Articles on sex therapy

Sex Therapy

Dr. Ramesh Maheshwari, Sexologist
Sex therapy is based on behavior therapy. It is a type of re-educative therapy. The fundamental of behavior therapy is that all the behaviors are learned, even the maladaptive behaviors. The behavior therapist helps the client to unlearn the unadaptive behavior and replaces it with newly learned adaptive behavior. The aims of behavior therapy are primarily educational and techniques facilitate improved self control.From amongst several techniques that are used in behavior therapy, ‘systematic desensitization technique’ is used in sex therapy. Prior to 1970, sexual dysfunctions were managed by psychiatrists. After  1970, the masters and Johnson model of sex therapy made it possible to treat sexual dysfunction by psychologists, social workers, nurses, counsellors, and medical doctors.Their approach included :Instead of treating the affected individual, the couple is treated. It is the relationship that is affected. This strategy provides an opportunity to gain  the co-operation and understanding of both the partners in overcoming the problem.Two therapist-a man and a woman work together as a team. This gives each partner a same sex therapist to whom he or she can relate more easily.Masters and Jonson recognized that it was important to identify organic conditions that might require medical or surgical treatment instead of sex therapy.They also found that explanining the anatomy and physiology of sexual response to the clients often had important therapeutic benefits.To individualize the therapy so as to meet the specific needs of each couple.The therapist must avoid imposing his own values on the client.The fear of performance and ‘spectatoring’ are often central to the cases of sexual dysfunction. The pressure of performance is removed initially by banning sexual contact. Couples are then helped to rediscover the sensual pleasures of touching and being touched without the goal of particular sexual response (Sensate Focus Exercise).Blaming each other for the sexual problem is discouraged.When a couple’s relationship improves outside the bedroom, it is apt to have positive results in the bedroom too.Basis : Sexual response is the function of Autonomic nervous system and is a physiological change when effective sexual stimuli are present , and a person is psychologically prepared to respond to them. All the sense organs are to be used to create a situation conducive to sexual response . (touch is most important).Systematic Desensitization : A mode of psychotherapy where all the anxiety provoking stimuli are arranged in an ascending level, and the client is exposed to, one by one, both the partners are to be involvedRelaxation: Deep breathing, deep muscle relaxation and plesant imagery are incorporated.Reassurance.Stages :Sensate focusWoman superior positionLateral positionMen superior positionFormat: No rigid format Variations in time, frequency and structure depending upon the dysfunction, the patient and the therapist.Results: Not as definite as in pharmacotherapy.As you shall sow and water, so you shall reap: A skilled and knowledgeable therapist is like a good seed. Client’s receptive mind is like fertile soil. Compliance and co-operation by wife is like watering by gardner. When all the three factors combine, the results are good. When sex therapy works, it does wonders and results are unparalleled for that particular couple.Contraindications:Severe DepressionActive psychopathologySubstance abuseIIInessHostility in couple-interaction

How Much Sex Should You Really Have?

Dr. Rahman, Sexologist
How much sex should you really have?Sex is an extremely personal and subjective matter. Different individuals relate to and indulge in sex differently. The idea of sex also varies from person to person and may not always fit the stereotypical penile-vaginal penetrative intercourse.There is no way of determining exactly how much sex is good and how much of it is too much. Some people like to be sexually active with thorough regularity while others find comfort in abstinence. Age also plays an important role here with people between the ages of 18-29 indulging in higher levels of sexual activity than those who are middle-aged or elderly.The different levels and frequencies of sexual activity have varying degrees of impacts on the overall mental, physical and sexual health of a person. There are numerous health benefits attached to having an active sex life, which manifests themselves in both the body and the mind.The health benefits of having sexAs per studies conducted, it has been shown that having sex, at least, two times a week can boost overall physical and mental health. The many health benefits of being sexually active are as follows:It improves immunity and makes the body more resilient to diseasesIt improves bladder control in women and prevents urinary incontinence It prevents erectile dysfunction in menIt improves blood circulation and lowers blood pressureIt acts as a stress relieverIt improves functioning of the heart and lowers the risk of heart diseaseIt reduces sensitivity to painThere are several other benefits of sex, which include the effective healing and nurturing of the body in a holistic manner.

