1 00:00:10,840 --> 00:00:14,520 Speaker 1: Welcome to the Therapy for Black Girls Podcast, a weekly 2 00:00:14,560 --> 00:00:19,320 Speaker 1: conversation about mental health, personal development, and all the small 3 00:00:19,360 --> 00:00:22,520 Speaker 1: decisions we can make to become the best possible versions 4 00:00:22,520 --> 00:00:26,640 Speaker 1: of ourselves. I'm your host, doctor Joy hard and Bradford, 5 00:00:27,000 --> 00:00:32,080 Speaker 1: a licensed psychologist in Atlanta, Georgia. For more information or 6 00:00:32,200 --> 00:00:35,600 Speaker 1: to find a therapist in your area, visit our website 7 00:00:35,720 --> 00:00:39,440 Speaker 1: at Therapy for Blackgirls dot com. While I hope you 8 00:00:39,479 --> 00:00:43,479 Speaker 1: love listening to and learning from the podcast, it is 9 00:00:43,520 --> 00:00:46,440 Speaker 1: not meant to be a substitute for a relationship with 10 00:00:46,479 --> 00:00:57,400 Speaker 1: a licensed mental health professional. Hey, y'all, thanks so much 11 00:00:57,400 --> 00:00:59,480 Speaker 1: for joining me for session four twenty eight of the 12 00:00:59,480 --> 00:01:02,600 Speaker 1: Therapy for Black Girls Podcast. We'll get right into our 13 00:01:02,600 --> 00:01:14,319 Speaker 1: conversation after a word from our sponsors. We can't let 14 00:01:14,400 --> 00:01:19,279 Speaker 1: September go by without acknowledging sex positive September. Over the years, 15 00:01:19,280 --> 00:01:23,600 Speaker 1: we've done dozens of episodes exploring sexual liberation, sexuality, and 16 00:01:23,760 --> 00:01:26,920 Speaker 1: sexual health, so we wanted to pull from our archives 17 00:01:26,959 --> 00:01:30,760 Speaker 1: to bring you this essential conversation. You know how sometimes 18 00:01:30,800 --> 00:01:33,399 Speaker 1: you can feel amazing in every other area of your life, 19 00:01:33,640 --> 00:01:37,560 Speaker 1: but when it comes to intimacy, that confidence just disappears. 20 00:01:38,319 --> 00:01:41,240 Speaker 1: Where we're talking all about that today with doctor Pia Golf. 21 00:01:42,000 --> 00:01:44,800 Speaker 1: In this episode, we get real about what chips away 22 00:01:44,800 --> 00:01:48,000 Speaker 1: at our sexual confidence, why some of us struggle with 23 00:01:48,040 --> 00:01:51,160 Speaker 1: arousal and pleasure, and how to actually talk to your 24 00:01:51,200 --> 00:01:54,800 Speaker 1: partner about what you need. Plus, doctor Pia breaks down 25 00:01:54,840 --> 00:01:59,080 Speaker 1: sin save focused therapy and how it's helping couples reconnect. 26 00:01:59,360 --> 00:02:03,000 Speaker 1: This conversation is all about reclaiming your confidence and your pleasure, 27 00:02:03,560 --> 00:02:07,000 Speaker 1: which is exactly what Sex Positive September is all about. 28 00:02:07,280 --> 00:02:13,560 Speaker 1: Press play and let's dive in. Thanks so much for 29 00:02:13,680 --> 00:02:15,280 Speaker 1: joining us today, Doctorpia. 30 00:02:15,320 --> 00:02:16,880 Speaker 2: Thank you so much for having me. 31 00:02:17,480 --> 00:02:19,720 Speaker 1: Yes, I'm so excited to have you here. So for 32 00:02:19,760 --> 00:02:22,600 Speaker 1: those of you who are not following doctor Pia on IG, 33 00:02:22,800 --> 00:02:25,680 Speaker 1: you definitely have to because she has this feature that 34 00:02:25,760 --> 00:02:29,200 Speaker 1: she calls just the Tip Tuesday, which is super fun, 35 00:02:29,360 --> 00:02:32,639 Speaker 1: but she gives great information about sexuality and to help 36 00:02:32,680 --> 00:02:35,799 Speaker 1: you start thinking about how to think differently about your 37 00:02:35,840 --> 00:02:38,920 Speaker 1: sexual relationships and just you know, great information overall. So 38 00:02:38,960 --> 00:02:42,760 Speaker 1: definitely check out her ig. Becky, Yeah, so I wanted 39 00:02:42,800 --> 00:02:44,840 Speaker 1: to make sure that we kind of started, i know, 40 00:02:44,919 --> 00:02:47,680 Speaker 1: and when we were talking about planning for the episode, 41 00:02:48,160 --> 00:02:50,800 Speaker 1: you share that you feel like there is still a 42 00:02:50,880 --> 00:02:55,560 Speaker 1: significant level of discomfort with people even talking about sexuality. 43 00:02:55,840 --> 00:02:58,240 Speaker 1: Can you share more about like what you've seen and 44 00:02:58,360 --> 00:03:00,720 Speaker 1: why you think there is still so much discomfort. 45 00:03:00,919 --> 00:03:05,440 Speaker 2: Absolutely, I feel like people often lack the verbiage of 46 00:03:05,560 --> 00:03:08,320 Speaker 2: how to talk about sex, right. A lot of us 47 00:03:08,400 --> 00:03:12,200 Speaker 2: weren't taught about sex, whether that was in school or 48 00:03:12,240 --> 00:03:15,880 Speaker 2: in our home environment. It's just there's a level of embarrassment. 49 00:03:16,320 --> 00:03:18,960 Speaker 2: There's a level of fear of judgment and shame that 50 00:03:19,000 --> 00:03:23,160 Speaker 2: I particularly see, especially with Black women, that oftentimes they 51 00:03:23,160 --> 00:03:26,520 Speaker 2: feel that they've been over sexualized, maybe in the media 52 00:03:27,080 --> 00:03:30,520 Speaker 2: or maybe even just growing up being told okay, well 53 00:03:30,560 --> 00:03:33,239 Speaker 2: you know you can't wear certain clothing because men well 54 00:03:33,280 --> 00:03:35,800 Speaker 2: you know, look at your body if they're more voluptious. 55 00:03:36,280 --> 00:03:40,160 Speaker 2: All of these different factors impact a woman's discomfort with, 56 00:03:40,400 --> 00:03:42,240 Speaker 2: you know, talking about sex with other people. 57 00:03:42,600 --> 00:03:45,400 Speaker 1: That is a great observation a coupia, because you know, 58 00:03:45,480 --> 00:03:47,880 Speaker 1: I think we see a lot of conversations online and 59 00:03:47,920 --> 00:03:51,360 Speaker 1: there's I think even being research I'm sure about you know, 60 00:03:51,560 --> 00:03:54,160 Speaker 1: like really wanting to kind of maybe play down your 61 00:03:54,200 --> 00:03:57,760 Speaker 1: sexuality as not to feed into stereotypes as a black woman. 62 00:03:58,000 --> 00:04:02,080 Speaker 2: Correct, you know, absolutely, and so that you know causes 63 00:04:02,120 --> 00:04:05,360 Speaker 2: people to be very self conscious about either their appearance 64 00:04:05,840 --> 00:04:08,800 Speaker 2: or you know, playing into how they should you know, 65 00:04:08,880 --> 00:04:11,080 Speaker 2: quote unquote should I hate the words should, but how 66 00:04:11,120 --> 00:04:15,120 Speaker 2: they should present as a sexualized person. And so it 67 00:04:15,200 --> 00:04:18,520 Speaker 2: causes folks to not want to explore their own sexuality 68 00:04:18,680 --> 00:04:21,400 Speaker 2: or have knowledge about what they prefer don't prefer. 69 00:04:22,120 --> 00:04:26,839 Speaker 1: And are there particular sexual acts or aspects of sexuality 70 00:04:26,839 --> 00:04:30,240 Speaker 1: that you find This happens more often with so. I know, 71 00:04:30,360 --> 00:04:32,280 Speaker 1: like when I was in college and we even talked 72 00:04:32,279 --> 00:04:35,839 Speaker 1: about this, you know, like the idea of like giving 73 00:04:36,040 --> 00:04:38,600 Speaker 1: oral sex was a really big taboo, right, Like that 74 00:04:38,720 --> 00:04:40,599 Speaker 1: was not something that you did, not something that you 75 00:04:40,680 --> 00:04:43,880 Speaker 1: talked about. And I don't know that that still exists, 76 00:04:43,960 --> 00:04:45,840 Speaker 1: or maybe not to the same level, but I do 77 00:04:45,880 --> 00:04:48,400 Speaker 1: think that there is still some taboo around that can 78 00:04:48,440 --> 00:04:50,960 Speaker 1: you talk more about any particular acts that you feel 79 00:04:50,960 --> 00:04:53,920 Speaker 1: like have more of a stigma than others. Absolutely, so 80 00:04:54,040 --> 00:04:56,800 Speaker 1: I think that there is still not as greatly as 81 00:04:56,800 --> 00:04:58,280 Speaker 1: it used to be with there is still a huge 82 00:04:58,320 --> 00:05:01,640 Speaker 1: stigma around oral then who you're going to give oral 83 00:05:01,680 --> 00:05:03,520 Speaker 1: sex to or who you're going to allow to perform 84 00:05:03,600 --> 00:05:06,360 Speaker 1: oral sex on you. I think the new biggest thing 85 00:05:06,400 --> 00:05:09,080 Speaker 1: now is a taboo around anal sex, not wanting to 86 00:05:09,120 --> 00:05:12,480 Speaker 1: have conversations about that and what that might mean about. 