Archive for August, 2010

Do your Kegels!

Wednesday, August 25th, 2010 by Bat Sheva Marcus LMSW MPH PhD

I’m sure I’m not the first one to tell you this, but kegel exercises are really important. As you age, the muscles around your vagina and urethra weaken. This can lead to all kinds of problems which, trust me, you don’t want.

Most often women experience leaking urine when they cough, laugh or sneeze. It happens to some women when they have an orgasm. While this is not the worst thing in the world (Panti-liners and towels on the bed during sex help handle the “symptoms”) it is a part of our physical health and well-being.  And because there is a simple way to work on this, there’s really no excuse for slogging through a soggy situation.

The Medical Center For Female Sexuality is putting out a Kegel CD to help you exercise your kegels every day. Stay tuned. We promise we’ll let you know as soon as we have it for you! In the meantime, check our website for instructions on how to do kegel exercises.

The Cookie Sutra

Monday, August 23rd, 2010 by Bat Sheva Marcus LMSW MPH PhD

Every once in a while a book comes out that makes us smile. The Cookie Sutra is one of them.

Written with a witty tongue-in-cheek style with adorable pictures of gingerbread men and women in a variety of compromising positions, this book would make a really fun gift. As the cover states, this is the book  “Where imaginations are fertile, love will never grow stale, nor crumble.” The book’s dedication is (presumably) to the author’s  partner: “For Lisa, for showing me where we keep the baking stuff and not asking why.” And it even has a recipe for gingerbread cookies at the end. Haven’t tried it yet… but believe you me, I will!

Book Review: Will “Sex at Dawn” influence sex therapy?

Wednesday, August 18th, 2010 by Stephen Snyder, MD

Recently, Sexuality Resource reviewed Christopher Ryan and Cacilda Jetha’s Sex at Dawn a new book drawing on a vast amount of cultural and physical anthropological scholarship to argue that for our hunter-gatherer ancestors, sexual promiscuity may have been an established way of life.  And that the development 10,000 years ago of agriculture, an ownership society, and sexual monogamy brought an end to this golden age of sexuality.

As a sex therapist in New York City (where the kind of ownership society begun 10,000 years ago has perhaps reached a pinnacle of development), I wonder about whether the ideas discussed in this book will influence my field much.

So far, it doesn’t look promising.  The dominant public reaction to the book in its first month has been that it “shows that humans are meant to be sexually promiscuous.”   This is a subtle and understandable misreading of Sex at Dawn, but a misreading nonetheless.

Let me explain why it’s a misreading — using an excerpt from Sex at Dawn that you may worry is a digression.  But trust me, it’s relevant.

Human nature?  It’s the bananas, stupid.

During Jane Goodall’s first four years studying chimpanzees in Tanzania, according to Sex at Dawn, she observed them to be remarkably peaceful creatures.  But they were difficult to observe, since they tended not to hang around her camp much.   So she tried to attract them nearer by regularly feeding them bananas.   The effect, evidently, was to make the chimpanzees more aggressive.  Fighting between them increased dramatically.

Now, which represented the chimpanzee’s true nature?   The gentle chimpanzees happily feeding far apart in the forest, not bothering each other?   Or the hoodlum chimpanzees shoving each other out of the way at the daily banana trough?

The answer, as Ryan and Jetha eloquently express, is neither.   It’s like asking whether water’s true nature is ice or liquid. It all depends on the conditions. Change the conditions, and you change which of many potential natures will be manifest.

Goodall’s observations also show the relative delicateness and vulnerability of an established primate social order.  For the chimpanzees, a peaceful society depended on abundant food supply that was dispersed, with lots of feeding spots for everyone. Stick a big box of bananas in the middle of the forest, and the whole neighborhood goes to hell.

The kind of early human social structure that encouraged sexual promiscuity was a delicate thing.  It required a small tightly-knit group of less than 150 individuals, an abundant natural food supply, and an inability to hoard resources.   As I look out my front door in New York City, I don’t detect much potential for the establishment of that kind of social order.   It’s strictly big boxes of bananas, all the way up Columbus Avenue.

