Sex Therapy in Sacramento

Sacramento sex therapists come from various backgrounds e.g. counselling, psychology, nursing and medicine. After postgraduate, clinical and academical training they are qualified to work in clinical practice.

Most misunderstanding and unhappiness could be avoided if people were prepared to talk to each other more openly and were also not afraid to seek professional help if their relationship or sex life were not going well.

A lot of people are still gaining their sexual knowledge from nude experimentation in the back seat of cars or from their so called "experienced" friends often colorful advice. Even popular 'scientific' research through magazine surveys could be misleading.

Sex therapists work with individuals or couples who have sexual and/or relationship problems. To this extent their work can be described as secondary prevention; that is, how to help people who have already developed these problems. They are also involved with primary prevention as well, and this leads to the controversial topic of sex-education.

Sex-therapists meet their clients on a weekly basis. After an initial assessment session the therapist is able to formulate the sexual problem and perhaps some underlying emotional issues. Past history must also be clarified, as this also can contribute to the dysfunction.

Sex-therapy usually requires the couple to participate, though there are individual therapies available also. Clients are assigned a homework agenda with their partners, or given individual assignments. Through these and the therapy sessions they can learn new sexual behavioural patterns and thus a more advanced communication.

The therapist's role is to guide them through these sexual homework sessions, give them information about sexual matters and resolve their initial emotional conflict.

There are both physical and psychological problems can contribute to male and female sexual problems. They include: impaired sexual interest; impaired sexual arousal, (for men this could manifest as erectile dysfunction);orgasmic dysfunction, (for men this can translate as premature ejaculation, retarded ejaculation or ejaculatory pain). Other types of problems are as follows: vaginismus (for women this means a painful spasm of the vaginal muscles that prohibits intercourse), dypareunia (painful intercourse) and sexual aversions and phobias for both genders. Sexual identity and orientation problems and unusual sexual behaviours (sexual perversions).

Another controversial area of sexual counseling is the use of sexual surrogates and sexual coaches to demonstrate actual sexual techniques to the clients. Great care must be taken to avoid charges of prostitution when sex counseling becomes "hands on".

"Sexual practices are currently being revolutionized by he threat of HIV virus. It is accordingly envisaged that masturbatory practices will receive widespread review and such sexual behaviour will gain more universal acceptance" (Kay, 1992)

I am regularly asked by young visitors to this web-site whether or not masturbation is harmful to their health. I have to clarify a long standing taboo about masturbation here. My answer to the above stated question would be undoubtedly NO it is not harmful to you and YES masturbation is in fact good for you. It will not make you blind or insane, and it will not make your hair fall out prematurely (i.e. all bald people are not necessarily compulsive masturbators!). Even if you masturbate regularly you can still function perfectly well in a relationship.

SOME 'BORING' STATISTICS

Masturbation can be observed in many subhuman mammal species such as the male primates. This self-induced ejaculation occurs even when intercourse with a partner is possible. However, behaviour such as this is rare among female mammals.

Genital play probably starts as early as about 6-7 months for boys and 10-11 months for girls. Boys engage in a more obvious type of masturbatiory behaviour by the ages of 15-16 months, while girls show more intermittent play patterns. There is a tendency for both sexes to choose inanimate objects such as dolls or toys. When masturbation starts in early childhood it can carry on into puberty if it is not stopped and frowned upon by parents and teachers. Unfortunately this prohibition can lead to many sexual problems later on in life.

Certainly about 95-99% males and 40-60% of females have masturbated at some point in their lives This is a common and universal form of sexual behaviour. Frequency of masturbation is based on age, gender, social class, religiosity and the availability of alternative sexual outlets. Adolescents tend to masturbate more often than older people.

IS MASTURBATION GOOD FOR YOU? - THE PROS AND CONS

1. Firstly, masturbation is the safest sexual activity available. The risk of infection from sexually transmitted diseases (STD's) and unwanted pregnancies can be avoided. Mutual masturbation between couples is also a safe sexual practice as long as semen and vaginal fluids touch only healthy unbroken skin. HIV and other STD organisms are microscopically small and it does not require a visible sore or cut for them to enter the body. It is worth remembering to take care that semen does not enter the vaginal tract, as pregnancy can occur this way.

