Hot Topics Volume 2, Issue 3: March 2003

Welcome to the latest issue of Hot Topics, the newsletter from www.smartsextalk.com.

We invite you to send your suggestions, your questions, and your comments to us at editor@smartsextalk.com.

**Please note: Let us know whether or not you want your mail to be published. We will NEVER publish your mail or identity without your permission. You may send mail anonymously, but if you do not wish it to be reprinted, you must say so. We want you to feel safe to write - please address any questions about our confidentiality policies to editor@smartsextalk.com.

In This Issue:

Letter From The Editor
Featured Topic: What is sex therapy?
Humour
Quote of the Month

Letter From the Editor

Many of you have written in with questions about what sex therapy is, and about what kind of issues bring people to see a sexologist. In response, this month's Hot Topics is dedicated to addressing these questions.
Look for a return to our regular format next month, and as always, keep those suggestions and questions coming.

~ Editor

Featured Topic: What exactly IS sex therapy?

So many of you respond my website! It is gratifying that I am able to reach such a broad audience through a venue I find so enjoyable. Hot Topics gives me the opportunity to answer those questions you bring to me, and “What does sex therapy address?” seems often to be on the top of your lists.

The particulars of your situations are unique, of course, but the following information should help to clarify the range of issues appropriate regarding sex therapy.


Primary in any examination of sexuality is sexual communication and negotiation, important in a culture that denies information and silences discussions about sex. We are bombarded with opposing messages that tease us that if we are sexually desirable we will be happy and loved, while at the same time threatening us with rejection and shame if we do not underplay our sexual histories and curiosity. We walk a tightrope, balancing between open discussion and the silence required to maintain our reputations.

Still, if we are to establish and maintain intimate and sexually fulfilling relationships, we have to learn to speak the words that inform our lovers of our wants and needs. Sex therapy addresses the damage done by our culture's messages about body image and sex-negative conditioning. We are taught to revere beauty yet abhor vanity, so no one can ever win. If I believe I am beautiful, you call me vain; if I believe I am ugly, you accuse me of lacking confidence or the willpower to change myself into today's 'model'. How sad. It can be difficult to be sexually expressive and self-conscious about our bodies simultaneously. Negative body images rob us of full sexual abandon and intimacy.

I get frequent calls from young men wanting to know if their penises are big enough. I tell that most penises are between 4 and 6 inches long when fully erect. I add that the vagina has nerve endings in only the outer couple of inches (which is why women can't feel tampons), so two inches or more of penile length is sufficient. It's also true that men are generally far more concerned with this issue than are their girlfriends.

I also get many calls about sexual desire, especially what we call disparate desires, when one person in a relationship is more interested in sex than the other. This problem is much more easily prevented than cured, but that must be done with sexual communication in the early months of a relationship, not after that couple is already established. It's a tough one to untangle and most couples find the help of a sex therapist invaluable in understanding and addressing this painful issue.

Sexual development, maturation, and aging questions often come up in a sex therapist's office, and these stem from our lack of non-judgmental, accurate sex education. Sex is lifelong, and so is the process of learning about how our bodies change and adapt throughout our life spans. Sex education is integral in the work I do with people, and I find it rewarding to dispel myths and replace them with life-affirming knowledge about how our minds and bodies work.

I am frequently asked questions about medical considerations affecting sexuality. How do drugs (both street drugs and prescription drugs) affect our sex lives? What about side effects? Are there really any aphrodisiacs? (The short answer is 'no'). Even such innocuous medications as the birth control pill and thyroid tablets affect our whole bodies. Add more than one drug, or vary the dosage, or skip a dose, and we experience changes within our bodies. We each need to educate ourselves, and sometimes that knowledge is unfortunately difficult to access. With a signed Consent for Release of Information, I can work with your family doctor or specialist to ensure the best management of your medications and symptoms.

Clients sometimes call hoping for relief from the effects of inappropriate adult/child sex, or wonder whether childhood abuse and trauma are responsible for their sexual dysfunction as adults. Sometimes they want to explore new ways of framing such experiences so they can get on with happy and fulfilling sex lives. And sometimes they come in because they feel guilty that they experienced adult/child sex and didn't suffer from it. Sex therapy addresses and explores all the possible variations of responses to experiences that happen to children before they understand the nuances and significance of sexual behaviour.

I also work with people confused about their sexual orientation (that's who we're attracted to) or their gender orientation (that's how we feel about being boys or girls or somewhere in between). Sex therapy is helpful in these cases, for we must first brush away the cobwebs of parental and societal expectations before we can understand the private workings of our internal definitions. Following that, we must learn the skills to 'come out,' the process of sharing knowledge of our orientation with those around us, not something to be done easily without guidance and support.

Although I am sometimes approached by parents wanting to know how to speak with their children about sexual matters, and sometimes by children wanting to know how to speak with their parents about sex, I am more often contacted by couples crippled with embarrassment or fear about how to communicate with and relate to each other. Here, learning accurate sex information and practical skills melds with the insights and perspectives gained through the therapeutic process to bring couples closer together and cement their bond of intimacy. A therapist, with more dispassionate perspective, can help identify unproductive patterns and design options to help the couple effect their desired changes.

People concerned that their particular brand of sexuality is not okay call for help, too. Those with arousal patterns not considered mainstream often suffer in silence and shame, unaware that there are others who share their turn-ons. Sex therapy can lift the burden of isolation and embarrassment and allow folks to enjoy their individual sexual patterns. One must have an unusual fetish indeed to be truly alone. We are so very quick to judge ourselves and others as 'wrong'. Sex therapy can help to normalize sexual preferences and sort out the choices for each individual. We work together to explore skills and options for building the best possible set of personal decisions.

Sex therapy examines issues particular to women, such as orgasm, masturbation, partnered sex, painful intercourse, and lubrication and men's issues of erectile difficulty (not being able to get or keep it up) and timing of ejaculation (coming too quickly or not at all). These are topics we are all curious and nervous about, and sex therapy provides a forum for you to ask your individual questions in a safe and confidential environment.

In sum, sex therapy addresses all the topics you would expect, and also examines our motivations for and attitudes about our behaviour. It informs us about the healthy functioning of our bodies, guides us through decisions on how best to manage changes to those bodies, helps us to examine our attitudes about sexuality in general and how they affect us personally, and guides us through our options about how to attain and maintain the best standards of personal and interpersonal growth.

- Pega

A woman meets a man in a bar. They talk, they connect, they end up leaving together. They get back to his place, and as he shows her around his apartment, she notices that his bedroom is completely packed with sweet cuddly teddy bears. He has hundreds of cute small bears on a shelf all the way along the floor, cuddly medium-sized ones on a shelf a little higher, and huge enormous bears on the top shelf along the wall.

The woman is surprised that this guy would have collection of teddy bears, especially one that's so extensive, but she decides not to mention this to him, and actually is quite impressed by his sensitive side. She turns to him... they kiss... and then they rip each other's clothes off and make hot steamy love.

After an intense night of passion with this sensitive guy, they are lying there together in the afterglow, the woman rolls over and asks, smiling, "Well, how was it?" The guy turns to her and says: "Help yourself to any prize from the bottom shelf."

Quote of the Month

"It is not because things are difficult that we do not dare; it is because we do not dare that they are difficult."

~ Seneca

Copyright 2003. Dr. Pega Ren. All Rights Reserved.