DID YOU SEE: New York Times on sex after cancer


Following on the heels of my last post, I was struck by an article that Susan Gubar published in the New York Times about how cancer patients deal with developing or maintaining a sex life after their diagnosis. Gubar knows whereof she speaks, having been diagnosed with ovarian cancer and written a lot about the subject. What impressed me about the article is how the cancer patients she talks about articulate a broader sex of what constitutes sex beyond intercourse-to-ejaculation.

We all have limitations in our capacity to engage in pleasurable and satisfying sex, even though we may be reluctant to admit it. But for cancer patients, there’s no getting around the reality of facing those limitations head on. Everybody handles the situation in their own way. Reviewing a new book called “Sex and Cancer” by gynecologic cancer specialist Saketh R. Guntupalli and Maryann Karinch, Gubar writes:

The capacious term “sex” should not be conflated with penetration or intercourse, according to Dr. Guntupalli and Ms. Karinch. “There is no dysfunction if both members of the couple are happy with the level and style of intimacy they enjoy.” Kissing, hand-holding, cuddling, caressing and massaging bond couples by kindling arousal and ardor. The authors do not mention the useful word “frottage” which comes from the French for rubbing or friction; it neatly bundles together many forms of stimulation that prompt tenderness and excitement.

Gubar goes on to mention her cancer support group and the wide range of challenges its members deal with on a daily basis when it comes to sex and intimacy.

The youngest member of my support group nevertheless found herself “less easily aroused and less orgasmic.” Her explanation of how she cultivated “the art of desire” strikes me as illuminating for women and also for men. She uses exercise to appreciate her body’s tremendous resilience; acknowledges that she is anatomically, psychologically and hormonally changed; experiments with solo sex and also extended foreplay with her partner; and samples the shared stimulation of movies, concerts and travels to create a sense of closeness. Since her marital bed had been her sick bed, she refurbished the bedroom with sensory stimulants. It now promotes joy in her partner’s life and in hers as well.

Check out the whole article online here and let me know what you think.

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DID YOU SEE: the New York Times on A Frenchwoman’s Guide to Sex After Sixty

Judith Newman writes a monthly column for the Sunday New York Times Book Review about self-help books. In yesterday’s paper, she led with a capsule review of Marie de Hennezel’s A Frenchwoman’s Guide to Sex After Sixty that so beautifully articulates a philosophy of sex at any age that I can’t resist quoting that passage in full. The book, Newman writes,

immediately catches your attention because the cover shows a woman of a certain age glancing coquettishly over the bedsheets. But that age isn’t 40. It’s perhaps 75. So this isn’t the American version of old; it’s the French version, which is to say: old. And that’s what makes this volume uniquely French: It’s deeply un-American in its realism. Aches and pains, medications that reduce libido, a diminution of hormones that mean friction is tougher on our naughty bits and of course the occasional urge to cover all the mirrors in the house: Aging ain’t pretty, Hennezel admits. Yet for many of us, Eros lives, and Eros wants its due. What’s called for, then, is a revolution in the way we look at sexuality: a de-emphasis on orgasms in favor of kissing and caressing, more solo play to connect with our erotic selves and “making affection” as an alternative to making love. Feeling good through exercise and a healthy diet is paramount; looking younger through plastic surgery is mentioned not at all. Reading the stories of septuagenarians and octogenarians who are finding love or intimacy or sometimes just sex, one is reminded that the very French concept of joie de vivre — a sense of joy that comes from curiosity and playfulness, from looking outward instead of inward — is its own form of Botox.

You can check out Newman’s whole column online here.

DID YOU SEE…?: New York Times on Women of Sex Tech

In last Sunday’s New York Times, reporter Anna North wrote a fascinating story called “Women of Sex Tech, Unite” about the savvy female entrepreneurs — many of them millennials — who are pouring their attention, energy, talent, and skills into developing sex toys and related products and helping other women who are marketing and distributing them.