5 Exercises You Should Be Doing Now for Great Sex

Dr. Raviraj Francis, Physiotherapist
Exercises increase energy, tones your muscle, burns fat, improves your mood and self image but you may be surprised to know that it may also improve your sex life.A recent Lancet research paper suggests that as little as 200 calories burnt a day can actually lower the erectile dysfunction risk.In Addition to strength training and cardio, stretching is a great way to loosen up enabling you to experiment with different positions. So even if you have a great sex life, incorporating these exercises and stretching into your workout routine would help you1 - KEGLESYa thats right for both men and women they improve endurance and control of pubococcegus muscle (which holds urine) & Perineal muscles (which provide power before ejaculation). Pelvic floor muscle training can also improve many functions like premature ejaculation and overactive bladder.HOW TO DO:Start by interrupting the flow of urine when going to the bathroom to get familiar with the PC muscles. Once you’re familiar with them, your goal will be to progressively increase the squeeze duration, intensity and number of reps until you tire. But when you do them, don’t hold your breath, push down or tighten your stomach, buttocks or thigh muscles. Work up to five-second squeezes, relaxing in between each contraction, for 10 to 20 reps.2 - PLANK POSEIt is the most perfect way to improve stamina and endurance at the gym. And in the bedroom it gives staying power for various on top positions. It also strengthen core which helps in thrust improvement & supports the back to prevent injury.HOW TO DO:Think of your body as a wooden plank, attain a push up level with hands shoulder width apart arms strong and pelvis level. In this position squeeze the inner thigh and & butt cheeks together, tighten the quads and press the hell back so that the feet are flexed. Hold this position for 15 sec and work upto 2 mins, at a time do 2 to 8 repetitions a day and then increase gradually.3 - LYING LEG RAISESIt Provides intense core workout and helps you to last longer in upright position.HOW TO DO:Lie with back flat and legs stretched out in front then raise your legs straight up towards the ceiling and stop when legs are perpendicular to body and floor. Then slowly lower your legs back until they are one inch off the floor. Repeat 3 to 5 times and rest for half a minute. Start with 3 settings initially.4 - PUSH UPsYes the good old push ups strengthen the upper body, core and increase endurance. Doing them regularly will have an intense benefit of upper body strength and overall core during sex.HOW TO DO:Begin in a Plank position hands under the shoulder and feet hip distance apart. Lower the chest to the floor and slowly press back up. Do as many times as you can. 5 - UPWARD FACING DOGThis is a mystic pose also mentioned in early civilization when people's sex life was almost perfect owing to rustic lifestyle and zero pollution. This exercise protects the lower back from heavy lifting either in gym or bedroom. It also stretches the core and hip flexors which rushes the blood to your pelvic area.HOW TO DO:Lie on your belly with legs hip distance apart. Bring hands to the side of the chest and lift the torso by pressing through your hands. Don't hunch the shoulders into the neck keep them stretched and don't hold your breath. Keep this posture for 15 sec and repeat 5 times.

When Do You Need to Consult a Sex Therapist

Dr. Saatiish Jhuntrraa, Psychiatrist
Some people shy away from the idea of going to a therapist, especially one that wants to talk about sex, which is a particularly sensitive subject. However, I think sex therapy is a wonderful thing and it’s definitely needed in certain situations. Sex therapists are people who are specially trained to deal with sexual issues, so you don’t have to be embarrassed to bring anything up with them. They’ve definitely heard it all! How do you know if you need to see a sex therapist?Here are 8 ways to tell…1. A persistent problem – If you have a persistent sexual problem that just won’t go away and is causing you personal stress or putting stress on your relationship,it might be time to contact a sex therapist. Only you know if the problem is out of your control and is causing enough trouble in your life, but don’t be afraid to see a therapist. Just like you would take your car to the mechanic if you needed to have a tune up, you need to see a therapist if you have a sexual issue.2. Painful sex – Sex shouldn’t be painful (except in those situations that someone is seeking out pain during BDSM!). If you’re experiencing some kind of pain during sex it might be because you or your partner (or both) have some kind of health problem. Your first step should be to see your doctor, but if your doctor isn’t able to figure out the cause of the pain then it’s time to call a sex therapist who may be able to help you connect with other specialists. They can also help you to find the best positions, sex acts and techniques for pain that can’t resolved (like chronic pain or issues from other diseases or health problems).3. Orgasm issues – One thing to keep in mind is that it’s not a problem to not have an orgasm during sexual activity. It’s only a problem if you feel it’s a problem. There are many women and men who don’t have orgasms and have a perfectly satisfying sex lives. However, if you don’t have orgasms and it causes you distress then you can see a sex therapist about it and they can help.4. Concerns about addiction – Some people might be concerned that they are addicted to sex or pornography and a sex therapist can help you assess if your behavior might be problematic. If it is, he or she can also help you put a treatment plan into effect.5. Feeling ashamed about your sex life or fantasies – A sex therapist can help you to come to terms with any shame or embarrassment you feel about the things you find sexually exciting. Sex should be fun, not shameful.6. Problems in your sexual relationship with your partner – Are you arguing about sex with your partner?Are one or both of you unsatisfied with your sexual relationship? Although it can be hard and a little scary to open up to each other and a stranger about your sex life, going to a sex therapist can make a huge difference in the overall satisfaction and well being of your relationship.7. Lack of desire – If you or your partner are struggling with a lack of desire and it’s causing you distress, a sex therapist can help. Again, for some people they don’t mind not having a strong libido and that’s okay, but if it is an issue that bothers you then you can seek help in this way. Remember that desire will ebb and flow in a relationship and that’s completely normal too.8. Challenging views about sex – Sometimes people have difficulty with sex because of how they grew up, what they learned about sex when they were young or because of religious beliefs. A sex therapist can help you work through any conflicting feelings, guilt or any unpleasantness you have regarding sex.