87 00:05:12,279 --> 00:05:14,880 Speaker 2: You if your engaging in anal sex. And then the 88 00:05:14,920 --> 00:05:17,200 Speaker 2: next one that I see a lot with women is 89 00:05:17,200 --> 00:05:21,039 Speaker 2: a taboo around masturbation and feeling like a feeling of 90 00:05:21,080 --> 00:05:24,480 Speaker 2: shame for masturbating, or feeling like they don't need to masturbate, 91 00:05:24,600 --> 00:05:26,440 Speaker 2: or oh that's girls, I don't want to touch myself 92 00:05:26,480 --> 00:05:29,640 Speaker 2: like that, or wanting to even have conversations with others 93 00:05:29,680 --> 00:05:32,120 Speaker 2: about masturbation, oral sex or anal sex. 94 00:05:32,279 --> 00:05:35,080 Speaker 1: So, of course I think conversations like this really help 95 00:05:35,240 --> 00:05:38,360 Speaker 1: people to get a verbiage to talk about some of this. Well, 96 00:05:38,360 --> 00:05:40,360 Speaker 1: what are some of the other things that people can 97 00:05:40,400 --> 00:05:44,360 Speaker 1: be doing to become more comfortable not only exploring and 98 00:05:44,480 --> 00:05:46,560 Speaker 1: you know, maybe engaging in some of these ass but 99 00:05:46,680 --> 00:05:48,240 Speaker 1: just the idea of talking about it. 100 00:05:48,440 --> 00:05:52,520 Speaker 2: Yeah, so I think first recognizing for themselves what is 101 00:05:52,640 --> 00:05:55,919 Speaker 2: causing the barrier. You know, a lot with my patients, 102 00:05:56,040 --> 00:06:00,240 Speaker 2: I go through a sexual history review with them to learn, well, 103 00:06:00,240 --> 00:06:03,040 Speaker 2: what images did you see growing up regarding sex, What 104 00:06:03,120 --> 00:06:06,280 Speaker 2: conversations did you have about sex? How did you build 105 00:06:06,640 --> 00:06:09,280 Speaker 2: a stigma around sex? If you did or perhaps you 106 00:06:09,320 --> 00:06:12,200 Speaker 2: grew up in a really open sexual environment, so really 107 00:06:12,279 --> 00:06:14,520 Speaker 2: learning from them, what is their schema about sex, what 108 00:06:14,560 --> 00:06:17,520 Speaker 2: are their thoughts about sex on an individual basis, So 109 00:06:17,640 --> 00:06:21,080 Speaker 2: doing some more self reflective work that will allow them 110 00:06:21,120 --> 00:06:24,240 Speaker 2: to kind of have some knowledge and tools and skills 111 00:06:24,279 --> 00:06:27,040 Speaker 2: about how to talk about sex with others. Then I 112 00:06:27,080 --> 00:06:30,240 Speaker 2: often recommend you, know, hey, like read some books about sex, 113 00:06:30,360 --> 00:06:33,479 Speaker 2: follow some podcasts, follow some things on ig to see 114 00:06:33,520 --> 00:06:37,599 Speaker 2: how other people are communicating about sex, to allow yourself 115 00:06:37,600 --> 00:06:41,000 Speaker 2: to have an open dialogue with either your girlfriends or 116 00:06:41,000 --> 00:06:41,800 Speaker 2: your partner, etc. 117 00:06:42,320 --> 00:06:45,760 Speaker 1: And you mentioned like following different like accounts on social media. 118 00:06:45,800 --> 00:06:47,960 Speaker 1: I know you and lots of other sex therapists are 119 00:06:48,040 --> 00:06:51,599 Speaker 1: very active on reticularly Instagram, but I think also Twitter 120 00:06:51,640 --> 00:06:54,400 Speaker 1: and Facebook and giving information. Do you think that that 121 00:06:54,520 --> 00:06:55,599 Speaker 1: kind of stuff is helpful? 122 00:06:55,760 --> 00:06:58,599 Speaker 2: I do because I think it normalizes what they might 123 00:06:58,640 --> 00:07:01,839 Speaker 2: be going through. Times when women come into my office, 124 00:07:01,920 --> 00:07:04,039 Speaker 2: they have such a feeling of shame and think like, 125 00:07:04,040 --> 00:07:06,360 Speaker 2: oh my gosh, I'm the only one going through this 126 00:07:06,640 --> 00:07:09,039 Speaker 2: because they're not talking about it with their friends or 127 00:07:09,040 --> 00:07:12,000 Speaker 2: girlfriends or perhaps whatever they're going through. You know, no 128 00:07:12,040 --> 00:07:15,160 Speaker 2: one else is experiencing that. So being able to hear 129 00:07:15,280 --> 00:07:17,720 Speaker 2: others talk about this it's like, oh wow, okay, Like 130 00:07:17,760 --> 00:07:20,720 Speaker 2: this is something that a lot of people experience. There's 131 00:07:20,760 --> 00:07:23,760 Speaker 2: more of a comfort to ask more questions or to 132 00:07:23,840 --> 00:07:24,920 Speaker 2: learn more knowledge. 133 00:07:25,040 --> 00:07:26,800 Speaker 1: So I think you bring up a great point which 134 00:07:26,880 --> 00:07:29,160 Speaker 1: leads me to a question that actually one of our 135 00:07:29,240 --> 00:07:33,880 Speaker 1: listeners submitted around the idea of like would somebody come 136 00:07:33,920 --> 00:07:36,680 Speaker 1: to see you as a sex therapist if they're not 137 00:07:37,120 --> 00:07:40,800 Speaker 1: actively engaged in a sexual relationship? Like what benefit would 138 00:07:40,800 --> 00:07:42,520 Speaker 1: it be to come and meet with a sex therapist 139 00:07:42,560 --> 00:07:44,640 Speaker 1: if you're not actually in a sexual relationship? 140 00:07:44,760 --> 00:07:47,320 Speaker 2: Yeah? Absolutely, And you know what, that tends to happen 141 00:07:47,360 --> 00:07:50,440 Speaker 2: a lot more than folks would think. The main reason 142 00:07:50,480 --> 00:07:52,080 Speaker 2: I tend to see folks who are not in a 143 00:07:52,120 --> 00:07:54,600 Speaker 2: relationships because they're saying, I don't know how to be 144 00:07:54,640 --> 00:07:56,160 Speaker 2: in a relationship. I don't know how to be in 145 00:07:56,200 --> 00:07:59,360 Speaker 2: a sexual relationship. And while I'm in my single phase, 146 00:07:59,400 --> 00:08:02,000 Speaker 2: I want to figure out, you know, what's what's creating 147 00:08:02,000 --> 00:08:05,600 Speaker 2: these barriers. Sometimes that's an impact of sexual trauma and 148 00:08:05,640 --> 00:08:08,280 Speaker 2: trying to figure out how do I heal from sexual trauma? 149 00:08:08,400 --> 00:08:11,280 Speaker 2: How can I be you know, this sexual being with 150 00:08:11,360 --> 00:08:14,520 Speaker 2: a new partner when I don't feel comfortable right, So 151 00:08:14,560 --> 00:08:17,000 Speaker 2: if there's a sexual trauma or two. If there's someone 152 00:08:17,000 --> 00:08:20,200 Speaker 2: who you know hasn't had positive sexual interactions in the 153 00:08:20,240 --> 00:08:23,960 Speaker 2: past and they don't engage in self exploration of their body, 154 00:08:24,200 --> 00:08:26,640 Speaker 2: so they come in to figure out, well, what do 155 00:08:26,680 --> 00:08:28,800 Speaker 2: I do with that? So how can I be you know, 156 00:08:28,880 --> 00:08:32,160 Speaker 2: a more fulfilling partner and being more fulfilling relationships? 