North writes:

In 2017, women entrepreneurs in the field still seem to be very much in the minority. Today around 70 percent of sex product companies are run by men, according to an analysis by Unbound. But women, many of them millennials, are starting to harness their economic and social power to disrupt the industry, both on the business and on the consumer side, Ms. Fine said. Millennials can be more comfortable talking about sex than their elders, explained Helen Fisher, an anthropologist and research fellow at the Kinsey Institute. “It’s a transparent generation that’s practical, go-getting, tech-oriented and eager to have it all.”

Besides providing surveying the modern history of sex toys without the usual sniggering tone, the article mentions a whole bunch of resources (products, companies, websites, publications, podcasts) that I’d never heard of but that I’d like to know more about, in the interests of supporting women in expanding their access to greater sexual pleasure and erotic awareness.

North leads with Janet Lieberman and Alexandra Fine, two Brooklyn-based entrepreneurs (above) who started Dame Products, the first company to receive Kickstarter funding to develop a sex toy.

If the movement has an ideological center, it’s probably Women of Sex Tech, a group founded last year by Polly Rodriguez [pictured below center, with her team], 30, the chief executive and co-founder of Unbound, a Manhattan-based sex toy company that sends subscribers a box of products every quarter, and Lidia Bonilla, 38, who started House of Plume, which sells storage boxes for sex toys. Based in New York, the group has since expanded to include more than 70 people, including members in California, Spain and China. New York City-based members include Meika Hollender, the co-founder of Sustain, which makes organic and fair trade lubricants and condoms; Mia Davis, who created a sex education app called Tabú; and Bryony Cole, the host of the popular podcast, Future of Sex.

Check out the whole article here and let me know what you think.

DID YOU SEE: The Atlantic on the impact of pornography

In the latest issue of The Atlantic, Sophie Gilbert writes an excellent thoughtful piece about the impact of pornography, as it is reflected through Tom Perrotta’s novel Mrs. Fletcher and a podcast called The Butterfly Effect.

“It’s a surprisingly simple argument, and yet a shocking one, in a culture that’s as polarized over porn as it is over everything else. What if porn is neither good, nor bad, but both? What if it enables some people to feel less isolated even while it conditions others to do things they regret?”

Check it out here and let me know what you think.

DID YOU SEE: The Guardian on Laura Dodsworth’s MANHOOD

I’m always fascinated by the differences between American and British newspapers, especially how they handle discussions of sex and depictions of nudity. The Guardian, the most progressive of London’s daily papers, recently published a feature about photographer Laura Dodsworth and her latest book Manhood, for which she photographed 100 men naked from the waist down and interviewed them about their penises. (The book is a sequel to Bare Reality, in which women talked about their breasts.)

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In addition to talking to Dodsworth about her book, the Guardian published several excerpts of the interviews and every single one of the photographs. I can’t imagine any daily newspaper in the United States running pictures of 100 penises, can you? Above and beyond the initial titillation, the article (and the book) do a great public service by exploring a subject that men think about all the time but don’t talk about much at all, even to their closest friends and loved ones.

The men range in age from 20 to 92, and their bodies take many sizes, shapes, and colors. Unless you are an enthusiastic naturist and spend time on nude beaches or in other environments where naked bodies are the norm, you may not have seen very many penises in your life — outside of pornography, which almost exclusively features penises that are large, erect, and intimidating. In my experience, it’s almost always revelatory and healing for men (and women!) to see a large quantity of penises and realize how varied and individual they are. And the men in Dodsworth’s book talk very honestly and intimately about their private parts. Check out the excerpts online here and let me know what you think.

DID YOU SEE: Washington Post column on what to do when marital sex wanes

Scrolling through the Washington Post website, I couldn’t help noticing a headline that reflected a sentiment I’ve heard from many a client: “Husband who hasn’t had sex in years wonders, ‘Is this normal?'”

I was impressed with columnist Carolyn Hax‘s answer, the gist of which was this:

What’s “normal” in a marriage is less important than what’s mutual.

If you’re worried, then, yes, you should be; if you’re not worried, then you shouldn’t be.

By that measure, the cause for concern at home is that you and your wife aren’t talking or touching.

Talking and sex are a fickle combination, though, with couples just as often cooled off by it as warmed up. If you tend to the former, then try this, first: Introduce more fun, physical but nonsexual activity to your lives together. As it stands now, you’re not touching, you’re not passionate, you’re putting on weight — this is about more than sex, no? It’s about losing your connection to your own bodies. When was the last time you and your wife hiked, biked, paddled, danced?

