Feature by Dr. Sara Schapiro and Nikita Fernandes, MHC-LP

Although sex therapy has been around for awhile, people still have misconceptions about what sex therapy entails. For example, what makes a sex therapist different from other therapists? For starters, sex therapists work with clients on a variety of challenges that range from sexual trauma to kink explorations. Sex therapists also collaborate with other sex and intimacy professionals such as surrogate partners or sexological body workers in order to offer clients a holistic framework for healing. Partnering with other health professionals enables sex therapists to understand the client better as the therapist gains a comprehensive view of the clients background both inside and outside the therapy session.

Feature by Nikita Fernandes

Imago Relationship Therapy is a type of relationship and couples therapy that focuses on relational counseling to turn any conflicts between couples into chances for healing and progress. It was created by Drs. Harville Hendrix and Helen LaKelly Hunt in 1980. The word 'imago' means image in Latin. The idea behind the therapy is to help couples understand what their partner is saying and how their partner might be feeling. Using imago therapy with couples has been beneficial in helping clarify misconceptions, reduce conflict, and rediscover ways to connect with and communicate effectively with one another.

I recently read the book by Emily Nagoski “Come as you are” and the overall voice of her book is her intense desire to announce to the world “you need to know this!” I caught that fever when I read the chapter on sexual non-concordance. Here I am carrying the inspiration forward and shouting (in my head) you need to know this!

What is sexual non-concordance?
Sexual concordance is when the genital response and the subjective sexual response; “I am interested in sexy time” are in alignment. Meaning, that there are evident physiological responses; a man has an erection and a woman has vaginal swelling and lubrication, plus the person reports feeling aroused. Sexual non-concordance is when we consciously do not report sexual arousal, but physiologically, our body is responding. Visa versa, we can subjectively report interest in sexual activity but physiologically the genitals are not aroused (Nagoski, 2015). For example, a woman might feel aroused and excited to have sex with her partner, but when she attempts to have sex she experiences vaginal dryness. Similarly, a man might be excited and emotionally aroused but then unable to attain an erection.

How does this sexual non-concordance happen?
There are two ways that we process information; bottom up processing and top down processing. Bottom up processing is referring to our bodies response to outside stimuli that is not in our conscious control. Top down processing is referring to our cognitive appraisal, cognitive control, and attention toward stimuli presented to us. Top down processing is dependent on personal goals, biases, perception, appraisal, and what we believe is appropriate. Top down is an active process and a conscious response to information. As for bottom up, it is an automatic response without our conscious control.
Bottom up sexual arousal is the physiological response to sexually explicit stimuli (something you find sexy), such that there is genital arousal, however, this does not mean that you will be interested in sexy time. Even more, you might not even be conscious of your arousal. Researchers showed a variety of porn scenes to men and women and asked them to rate the porn based on how aroused they felt. The participants reported feeling aroused for only one type of porn but when they measured their physiological sexual arousal (heart rate, vaginal blood flow) they were equally aroused for all the porn scenes. Top down sexual arousal, is the conscious awareness AND interest in sexual arousal. Such that, the person will report the sexual arousal and possibly pursue sexual activity. For example, being touched gently by your partner while you are rushing and trying to leave the house might feel irritating. If you are being touched gently by your partner while relaxing in bed, you will experience the touch as sexually arousing. This means that being aware of sexual information or receiving sexual stimulation is not enough. The top down processing is responsible for the motivation and interest in sexual activity.
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Because two systems are at play when sexual arousal and sexual interest occur, there is a potential for miscommunications between the systems. Not only is there miscommunication between systems, sometimes, the top down process suppress and stops the bottom up processing. Once the person is sexually stimulated, he or she must make the conscious decision to enjoy the sexual arousal in pursuit of sexual activity. However, since top down processing is subject to biases, attitudes, and social rules, it can easily interfere with genital arousal and stop sexual arousal despite the desire to be sexually active. As mentioned before, top down processing is our cognitive control over presented information. Even if there is a biological genital response to sexually explicit information, the possibility of sexual arousal is dependent on the mood and the environment. We cognitively need to evaluate the sexual stimulus and the environment as arousing. Hence, there might be blood flow to the genitals and vaginal lubrication (bottom up), but if the conscious mind (top down) is not “in the mood”, or in the right emotional state, sexual activity will not happen.
 

