays (see my article: What Are the Benefits of Sexual Role Play?).

He could tell from the look of her face that she was hesitant about this, which made him feel emotionally vulnerable and embarrassed that he even suggested it, so he told her to forget it.  

When she saw the look of embarrassment on his face, Nina wanted to say something comforting, but she didn't know what to say, so she turned on the TV to cover the awkward silence between them.

After that awkward conversation, they didn't talk about sex again for another year.  They continued their usual sexual routine, even though they were both bored with it.  Over time, they had less and less sex because neither of them looked forward to it.

So, a year after his first attempt, Tim tried talking to her about their sex life again, but he could see how uncomfortable she was, so he suggested they see a sex therapist to work on this, which Nina agreed to do.

Their sex therapist normalized their difficulty with talking about sex.  She also told them that it was common for sex to become routine for couples in long term relationships and they were no different from many other couples (see my article: What is Sexual Boredom in Long Term Relationships?).

Gradually, Nina and Tim began a dialog about their sex life in their sessions.  They also worked on their emotional connection, which they both wanted to strengthen.

Strengthening their emotional connection helped Nina to feel more comfortable talking the possibility of trying new sexual activities, including role playing.  She was also able to listen to Tim tell her what turned him on about role playing.

Nina also worked on the shame and guilt related to her religious and cultural background, so she was able to open up to her own sexual curiosity. 

In addition, Nina explored her own core erotic themes to understand herself as an erotic being. This enabled Nina to get curious about her erotic needs as well as Tim's (see my article: Sexual Self Discovery with Pleasure Mapping).

Getting Curious About Your Own and Your Partner's Turn-Ons

Nina and Tim's curiosity motivated them to try sexual role plays, which added spice to their sex life together.  They also began exploring other sexual activities they were both curious about, which was pleasurable for both of them.

Conclusion

Aside from guilt and shame, there can be many other reasons why you might hesitate to explore your own and your partner's sexual turn-ons.  

If your initial reaction is to criticize or show contempt for your partner's turn-ons, try to get curious instead.

When you get curious, you allow yourself to be open to new possibilities that could expand your sexual repertoire. This can lead to a more pleasurable sex life for you and your partner.

Getting Help in Sex Therapy

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

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

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

Rather than struggling on your own, seek help from a licensed mental health professional who is a sex therapist.

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.

What is Erotic Empathy?

The term "erotic empathy" was coined by Canadian psychotherapist Amanda Luterman, founder of the Centre for Erotic Empathy, as she observed couples struggling to understand each other sexually (see my article: Don't Yuk Anybody's Yum).

Developing Erotic Empathy

What is Empathy?

Before delving into the meaning of erotic empathy, let's define the meaning of the word "empathy."

As psychotherapists in training learn early on, empathy is an essential part of working with clients in psychotherapy (see my article: Why is Empathy Important in Therapy?).

Empathy has been defined in many ways and it includes a wide range of experiences. 

Emotion researchers define empathy as the ability to sense other people's emotions and to imagine what other people might be thinking and feeling.

Empathy is the first step in experiencing compassion.

Researchers believe that empathy has an important evolutionary history among mammals for cooperation and survival.

Researchers describe different types of empathy:

• Affective Empathy: The ability to experience sensations and feelings derived from other people's emotions

• Cognitive Empathy (also called Perspective Taking): The ability to identify and understand other people's emotions

What is Erotic Empathy?

Erotic empathy is the ability to communicate your emotional and sexual needs to your partner as well as the ability to understand their needs.  

Developing Erotic Empathy

Erotic empathy does not mean that you do things you don't want to do sexually or that you expect your partner to do things they don't want to do (see my article: What Are the Basic Rules of Sexual Consent?).

But when either of you suggests doing something the other doesn't want to do, erotic empathy means you don't criticize, show contempt or respond with disgust (see my article: How to Improve Your Communication By Avoiding the "4 Horsemen of the Apocalypse").

Why is Erotic Empathy Important in Your Relationship?

Good communication is essential to a healthy relationship.

