LET’S TALK ABOUT SEX: advice for young men from New Zealand cartoonist

Auckland-based artist Toby Morris created and produces the webcomic The Pencil Sword. His latest post speaks frankly about sex to young men and delivers what he describes as “two things I wish someone told me as a teenage boy.”

Here’s the first page:

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Check out the rest of his comic here and let me know what you think.

SEXUAL HEALTH: psychedelics and sex therapy

In recent years, medical research into the therapeutic use of psychedelic drugs has cautiously re-emerged after decades of being shut down by War on Drugs rhetoric. Major medical centers are now participating in multi-stage trials of MDMA (ecstasy) for treatment of post-traumatic stress disorder (PTSD) and psilocybin (the active ingredient in magic mushrooms) for treating depression, cancer anxiety, and alcoholism. In South America, the Amazonian plant medicine ayahuasca has been used to manage a variety of ailments, especially alcohol and drug addiction.

Like a lot of people, I caught wind of this renewed research into psychedelics from reading an article by Michael Pollan called “The Trip Treatment” that was published in the New Yorker two years ago. Pollan noted:

Beginning in the nineteen-fifties, psychedelics had been used to treat a wide variety of conditions, including alcoholism and end-of-life anxiety…Between 1953 and 1973, the federal government spent four million dollars to fund a hundred and sixteen studies of LSD, involving more than seventeen hundred subjects…Psychedelics were tested on alcoholics, people struggling with obsessive-compulsive disorder, depressives, autistic children, schizophrenics, terminal cancer patients, and convicts, as well as on perfectly healthy artists and scientists (to study creativity) and divinity students (to study spirituality)…

By the mid-nineteen-sixties, LSD had escaped from the laboratory and swept through the counterculture. In 1970, Richard Nixon signed the Controlled Substances Act and put most psychedelics on Schedule 1, prohibiting their use for any purpose. Research soon came to a halt, and what had been learned was all but erased from the field of psychiatry.

It’s taken decades for conditions to shift so that research into the therapeutic use of pyschedelics can pick up where it left off in 1970. The bulk of Pollan’s article focused on participants in clinical trials at several universities, including N.Y.U., in which psilocybin was being administered to cancer patients in an effort to relieve their anxiety and “existential distress.”

One of the researchers was quoted as saying that, under the influence of the hallucinogen, “individuals transcend their primary identification with their bodies and experience ego-free states . . . and return with a new perspective and profound acceptance.”

Naturally, as a sex therapist, I was intrigued to attend a presentation last December called “Reclaiming Ecstasy: An Exploration of the Therapeutic Use of Psychedelics and Sacred Plant Medicines in the Treatment of Sexual Trauma and Dysfunction” given by my friend and colleague Dee Dee Goldpaugh. The presentation took place as part of the Sexuality Speakers Series, hosted by Dulcinea Pitagora and Michael Aaron, creators of the AltSex NYC Conference.

reclaiming ecstasy

image by Alex Grey

In her talk, Goldpaugh laid out some basic pharmacological information about the two classes of psychedelics (the hallucinogens such as psilocybin, LSD, and ayahuasca/DMT and the empathogens such as mescaline, 2cb, and MDMA) and the difference between therapeutic use (pure substances in measured doses) and self-administration. She shared the distinction that clinicians make between big-T trauma (rape, incest, assault, molestation) and little-T trauma (being catcalled, medical exams, being belittled, punished for masturbation, boundaries not respected by caregivers). And she explained the numerous ways in which sexual abuse has lasting effects on those have been sexually abused: PTSD, depression, dissociation, substance abuse, distrust, dysfunction, shame, self-blame, body image issues, sexually transmitted infections.

Citing the work of Friedericke Meckel Fisher (Therapy With Substances) and Bessel van der Kolk (The Body Knows the Score), Goldpaugh then laid out some of the explorations researchers are conducting to use psychedelics to treat trauma, especially in the area of sexuality, intimacy, and relationships. MDMA, for instance, was first patented in 1914 and until it was outlawed in 1985 was used for couples therapy, among other things, because of its effectiveness in treating symptoms of PTSD and because it seemed to activate long-term memory and allow subjects to reprocess traumatic material safely. Because it induces pleasurable sensations, MDMA allows users to feel fully embodied, increases empathy, and reduces shame.

Psilocybin studies suggest that it increases openness and facilitates mystical experiences by helping the brain bypass habitual thinking. Goldpaugh proposed that psilocybin could be useful in sex therapy to reduce body anxiety and to be present with pleasure. Similarly, ayahuasca enables users to override old responses and write new stories of their own experience. Goldpaugh suggested that these substances have potential to enhance a spirituality often neglected in sex therapy. She gave examples of using guided visualizations with trauma survivors who experience intrusive images during sex, helping them identify non-sexual images they can connect to in an embodied way during sexual activity (including masturbation).

Goldpaugh was very upfront in saying that she doesn’t give psychedelics to her clients or refer them to “underground” practitioners who do. At the same time, she does advocate working to legalize the use of these medicines and to support further research through organizations such as MAPS (Multidisciplinary Association for Psychedelic Studies). Her website introduced me to the term “psychedelic integration therapy,” indicating that she helps clients process their experiences with psychedelics, as I have begun to do in my own work.