157 00:08:32,320 --> 00:08:34,120 Speaker 1: And so what are some of the things that you 158 00:08:34,200 --> 00:08:36,600 Speaker 1: will introduce to somebody who comes in and says something 159 00:08:36,640 --> 00:08:37,880 Speaker 1: like that, like, where would you start? 160 00:08:39,080 --> 00:08:41,880 Speaker 2: So I start with this sexual history to you know, again, 161 00:08:42,040 --> 00:08:46,040 Speaker 2: get their background on their thoughts about sex, their past 162 00:08:46,080 --> 00:08:50,200 Speaker 2: sexual encounters and any sexual trauma, the age at which 163 00:08:50,200 --> 00:08:52,640 Speaker 2: they first engaged in sex, and you know, typically just 164 00:08:52,679 --> 00:08:55,560 Speaker 2: how they think about sex, and then we start talking 165 00:08:55,559 --> 00:08:58,480 Speaker 2: about it and ruling out any type of sexual dysfunctions. 166 00:08:58,760 --> 00:09:02,040 Speaker 2: I see a lot of women who come in with vaginusness, 167 00:09:02,080 --> 00:09:04,400 Speaker 2: which is a contraction of the public floor in which 168 00:09:04,440 --> 00:09:07,000 Speaker 2: they're not able to be penetrated. I see a lot 169 00:09:07,040 --> 00:09:11,079 Speaker 2: of women who suffer from female sexual arousal disorder in 170 00:09:11,120 --> 00:09:14,760 Speaker 2: which they just simply aren't desiring sex, whether that's been 171 00:09:14,880 --> 00:09:18,720 Speaker 2: you know, lifelong, or it's occurred perhaps after childbirth, et cetera. 172 00:09:19,080 --> 00:09:21,560 Speaker 2: So sort of reviewing some of those things and putting 173 00:09:21,559 --> 00:09:24,760 Speaker 2: a name to symptoms and which women say like, Wow, 174 00:09:24,760 --> 00:09:26,320 Speaker 2: I didn't even know that was a thing, Like I 175 00:09:26,320 --> 00:09:28,559 Speaker 2: didn't even know this is something that I could come 176 00:09:28,600 --> 00:09:31,280 Speaker 2: in to talk to someone about. And sunny enough, just 177 00:09:31,320 --> 00:09:33,240 Speaker 2: sometimes when women come into my office and they see 178 00:09:33,240 --> 00:09:35,400 Speaker 2: the books on my wall, they're like, Oh, I was 179 00:09:35,440 --> 00:09:37,360 Speaker 2: just coming in for anxiety, but I see that you 180 00:09:37,440 --> 00:09:40,080 Speaker 2: have this book about you know, she comes first, like, 181 00:09:40,080 --> 00:09:43,080 Speaker 2: what's that about? I usually don't have orgasm. Sometimes the 182 00:09:43,120 --> 00:09:46,240 Speaker 2: conversation ends up being organic that leads us down the 183 00:09:46,320 --> 00:09:49,160 Speaker 2: road of exploring their sexuality. 184 00:09:49,200 --> 00:10:01,560 Speaker 1: More from our conversation after the break. I'm wondering how 185 00:10:01,600 --> 00:10:04,040 Speaker 1: often that does happen either for you and you know, 186 00:10:04,080 --> 00:10:06,160 Speaker 1: it would be interesting to even talk with other therapists 187 00:10:06,160 --> 00:10:08,640 Speaker 1: about that, you know, like how often somebody will come 188 00:10:08,679 --> 00:10:10,679 Speaker 1: in for one thing and then it leads to this 189 00:10:10,720 --> 00:10:14,000 Speaker 1: other thing? Or are you seeing that people are presenting 190 00:10:14,040 --> 00:10:16,280 Speaker 1: with one thing but really the sex stuff? Is that 191 00:10:16,400 --> 00:10:17,760 Speaker 1: what they really want to talk about? 192 00:10:17,880 --> 00:10:20,040 Speaker 2: You know what I think that right now it's been 193 00:10:20,080 --> 00:10:23,480 Speaker 2: happening is people are coming in under the give of anxiety, 194 00:10:23,960 --> 00:10:27,439 Speaker 2: and anxiety is so prevalent that even like schueduling the 195 00:10:27,480 --> 00:10:30,720 Speaker 2: initial session, they're unable to say that they're coming in 196 00:10:30,760 --> 00:10:34,120 Speaker 2: for sexual concerns. And then I think coming into the 197 00:10:34,200 --> 00:10:37,040 Speaker 2: environment and seeing the books are hearing me first, you know, 198 00:10:37,080 --> 00:10:39,119 Speaker 2: put it out there like let's talk about your sexuality, 199 00:10:39,160 --> 00:10:42,679 Speaker 2: let's talk about sex. It's like, oh, okay, she's comfortable 200 00:10:42,679 --> 00:10:45,120 Speaker 2: with talking about this. I've had, you know, some folks 201 00:10:45,120 --> 00:10:48,160 Speaker 2: come in and say, my last therapist they didn't want 202 00:10:48,200 --> 00:10:50,559 Speaker 2: to talk about sex, so I felt uncomfortable in doing so. 203 00:10:50,800 --> 00:10:52,719 Speaker 2: I didn't know how to bring it up. So by 204 00:10:52,760 --> 00:10:56,120 Speaker 2: me initiating that conversation and showing that I feel comfortable 205 00:10:56,120 --> 00:10:58,920 Speaker 2: talking about it will help ease them into it. So 206 00:10:58,960 --> 00:11:01,880 Speaker 2: I would say more so seeing people who don't necessarily 207 00:11:01,880 --> 00:11:04,240 Speaker 2: intend on coming in for that right. 208 00:11:04,520 --> 00:11:06,840 Speaker 1: And I think that's another benefit of you know, so 209 00:11:06,920 --> 00:11:10,360 Speaker 1: many therapists being active on social media and giving videos 210 00:11:10,360 --> 00:11:13,240 Speaker 1: and information because it does let people know that this 211 00:11:13,360 --> 00:11:15,400 Speaker 1: is the thing that can be talked about in therapy. 212 00:11:15,800 --> 00:11:18,439 Speaker 1: But as you mentioned, I do think that some therapists 213 00:11:18,440 --> 00:11:21,080 Speaker 1: are still uncomfortable, you know, like if they're not necessarily 214 00:11:21,160 --> 00:11:24,320 Speaker 1: a sex therapist, that may not be something that they ask, 215 00:11:24,520 --> 00:11:26,760 Speaker 1: but it is important because it is a part of 216 00:11:26,840 --> 00:11:28,000 Speaker 1: the whole person. 217 00:11:27,960 --> 00:11:31,200 Speaker 2: Right, absolutely. And I think when you asked earlier, why 218 00:11:31,200 --> 00:11:34,040 Speaker 2: aren't people talking about sex and why aren't therapists talking 219 00:11:34,080 --> 00:11:36,360 Speaker 2: about sex? We're not taught it, you know, we're not 220 00:11:36,480 --> 00:11:39,160 Speaker 2: taught it in our graduate programs. How to have these 221 00:11:39,200 --> 00:11:42,280 Speaker 2: conversations feel like oftentimes it's something that you have to 222 00:11:42,360 --> 00:11:45,160 Speaker 2: you know, specialize in er you know, condditional training. End. 223 00:11:45,520 --> 00:11:47,920 Speaker 2: So there's you know, there's just again not the verbage 224 00:11:47,960 --> 00:11:49,720 Speaker 2: of how to have these conversations. 225 00:11:49,800 --> 00:11:52,840 Speaker 1: Right. So, you mentioned a couple of sexual disorders that 226 00:11:52,880 --> 00:11:56,800 Speaker 1: I want to follow up about, so specifically female sexual 227 00:11:56,840 --> 00:11:59,880 Speaker 1: arousal disorder. Can you say more about what that is 228 00:12:00,080 --> 00:12:02,120 Speaker 1: and maybe some of the things that may lead to 229 00:12:02,160 --> 00:12:03,280 Speaker 1: someone struggling with that? 230 00:12:03,920 --> 00:12:08,320 Speaker 2: Yeah? Absolutely, So, female sexual interest or arousal disorder pretty 231 00:12:08,360 --> 00:12:11,800 Speaker 2: much means a reduced interest in sexual activity or you know, 232 00:12:11,880 --> 00:12:15,240 Speaker 2: or reduced insents in thoughts or fantasies, a lack of 233 00:12:15,280 --> 00:12:18,679 Speaker 2: excitement or pleasure during sexual activity majority of the time. 234 00:12:19,200 --> 00:12:21,560 Speaker 2: And you know, this happens over the course of at 235 00:12:21,640 --> 00:12:25,240 Speaker 2: least six months to be able to receive such a diagnosis. 