Every time I suggest to a client the idea of scheduling sex, without fail I get the same reaction. Either turning up their nose or a flat out no accompanied by “that so unromantic” or “it kills the vibe, if I need to schedule sex I would rather not do it.”  
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Since you refuse to schedule sex, this is what it looks like: You want to flirt but you withhold because you're afraid that it will lead to sex and you just do not have time. Days go by as you and your partner make halfhearted attempts at initiating sex but you are both so distracted that nothing ever happens. You are tempted to sext your partner but abstain because you know you’ll both be drained at the end of the day, so why bother ignite the passion. You neglect to do anything to spark sexual tension because you've completely forgotten that sex is even a thing.
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Imagine this, you know that your sex-date is scheduled for Monday or Wednesday or whatever your favorite day of the week is. You allow yourself to flirt, because you know there is no way sex is happening. So flirt all you want because you are going right back to that task that is waiting for you. You sext or send naughty messages as your sex-date draws closer. You allow sexual tension to build up because you know you are going down (or up) with a bang. All the passion that you invest has a goal and when on your sex-date you are present, no distractions. You are excited to remain intimately engaged because you most definitely remember that sex is a still a thing.
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And if you break the schedule... have sex outside the allowed day… oh well, I doubt you'll complain.
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​The common myth is that men desire pleasure and women desire intimacy. In fact, men and women want more than just intimacy and pleasure. Even more so, research has shown that the myth that men are only interested in sex is false, men desire intimacy as well. There are three things men and women desire most. Men desire, pleasing their partner, pleasure, and orgasm and women desire, intimacy, feeling sexually desirable, and emotional closeness.
 
The Man
Pleasing his partner
The challenge for some men is that they do not know how, or what to do in order to please their partner. To help your man please you, start to communicate. Let your partner know what you enjoy. Research shows that people who are more sexually forward have higher sexual satisfaction. When a man is able to please his partner it affirms his masculinity. An excited partner is rewarding feedback, letting him know that he is doing a good job.
 
Desire for pleasure and orgasm
Sex has a different meaning for men and women. Men desire sex because this is how they feel loved. They see sex as being needed and wanted by their partner. Men will often want to have sex when they feel lonely or rejected by their partner. This is not to say, that men only want sex and not intimacy. Lack of open communication about sexual preferences and interests can significantly hinder sexual satisfaction. Often, men avoid telling their partners about a specific sexual position or sexual play that they would like to try, out of the fear that their partner will reject them. When your partner shares with you his interests, respond respectfully and avoid judgment.
 
The Woman
Intimacy and emotional closeness
Women see sex as a reinforcement of their love. Women desire sex most, when they are feeling intimate and close to their partner. For some people, emotional closeness and intimacy feels threatening. These people avoid being vulnerable with their partners because they fear their partner will judge them or abandon them.
 
Feeling sexually desirable
When a woman does not feel sexually desired she is more likely to close herself off and avoid having sex with her partner. If you are finding that your lady is being very argumentative, or gets very upset when you go out with your friends, that means your lady is feeling unloved and unnoticed. Women who do not feel sexually desirable are more prone to having an affair
 
Most importantly, not all men and women are the same. Tune-in and take the time to notice what your partner wants the most. 

 
When marrying, for the majority of traditional couples, there is an implicit understanding that the relationship is exclusive between the two partners. Yet, Darrel Ray, Ed.D sites in his book, Sex & God: How Religion Distorts Sexuality, that 70% of couples indicate that they have cheated on their partner. Much research points to the idea that humans are not wired for monogamy. The commitment to monogamy is based on religious and social expectations (Ray, 2012).
 
It is important to understand the motivation for cheating when one is in a committed relationship. Understanding the motivations can possibly help prevent cheating. It can also help the partner forgive the one who has transgressed.
 
1.Opportunity 
In the article, To Stay or Stray? the author calls this category of cheating, “crimes of opportunity.” Simply, an opportunity presented itself and the person took it. Perhaps he or she was traveling out of town, a partner was not home, or the office was empty and a hot co-worker came onto him or her. All these incidents are indicative of a last-minute fling. The person may have never thought of cheating before, an opportunity came about and they acted on it.
 