2. Masturbation is always available and rarely dissatisfying. There are usually no disappointments.

3. There is no scientific data that supports the idea that abstaining from sex makes you sick. However, some research suggests that a regular sexual outlet, or at least an orgasm, might be one of the basic elements of good health. Post-menopausal women who either masturbated or had regular intercourse showed a much healthier vaginal tissue and urinary tract than women who did not have a sexual outlet at all. Likewise urologists who treat men with prostate problems suggest to their patients to have more regular ejaculations. Orgasm itself has pain relieving qualities that release endorphins into the system and act as natural opiates.

4. For adolescents of both genders masturbation can help as an aid for the adjustment of their later sex lives as adults. Women who have masturbated prior to their heterosexual relationships are more likely to be orgasmic. They are able to teach their partner the most appropriate stimulation for their needs.

5. Masturbation is widely used as a sex-therapeautical tool in the treatment of many sexual problems e.g. unorgasmia in women, premature ejaculation, the treatment of sexual offenders etc.

5. The only danger of excessive masturbation is that you may learn to focus on yourself rather than meeting potential partners. Also you may accustom yourself to a particular touch, stimulation or timing when you are alone, thus making it difficult to accommodate yourself to a particular partner's needs later on.

Fortunately, masturbation is now considered harmless from a scientific point of view. As an aspect of sexuality it still causes embarrassment to many people, especially the young. Perhaps masturbation should not be judged from a moral point of you but rather understood in its biological framework, and suggested to the young as an alternative to premarital coitus.

Thoughts On Erectile Problems

Performance Anxiety

One of the most worrying male sexual problems is impotence - or erection problems. It is a truly distressful experience for both partners and affects the general relationship of the couple. The decreased self-esteem of both parties often leads to communication problems and even, on occasion, the break up of the relationship.

Physical versus psychological causes

Todays estimates indicate that in the USA alone approximately 10-20 million men suffer from various degrees of impotence at some point in their life.

In spite of the widespread believe that erectile problems are mainly caused by psychological factors, since the 1980's it is revealed that perhaps about 80% of the erectile dysfunctions start with a physical factor. These could be surgical trauma, accident, diabetes, circulation problems, neurological problems, drug or alcohol abuse or as a side effect to medication.

However it is important to consider the interaction between the psychological and physical causes as a maintaining factor of this problem.

Performance anxiety- the vicious circle

One should also make a clear differentiation between erection problems which are persistent, and those which are present in some situations but not in others.

In sex therapy it is described as situational erectile dysfunction - and is referred to it in an enormously rarefied tome- the DMS IIIR (Diagnostic Manual of the American Psychiatric Association) - as a "...persistent or recurrent partial or complete failure in males to maintain erection until the completion of sexual activity".

If a man fails to perform for any reason which, in certain circumstances, is quite common, he may well start worrying. Later on, the specific cause of his failure may be sorted out, but the anxiety remains, setting a vicious circle in motion: he worries because he cannot perform, and he cannot perform because he worries.

This kind of anxiety can interfere with the man's excitement level and as a consequence he will lose his erection.

The more often he worries about his erections the more likely he is to lose them.

Most negative emotions like anger, resentment towards the partner, guilt and negative past emotional experiences can interfere with the excitement level. It is because it is not just a biological dynamo that powers sexual activity (like hormone level etc.) but also the processing of information in the brain.

Both biological and emotional factors can negatively and positively influence sexual arousal. A useful analogy in this instance would be that of a circuit, the point of which could equate to the brain (fantasy, sexual thoughts), perception (sight, hearing, smelling etc.) touch and emotions towards the sexual partner.

If a certain stimuli is negative at any given point on this circuit (e.g. painful stimulation, undesirable appearance of the partner) then the person would lose his or her sexual excitement; rather like turning the light on and off. If a man feels anxious or guilty during sexual activity, then it matters little how willing and pretty his partner is. Click, out goes the light.

Feelings towards each other

The most common secondary problem that arises is how the partners cope with this problem. Most people desire to please their partners, and it is fine until this desire gets out of hand. The person could become a victim of his own feelings; that of wishing to please the partner at any cost, and the expense of his or her own needs.The result could be lack of confidence in self.
If the partner is unsatisfied she may well react with anger, and in turn both feel unloved and rejected. These are obviously not ideal conditions for love making.