236 00:12:25,559 --> 00:12:27,880 Speaker 2: I sometimes joke with folks and say, like this is 237 00:12:27,960 --> 00:12:31,760 Speaker 2: like a heterosexual woman watching ghosts on Power and having 238 00:12:31,800 --> 00:12:34,280 Speaker 2: you know, it's like watching paint drive. There's no reaction 239 00:12:34,480 --> 00:12:36,280 Speaker 2: to the stimulus at hand. 240 00:12:36,600 --> 00:12:38,880 Speaker 1: I would imagine that it may be difficult to kind 241 00:12:38,920 --> 00:12:44,040 Speaker 1: of gauge like whether somebody is struggling in this area, 242 00:12:44,160 --> 00:12:46,360 Speaker 1: like how do you know what normal would be? 243 00:12:47,000 --> 00:12:48,920 Speaker 2: Yeah? And so I tell them, you know, we all 244 00:12:48,920 --> 00:12:52,320 Speaker 2: get to decide what our normal is. And oftentimes when 245 00:12:52,360 --> 00:12:55,800 Speaker 2: I see women coming in heterosexual women, it's because their 246 00:12:55,880 --> 00:12:59,040 Speaker 2: partner might say to them, well, you don't want sex 247 00:12:59,080 --> 00:13:02,400 Speaker 2: as much as I do you, And we're socialized to 248 00:13:02,800 --> 00:13:06,120 Speaker 2: use men as the default narrative to how frequently we 249 00:13:06,440 --> 00:13:09,720 Speaker 2: quote unquote you know should be having sex, And so 250 00:13:10,200 --> 00:13:13,040 Speaker 2: working with women to normalize, well, how often do you 251 00:13:13,120 --> 00:13:15,360 Speaker 2: desire it? Or what you know, what is the amount 252 00:13:15,400 --> 00:13:18,080 Speaker 2: of times that you would feel comfortable having sex? And 253 00:13:18,120 --> 00:13:20,880 Speaker 2: sometimes one might say, you know, not at all, And 254 00:13:20,920 --> 00:13:24,320 Speaker 2: then it's an exploration of what's causing that lack of 255 00:13:24,360 --> 00:13:27,680 Speaker 2: desire to happen. Are we feeling really overwhelmed, are we 256 00:13:27,720 --> 00:13:30,560 Speaker 2: feeling really stressed? Are we not having pleasure? Are we 257 00:13:30,600 --> 00:13:33,000 Speaker 2: not being able to get aroused during sex? So it's 258 00:13:33,080 --> 00:13:34,720 Speaker 2: kind of like, well, I don't want to engage in 259 00:13:34,720 --> 00:13:37,520 Speaker 2: this sectivity that doesn't bring me any joy or any pleasure. 260 00:13:37,760 --> 00:13:41,920 Speaker 1: So the understanding is that you should have some arousal. 261 00:13:42,200 --> 00:13:45,360 Speaker 1: I mean, because I'm thinking about people who identify as asexual. 262 00:13:45,960 --> 00:13:48,240 Speaker 2: So how do you like make. 263 00:13:48,120 --> 00:13:51,120 Speaker 1: The distinction between like somebody who identifies as a sexual 264 00:13:51,160 --> 00:13:53,320 Speaker 1: and someone who may be struggling with like a sexual 265 00:13:53,520 --> 00:13:54,280 Speaker 1: arousal thing? 266 00:13:54,880 --> 00:13:56,800 Speaker 2: Right? So I feel like the person who's struggling with 267 00:13:56,800 --> 00:13:59,760 Speaker 2: a sexual arousal, they are distressed that they're not. 268 00:14:00,480 --> 00:14:03,360 Speaker 1: Desire, got it. Okay, So that's really the key. 269 00:14:03,720 --> 00:14:07,000 Speaker 2: Right, They're distressed that it's causing conflict within their relationship, 270 00:14:07,320 --> 00:14:08,960 Speaker 2: or perhaps they're saying, you know, I used to be 271 00:14:09,000 --> 00:14:10,680 Speaker 2: really sexual, and I used to be really warning and 272 00:14:10,679 --> 00:14:12,280 Speaker 2: want sex all the time, and now that's just not 273 00:14:12,360 --> 00:14:15,599 Speaker 2: happening for me. Okay, Okay, got you. 274 00:14:16,440 --> 00:14:18,839 Speaker 1: So I do think that that can be really delicate, right, 275 00:14:18,840 --> 00:14:21,520 Speaker 1: doctor Pia, Because I think sometimes when you're in a 276 00:14:21,560 --> 00:14:24,120 Speaker 1: partnership and maybe you're not feeling aroused, or maybe you 277 00:14:24,280 --> 00:14:26,880 Speaker 1: used to and you're not feeling anymore, that can be 278 00:14:26,920 --> 00:14:30,240 Speaker 1: really difficult to talk to a partner about. So what 279 00:14:30,280 --> 00:14:32,520 Speaker 1: are some suggestions you have for like how you might 280 00:14:32,560 --> 00:14:34,600 Speaker 1: be able to have this conversation with a partner. 281 00:14:35,240 --> 00:14:38,560 Speaker 2: Sure, I think it comes with first some self reflection 282 00:14:38,760 --> 00:14:42,400 Speaker 2: on what's going on for yourself first. Right, So if 283 00:14:42,400 --> 00:14:44,600 Speaker 2: we're able to come to our partner and speak in 284 00:14:44,680 --> 00:14:48,120 Speaker 2: I statements about what's going on personally for us, it 285 00:14:48,160 --> 00:14:50,480 Speaker 2: puts us on the seat of being vulnerable, but it 286 00:14:50,520 --> 00:14:53,400 Speaker 2: allows your partner to be a little bit more receptive 287 00:14:53,640 --> 00:14:56,120 Speaker 2: to express like, Hey, this is something that I'm going 288 00:14:56,160 --> 00:14:58,960 Speaker 2: through and I don't know why it's happening. I'm noticing 289 00:14:59,000 --> 00:15:02,040 Speaker 2: this ship. I really want to be more connected with you, 290 00:15:02,480 --> 00:15:06,480 Speaker 2: and I'm struggling with that right now. Right, it distresses 291 00:15:06,520 --> 00:15:09,640 Speaker 2: me that this is happening. So really figuring out for 292 00:15:09,680 --> 00:15:14,040 Speaker 2: yourself what's going on and perhaps why that's happening, and 293 00:15:14,080 --> 00:15:15,640 Speaker 2: then bringing that to your partner. 294 00:15:15,760 --> 00:15:18,040 Speaker 1: Yeah, And I think it also is important to make sure, 295 00:15:18,120 --> 00:15:20,720 Speaker 1: like you said, like really talking about the fact that 296 00:15:20,760 --> 00:15:23,040 Speaker 1: you are struggling with it and that it's not that 297 00:15:23,120 --> 00:15:26,160 Speaker 1: you don't care, but you're not sure what's going on either, 298 00:15:26,640 --> 00:15:28,400 Speaker 1: as a way of making sure that you're not like 299 00:15:28,480 --> 00:15:32,840 Speaker 1: blaming the other person for your lack of interest exactly. 300 00:15:32,960 --> 00:15:36,680 Speaker 2: And oftentimes what I hear is that a person's partner 301 00:15:36,720 --> 00:15:39,000 Speaker 2: might say, well, do you not are you not attracted 302 00:15:39,040 --> 00:15:42,520 Speaker 2: to me anymore? Do you not want me anymore? Are 303 00:15:42,560 --> 00:15:46,880 Speaker 2: you not physically responding to me anymore? And majority of women, 304 00:15:47,160 --> 00:15:51,040 Speaker 2: arousal starts for us in the brain, right. We need 305 00:15:51,080 --> 00:15:55,320 Speaker 2: to be intellectually stimulated and mentally stimulated, and a lot 306 00:15:55,360 --> 00:15:59,200 Speaker 2: of times that happens via conversations or having date night 307 00:15:59,440 --> 00:16:01,960 Speaker 2: or all type of things of that. So part of 308 00:16:02,000 --> 00:16:05,520 Speaker 2: having that conversation with the partner can involve well, have 309 00:16:05,720 --> 00:16:08,200 Speaker 2: you noticed there has been a shift in the relationship 310 00:16:08,240 --> 00:16:11,880 Speaker 2: in general? Is there, you know, feelings of resentment? Or 311 00:16:12,160 --> 00:16:15,600 Speaker 2: have we gotten so busy that we don't experience pleasurable 312 00:16:15,600 --> 00:16:17,440 Speaker 2: times together like date nights, et cetera. 313 00:16:17,760 --> 00:16:20,600 Speaker 1: And I would imagine that another thing that may really 314 00:16:20,640 --> 00:16:24,600 Speaker 1: be a struggle is an internalizing of an arousal issue. 315 00:16:24,640 --> 00:16:25,960 Speaker 2: So is something wrong with me? 316 00:16:26,080 --> 00:16:27,560 Speaker 1: Am I broken? Somehow? 