2.Emotional affair
The other side of something as flippant as opportunity is the need for an emotional connection. Often, one partner might feel lonely or bored in the relationship. When an affair happens, it is to fill the void. Researchers have found while men indicate reasons for cheating are related to both sexual and emotional dissatisfaction, women more often indicate emotional dissatisfaction. This is not to say women only cheat for emotional dissatisfaction. As women are becoming more financially independent, their motivations for cheating are beginning to equal the motivations for cheating in men.
 
3.To act on a fetish or sexual fantasy
Sexual interests don’t always line up. In fact, sexual interests do not have to line up. Each person should have the space to express his or her interest or disinterest in a particular sexual fetish or fantasy. The trouble begins when one cannot take a no for an answer. When a partner expressed disinterest in acting on the fetish, the other finds someone who will participate in his or her sexual fetish. There is always an option of permitting your partner to go out on their own and find a space to express their need (see When Someone You Love is Kinky by Dossie Easton). But, hiding from your partner that you are seeking your sexual fetish elsewhere and having sex outside of your relationship, is cheating.
 
4.Revenge
Couples can seek revenge for many reasons. Having a relationship where taking revenge is the norm, is toxic and unhealthy. Revenge can either be because one partner cheated or was suspected of cheating. Yet, revenge can also be for reasons other than the partner’s sexual transgressions. Out of anger, spite, hurt, rejection, a person will have an affair to punish the action of his or her partner.
 
5.Curiosity / sexual boredom
Sexual energy and the sexual libido between two people are often not a perfect match. Healthy couples are able to find a balance where both partners are satisfied. Struggling couples cannot seem to find the balance, causing one partner step outside of the relationship. An imbalance in sexual interest does not excuse the action. If you need something, say something. There are many ways couples can maneuver around this imbalance. Cheating does not have to be the answer. 
 
All of the above are not to justify cheating but to bring awareness to the triggers. If you see any of these red flags in your relationship talk it through with your partner. If speaking to your partner seems difficult, seek out a therapist who can help you find solutions to your concerns. 

​Sara Schapiro-Halberstam, MHC-LP, CASAC is a psychotherapist in New York City where she practices individual therapy, couples counseling, and sex counseling. You can contact Sara at sara@mwr.nyc and read more blog posts at www.mwr.nyc
Follow me on Instagram @sexfacts4dummies
Follow me on Twitter @flashtherapy15

My favorite infograph of the year! 

Gender – There are three aspects that makeup the complete understanding of ones own gender:
1. Biological gender - your physical gender presentation
2. Gender Identity - your internal understanding of self as male, female, both, or none
3. Gender Expression - how you relate to another gender.
 
Sex – the anatomy you have at birth, including your gonads, your sex chromosomes, and sex hormones. When a baby is born, the baby is assigned the male or female sex according to the physical presentation.
 
Developing a gender identity: John Money (1993) explains that we understand our gender identity in two ways, identifying and complementing. Identifying is when we copy someone who has the same gender identity as our own. Complementing is when we learn how our gender identity compliments another’s gender identity. For example, we learn how to dance by identifying (copying) with the instructor and we learn about the beauty of dance by watching how we compliment our dancing partner.
 
The gender spectrum: Because we see sex and gender as interchangeable terms we have only two affixed terms for gender: male or female. Yet, taking a look at the Bem Sex Role Inventory tells us that gender is more complex than the assigned sexual anatomy. The Bem-Sex role inventory was designed in 1971 in order to measure the masculine, feminine, and androgynous traits in each person. The inventory places each person on a spectrum from femininity to masculinity in contrast to 2 affixed terms.
 
To more accurately explain the human experience we would have to move away from our binary understanding of gender, to a continuum of gender traits. While many may don't care about their male or female title, some are yearning to connect to their gender experience with a more expansive non-binary term. Welcoming a gender spectrum would benefit even those who are comfortable with their matched sex and gender (cis-gender). This would allow all of us to experience both our male and female attributes without feeling forced to suppress our counter-sex traits.
 
See this video posted by The Huffington Post for a detailed list of gender identity terms.
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In 2012 the FDA approved the first HIV over-the-counter, home-use test. Users can do a simple oral swab and will receive a response in a matter of minutes. Unfortunately, the test did not get the attention it deserves. The benefits of the OraQuick in-home HIV tests can help people know their HIV status a lot sooner.  The sooner someone knows their HIV status, the sooner they can get help. Treating HIV early improves treatment outcomes and quality of life.
 
