Five Most Important Questions About Good Sex

People ask me all the time in my role as a sexologist,
"How can I have good sex?" Their number one question
is simply "What's the most important thing in having good
sex?" Here's the answer: It's all about your capacity to focus
on physical sensation and pleasure. Your body knows how to
become aroused.

Question 2: "If its so natural and simple, why do people have
so many problems?" The answer: Everything else besides sensation
is a distraction.

Question 3:
What are the top distractions? " Performance anxiety is king or
or queen. When people worry about what will happen and how
they perform they tense their muscles and breathe less deeply.
Tense muscles decrease blood flow and this is critical for sex.
When there is less blood flow to the pelvic region it's a kind of
"reverse-Viagra" effect. If they are in a relationship other emotions
from the relationship can enter in and provide distraction.
Interestingly the next most problematic distraction is an over
preoccupation with partner pleasing that dampens personal pleasure.

Question 4: So how do people overcome these problems? The
Gestalt therapist Fritz Perls had a saying: "Lose your mind and
come to your senses". I use a combination of relaxation and
self-hypnotic techniques to enhance muscle relaxation and blood
flow. I teach visualization and mental practice techniques to enhance
the focus on sensation. These are combined with cognitive or thinking
strategies that relieve the individual of irrelevant preoccupations.
Behavioral exercises for partners are used for practice and homework
to enhance their sense of sexual competency and to encourage them
to play and have fun. Then they are more able to put aside distraction.

Question 5: Why not just have people take a pill? Medications don't
work for everyone, some people don't like the side effects, and some
people simply don't want to use medication. The truth is that for some
people medications are a "godsend"when other measures don't work.
There are also situations in which combining medical treatment and
sex therapy may work best. The main point is that people should have
the available options for treatment so they can make informed
choices based on their needs.

Hypnosis and Sex Therapy

Hypnosis can be a powerful tool in helping clients with
a variety of sexual problems. First of all there is the issue
of relaxation that has its place in treating erectile dysfunction
(ED) especially when there is performance anxiety involved.
Relaxation enhances blood flow and this is very useful
with ED.

Subjects who are able to alter sensation can apply their
training in self-hypnosis to ejaculatory control problems.
Sexual pain disorders involving muscle contraction and spasm
may respond to hypnotic relaxation along with other sex
therapy techniques.

Masters and Johnson's "Sensate Focus" techniques can
be enhanced with hypnosis since hypnosis involves a
relaxed state of focused attention. Sensate focus
requires focusing on sensation and pleasure during
lovemaking and couple exercises. Combining the
two techniques may assist couples in moving
more quickly through their learning experience.

In addition, the use of mental practice and visualization
as part of sex therapy "reconditioning" can be applied
to arousal and desire disorders as clients explore what
feels pleasurable to them. Hypnosis can help the clients
immerse more deeply in what they are experiencing.

Hypnosis also has its place in encouraging sexual self-esteem
as clients learn to appreciate their sexual selves and identity.

Hypnotizability matters. Some clients are more
talented than others with hypnosis. So, measuring this
ability is part of any initial assessment and treatment plan.

The Power of One Word

The Power of One Word (First Published in 2003)
=====================================
For years I've been telling clients and friends how
one trip to a hypnotherapist busted my writer's block
and helped me finish my dissertation. Eighteen years
later, while preparing a virtual class for book writers,
I discovered the secret magic formula within the
suggestion (or incantation?) that untied my
Gordian knot.

Let me tell you about my block, the single phrase
suggestion, and the secret that went undiscovered
till I meditated on it 18 years later. I never quite
understood how this worked. Now I know the source
of the 'power' within the phrase.

Two years after most of my classmates had finished
their dissertations, I was frozen solid, stuck,
totally blocked. My chair seemed to keep changing things
to the point where I was convinced the work would go on
forever, I would never graduate, and all the years of
sacrifice would go unrewarded. I couldn't write a thing,
dreaded approaching any member of my committee, and was
convinced there was nothing I could do to change things.

I believed the situation was hopeless.

A friend suggested the hypnotherapist. I arrived at the
office very curious about what would happen. The hypnotherapist
spoke to me in a matter of fact way. I offered my lament
about what the chairperson seemed to be doing. I remember
him saying in a very curious way, with a Cheshire smile,
'Isn't it nice that things can change?' I started laughing.
I wasn't consciously aware of why this happened. Something
was different.