317 00:16:28,160 --> 00:16:31,560 Speaker 2: Yes? Absolutely? That's like the actual word that so many 318 00:16:31,560 --> 00:16:33,920 Speaker 2: women use of, like I feel broken it it's not 319 00:16:34,000 --> 00:16:37,280 Speaker 2: working anymore? Why do I not desire this person? And 320 00:16:37,280 --> 00:16:40,920 Speaker 2: then there's there's again those feelings of shame and embarrassment. 321 00:16:41,280 --> 00:16:43,920 Speaker 1: So it sounds like typically you would see these clients 322 00:16:43,920 --> 00:16:46,920 Speaker 1: in your office, maybe after a partner has suggested like, hey, 323 00:16:47,160 --> 00:16:49,920 Speaker 1: something's really going on here, yes. 324 00:16:49,800 --> 00:16:54,280 Speaker 2: Yes, Or after a woman has given birth and desire changes, 325 00:16:54,680 --> 00:16:58,440 Speaker 2: or perhaps they are adjusting to new psychotropic medication that's 326 00:16:58,480 --> 00:17:01,440 Speaker 2: inhibiting them from lubricating like they used to, so they're 327 00:17:01,520 --> 00:17:04,320 Speaker 2: stopping to desire sex, or perhaps, like I said, if 328 00:17:04,320 --> 00:17:07,920 Speaker 2: they've had vaginismus, there any sort of pain or discomfort 329 00:17:07,960 --> 00:17:10,040 Speaker 2: with sex. You know, that's why I'll see them more 330 00:17:10,040 --> 00:17:12,480 Speaker 2: so coming in on their own, not just because their 331 00:17:12,520 --> 00:17:13,960 Speaker 2: partner has, you know, suggested. 332 00:17:14,040 --> 00:17:17,200 Speaker 1: So can you talk more about vaginismus because I don't 333 00:17:17,200 --> 00:17:19,760 Speaker 1: think that there is again another disorder that we hear 334 00:17:19,880 --> 00:17:23,440 Speaker 1: about often, and the fact that it is psychiatric disorder, 335 00:17:23,480 --> 00:17:25,800 Speaker 1: so it's not necessarily a medical thing, though I think 336 00:17:25,920 --> 00:17:27,960 Speaker 1: you know, some of that go exist. Can you talk 337 00:17:28,000 --> 00:17:30,320 Speaker 1: more about what that is and what kind of things 338 00:17:30,440 --> 00:17:31,680 Speaker 1: may leads to vaginismus. 339 00:17:31,880 --> 00:17:36,080 Speaker 2: Yeah, So, vaginismus is the inability to be penetrated vaginally 340 00:17:36,560 --> 00:17:39,520 Speaker 2: during intercourse. A lot of times they see women they're 341 00:17:39,600 --> 00:17:42,560 Speaker 2: unable to insert a tampon or even get a finger 342 00:17:42,880 --> 00:17:45,800 Speaker 2: into the bulble because the public floor muscles are so 343 00:17:46,119 --> 00:17:50,320 Speaker 2: tightly closed. And so this can happen for a variety 344 00:17:50,359 --> 00:17:52,280 Speaker 2: of reasons. I see this a lot with women who 345 00:17:52,320 --> 00:17:55,480 Speaker 2: have had unconsummated marriages. They're just very scared that it's 346 00:17:55,520 --> 00:17:58,439 Speaker 2: going to be painful. I've seen this with women who've 347 00:17:58,440 --> 00:18:02,760 Speaker 2: suffered some sort of trauma, whether that be rape or 348 00:18:02,760 --> 00:18:05,639 Speaker 2: perhaps when they were a child they fell on a 349 00:18:05,680 --> 00:18:08,160 Speaker 2: bicycle and broke their hymen, and how to really distrusting 350 00:18:08,280 --> 00:18:11,240 Speaker 2: experience happen in that way. I've seen this happen after 351 00:18:11,320 --> 00:18:13,560 Speaker 2: women have given child a birth, and there's just so 352 00:18:13,640 --> 00:18:17,159 Speaker 2: much pain associated with thinking about being penetrated. 353 00:18:17,359 --> 00:18:19,600 Speaker 1: Gotcha. So it sounds like much of it is related 354 00:18:19,640 --> 00:18:22,640 Speaker 1: to maybe a past trauma or some kind of traumatic 355 00:18:22,720 --> 00:18:26,159 Speaker 1: experience that results in this, and or just like. 356 00:18:26,280 --> 00:18:30,080 Speaker 2: An extreme anxiety or fear about penetration being painful. 357 00:18:30,400 --> 00:18:32,520 Speaker 1: And I think that goes back to your earlier comment 358 00:18:32,640 --> 00:18:36,840 Speaker 1: right about not even being taught as young people about 359 00:18:36,880 --> 00:18:39,320 Speaker 1: like what sex is, and that you know it may 360 00:18:39,359 --> 00:18:41,239 Speaker 1: be painful the first time, and you know, like how 361 00:18:41,280 --> 00:18:43,360 Speaker 1: do you manage some of the anxiety that may come 362 00:18:43,440 --> 00:18:45,679 Speaker 1: later in life? You know, if you decide to become 363 00:18:45,720 --> 00:18:49,000 Speaker 1: sexually active, that could be avoided if we were giving 364 00:18:49,080 --> 00:18:54,160 Speaker 1: kids the proper information about sex early on. Absolutely more 365 00:18:54,200 --> 00:19:08,320 Speaker 1: from our conversation after the break, how would you design 366 00:19:08,520 --> 00:19:12,160 Speaker 1: a perfect sex education class where like high schoolers if 367 00:19:12,160 --> 00:19:12,680 Speaker 1: you were in. 368 00:19:12,720 --> 00:19:18,159 Speaker 2: George, Oh wait, that's a good one. I think first 369 00:19:18,280 --> 00:19:23,560 Speaker 2: teaching you know, proper terminology and anatomy. Definitely teaching consent. 370 00:19:23,880 --> 00:19:26,920 Speaker 2: I think that's something that you know is totally avoid 371 00:19:27,320 --> 00:19:33,840 Speaker 2: within sexual education and normalizing self exploration and masturbation, and 372 00:19:33,920 --> 00:19:37,920 Speaker 2: also normalizing pleasure. I feel that from what I've seen, 373 00:19:38,200 --> 00:19:40,600 Speaker 2: sex ed is more so like these are the parts, 374 00:19:40,680 --> 00:19:43,560 Speaker 2: this is what happens, This is what your menstrual cycle 375 00:19:43,600 --> 00:19:45,159 Speaker 2: is going to be, like, this is what a you know, 376 00:19:45,200 --> 00:19:47,800 Speaker 2: a direction is, and then you have sex and baby 377 00:19:47,800 --> 00:19:51,119 Speaker 2: coms and here we go. And it really lacks just 378 00:19:51,160 --> 00:19:56,960 Speaker 2: providing more information, more real life example information to teenagers 379 00:19:57,119 --> 00:20:00,679 Speaker 2: and to talk about what happens in sexual relation and ships, 380 00:20:00,720 --> 00:20:05,479 Speaker 2: talking about birth control, you know, other contraceptive methods. I 381 00:20:05,520 --> 00:20:07,600 Speaker 2: know there's a lot of folks myself it included I 382 00:20:07,600 --> 00:20:11,000 Speaker 2: went to Catholic school, so contraception was never discussed. Pleasure 383 00:20:11,119 --> 00:20:15,000 Speaker 2: was never discussed in sexual education. Teenagers are trying to 384 00:20:15,040 --> 00:20:17,240 Speaker 2: serve the internet to get that information or you know, 385 00:20:17,320 --> 00:20:19,240 Speaker 2: talking to their friends where it's sort of like blindly 386 00:20:19,359 --> 00:20:22,200 Speaker 2: in the blind sometimes to disseminate that information. 