Medico Legal Aspects of Sex Therapy

Dr. Ramesh Maheshwari, Sexologist
Sex and human sexuality are sensitive subject. To deal effectively with any problem of human sexuality , one has to constantly evaluate its merits and demerits from social, scientific, moral, ethical and most importantly from the legal angle. Following are some of the guidelines for therapist to keep in mind while dealing with clients with sexual problems.ConsentTaking informed and expressed consent is of utmost importance while managing any patient. Examining and / or treating a patient without consent would amount to assault and battery which is punishable under criminal law irrespective of absence of negligence or successful outcome of treatment. The consent should be free willed, informed, intelligent , specific and express. Person giving consent should be competent to do so, failing which, consent should be obtained from the lawful guardian of the patient (In cases of minor and/or mentally retarded).Examination of a female clientBesides obtaining a valid consent, in case of female patient, the therapist should always have a female assistant present when examining  a female patient This is important for the therapist in order to protect himself from a possible charge of indecent behaviour, molestation or even sexual offence like rape etc. being leveled against him . Mere presence of husband or any male companion of the female patient is not enough. A sex therapist, in particular, is most vulnerable and therefore should be most careful.Use of surrogate partners Use of surrogate Partners for sex therapy is questionable both ethically as well as legally. Sexual involvement of the therapist is universally accepted as unethical. There have been a number of cases where the therapists themselves, having acted as surrogates, have been punished for sexual molestation of their patients. It may also invite a criminal charge of adultery in some countries, including India. There are cases on record where the therapists have been charged with and convicted of rape.Unlike some other countries, the socio-cultural set up in India is different. The laws governing sexual behaviour are neither liberal nor evolved as much as in some of the western countries. Besides, surrogacy is likened to prostitution by many. Even if one were to consider surrogate partner as a therapist, then the ethical code prevents a sexual relationship with a client. Moreover, there is every possibility of a disease being transmitted. Particularly the HIV infection, in view of sex with multiple partners by a surrogate person.Therapist should have uppermost in mind the special values of intimacy and love that our culture teaches us to nurture.Professional competencyIt is the ethical responsibility of every sex therapist to maintain high standards of professional competence and integrity. Competence without integrity or integrity without competence is an unsatisfactory compromise of professionalism. It is most important to protect the public and the other professionals from persons who represent themselves as sex therapists who are in fact lacking in competence and integrity.Competence in another primary discipline such as psychology,  psychiatry or counselling is not equivalent   to competence in sex therapy.A sex therapist should possess adequate knowledge of the following: Sexual and reproductive anatomy and physiology.Developmental sexuality from a psycho-biological point of view.Marital, Family and Interpersonal Relationship and Socio-cultural factors in sexual valuesPhysiological and medical factors that may influence sexual functions such as pregnancy, contraception and fertility, illness, disability, medications .Multi-model  techniques and theory of sex therapy and psychotherapy.Pharmacology of the medications used to treat sexual dysfunctions particularly with respect to their adverse effects and interactions with the drugs being consumed for other ailments.Ethical issues in sex therapy and principles of evaluation and referral.Laws related to sexual behaviour.POINTS TO BEAR IN MINDAll forms of sex therapy which violate the local laws should be handled with care recommending oral sex as a part of therapy is violation  of section 377 of the Indian penal code which deal with unnatural sexual offences.The Hippocratic oath forbids the physician to take advantage of the therapeutic context in order to engage in either homosexual or heterosexual relationship.It is a universal rule that whenever dealing with reproductive functions is involved, express consent of both the spouses should be obtained.Proof of competence is the ability to provide objective and responsible services to the clients.There does exist a potential liability under the laws of the land prohibiting consensual conduct such as prostitution, fornication, lewd and lascivious behaviour and adultery which might arise from therapeutic or non- therapeutic sex research activities.Sex between therapist and client is always unethical. No matter how therapeutic the rationale might appear, there is no justification for a therapist having sex with a client. The purpose of sex therapy is to improve function, not to change values or beliefs of the client.