He said something else that sounded like the first phrase but
was more personal. I associated to all the good changes that
had occurred in my life and to the wonder of many changes
within the world, such as the change of seasons. Something
was melting. I began to feel a sense of freedom and hope.
The session was over, but something had changed, big time!
What remained obscure was the phrasing of the second
suggestion and why the impact of this one session and two
simple phrases had been so profound.

Within a few short weeks I confronted my chairperson and
refused the direction he was taking. There was a brief,
brutal, intellectual and administrative struggle. He was
replaced and I survived. Within a few months I completed my
work and graduated in the fall of that year. A lot changed
very quickly.

In the ensuing years I repeated the story emphasizing
the phrase 'Isn't it nice things can change.' But some-
thing was missing. It wasn't just 'nice”. Something powerful
had happened. There was something more.

This past week, as I prepared a section of my class on
writer's block, I thought about the session in the hypno-
therapist's office. I was preparing a meditation to be
used in my teleclass as an illustration of a method for
dealing with writers block. I began to meditate on the
words and experiences of 18 years ago. I closed my
eyes and took a deep breath. A visual image of one word
appeared eidetically in my mind's eye: 'YOU'! He had said
or implied, 'Isn't it nice that 'You can change things!'?'

I was indeed the only one who could change my situation.
I had to take a profound action. I confronted my fear and
acted in the situation. What was missing from consciousness
all these years was the awareness that 'You can change
things!'. Having overcome my fears and acted, the writing
was easily completed.

The power to act was always potentially there. The hypno-
therapist helped me unlock my potential by leading me to
the opposite of what my fear of change had locked me into.
The power was within my grasp. He helped me by pointing
out the simple eloquence and power within 'You!'.

So now I have it in spades. The single most powerful word
I know: 'You'! Therein lies the power. It is within you,
each and everyone of us to transform our lives. Not only
are you the block, but also the power to undo it and the
power to complete your work on this planet.

Geoff can be reached at 703-883-1770 (voice) or
GeoffMichaelson@hotmail.com (e-mail)

Real Couples Therapy

So many couples come to therapy and rehash
their complaints. They get angry and have one
more complaint. It doesn't change anything!
While its good for me as a therapist to know
the complaint list, that's not what change is
about. The first question I have is: What do you
really want in your relationship? The second is:
How hard are you willing to work to get it?
Third: How will you attempt to sabotage our
every effort?

A major blockage in couples work is constant
referencing of past grievances. Its important
to "grieve the grievances". Ultimately we must
let them go and replace them with something
more satisfying. This brings us to the "most
important thing" in couples work: Finding the
fun, joy, and pleasure you are looking for.

If you are going to "work" on your relationship,
the relationship must become intrinsically
rewarding. That is the motivational key.

Couples: The Communication

Its almost a given in my couples work that the
"most important thing" couples say they receive
regarding communication is the capacity to hear
and be heard and to understand and be understood.
That's the core issue in their communication.

It sounds so simple. So how do we go about not
accomplishing this very or most important thing?
Well, that takes assuming you know what your partner
means or what the meaning of something is for them.
Sometimes you only know what the meaning is for you
and you attribute it to them. You end up relating
to your own thought or emotion rather than to the
person you are with.

So, ask your partner what they mean or what something
means to them. Make very few assumptions and really
listen to what they say. Tell them what you think you've heard
and get their confirmation. Now you are actually relating to
them, not the idea you have been carrying around in your
head.

Injury Prevention in Sports

Its fascinating that predictors of injury in athletics
are similar to predictors of performance. For example,
an athlete's ability to mitigate a stress response during
competition allows them to play more effectively.
The stress response also contributes to injury. How
does this happen?

During the stress response, performance concerns,
overly tense muscles, anxious sensations (butterflies,
etc.) pull the athlete off task. They are not as focused
on what they have to do. A lack of proper focus or task
appropriate muscle tension can pull an athlete off track.
Performance is hampered and worse, you may not be
aware of things happening around you or even your
physical trajectory. Then accidents are more likely to
happen.

A basic question becomes, who is more likely to be
injured let alone suffer poorer performance than
their skills and training would suggest? Some athletes
more easily focus on task. Focusing on competition
and winning counts. But, when an athlete is more
focused on the win, the end result, and less focused
on the task, the play by play, of getting there,
then injury and sub-par performance are more likely.

The good news is that athletes can enhance their focus
and task orientation through sports psychology skills
training. They can improve resilience to the stress
response through mental skills training as well. By
enhancing mental skills, they can reduce injury
incidence.