387 00:20:22,640 --> 00:20:25,320 Speaker 1: Yeah, parents get really freaked out about us giving Kis 388 00:20:25,320 --> 00:20:28,000 Speaker 1: lots of information, but how often do we give kids 389 00:20:28,000 --> 00:20:30,280 Speaker 1: information about other things and they don't follow us? 390 00:20:30,400 --> 00:20:33,960 Speaker 2: Absolutely? Absolutely, And you know, research is showing us that 391 00:20:34,480 --> 00:20:37,639 Speaker 2: providing children with information is not leading them to be 392 00:20:38,040 --> 00:20:40,920 Speaker 2: you know, more quote unquote promiscuous or having sex at 393 00:20:40,960 --> 00:20:44,639 Speaker 2: younger ages. We're actually seeing that teenagers are having sex 394 00:20:44,960 --> 00:20:47,840 Speaker 2: at a later age more historically now based on them 395 00:20:47,920 --> 00:20:50,760 Speaker 2: having that information because it's not as taboo as it 396 00:20:50,760 --> 00:20:52,119 Speaker 2: once was to talk about it. 397 00:20:52,520 --> 00:20:54,800 Speaker 1: I also really like that you included the idea of 398 00:20:54,840 --> 00:20:58,160 Speaker 1: sex being pleasurable for everyone, because we often only hear 399 00:20:58,200 --> 00:21:00,840 Speaker 1: about sex being pleasurable for God as one. Of course, 400 00:21:01,080 --> 00:21:03,000 Speaker 1: women deserve to receive pleasure as well. 401 00:21:03,520 --> 00:21:09,760 Speaker 2: Absolutely, and just exploring one sexuality and normalizing that absolutely well. 402 00:21:09,840 --> 00:21:12,080 Speaker 1: I don't know very much about it, doctor Pia, but 403 00:21:12,160 --> 00:21:15,280 Speaker 1: I know that you practice since saate focus therapy. Can 404 00:21:15,320 --> 00:21:16,439 Speaker 1: you tell us more about it? 405 00:21:16,960 --> 00:21:20,600 Speaker 2: Yeah? Absolutely so. Sins focused therapy was first started by 406 00:21:20,920 --> 00:21:24,639 Speaker 2: Masters and Johnson. It has now been readapted by Linda 407 00:21:24,680 --> 00:21:28,040 Speaker 2: Winer and constant avery clerk, and we use this a 408 00:21:28,080 --> 00:21:32,120 Speaker 2: lot when patients are coming in with desire disorders, and 409 00:21:32,200 --> 00:21:36,040 Speaker 2: it's just like the name sounds sensate sensations, focusing on 410 00:21:36,240 --> 00:21:39,960 Speaker 2: the art of touch. I feel like so often sex 411 00:21:40,000 --> 00:21:43,760 Speaker 2: has become this idea of being very procedural, and a 412 00:21:43,800 --> 00:21:45,600 Speaker 2: lot of folks when they think of sex, the first 413 00:21:45,600 --> 00:21:47,720 Speaker 2: thing they think of is penis and vagina sex, and 414 00:21:47,760 --> 00:21:50,720 Speaker 2: that's become like the heteronormative, you know, explanation of what 415 00:21:50,760 --> 00:21:55,760 Speaker 2: sex looks like, and we lose the art foreplay and touch. 416 00:21:56,280 --> 00:22:00,000 Speaker 2: So what sin sat focus does is it teaches clients 417 00:22:00,200 --> 00:22:05,040 Speaker 2: to focus on the sensations of temperature, texture, and pressure, 418 00:22:05,600 --> 00:22:10,320 Speaker 2: and it really encourages patients to explore touch without any 419 00:22:10,359 --> 00:22:14,240 Speaker 2: sort of motive or any sort of goal or expectation 420 00:22:14,440 --> 00:22:17,919 Speaker 2: about arousal or pleasure. Right, Because when someone's coming in 421 00:22:17,960 --> 00:22:20,840 Speaker 2: with a desired disorder, they feel like, I'm not performing 422 00:22:20,880 --> 00:22:24,040 Speaker 2: how I'm supposed to. My partner is upset because I'm 423 00:22:24,080 --> 00:22:27,120 Speaker 2: not doing what they quote unquote expect me to do. 424 00:22:27,160 --> 00:22:29,840 Speaker 2: So there's a lot of judgment there, right. So when 425 00:22:29,840 --> 00:22:33,800 Speaker 2: I leave someone through as some say, focus exercise, I 426 00:22:33,840 --> 00:22:38,720 Speaker 2: invite them to take some time and allow themselves to relax, 427 00:22:39,280 --> 00:22:42,000 Speaker 2: get themselves into an environment where they're good with the 428 00:22:42,040 --> 00:22:44,840 Speaker 2: temperature of the room, the lighting of the room, there's 429 00:22:44,840 --> 00:22:48,360 Speaker 2: not going to be any distractions, and you instruct them 430 00:22:48,359 --> 00:22:52,560 Speaker 2: to explore their body from head to toe again focusing 431 00:22:52,600 --> 00:22:55,800 Speaker 2: on the temperature whether that's cool or warm, the texture, 432 00:22:55,960 --> 00:23:00,720 Speaker 2: whether that's smooth or rough, and the pressure whether that's firm, 433 00:23:01,160 --> 00:23:04,960 Speaker 2: and just allowing them to notice what comes up. And 434 00:23:05,160 --> 00:23:07,119 Speaker 2: oftentimes folks home, my, oh, my gosh, like I'm supposed 435 00:23:07,119 --> 00:23:08,800 Speaker 2: to be touching myself for how long? And you know 436 00:23:08,840 --> 00:23:11,040 Speaker 2: this is going to get boring and all of these things. 437 00:23:11,320 --> 00:23:16,679 Speaker 2: And so it's encouraging mindful exploration of the body and 438 00:23:16,800 --> 00:23:19,600 Speaker 2: to have an awareness that you might have thoughts come 439 00:23:19,680 --> 00:23:23,480 Speaker 2: up during this touching exercise and those are distractions there there, 440 00:23:23,840 --> 00:23:26,160 Speaker 2: and to acknowledge them that they come up, and then 441 00:23:26,280 --> 00:23:30,000 Speaker 2: just turn back to focusing on temperature, texture, and pressure. 442 00:23:30,280 --> 00:23:32,080 Speaker 1: Is this something that you do in the office or 443 00:23:32,160 --> 00:23:34,480 Speaker 1: is this something that you're instructing them to do outside 444 00:23:34,520 --> 00:23:35,240 Speaker 1: of the office. 445 00:23:35,440 --> 00:23:37,640 Speaker 2: No, no, no, this is definitely something that's done at home. 446 00:23:37,840 --> 00:23:38,240 Speaker 1: Okay. 447 00:23:39,600 --> 00:23:43,399 Speaker 2: I sometimes adapt it for patients, like if someone's coming 448 00:23:43,440 --> 00:23:47,119 Speaker 2: in with a history of trauma or a significant reluctance 449 00:23:47,200 --> 00:23:50,440 Speaker 2: or fear to engage in partnered sex. I'll have them 450 00:23:50,640 --> 00:23:55,320 Speaker 2: complete these exercises by themselves before introducing their partner. So 451 00:23:55,520 --> 00:23:57,720 Speaker 2: usually I say, week one, I want you to go 452 00:23:57,880 --> 00:24:01,879 Speaker 2: home and engage in this touching exercise for about three 453 00:24:01,960 --> 00:24:04,760 Speaker 2: times a week, and that should range anywhere between five 454 00:24:04,840 --> 00:24:07,960 Speaker 2: to twenty minutes, focusing on again temperature, touchture, and pressure. 455 00:24:08,280 --> 00:24:11,880 Speaker 2: Week one would be doing this with perhaps like pajamazon. 456 00:24:12,480 --> 00:24:15,359 Speaker 2: Next week they'll move up to perhaps just like a 457 00:24:15,359 --> 00:24:19,400 Speaker 2: bathing suit or underwear. The following week they'll move into 458 00:24:19,440 --> 00:24:23,679 Speaker 2: being completely nude exploring without insertion of any sort or 459 00:24:23,920 --> 00:24:26,560 Speaker 2: touching the breast or genitals in any way. And then 460 00:24:26,680 --> 00:24:29,840 Speaker 2: fourth week you can involve touching of genitals and insertion. 461 00:24:30,160 --> 00:24:31,840 Speaker 2: So that's when you're working with someone just on an 462 00:24:31,840 --> 00:24:35,640 Speaker 2: individual basis. When I'm working with couples together and there 463 00:24:35,640 --> 00:24:38,840 Speaker 2: isn't a significant trauma history on board, I will invite 464 00:24:38,880 --> 00:24:41,560 Speaker 2: them to take turns with one person being the toucher 465 00:24:41,960 --> 00:24:45,120 Speaker 2: and one person being the touchy, and so they'll take 466 00:24:45,240 --> 00:24:48,880 Speaker 2: turns touching one another head to toe, and that can 467 00:24:48,920 --> 00:24:51,639 Speaker 2: be adapted to not having any clothing on. But again 468 00:24:51,720 --> 00:24:54,439 Speaker 2: it's kind of staying away from the genitals and breast 469 00:24:54,440 --> 00:24:57,919 Speaker 2: as well and focusing on just temperature, touchture, and pressure. 470 00:24:57,960 --> 00:24:59,480 Speaker 2: I know, I keep saying it over and over again. 