It's often hard for people to talk about what they want sexually, so if you respond to your partner with criticism, contempt or disgust, you could shut your partner down and make it that much harder for them to talk to you about sex the next time (see my article: How to Talk to Your Partner About Sex - Part 1 and Part 2).

Developing Erotic Empathy

Rejecting sexual suggestions without compassion is hurtful to your partner. Feeling rejected, your partner might withdraw emotionally and sexually from you (see my article: Coping With Sexual Rejection From Your Partner).

The outcome could be that you both get stuck in a rut following the same boring sex script indefinitely (see my article: What is Sexual Boredom in Long Term Relationships?).

And just like you probably wouldn't want to eat your favorite meal every day from now until forever, you would get tired of engaging in the same sexual acts all the time (see my article: How to Change Your Sex Script).

Clinical Vignette About Erotic Empathy

The following clinical vignette is a composite of many different cases with all identifying information removed. It illustrates how a couple can learn to develop and use erotic empathy.

Bill and Lena

One day Lena came in the house after doing yard work. Her husband, Bill, gave her a hug and said, "The kids will be out for a few hours. Let's have sex."  

Inwardly, Lena groaned. She felt sweaty and dirty from doing yard work. Having sex while she felt this way was the last thing she wanted to do so she told him, "Forget it! How could you even suggest having sex while I'm such a mess."  

Then she saw the hurt look on his face, but she didn't know what to say, so she left the room to take a shower.  

While she was showering, she had time to think and she felt badly about rejecting Bill. She thought she should talk to him about it, but when she went back into the living room, she saw Bill was on his computer finishing up some work.  When he didn't look up when she walked into the room, she took that as a sign that he didn't want to talk and she went to the kitchen to start dinner.  

After a few more incidents like this, Bill stopped initiating sex and Lena felt too uncomfortable initiating.  As a result, months went by and neither of them felt comfortable initiating sex or even bringing up the topic.  

Then, one day, after feeling increasingly uncomfortable, Lena blurted out that they should attend sex therapy because their sex life had become nonexistent, and Bill agreed.

Their sex therapist helped them to understand their feelings and why it was so hard for them to talk about sex.  

She also helped them to develop erotic empathy for each other so that, instead of rejecting each other sexually, they learned to start by being open and getting curious.  

After they went over the incident with their sex therapist where Lena rejected Bill, they learned a different way to communicate with each other.

Lena said, "I realize how I responded to Bill was hurtful. The truth is I enjoy sex with Bill, but I just felt so dirty and smelly that I needed to take a shower.  I wish I would've told him, 'I would love to have sex with you. Let me take a shower first and then let's meet in the bedroom.'"  Then, turning to Bill, she said, "I'm sorry I rejected you. I didn't mean to hurt your feelings."

As Bill turned towards Lena and put his arm around her, he said, "I wouldn't have minded if you were dirty and smelly. I think it might've even been a turn-on for me, but I understand you didn't feel comfortable, so I would've been happy to wait while you took a shower. I'm sorry I didn't understand how you were feeling."

As part of their sex therapy homework, Bill and Lena practiced developing erotic empathy with each other as part of improving their communication.

As part of expanding their sexual repertoire, over time, Lena and Bill learned to overcome their shame and discomfort with talking about sex so they could communicate more effectively with each other and expand their sexual repertoire (see my article: Changing Your Sex Script: The Beginning Phase - Sexual Arousal).

At one point, their sex therapist gave them a Yes, No, Maybe list to see what sexual activities they both would like to add to their sexual repertoire.  

The list had over 100 sexual activities with a scale of 0-5 with 0 indicating no interest, 5 indicating a strong interest and the rest of the scale being a spectrum indicating various degrees of interest or disinterest (see my article: Creating Your Sexual Menu With a Yes, No, Maybe List).

Each of them filled it out separately and then brought their filled out list to their next sex therapy session.  

Their sex therapist helped them to start by adding the sexual activities where they both had a strong interest (5 on the Yes, No, Maybe List).

There was a clear understanding that neither of them had to do anything they didn't want to do, but they had to communicate with erotic empathy.

As they included more items from the list as part of their sexual repertoire, they talked about it in their sex therapy sessions.  