How to Begin Your Sex Life?

Dr. Ashwini Billampelly, Sexologist
How to begin your sex life is the question which looms largely on the minds of some people who have opted for virginity until  late age of 25 or more!Here are some tips for those who are looking forward to begin with the most important relationship of their lives: 1: Prepare yourself - GET READY mentally and physically. Make sure you are healthy and normally developed. Make sure all your organ systems are working fine. Do the investigations if necessary. Take time to learn about your own body and your that of your partner. Share your ideas about hygiene and mend your ways if your partner so desires. Get well acquainted. 2: Develop a good mental rapport with your partner. Whether an arranged or a love marriage; good communication, sharing your sexual fantasies, body image, expectations in life, health issues is a must. Many people think putting out their best foot is essential to impress a would-be partner. But in time you will realise HONESTY is the most attractive quality in a spouse.3: Do not commit to a relationship until you are absolutely sure of what you want. If you are anxious about your sexuality, do not rush in anything.4: Do not carry baggage of  any feelings of guilt attached to your sexual being, appearance or financial burdens if any. Interpersonal comfort  and openness is very essential in a couple’s life. 5: Find what you like the most about each other and appreciate your partner frequently. You can begin with the “likes” and then point to minor “dislikes” in that order! That minimizes the impact and hurt caused by criticism. Criticism is a part of good communication, but should not be used to put the other person down. Both partners should be mature enough to take it lightly. 6: Be Well -Informed: - Relaying on porn videos or discussing with  friends or trying to use commercial sex to learn about how to perform sex has its own disadvantages. You may land up with infections or worse,  or myths and irrational fears.  Seek premarital counselling session from an expert sexologist.  Wish you happy life!

Safe Sex Education - the Only Way Forward!

Dr. Amar Deep, Homeopath
Planned Parenthood believes that parents and guardians should be the primary sex educators of their children. As with other complex issues, many parents may need support, resources, and expertise from schools and other organizations. It is important that young people receive age-appropriate sexual health information and develop practical skills for keeping healthy. Educators can help families by providing culturally meaningful learning opportunities in safe and non-judgmental environments so that young people can learn about sexuality in a healthy and positive context.Sometimes, people mistakenly believe that “sex ed” refers only to sexual behavior (e.g., sexual intercourse) and not the full array of topics that comprise sexuality. These include information and concerns about abstinence, body image, contraception, gender, human growth and development, human reproduction, pregnancy, relationships, safer sex (prevention of sexually transmitted infections), sexual attitudes and values, sexual anatomy and physiology, sexual behavior, sexual health, sexual orientation, and sexual pleasure. Comprehensive sex education covers the wide array of topics that affect sexuality and sexual health. It is grounded in evidence-based, peer-reviewed science. Its goal is to promote health and well-being in a way that is developmentally appropriate. It includes information and communication skills building as well as values exploration. Sexuality is an integral part of each person’s identity. Learning about our sexuality and achieving sexual health and well-being are lifelong processes that begin at birth and continue throughout our lives. Although parents and guardians are the primary sex educators of their children, children also receive messages about sexuality from many other sources. Some of them may have more negative than positive impact. Schools and other community-based organizations can be important partners with parents to provide young people accurate and developmentally appropriate sex education.The goals of comprehensive sex education are to help young people gain a positive view of sexuality and to provide them with developmentally appropriate knowledge and skills so that they can make healthy decisions about their sex lives now and in the future. Medically accurate sex education is an investment in our children’s future — their well-being. Our “return on investment” could be a generation of young people who have heard more helpful messages about sexuality than the provocative media images and/or silences they currently witness. It could be a generation of women and men comfortable in their own skin; able to make well-informed, responsible decisions; form healthy relationships; and take care of their bodies.It can be normal to feel overwhelmed by the task of developing and implementing comprehensive sex education in your school or program. Some educators find it helpful to talk with other professionals — mentors and/or supervisors — who have already implemented comprehensive sex education. It is important to get support from your school or organization. While this may feel like a huge undertaking, break it down into discrete steps such as:Assessing the needsResearching solutionsGarnering supportDeveloping a planDeveloping or selecting a curriculumCreating lesson plansGathering resourcesHaving fun!It may help to keep in mind that you may be the only adult who will ever talk to a young person about sexuality in an honest, accurate, and nonjudgmental way. Your good intentions, your positive, healthy attitude, your nonjudgmental tone, and the information you offer may be more than appreciated — it may save a young person’s life. Armed with knowledge about comprehensive sex education, you now need to jump in!  Talk with a mentor or colleague, browse your local library, or surf online to become acquainted with the breadth and scope of resources available. Contact Planned Parenthood educators near you to talk with and learn more about this important topic. Many Planned Parenthood affiliates provide consultation and training to assist with implementing sexuality education programs.