471 00:25:00,080 --> 00:25:02,520 Speaker 2: That's what we want them to focus on, versus trying 472 00:25:02,560 --> 00:25:07,200 Speaker 2: to explore for pleasure or trying to have any expectations 473 00:25:07,240 --> 00:25:10,280 Speaker 2: that sex is going to occur after this. Really just 474 00:25:10,280 --> 00:25:13,160 Speaker 2: getting comfortable with touching and the senses. 475 00:25:13,640 --> 00:25:16,159 Speaker 1: It sounds like that could be really important. Sounds like 476 00:25:16,160 --> 00:25:18,480 Speaker 1: that could go a really long way in establishing trust 477 00:25:18,520 --> 00:25:22,120 Speaker 1: in the relationship without the expectation of sexual such. 478 00:25:22,240 --> 00:25:24,840 Speaker 2: Absolutely, because a lot of times folks who are having 479 00:25:24,840 --> 00:25:28,480 Speaker 2: issues with desire, they feel, you know, this expectation to 480 00:25:28,680 --> 00:25:32,400 Speaker 2: perform in a certain way, right, and there's a lack 481 00:25:32,520 --> 00:25:35,439 Speaker 2: of verbiage right to talk about sex. So engaging in 482 00:25:35,440 --> 00:25:39,320 Speaker 2: the sensate focus exercise or moves that pressure right. Because 483 00:25:39,359 --> 00:25:41,560 Speaker 2: I also instruct people, look, this should not be an 484 00:25:41,560 --> 00:25:44,080 Speaker 2: exercise on what you're talking to one another. I want 485 00:25:44,080 --> 00:25:47,679 Speaker 2: you to really focus on just those sensations. And so 486 00:25:47,760 --> 00:25:49,479 Speaker 2: clients might ask, well, well, what do I do if 487 00:25:49,520 --> 00:25:51,560 Speaker 2: I don't like where I'm being touched or I really 488 00:25:51,560 --> 00:25:54,200 Speaker 2: am enjoying that certain area that's being touched, and that's 489 00:25:54,200 --> 00:25:57,399 Speaker 2: where reinstruct them to engage in what's called handwriting. So 490 00:25:57,400 --> 00:26:00,560 Speaker 2: that's either placing your hand on top of orneath your 491 00:26:00,560 --> 00:26:03,199 Speaker 2: partners to either guide them awake from an area that 492 00:26:03,240 --> 00:26:06,520 Speaker 2: feels uncomfortable or to invite them to stay on an 493 00:26:06,520 --> 00:26:09,480 Speaker 2: area that does feel comfortable. So that helps take away 494 00:26:09,520 --> 00:26:11,719 Speaker 2: this pressure to people feel like I don't know how 495 00:26:11,720 --> 00:26:13,800 Speaker 2: to talk dirty or you know, I don't know how 496 00:26:13,840 --> 00:26:16,879 Speaker 2: to share that I'm really enjoying something. So taking the 497 00:26:17,000 --> 00:26:19,480 Speaker 2: verbal part out can be really really helpful. 498 00:26:20,320 --> 00:26:22,920 Speaker 1: Ah, Okay, that sounds like it could be helpful even 499 00:26:22,960 --> 00:26:24,160 Speaker 1: outside of this activity. 500 00:26:24,600 --> 00:26:27,240 Speaker 2: M h. For sure, maybe something. 501 00:26:26,920 --> 00:26:29,400 Speaker 1: That would be good for people who have trouble initiating 502 00:26:29,440 --> 00:26:33,159 Speaker 1: sex or things like that. Absolutely, you know, as you 503 00:26:33,200 --> 00:26:35,320 Speaker 1: were talking, it made me wonder if this might also 504 00:26:35,359 --> 00:26:38,359 Speaker 1: be helpful for people who struggle with central arousal disorder, 505 00:26:38,680 --> 00:26:40,679 Speaker 1: because I think a lot of times what happens is 506 00:26:40,680 --> 00:26:43,200 Speaker 1: that they may be afraid to even initiate any kind 507 00:26:43,200 --> 00:26:46,200 Speaker 1: of affection for fear that their partner will expect something 508 00:26:46,240 --> 00:26:47,200 Speaker 1: more that. 509 00:26:47,200 --> 00:26:50,560 Speaker 2: Is exactly correct, that is exactly correct. To remove that 510 00:26:50,760 --> 00:26:54,720 Speaker 2: idea of expectation of any sort, and to just focus 511 00:26:54,760 --> 00:26:58,480 Speaker 2: on what is coming up, right, and during the exercises, 512 00:26:58,520 --> 00:27:01,040 Speaker 2: you begin to learn that sex is a natural function. 513 00:27:01,440 --> 00:27:03,400 Speaker 2: It's not something that can be taught, right, It's kind 514 00:27:03,400 --> 00:27:05,840 Speaker 2: of like breathing that comes natural to us. We might 515 00:27:05,840 --> 00:27:08,679 Speaker 2: be able to teach people different breathing techniques, but the 516 00:27:08,680 --> 00:27:12,040 Speaker 2: basic tenents of breathing we're born with. Same with sexual function, 517 00:27:12,200 --> 00:27:15,520 Speaker 2: We're born with those. Borrowing any dysfunction, we're born with 518 00:27:15,560 --> 00:27:18,879 Speaker 2: that as a natural function. So touching for you know, 519 00:27:18,960 --> 00:27:21,639 Speaker 2: exploration of the sensations. You're going to begin to notice 520 00:27:21,680 --> 00:27:24,720 Speaker 2: your body becoming aroused. What happens? What do you need 521 00:27:24,760 --> 00:27:27,680 Speaker 2: in order to have arousal or desire come up? So 522 00:27:27,720 --> 00:27:29,480 Speaker 2: we're moving that expectation there. 523 00:27:29,800 --> 00:27:32,359 Speaker 1: So how long might you be practicing sin say focused 524 00:27:32,400 --> 00:27:34,879 Speaker 1: techniques with someone before you might see a difference in 525 00:27:34,920 --> 00:27:36,080 Speaker 1: their arousal states. 526 00:27:36,560 --> 00:27:40,160 Speaker 2: Yeah, I think that definitely differs from client to clients. 527 00:27:40,800 --> 00:27:42,960 Speaker 2: I think that in the first few weeks they begin 528 00:27:43,080 --> 00:27:46,760 Speaker 2: to notice different areas of their body that produce the 529 00:27:46,760 --> 00:27:49,520 Speaker 2: feelings of arousal. Right, Like I've had women come in 530 00:27:49,600 --> 00:27:51,240 Speaker 2: like oh my gosh, I didn't realize, like the back 531 00:27:51,280 --> 00:27:54,720 Speaker 2: of my thigh really, you know, brings up these experiences 532 00:27:54,720 --> 00:27:57,399 Speaker 2: for me or brings up the feeling of pleasure for me, 533 00:27:57,600 --> 00:27:59,600 Speaker 2: or I really don't like it when you know the 534 00:27:59,600 --> 00:28:02,360 Speaker 2: small buy back has touched it, so it becomes an 535 00:28:02,400 --> 00:28:06,880 Speaker 2: explor explorative exercise for them. The whole course of sensate 536 00:28:06,920 --> 00:28:10,520 Speaker 2: focused therapy tends to last between four and six weeks. 537 00:28:10,680 --> 00:28:12,720 Speaker 1: It sounds like it's a pretty structure thing that you're 538 00:28:12,760 --> 00:28:15,760 Speaker 1: taking either the person or then with their partner through. 539 00:28:15,920 --> 00:28:19,080 Speaker 2: Yes And the hardest part of it all is that 540 00:28:19,160 --> 00:28:22,360 Speaker 2: when they're engaging in this, I ask them to refrain 541 00:28:22,480 --> 00:28:26,080 Speaker 2: from having intercourse and people you tend to get really upset. 542 00:28:26,119 --> 00:28:27,560 Speaker 2: They're like, wait a minute, I'm coming in here to 543 00:28:27,680 --> 00:28:31,400 Speaker 2: have and of course you want to and oh my goodness. 544 00:28:31,480 --> 00:28:33,880 Speaker 2: The partners are like, ah, I'm not signing up for this, 545 00:28:34,400 --> 00:28:36,840 Speaker 2: but I tell them, you know, it's just like anything else. 546 00:28:36,880 --> 00:28:38,960 Speaker 2: Think back to when you first you know, we're having 547 00:28:39,040 --> 00:28:42,760 Speaker 2: sex with a partner, that thrill and anticipation and you 548 00:28:42,800 --> 00:28:45,240 Speaker 2: know hoping that it'll be tonight that you finally get 549 00:28:45,280 --> 00:28:49,080 Speaker 2: to have sex. Right, So it's building that anticipation. It's 550 00:28:49,080 --> 00:28:51,760 Speaker 2: like the longest for play ever, right, But it's like 551 00:28:51,840 --> 00:28:55,440 Speaker 2: that's what needed to sort of rekindle desire and to 552 00:28:55,560 --> 00:28:58,880 Speaker 2: again remove the expectation that we're going to touch and 553 00:28:58,920 --> 00:29:01,600 Speaker 2: this is going to lead to suck. So taking that away, 554 00:29:01,720 --> 00:29:04,560 Speaker 2: knowing okay, we can't have sex allows the person with 555 00:29:04,600 --> 00:29:07,040 Speaker 2: the arouse the disorder to feel more at ease and 556 00:29:07,080 --> 00:29:09,120 Speaker 2: more comfortable to engage in that exercise. 