Facebook Like


Tuesday, May 30, 2006

Hating Viagra

Okay, I’m sure some people have good reasons for taking this drug. I’m just not so into them. And as counter-intuitive as this may sound, I’m NOT getting into why men have erectile dysfunction on this post. For more on sexual dysfunction look at Lessons from a Family Therapist

Suffice it to say that sexual dysfunction by definition is a couple problem.

It is a problem that surely cuts deep, hurts both partners, may have roots in family attitudes, religious upbringing, sexual traumas, lack of education about the human body and what it can and can not do and when, and may be associated with 25% of all divorces in the United States.

So why don’t you guys just take an expensive pharmacological treatment and FIX IT?!?!

Now, doesn’t that sound silly? There, I’ve said it. No more on this for a long time excep to say that:

Actually, 80% of couples with sexual dysfunction treated with behavioral-psychotherapy (by trained sex therapists) are cured.

Look up an AASECT provider in your home town. It's also something some marital therapists (like me) do for loads of money using NO surrogates. Surrogates may work on Boston Legal, but here in Chicago it's all about your marriage.

Therapy Doc

Emotional Intimacy and Give Me Space

Intimacy—you can't live with it, you can't live without it.

But the truth is that you really can. You can live with it and you can live without it. Relationship therapists have a bias that indeed, you're better off WITH emotional intimacy, than WITHOUT IT. It's a standard of living thing.

We have to begin with psychological space. Everyone has a personal need for psychological space. This is the place where we think, read, write, paint, work (if we're lucky and our work requires our undivided attention), practice our skills, fantasize, and play.

Even invading someone's silly game of Spider is invading his or her personal space. So you can imagine that if there is a disparity, if two people have very different needs for the amount of personal space they need, how that can make for problems in the relationship.

An extreme need for personal space is psychosis. People who are labeled psychotic have a tremendous need for psychological space. They're entire world is preferably private. We'll discuss that more in my chapter on psychosis. That's just the extreme. Most of us aren't there, and frankly, it's not nice to call someone psychotic. Psychosis is serious business. So if your partner needs a lot of psychological space, don't call him/her psychotic. Please.

But do tell him or her that you sometimes feel alone or abandoned.

Usually couples start out their relationship needing about the same amount of psychological space. But that often changes over time. For example, one may go back to school or get a more time-intensive job, or a parent or child may get sick, requiring not only our emotional resources, but time.

Although I'm defining psychological space as essentially alone time, time in general can be a problem in relationships. If one partner goes back to school, not only is he or she thinking about school, but school requires time away. So psychological space and time, real time away from a partner can both serve as intimacy busters.

What to do, what to do.

It can be very complicated. A partner who wants more attention and time from the other may complain that the other: always has to be with other people, is always running over to help someone else, always has to go out on the weekends, is always talking on the phone, never wants to go to bed until it's the end the day and both are exhausted, is always at the computer, is always last on the list etc.

Is this a crime to complain about not getting enough time from your partner? Does it make you overly dependent?

I'm thinking not. But there is a middle ground.

A novice therapist will look a couple straight in the eyes (not easy, four eyes staring you down, hanging on your every word) and say, Well this is easy. Each of you do your thing and then the two of you get together at the end of the day, not too late, of course, and compare notes and hang out together and have sex.

Or, to make it simpler and even less effective, perhaps a novice therapist will press the partner who wants more intimacy and time to get a hobby, or as we say in the biz, individuate, grow.

Rather than focus on helping the couple become more intimate, such a doc may unwittingly increase the psychological space and time apart by encouraging the one who is less busy to become more busy, more self-actualized. You go to school. You grow.

You get a life, the therapist tells the one who wants more intimacy, which is fine, except that it doesn't solve the problem.

Telling the partner with the greater need for intimacy to stuff that need, sublimate it and fill life up with other people and things is not the solution to the relationship problem. In the short run, yes, it helps, but not in the long run for many reasons that we'll talk about another time.

Suffice it to say that needing more intimacy and getting more intimacy is a good thing and bodes well for a future.

When we're young, we may need less intimacy (more sex, maybe, but sometimes less from one another emotionally). We're stronger, better looking, and hopefully haven't suffered many financial, physical, or emotional hardships.

As we age, however, the challenges of life begin to wear on us. We become less defended, more vulnerable. If we don't need physical holding when we are young, we may very well need it sooner than we think, and having a partner becomes a very, very good thing, a real gift. Lonely people already know this.

Therefore I push couples to work on being close, not at the expense, necessarily, of becoming better individuated people. Personal growth is still a good thing, and we should do that anyway, develop interests that make us happy, add to our sense of self with experiences and skills. Having things that we can say that we do or know is the natural way to stay happy.

Personal growth shouldn't have to detract from our intimacy with a partner, however. Intimacy is really all about quality, not quantity. Yet there's no question, to be emotionally intimate, the partner who needs more personal space does have to suck it up and Be There emotionally and psychologically for the partner who needs more intimacy. And that will take time.