There were times when they both enjoyed a sexual activity they explored. There were also other times when one of them enjoyed it and the other one thought they would enjoy it but, once they tried it, they didn't.  

Each time, they learned how to talk about what they liked and disliked with empathy for the other partner.  

After trying all the #5 items on the Yes, Maybe, No list, they talked about the other items from Level #4 and below.  

At times, it was challenging, but they maintained their sense of openness and curiosity and respected each other's decisions.

Throughout this process, their sex life became more satisfying for both of them.

How to Develop Erotic Empathy

• Develop a Sense of Openness: To start, learn to cultivate a sense of openness about understanding your own and your partner's sexual turn-ons.  Start by understanding your own erotic blueprint.  You can explore your own sexual pleasure through pleasure mapping.  This kind of openness can be difficult if you experience sexual shame and guilt for personal, interpersonal or cultural reasons. Choose your discussion time wisely. Don't try to have a talk about sex when you're tired, rushed or when you don't have privacy. Choose a time when you're both relaxed but not when you're about to have sex because that will cause too much pressure. So, for instance, you can both be sitting on the couch and enjoying each other's company when you bring the discussion.

• Get Curious About Your Own and Your Partner's Sexual Turn-ons: Along with a sense of openness, a sense of curiosity also helps you talk to your partner about what each of you would like. Instead of automatically rejecting your partner's sexual suggestions, ask your partner what s/he likes about a particular sexual activity. If you each understand what makes this sexual act appealing, you might be more willing to try it or, if not, you might come up with a compromise that you both might like and get just as turned on by it (see my article: Getting to Know Your Own and Your Partner's Sexual Brakes and Accelerators).

Developing Erotic Empathy

• Get to Know Your Own and Your Partner's Sexual Turn-offs: Sexual turn-offs can change to turn-ons for some people after they give it a try.  But if not, you each need to respect the other's wishes. So, for instance, if you know you need a little time to decompress after coming home from a stressful day at work, let your partner know this. Be as specific as you can about what you need so your partner will understand. In the same vein, learn to appreciate your partner's needs. Be aware that stress can be a libido killer, so take steps to reduce stress.

• Learn to Experiment and Develop a Willingness to Try New Sexual Activities: As long as it's not a complete turn-off, try to learn to be sexually explorative for sexual activities you and your partner can try. Sometimes you might discover you don't like a particular activity, but at other times you might discover something else that's new to add to your sexual repertoire.

• Know That Discrepancies in Libido Are Normal: You wouldn't expect that you and your partner would always like the same food or the same hobbies, so why would you expect that you would both enjoy the same sexual activities in bed?  Discrepancies in libido are the #1 problem that people in relationships seek help with in sex therapy because one or both partners are unhappy with either the frequency, duration or type of sex they're having. But discrepancies in libido are normal, and you can learn to negotiate these differences with help from a sex therapist (see my article: What is a Sexual Libido Discrepancy in a Relationship?).

• Learn the Difference Between Spontaneous Sexual Desire and Responsive Sexual Desire: Both men and women can experience spontaneous sexual desire or responsive sexual desire. With spontaneous sexual desire, a person can think about sex and get turned on. With responsive sexual desire, a person might have to start having sex to get turned on, but they know from personal experience that once they start having sex, they will get sexually aroused. So, it's important to know how you and your partner each experience sexual desire. If you're the person who tends to experience responsive desire, rather than saying "no" when your partner wants to have sex because you're not immediately turned on, you can explore your own willingness to allow yourself to get sexually aroused after you begin having sex. And if you're the partner who experiences spontaneous desire, you can learn to be patient and allow your partner's sexual desire to build (see my article: For People Who Experience Responsive Sexual Desire, a Willingness to Start Having Sex is Often Enough to Get Sexually Aroused).

• Get Help in Sex Therapy: If you have tried to work on sexual problems on your own and you haven't been successful, you can seek help in sex therapy.  Most individual therapists and couples therapists aren't trained to deal with sexual problems, so you need to seek help specifically from a sex therapist for sexual problems.

Getting Help in Sex Therapy

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

Many 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?).

There is no nudity, physical exams or sex during sex 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.

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.