From the above explanation it is obvious that relationship issues play a complex part in performance anxiety. Erectile problems, as in most sexual problems, cannot be treated independently. They have to be managed in the context of a relationship. That is the reason why relaxation and experimentation with tranquilizers alone are often times in vain though in some instances they can help.

Most of the time it is advisable to seek professional help to unravel the underlying psychological issues of the problem.

The possible cure

When the relationship problems are resolved and communication is reestablished between the partners, then the sexual problem can be targeted.

The most common technique used is called sensate focus: this involves teaching the couple to focus on their own feelings and sensations, and to participate together on homework assignments.

The idea behind this is to allow people to become relaxed with each other both physically and mentally, thereby allowing them to recognize their own feelings. In order to reduce stress and performance anxiety, the couple is advised to refrain from intercourse for an initial period of a few weeks. The couple is told to caress each other, but not in a sexual context. This hopefully reestablishes sensuality and intimacy in the relationship; both partners do not worry about penetrative sex, as they are not allowed to have it. There are different stages in this therapeutical process and the couple goes through them gradually. Most of the time guidance from a qualified therapist is essential, giving important feedback to the couple as they progress.

WORRIES ABOUT PENIS SIZE

Penis size is one of the most common concerns among males of any age. It is not only restricted to young men but the worries carry over to adulthood.

Most of the time these fears are groundless and relate to self-esteem problems. In the majority of the cases, the man feels depressed and frustrated about the size of his penis regardless of its actual size. The size of man's penis has always been a big issue as it is a common notion that the bigger the better. This relates to the sexual myth that women find bigger penises sexually more attractive and satisfying. Often erotic films and sexually explicit magazines promote this image by showing men parading longer and larger then average penises. Also a young teenager might compare his penis with his elder brothers and even his father. The result of these comparisons could start serious self-esteem problems later.

You must note that there are no scientific data suggesting that women prefer larger penises, but research is showing that most women do not care about their sexual partner's penis size. Survey results also indicate that women find a clean appearance and a good physique to be sexually attractive in males. Also, there is a physiological reason that contradicts the myth of penis size. Most women's sexual arousal and orgasm relates to the stimulation of the clitoris. It is also noteworthy to mention that most nerve endings in the vagina are in the outer two inches. This means that the clitoris can be much easier stimulated by touching with hands then thrusting with the penis.

If the penis size is between 5-7 inches erect, then anyone should consider himself average. However many men will have penises somewhat shorter and many will have somewhat longer. In general smaller size flaccid penises lengthen by a greater percentage during erection than larger ones. In case of a penis is 2 inches or less when erect, then sexual problems might occur, with the possibility of medical problems in the background. If this is the case, you should visit a urologist for examination.

Young readers must remember that they have nothing to worry about their penis size until their 18th birthday. Male puberty usually starts around the age of 9-15 and finishes around 18. The penis length actually starts to grow between 11-16. The penile circumference begins expanding between 11-17 while the length goes on increasing though somewhat slower. Growing rate in puberty is a widely variably process and the pace of growing often can have huge individual differences.

There are no magic potions, pills, creams, sprays or gels which will miraculously increase anyone's penis size. The only solution would be penis enlargement by surgery. This operation is only paid for by health insurance companies in the event of medical determinants. If done privately, for reasons of vanity, it is highly expensive.

Penis size is hereditary, and does not effect fertility or sexual ability, with the exceptions of the above example. The size of male and female genitalia varies greatly. Extreme cases can be compensated for by understanding and love between couples, and by the choice of appropriate sexual techniques and positions. If a person feels humiliated or ashamed by his penis size, he should consult a psychologist or psychiatrist and learn to accept his body the way it is. Large penis size (the largest ever recorded was 45 cm erect !) can cause sexual problems, by inflicting pain on the woman. Again it is the case of adjustment in position, technique and even partner.

Throughout history, man tried to enlarge their penises using various methods. The Kama Sutra mentions an interesting, but certainly painful method - that of inserting one's penis in a beehive. I would think millions of bee stings certainly would enlarge the organ, but with dire results.