The test is a simple oral swab and it will indicate a negative or positive response. A positive result on the test means the person has antibodies for the disease and should go see their primary care physician immediately. A negative result indicates the person has not been infected because the body did not build the antibodies. It is important to note that antibodies take time to build, if you know you have participated in risky sexual behaviors or shared a needle, test yourself again a few weeks or months later.
 
Many people avoid getting tested for HIV because they delay making an appointment, they are concerned about meeting someone in the waiting room, they are afraid to wait for their results an entire week, they get queasy around needles, and other reasons people avoid getting tested. The OraQuick in-home HIV test solves many of the above concerns. A. No waiting to see a doctor. The test is done in the comfort of your own home B. No need to worry about bumping into someone you do not want to meet in the waiting room C. The response is immediate, unlike other test where you wait for your results.  D. If you are afraid of needles, you do not have to draw blood. E. This is quick and easy. If you know you are at risk of contracting HIV you can stock up with these tests at home and test yourself every 3 to 6 months. If you are still not convinced, read this article on 7 reasons to get tested for HIV.
 
OraQuick can be purchased on Amazon.com #gettested
 
*Disclaimer: This article is not about endorsing the product but to bring awareness to the public. The best way to protect yourself from HIV and STD’s is practicing safe sex. 

Originally posted by Jewishnews.com

Distance and space are essential for creating sexual and erotic tension. Just as a burning fire needs space to burn, so do our emotions and feelings. One of the key generators of attraction is emotional space: the understanding of where you begin and end, and where the other begins and ends.

Emotional space is often created by physical distance. For example, when your lover travels abroad or is away for a business conference. The physical distance leads to feelings of longing and desire. Emotional space can also be created by emotional distancing, such as a fight. Arguments and fights between lovers distance them from each other and thus create emotional space. It is this temporary emotional detachment that results in makeup sex being so arousing and sexually stimulating.

What is it about space that fires eroticism? It’s the human nature to desire what we can’t have or what’s further than an arms distance. At the age of 5 it is the red lollypop that was taken away from us, at the age of 12 it is the computer game our parents won’t let us play, and at 16 it’s the boyfriend our friend has. From there on, throughout our adult life, we are attracted mostly to what appears out of our reach.

Creating emotional space doesn’t require physical distance or an uncomfortable fight. Emotional space can be created by self-confidence. In fact, confidence is the most effective and powerful tool in generating such space. When looking for a partner, people have different preferences and often find certain physical and personal features attractive. However, one specific feature that often tips us head over heels is a person’s confidence and assurance in their own abilities. Yes, there are a few exceptions: some people are attracted to a damsel-in-distress. However, can such attraction last? What happens when the other is no longer in distress, does the attraction fade?

Confidence creates distance because it sends the message: “I’m fine, I can function without you.”  For example, suppose you accompany your partner to her office’s holiday party. You observe her as she engages with her colleagues and boss. You see her in a different environment, playing a different role, and all of a sudden you find yourself more attracted to her then you’ve been in weeks. You might attribute it to her new party dress or perfect makeup, but it isn’t so. The “you-can’t-have” bells are beginning to ring. In this case it isn’t necessarily what you can’t have but rather about what you are not guaranteed. You realize that she has her own identity and that she is not dependent on you. You realize that she has a life outside your relationship, a corner of her own.

To make it clear, I am not referring to a snotty, arrogant, and stuck up behavior, but rather what I am describing is a genuine self-confidence and assurance. Indeed, life with a partner can enhance our experiences and our sense of who we are as people. However, having an identity outside the relationship is important. Confidence within a relationship is being comfortable and happy with who you are independently of whether you are in a relationship or not. To clarify once again, I’m not advocating for fear and paranoia that our partner might actually leave us. Living in such fear has the effect of pouring water on fire. Rather, we simply need to become aware of the emotional distance between ourselves and our partner. It is in this space that eroticism can flourish.
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The next time you dress up – while you’re putting on heels or a fancy tie -remember that attraction is strongly dependent on your confidence and not necessarily on the way the tie brings out the color of your eyes.