Using your body is the best way to wake it up — and not coincidentally, movement is a known emotional conductor. Get yourselves going, together, in a way that you both enjoy, and you stand to improve your connection (1) and communication (2) as much as you do your blood flow (3), all while adding an (I’m guessing) urgently needed shot of novelty (4) to your marriage — thereby accounting for the four cornerstones of passion. So. Take her hand, and go.

She has a few other things to say that make sense as well. Check out the whole column here and let me know what you think.

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DID YOU SEE…?: Bruce Perry on how stress works

Starting from my own personal experience and extending into my professional practice as a psychotherapist, I’ve long been aware that managing stress is a crucial part of health and well-being, every bit as important as diet, exercise, sleep, and touch. But I’ve never known the scientific particulars of how stress works on the body, especially the brain, for better and for worse, until reading an article published in the latest issue of The Sun, an excellent literary magazine published in North Carolina that doesn’t accept advertising and is completely supported by its readers — the magazine equivalent of National Public Radio, without the big federal grants. Each issue contains a lengthy Q-and-A interview with someone who’s an authority on some important political, social, spiritual, or medical concern. The November 2016 issue presents an interview conducted by Jeanne Supin with Bruce Perry, a North Dakota-born Houston-based psychiatrist and researcher who has co-authored two books, The Boy Who Was Raised as a Dog and Born for Love: Why Empathy Is Essential — and Endangered. In this conversation, titled “The Long Shadow: Bruce Perry on the Lingering Effects of Childhood Trauma,” Perry gives the simplest, most thorough explanation I’ve ever read of how stress interacts with the human body.

The interview is long and interesting and worth seeking out in full. I’d like to share here a significant chunk specifically talking about stress. Here’s the gist of what he has to say.

On the harmful impact of chronic stress: “When you are overstressed, you no longer have efficient access to your higher brain functions. By the time you’re in a state of alarm, significant parts of your cortex – the highest-functioning part of your brain – have shut down entirely. This is adaptive if you’re confronted by a predator, because you don’t want to waste time thinking about how to respond: you want to fight or run away. But to do your best reasoning, you need access to that sophisticated part of your brain. To learn and plan, you need to be in a relatively calm state.”

On the healthy aspect of stress: “Resilience comes from stress. It’s important that parents, teachers, and coaches not be afraid of it. Exploring, getting dirty, and falling down help you build resilience and tolerate novelty and discomfort.”

To put those passages in context, read on, and let me know what you think.

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Supin: Can you explain how our stress-response systems work?

Perry: All input – feelings of hunger or thirst, loud noises, the sound of someone’s voice, some information we learn – first enters the lower, more primitive part of our brains, which determines if this input is familiar or unfamiliar. If the input is familiar, it then travels to a higher, more evolved part of our brain, where we decide based on memory whether it’s good, bad, or neutral. If the input is unfamiliar, the brain’s default conclusion is This can’t be good. Any novelty – even desirable novelty, like learning something new – activates our stress-response system.

Some stress is actually good for us – for example, the stress related to meeting a new person or traveling to a new place. Predictable, controllable, and moderate activation of the stress-response system has been shown to build our capacity to manage challenges. When a child has the opportunity to challenge herself in the presence of supportive adults, it builds resilience. It’s the dose, the pattern, and the controllability that determine whether the stress is adaptive or harmful.

Let’s say you’re a six-year-old boy, and up until now your life has been OK. Mom and Dad split up, and there was some conflict around the divorce, but nothing too horrible. Then all of a sudden Mom has a new boyfriend in the house. That’s novel, so it generates moderate stress. At dinner he raises his voice at you; that’s unpredictable. He soon starts barking orders at you more frequently. He yells at your mom. He hits you, or he hits your mom. Your stress-response system doesn’t have time to return to baseline before another source of stress arrives. You start having anticipatory anxiety about what will happen next. Your baseline level of stress increases; things that would not have bothered you much before now bother you a lot. A harsh tone of voice that may have been mildly upsetting is now overwhelming. If the boyfriend’s behavior continues, your stress-response system may start to register any angry tone of voice as threatening. You’ve become what we call “sensitized.”