Yet the popular buzz in the book’s first month seems to miss all of this.   “We’re really meant to be promiscuous,” yell the headlines.

No.  The reality is more sobering.  The material conditions that would permit a stable culture of sexual promiscuity are long since gone.

The sober reality is that, as the poet Wordsworth wrote 200 years ago, talking about something completely different but really not so different — “nothing can bring back the hour / Of splendour in the grass, of glory in the flower.”

Will Sex at Dawn influence sex therapy?  In my own practice it already has.  But in a different way than you might think.

The Wordsworth poem about “splendor in the grass” begins with the poet’s awareness that as an adult he no longer is capable of the extremes of ecstatic pleasure that he recalls from childhood.

Since reading Sex at Dawn, I’m even more conscious in my work with individuals and couples that even our best sexual experiences are probably only a dim echo of a once-ecstatic form of sexual being.  One that can no longer be adequately described in words or images, because the psychological and cultural conditions necessary for it have vanished.

This once-ecstatic form of sexual being was probably often communal, and involved an absence of shame and a deep sense of communal connection that I cannot imagine.

There is currently some talk in the sex therapy field about whether we can “change the conversation” about monogamy vs infidelity that currently dominates the American media – perhaps change it to a more European-style model, which takes sexual infidelity less seriously.

Maybe.   But I think we’d just be tinkering around the edges.

To me the message of Sex at Dawn for sex therapists is this:  Be sensitive to the fact that we’re all sexual exiles.   Be tolerant of the sexual struggles of your fellow moderns.  They’re doing the best they can under quite compromised circumstances.  Or, to quote the Wordsworth poem again,

We will grieve not, rather find
Strength in what remains behind;
In the primal sympathy
Which having been must ever be;
In the soothing thoughts that spring
Out of human suffering.

Our sexual exile will not end anytime soon. In the meantime, we’ll do the best we can — to treat our sexual selves with kindness and understanding.

© Stephen Snyder, MD 2010    

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Tips for Selecting a Sex Therapist

Monday, August 9th, 2010 by Bat Sheva Marcus LMSW MPH PhD

At the Center we treat women who suffer from various conditions that prevent them from having satisfying sex lives.  Our goal is to uncover the physical causes of these conditions and treat them medically.

On staff at the Center are human sexuality counselors who conduct a psycho-sexual intake before a patient’s physical exam.  Through this intake, and by getting to know our patients as we treat them, we gain a better understanding of the psychological backdrop to a patient’s sexual issues.  And sometimes what we learn leads us to recommend that a patient or couple seek counseling with a sex therapist.

We, of course, have some local favorites, but often women write to us for recommendations beyond our geography and we don’t have a comprehensive list; or we just don’t have professional experience with them so we hesitate to recommend.

But we do have a strong perspective on what to look for in a sex therapist. Click here for some solid tips on choosing a sex therapist.

Should dinner always come first?

Wednesday, August 4th, 2010 by Bat Sheva Marcus LMSW MPH PhD

I’ve been thinking of the very romantic notions we have regarding dinner dates.

The typical order of events is: large, beautiful, (usually quite saucy) romantic meals and then great sex. In a way that makes sense because dinner is seen as the wooing and romancing which is then followed by sex. The problem with this picture is that so many people I know say they have better sex BEFORE they eat. Big dinners make them sluggish and tired, not exactly the two adjectives you’d want to use before the word “sex.”

Some people even go so far as to say that sex is better when they are a little bit hungry. Their senses are attuned and heightened. Now, I’m not suggesting that you starve yourself into great sex… I’m just suggesting that maybe flipping around the order a bit would make sex better.

So, next time you have a hot dinner date, maybe ravage your date BEFORE DINNER, doze for a few minutes and then go indulge your (now much bigger) appetite. Or, to help this fit into our real lives, when your partner gets home from work,  suggest a before-dinner tryst and see what happens!