Once an injury occurs, the athlete can also enhance the
recovery process by embracing rehabilitation as "part
of their game". Injury and recovery are just part of
what an athlete prepares for, deals with, and in most
cases overcomes. Mental skills training can also
optimize recovery time. Having clear goals for rehab,
carrying out the plan, good support from family,
friends and the sports medicine team all make a
a difference.

Pain, setbacks, and anxiety can be big challenges
for the athlete. Mental skills are crucial to over-
coming obstacles and dealing with the emotional
roller coaster that sometimes accompanies the
ups and downs of physical recovery and return
to competition. Athletes can learn psychological
skills to manage pain, stress, and anxiety during
rehabilitation from injury.

Hypnosis for Depression?

Hypnosis may be a useful adjunct to the treatment of depression.
For example, some people are both de-energized and chronically
tense over extended periods of depression, particularly when
waiting for their medication to "kick in" or the right prescription
and therapeutic dosage. They also report feeling very "stuck",
unable to make headway with their cognitive therapy while their
minds continue to spin with negative thoughts. Particularly
frustrating are the thoughts that "this will never stop" and a
sense that they are not getting any help.

When hypnosis is considered as an adjunct to their treatment
several things can happen. First, if a combined relaxation/self-
hypnosis training is accomplished, the individual can experience
periods of relaxation and calming that they have not experienced
in many months or longer. This can instill a sense of greater
efficacy and control, combating the sense of helplessness and
hopelessness. In addition, some people may apply the technique
to insomnia and night time waking to aid in their sleep. Second,
the individual may experience a degree of variability, even if only
slightly, that contrasts with the ongoing drone of their depressed
mood.

Another utility of hypnosis is combining the procedure for
relaxation and focusing with the cognitive-behavioral exercise
of challenging negative thoughts. It can be very difficult to focus
and do the cognitive exercises. Hypnosis is a relaxed state of
focused attention. Utilizing this state may help the individual
develop some focus to do the cognitive work.

As can be seen from the above, hypnosis is not a treatment that
necessarily removes depression by suggestion. Rather, it can be
a tool the individual uses to strengthen their resources to cope and
to accomplish their treatment program. Many hypno-therapists
complain that it is very difficult or "impossible" to get their clients
into a "relaxed and safe inner space". The challenge can be lessened
by understanding that one should not send some people directly to
an inner experience since this may simply lead them to focus where
they already unhappily are. They may need to transition through
a number of progressive mental states to get to or create a "positive
relaxing place".

For example, before doing any hypnosis at all and especially with
younger clients, its sometimes useful to discuss the things they like to
do, see, listen to, feel, in short what sensory experiences give them
relief. For other people, it is their pets that accomplish the beginning
shift out of sameness. Then a therapist can help the client creatively
utilize their experience as a resource to build a state of mind that
varies from depression. Working first with eyes open helps too. So,
first you help the client gather their internal and external
resources. Then they build an experience. Then, having constructed
something durable and comfortable, they may open the door, go
inside that space, and perhaps even invite you along.

When I feel really stuck with a patient in training self-hypnosis I
want to know everything about their environment in terms of who
and what is stressful. Working with this who and what may be
necessary before any hypnosis training is possible. Finally if the
clinician hasn't assessed hypnotizability in some fashion, he or she
may be leading themselves and their client down the path of
frustration and disappointment. I like informal methods of
assessment ("arm-drop","eye roll", etc.) to begin with as they
may be less draining in terms of time and energy for the client
while standard scales and techniques (HIP, Harvard, etc.) may
be added.

There are some new cognitive techniques (C-BASP) for depression
coming along and I have corresponded with one of the researchers
about combining a new technique with hypnosis and visualization.
I have had preliminary anecdotal success by adding this on to
existing techniques, by self-report from clients. The point is, don't
give up either as a patient or clinician. Be creative while building on
to what works rather than discarding the foundation of
cognitive therapy and medical intervention.

Resources: Books and articles by Dr. Michael Yapko on Hypnosis
and Depression, The American Society of Clinical Hypnosis (lists
specialists in hypnosis and their certification).

Slideways Into 2008

My metaphor for the new year occurred during a snow tubing
adventure at White Tail in Pennsylvania. The awareness that
there is no real control as you slide sideways, backwards, and
head first down the slope was freeing. Nothing to do but laugh
all the way to the bottom over and over again. And so we go
slideways into the future, the only control being how we want
to be about the direction it takes us...fighting the flow or "digging"
the snow. I am reminded that in sports and life we control
what we choose to do and how we react to what else is beyond
our control. On a tube there is no preparation, no goal, no plan,
just the ride. The more you let go, the better the ride.
Happy New Year!

Geoff Michaelson, Ph.D.