Best to be happy with what one has !

Sacramento Oral Sex

One of the ways to enhance a sexual relationship and widen its repertoire is to engage in oral sex. Oral / genital sex is quite a common practise, and is known as either cunnilingus (eating pussy) or fellatio (blow job) when performed respectively on the female and male.

While it can be extremely enhancing for both male and female parties, there are hangups and concerns involved from both sides.

Probably the most common concern about oral sex is the issue of cleanliness. Many people find the genital area somehow unhygienic when compared to the other parts of the body, and they are uncomfortable with giving or receiving oral sex.

That can be overcome by taking a shower or bath together. The soapy water and freshness can wash away doubts on this delicate issue, and at the same time be a bonding and intimate experience for both partners.

When one party starts fantasising about a particular sexual practise, discussion is important. It is helps to understand each others concerns and prejudices, and past experiences (where applicable), about any new sexual practise. However, there is always a gentle way to start the proceedings, and one way to go about it is to experiment.

The other great concern is the actual ability to provide satisfactory oral stimulation to the partner. The best way forward is if both partner's guide each other by giving exact feedback on what is best for them. One effective method is to start fondling, caressing and nuzzling each other around the genital area: the thighs, stomach, and pubic region.

During fellatio, the woman can provide various stimulations with her tongue and mouth. She can hold the penis with her hand and start licking and kissing the head of the penis. One of the most sensitive spots is the coronal ridge of the penis, which is on the lower side closest to the scrotum. When beginning, It is important to for the woman to give the amount of stimulation that she is most comfortable with.

Later, with more experience, a little genital touching a kissing can be extended to more direct stimulation. It is not necessary for her to move her mouth back and forth over the whole length of the penis - she can use her hand on the lower part and her mouth and tongue on the tip. She can also fondle and kiss the testicles, and the so called male G spot, which lies under the testicles on the perineum near the prostrate gland.

For extra added fun, one can rub fruit on the genitals such as strawberries or peaches, or even jam, honey and cream, melted chocolate too (but not too hot!). Sucking on ice cubes and strong mints, or eating ice cream during or between oral stimulation can give a nice cooling and tingling sensation to the genitals and can be quite enhancing for both genders.

In the, now classic, adult film Deep Throat, Linda Lovelaces technique is not as difficult as it looks. The secret is to get the woman's mouth and throat into proper alignment (imagine a sword swallower!). The best way to achieve this, is for the woman to lie on her back and hang her head down from the edge of the bed. It is important to take a deep breath, as breathing can become temporarily blocked. With practise, the gagging feeling that may result will pass, and breathing can be achieved during the outstrokes of the penis.

During cunnilingus, the partner can follow the same stimulation pattern as with fellatio. The secret is to begin slowly and gradually in the genital area, then move to direct stimulation of the clitoris.

Communication is all important, such as giving and receiving feedback about movement, pace and pressure. Oral stimulation in the vagina is also pleasurable, though the male should avoid blowing into the vagina as this is very dangerous.

There are several positions in which oral/genital stimulation are possible. Usually one partner is in the receiving role, while the other concentrates on giving the stimulation. The giver can kneel or lie near the genitals, while the receiver can sit, stand or lie down. The receiver can also sit on the chest of the giver. Mutual oral genital stimulation can be achieved in a position known as 69. This can be quite pleasurable for both parties, but it is important to mention that some people find it difficult to concentrate on giving and receiving at the same time. Positions for 69 have as many variations as intercourse positions. The partners experimental willingness can contribute greatly to finding out what is best for both.

Oral sex does not always result in orgasm - it can be used as either foreplay, or intermittently during or after intercourse.

Another problem that can occur for a woman is the act of swallowing semen. Semen is composed mainly of sugar and protein, and is completely harmless to swallow, providing the partner is healthy. For most men this can be intensely enhancing, but as a couple you need to work out what suits both of you. Neither you nor your partner need do anything which you find repulsive or disgusting.

Naturally if one partner has a cold, sore throath, cut or sore on his or her genitals, or has a sexually transmitted disease like herpes or AIDS, then oral-genital sex should be avoided altogether. Otherwise it is natural and fun, and can deepen the intimacy that already exists between a couple.