Bring Back Fire in Sex Life -1

Dr. Saatiish Jhuntrraa, Psychiatrist
Do you recollect the time you first met your partner many years ago? How did you feel? Were you eager and thrilled to talk? Did you think about him after the meeting? What did you feel like when you first touched his/her hand or kiss for the first time? Did you heart beat increase? Compare this with your present interactions with your partner. How many times do you hold each other’s hands? How much time do you spend talking (Other than arguments)?I observe so many young couples talking to each other on the phone in their leisure and private time, though I never understood what they could talk about in so much detail. They eventually get married and after some time they come to me with various sex problems. They often tell me that they don’t have time to talk or don’t feel like doing that. It is a proven fact that poor communication is an indication of a poor sex life. WHAT HAS CHANGED?Such a remarkable change is not accidental. It is due to a change in perception of sexuality over a period of time. Intercourse, orgasm and satisfaction has overshadowed the joys of pleasurable touching, sensual feelings and broad based sexuality.“Satisfaction” is a mirage, often judged by the peers criteria of what they’re doing in bed. There’s a lot more fear among boys regarding possible failure to satisfy their female partner. Person’s playfulness and enjoyment have been replaced by just touching for a couple of minutes leading to intercourse.  Fun and spontaneity has disappeared, replaced by a “rigid goal orientation which pressure the couple to make each sexual encounter a perfect one.” Still worse, now young couples start worrying for conception from each intercourse. “Time Intercourse” for conception as guided by experts have further worsened the situations.What to do? You need to reorient yourself towards pleasurable, sexual feelings while the emphasis should be on discovering in a relaxed, non-goal oriented manner, the sensual pleasure you can derive from touch or being touched. You need to find out the style of touching, stroking and caressing while feeling comfortable and pleasurable. Don’t make assumptions based on misconceptions, fall into ruts or feel devastated asking for a different type of touching. I shall be writing a few exercises for this purpose in the next bog. These are not guidelines but suggestions.

Ayurvedic Leech Therapy

Dr. Phanindra V V, Ayurveda
Leeches are used in the medical practice since ancient times to treat many diseases. It is a method in which localized impure blood is let out to heal the tissue. Leech therapy is Para-surgical treatment modality according to Ayurveda. Due to its therapeutic effects, this is successful even today. The description of using leech for therapy can be found in Sushruta Samhita written by Acharya Sushruta. He has described the nature of leeches, their habitat, the method of application, diseases indicated like Visarpa (Herpes), Skin diseases etc., in detail. Though there are hundreds leech species, only 15 are used for therapy. In the medieval ages, this was very popular. According to Ayurveda, Leech only sucks impure blood. Leech is used to relieve venous congestion and to improve blood circulation.Indications: Skin diseases, Vascular Problems, Varicose Veins, Acne, Non-healing Ulcers, Diabetic wounds, Boils and abscess, Herpes, Thrombosis, Arthritis, Sciatica, Dermatitis, Psoriasis, Alopecia, etc..Steps for application of LeechSnehana and swedana to the patient.Leech activation.Patient’s skin is cleaned.The leeches are applied.Cover the leech with wet cotton.Remove the leech once it has finished sucking the blood.Remove the blood from leech by inducing vomiting to the leech and then put back in fresh water container.The area should be cleaned and bandaged.Mode of Action: Leech have many distinct enzymes in its saliva, through which they act. The enzymes enter the blood through the place the leech sucks the blood. The most important is the Hirudin, which acts as an anti-coagulant. This leech enzymes also has the ability to stay in the blood and do vasodilation and further facilitate the blood supply to the surrounding tissue and prevent necrosis and healing. Some anti allergic factors ensure reduction in the lesions.