I consider Goldpaugh a kindred spirit in many ways, including how she describes a “psychedelic” approach to working with clients. This approach, she said, is based on strengths, not pathology; engages spirituality, “whatever that means for the client,” as an aspect of identity; embraces radical sex-positivity; sees all people as capable of change and growth; and views sexual pleasure as a sacred human right.

 

 

 

R.I.P. Mark Thompson

The latest issue of RFD, the radical faerie digest, is rightfully dedicated to commemorating Mark Thompson, the visionary gay writer and editor who died last August at the age of 63.

As I say in my contribution to the issue:

The radical faerie world will always be indebted to Mark Thompson for his skill and generosity in chronicling the emergence of this gay spiritual movement as a professional journalist and as an observer-participant. He attended the legendary first “Spiritual Conference for Radical Fairies” Labor Day weekend 1979 in the Arizona desert, convened by Harry Hay, Mitch Walker, and Don Kilhefner, and he wrote about it in Gay Spirit: Myth and Meaning, his ground-breaking anthology of writings that linked contemporary gay liberation thought to previous generations of gay visionary writing by the likes of Walt Whitman, Edward Carpenter, and Gerald Heard. Few books ever published have had as big an impact on the gay world as Gay Spirit did. It emerged from and contributed to a hunger for deep exploration of gay people’s evolutionary purpose on the planet, and it spawned a small but important pocket of gay scholarship that manifest in essential titles such as Randy Conner’s Blossom of Bone and Walter L. Williams’ The Spirit and the Flesh.

I am pleased to have my short essay published alongside the work of many dear friends and colleagues, including Andrew Ramer, Winston Wilde, Robert Croonquist (Covelo), Keith Gemerek, Bo Young, Stephen Silha, and Leng Lim. You can find the magazine in the kind of bookstores that still carry small-press gay journals, or you find out how to order it online here.

Here is my piece (click to enlarge):

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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.

get-naked-emotionally

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.

bruce-perry-sun-interview

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.

 

DID YOU SEE…: New York Times on workday stress reduction

Phyllis Korkki’s Applied Science column in today’s Sunday New York Times offers good sensible advice about using conscious breathing, posture, and body awareness tools to reduce stress and anxiety on the job. These are simple mechanisms that we all know about but it’s easy to forget them.

Seeking some assistance in dealing with mounting stress, Korkki says, “My first stop was Belisa Vranich, a clinical psychologist who teaches — or rather reteaches — people how to breathe. Dimly I sensed that the way I was inhaling and exhaling was out of whack, and she confirmed it by giving me some tests. First off, like most people, I was a ‘vertical’ breather, meaning my shoulders moved upward when I inhaled. Second, I was breathing from my upper chest, where the lungs don’t have much presence.

“In her Manhattan studio, Dr. Vranich taught me the right way to breathe: horizontally and from the middle of the body, where the diaphragm is. You should expand your belly while inhaling through your nose, she said, and squeeze your belly inward while exhaling.l way to breathe — the way children and animals do it, Dr. Vranich said. It’s when society begins to exert its merciless pressure on us that we start doing things the wrong way.

stress reduction illo by michael waraska                                  illustration by Michael Waraska

“When we are under stress at work, we tend to brace and compress ourselves, and our field of vision becomes narrow, Dr. Vranich said in a recent interview. This causes us to breathe more quickly and shallowly. The brain needs oxygen to function, of course, and breathing this way reduces the supply, causing muddled thinking. Also, the digestive system doesn’t receive the movement and massage it needs from the diaphragm, and that can lead to problems like bloating and acid reflux, she said. Stress can send people into fight-or-flight mode, which can lead them to brace their bellies to appear strong. This is exactly the stance that interferes with calm, alert thinking.”
Paying attention to these body cues and shifting your response to them is good practice. Check out the whole article online here and let me know what you think.

Quote of the day: MINDSET

MINDSET

My research started out looking at how people cope with failure and setbacks, especially students who were asked to solve challenging problems. Some students acted as though a failure was a catastrophe, while others actually relished the challenge. I was particularly interested in the latter group. I vowed that I’d figure out what their secret was and try to bottle it. It comes down to whether you focus on growing your abilities, as opposed to proving and validating them all the time. When you’re in what I call a fixed mindset, your goal in life is to prove you’re a smart, competent, worthwhile person and avoid doing things that could undermine that image of yourself. In the growth mindset, you believe these abilities and talents can always be developed, so you’re not on the spot every second to prove yourself, and you can focus on developing those abilities through taking on challenges and seeing them through. You can be more resilient from setbacks because they don’t define who you are. In other words, the fixed mindset is the idea that you have a fixed amount of intelligence, ability, or talent, and the growth mindset is the idea that you can always develop these abilities and talents. Of course, people differ in their abilities, but the underlying premise that separates people is the degree to which they believe they can develop their talents and capacities further.

–Carol Dweck, interviewed in Psychotherapy Networker

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