Conventional wisdom might suggest that the boy would get used to the angry, violent behavior and be less affected by it over time, but you’re saying the opposite is true.

Exactly. The more our stress-response system is activated in uncontrollable ways, the less able we are to handle even small amounts of stress.

When you are overstressed, you no longer have efficient access to your higher brain functions. By the time you’re in a state of alarm, significant parts of your cortex – the highest-functioning part of your brain – have shut down entirely. This is adaptive if you’re confronted by a predator, because you don’t want to waste time thinking about how to respond: you want to fight or run away. But to do your best reasoning, you need access to that sophisticated part of your brain. To learn and plan, you need to be in a relatively calm state.

Let’s go back to the six-year-old boy in your example. What happens to him at school?

The brain is good at generalizing from one kind of experience to another. Most of the time this ability is a gift, but this boy may generalize that all male authority figures who raise their voices are terrifying. This starts a vicious cycle: The boy arrives at school already on heightened alert due to his home situation, and he can’t pay attention. The teacher gets frustrated and raises his voice. The child is now even more on red alert. It’s impossible for him to concentrate. The rational parts of his brain shut down. Instead he has access only to the parts that process information valuable in threatening situations. He’s attuned to the teacher’s tone of voice, to whom the teacher is smiling at. He’s learning to read nonverbal cues. The calm child will learn the state capitals; the sensitized child will learn who is the teacher’s pet.

Can he recover from that?

Yes, opportunities for controlled, moderate doses of stress can shift these systems back toward well-regulated functioning. The key is that a moderate challenge for a typical child may be a huge challenge for a sensitized child.

The achievement gap in schools has a lot to do with the child’s home and community life if the family is concerned about not having money for food or rent or a doctor’s visit, that creates a pervasive sense of anxiety and unpredictability. The longer the child is in that environment, the worse the vicious cycle at school becomes. Eventually the kid says to himself, “There’s something wrong with me. I’m stupid.” And he drops out as soon as he can.

What about the character-building benefits of facing down adversity, of “rising to the challenge”? Is that ever applicable in these situations?

If you start from a healthy place, adversity can be character building. But if you grow up amid constant adversity, you are less likely to have the flexible and capable stress-response systems you need to face down adversity. Certainly many children do grow up with remarkable gifts and strengths despite their challenges, but when this happens, it’s often because there were people in the child’s environment who helped create a safe, predictable space for the child at least part of the time.

Are there instances in which well-intentioned parents protect their children from stress too much?

Yes, I’ve seen upper-middle-class children develop anxiety disorders because they had never been given the opportunity to explore the world. They’d been told only, “Don’t do this, don’t do that, don’t get dirty.” By the time these children went to preschool, they hadn’t learned to tolerate even slight discomforts. They became overwhelmed by the novelty of preschool and had meltdowns.

Resilience comes from stress. It’s important that parents, teachers, and coaches not be afraid of it. Exploring, getting dirty, and falling down help you build resilience and tolerate novelty and discomfort.

How might we apply this to whole communities?

First we have to understand that feeling connected to other people is one of our most fundamental needs. We feel safer when we are with kind and familiar people. Tension can arise from being part of a marginalized minority, whether you define that minority status by economics, race, ethnicity, religion, gender identity, sexual preference, or whatever. The marginalized group has a much higher level of baseline stress. It’s not a specific traumatic event; it’s a continuous sense of disconnection.

Our brain is constantly monitoring our environment to gauge whether or not we belong someplace. If we frequently get feedback that we don’t belong – or, worse, overt threats – then our body’s systems stay in a constant state of arousal. This increases the risk for diabetes and hypertension and makes learning, reflection, planning, and creative problem-solving harder. Over time it will actually change the physiology of your brain.

For example, for someone who already feels marginalized and is hypervigilant, even a relatively benign interaction, such as a police officer asking for your license, can trigger a volatile reaction. This is true for both the person being stopped and for the cop who’s doing the stopping. They both can be sensitized. People in law enforcement should know the principles of stress and trauma. It’s the key to understanding why some of their policies and behaviors have a destructive effect.