557 00:29:09,320 --> 00:29:11,480 Speaker 1: So you're saying that you take sex off this table 558 00:29:11,520 --> 00:29:14,200 Speaker 1: the entire time they're working with you on this. Yeah, 559 00:29:14,440 --> 00:29:16,520 Speaker 1: so they're saying, Okay, we'll do what doctor p is 560 00:29:16,520 --> 00:29:18,320 Speaker 1: saying for the next six weeks and then we'll see 561 00:29:18,320 --> 00:29:19,440 Speaker 1: how it goes. Yeah. 562 00:29:19,480 --> 00:29:21,600 Speaker 2: And it's funny like people will come in like week 563 00:29:21,640 --> 00:29:23,640 Speaker 2: two or three, like, all right, we got to tell 564 00:29:23,640 --> 00:29:27,800 Speaker 2: on ourselves we have sex, you know. And so it's 565 00:29:27,880 --> 00:29:30,120 Speaker 2: kind of like, because it becomes this thing you're not 566 00:29:30,160 --> 00:29:32,800 Speaker 2: supposed to do, they want to do it right, and 567 00:29:33,080 --> 00:29:35,840 Speaker 2: it's like, oh, okay, now you get what we're having 568 00:29:35,840 --> 00:29:36,920 Speaker 2: these instructions. 569 00:29:37,080 --> 00:29:39,080 Speaker 1: Yeah, I would imagine that this didn't allow us for 570 00:29:39,120 --> 00:29:41,760 Speaker 1: a great conversation about what happened and how we might 571 00:29:41,800 --> 00:29:45,719 Speaker 1: be able to reconstruct that for the future. Exactly, got it, 572 00:29:45,800 --> 00:29:47,440 Speaker 1: got it, I got to read more about this. This 573 00:29:47,520 --> 00:29:52,920 Speaker 1: sounds great. So doctor Pio What are some of your 574 00:29:53,000 --> 00:29:56,120 Speaker 1: favorite resources that you find yourself going to and recommending 575 00:29:56,200 --> 00:29:57,120 Speaker 1: over and over again. 576 00:29:57,760 --> 00:30:01,480 Speaker 2: Absolutely so, first and for most, I think most sex 577 00:30:01,480 --> 00:30:04,080 Speaker 2: therapists will swear by this book. Come as you are, 578 00:30:04,680 --> 00:30:07,640 Speaker 2: Doctuli Nagowski, Right, it's just such a great book to 579 00:30:07,720 --> 00:30:12,720 Speaker 2: normalize sexuality and you know, teach about sexuality. Then anything 580 00:30:12,800 --> 00:30:17,080 Speaker 2: by Barry McCarthy is awesome. I really recommend re Kindling 581 00:30:17,320 --> 00:30:20,880 Speaker 2: Desire to my couples and women in particular, also by 582 00:30:20,960 --> 00:30:23,680 Speaker 2: Barry McCarthy and Emily car McCarthy. It's a book called 583 00:30:23,800 --> 00:30:28,520 Speaker 2: Sexual Awareness. Then when I find couples or individuals who 584 00:30:28,520 --> 00:30:31,080 Speaker 2: are coming in who maybe have never had sex or 585 00:30:31,400 --> 00:30:34,520 Speaker 2: have really just not had a really good sexual education, 586 00:30:35,080 --> 00:30:37,120 Speaker 2: I recommend the book The Guide to Getting it on. 587 00:30:37,200 --> 00:30:39,240 Speaker 2: I mean it's a huge book, but you can kind 588 00:30:39,240 --> 00:30:42,080 Speaker 2: of flip through and you know, learn about different techniques, 589 00:30:42,160 --> 00:30:45,440 Speaker 2: learn about different the sexual response cycle. So it's really 590 00:30:45,520 --> 00:30:46,800 Speaker 2: and it's it's written in a kind of like a 591 00:30:46,880 --> 00:30:49,720 Speaker 2: joking nature, so it's an easy, easy read. 592 00:30:50,160 --> 00:30:52,840 Speaker 1: And where can people find you online? Doctor Pia? What's 593 00:30:52,880 --> 00:30:55,200 Speaker 1: your website as well as any social media handles you 594 00:30:55,280 --> 00:30:55,880 Speaker 1: want to share? 595 00:30:56,120 --> 00:31:00,680 Speaker 2: Yeah, so definitely follow me on Instagram at sex Pia, 596 00:31:01,240 --> 00:31:03,720 Speaker 2: and then the website for the practice and a part 597 00:31:03,760 --> 00:31:06,800 Speaker 2: of is Resilient Chicago dot com. 598 00:31:06,840 --> 00:31:08,520 Speaker 1: And of course all of that will be included in 599 00:31:08,560 --> 00:31:10,640 Speaker 1: the show notes so that people can find it easily. 600 00:31:11,240 --> 00:31:13,480 Speaker 1: Thank you so much for joining us today, doctor Pia. 601 00:31:13,560 --> 00:31:14,760 Speaker 1: I really appreciate it. 602 00:31:14,960 --> 00:31:16,760 Speaker 2: Thank you so much for having me, and thank you 603 00:31:16,840 --> 00:31:19,080 Speaker 2: so much for having this platform. I mean, I know 604 00:31:19,120 --> 00:31:21,200 Speaker 2: you heard all the time, but it has just really 605 00:31:21,440 --> 00:31:24,960 Speaker 2: changed the game for therapy for black women. I'm seeing 606 00:31:25,000 --> 00:31:27,920 Speaker 2: so many more people coming in because of your website, 607 00:31:27,920 --> 00:31:30,440 Speaker 2: and so I just have to give you eight kudos 608 00:31:30,480 --> 00:31:31,760 Speaker 2: to that. Thank you so much. 609 00:31:36,640 --> 00:31:38,720 Speaker 1: I'm so glad doctor Pia was able to join for 610 00:31:38,760 --> 00:31:41,880 Speaker 1: this conversation. To learn more about her and her work, 611 00:31:42,160 --> 00:31:44,040 Speaker 1: be sure to visit the show notes at Therapy for 612 00:31:44,120 --> 00:31:47,480 Speaker 1: Blackgirls dot com slash Session four twenty eight, and don't 613 00:31:47,520 --> 00:31:49,560 Speaker 1: forget to text this episode to two of your girls 614 00:31:49,600 --> 00:31:51,800 Speaker 1: right now and tell them to check it out. Did 615 00:31:51,840 --> 00:31:53,640 Speaker 1: you know you could leave us a voicemail with your 616 00:31:53,680 --> 00:31:56,720 Speaker 1: questions for the podcast if you want to suggest movies 617 00:31:56,800 --> 00:31:59,200 Speaker 1: or books for us to review, or have thoughts about 618 00:31:59,200 --> 00:32:01,760 Speaker 1: topics you'd like to hear us discuss. Drop us a 619 00:32:01,800 --> 00:32:04,880 Speaker 1: message at Memo dot fm slash Therapy for Black Girls 620 00:32:04,960 --> 00:32:06,920 Speaker 1: and let us know what's on your mind. We just 621 00:32:07,000 --> 00:32:10,080 Speaker 1: might feature it on the podcast. If you're looking for 622 00:32:10,120 --> 00:32:13,280 Speaker 1: a therapist in your area, visit our therapist directory at 623 00:32:13,320 --> 00:32:17,000 Speaker 1: Therapy for Blackgirls dot com slash directory. Don't forget to 624 00:32:17,040 --> 00:32:19,880 Speaker 1: follow us over on Instagram at Therapy for Black Girls 625 00:32:20,240 --> 00:32:23,840 Speaker 1: and join us over in our Patreon community for exclusive updates, 626 00:32:23,840 --> 00:32:26,920 Speaker 1: behind the scenes content, and more. You can join us 627 00:32:26,960 --> 00:32:30,720 Speaker 1: at community dot Therapy for Blackgirls dot com. This episode 628 00:32:30,760 --> 00:32:34,680 Speaker 1: was produced by Alise Ellis, Indietubu and Tyrie Rush. Editing 629 00:32:34,760 --> 00:32:37,560 Speaker 1: was done by Dennison Bradford. Thank y'all so much for 630 00:32:37,640 --> 00:32:40,520 Speaker 1: joining me again this week. I look forward to continuing 631 00:32:40,520 --> 00:32:43,800 Speaker 1: this conversation with you all real soon. Take good care.