It doesn't take that much time, however, to sincerely communicate love, affection and admiration. And to share and listen to another's sharing.

Having sex doesn't cut it, by the way, as a replacement for emotional intimacy. Hugging, gazing thoughtfully into one another's eyes, and listening are the emotionally intimate behaviors we're talking about.

And this doc feels that those of us who NEED emotional intimacy are actually more highly evolved. It says we care about others. We want to listen and we want to hear. It's a pretty big deal.

Copyright 2006, TherapyDoc

Monday, May 29, 2006

Recreational Intimacy, Play with me?

It's intimate, silly If you remember what I wrote about the five types of intimacy, requires that you do something together and work at making it fun. It's a nasty job, but somebody has to do it. At least for a couple of hours a week.

Even when both partners like a certain type of recreation, they can still manage to sabotage the fun. Even fun, see, can be a complete set up and total disaster. (More on this on the Types of Couples posts to come). Let's take my personal favorite recreation.

Tennis. Now there's a potentially intimate game, right? Two people can play together without a third or fourth to triangle one or the other out. (More on Triangles another day) It's potentially intimate because the players face one another from a short distance, across the court, usually in public, yet they are emotionally the only ones in the game. They wear scanty clothes, sometimes! They're exercising and will hopefully shower later. Should be fertile ground for recreational intimacy that could even lead to other types of intimacy. Should be.

But the recreational intimacy is very hard to pull off, actually, for many reasons. One may not want to beat the other or may feel terrible losing. One or both may be bad sports and tease, verbally abuse. Maybe one partner is really better than the other and gets frustrated at the other's lousy game. There are all kinds of things that can and do go wrong.

A famous neurologist, Jack Fox, says that everyone thinks he/she is a better tennis player than they really are. Let’s say that Jack's right. Now take Suz and Alan(made up names). They've been married a few months. They both played tennis in the past. They both loved the game. And no exception to Jack's rule, both thought themselves better at tennis than they really were.

So it was no surprise, when they started to play tennis, that each expected to win. It turned out that although Alan was no Bjorn Borg, he wasn’t that bad and he could beat Suz, beat her badly. He had a murderous serve. He smashed it, and when it was accurate, it flew way over her head. She hadn't a chance. She lost game after game and didn't like playing very much. What she wanted was that they each play with their own friends, not each other.

But Alan wanted to play with Suz. He really just wanted to play with her. Alan and Suz were not a conflictual or otherwise dysfunctional couple, and they really did want to do something fun together. But you can see how the situation was loaded with potential problems. So how did they manage it?

Suz, took some lessons and improved her game remarkably. Meanwhile, when they played together he tried to softened his serve. When he did smash the daylights out of the tennis ball (he still needed to do that for some reason) she took the smash from way behind the service line and by holding her racket steady, returned it fairly often. That was all she needed to do to put him on the defensive. She could rush the net to put away the next shot.

Such constructive problem solving! Not power tripping or giving up on the notion that they could have fun playing a game they both loved and were obviously VERY good at! And great problem solving is very, very intimate. More next time.

Copyright 2006, TherapyDoc

Work Intimacy: At the End of the Day

People in therapy use expletives to describe their days at work or at school. Some therapists work on self-relaxation with them, others, problem solving. And many of us encourage venting to friends, parents, and spouses, partners.

When the day isn't all that good, it feels good to dump it, source the stress, purge. Others just want to forget about it. And when it is good, we might want to share that, too, brag, ramble on about the good things that happened, right away. Yet others sit and wait to be asked, and if the question never happens, well, they don't share.

It doesn't matter what we do during those waking hours. We could sell cars, drill teeth, study bugs or bring them home, whatever a person does with time, many people, even kids, like to talk at the end of the day. Then there are those of us who don't want to utter word one.

If we're lucky and our verbal skills get better and better as life gets more and more complicated,, some of us want to talk more and more. Maybe not everyone, but enough of us get into this, I can't wait to tell you place. It becomes such a drive that we resent when the other won't let us get a word in edgewise. In couple's therapy it can look like this.
YOU WON'T LET ME GET A WORD IN EDGEWISE, THAT'S WHY I DON'T TALK
another variation of Why does it always have to be all about you?

Maybe it's a basic human need to want to talk about our day, especially if it was a particularly good or bad day. I should think especially with the bad ones.

Why? When a person talks about something bad, it disappears, or at least loses some of it's drama, importance, maybe just a tiny piece, maybe all of it. You drop it off, you give it to the person you've told it to. It's a gift, of sorts.  This is the psychological equivalent of procrastinating an obsessive negative thought, or worry. It loses a bit in the process, and we need to do that, lose the negative.

Sometimes I thank people for sharing in therapy, and get funny looks sometimes, but mean it. It isn't a THANKS FOR SHARING sarcastic.  I feel it is a gift when someone trusts me enough to tell me personal things, even if one of the covert rules of the relationship is that they're paying me to listen.

When we're in a relationship—that can be any relationship—friendship, sibship, parent-child, spouse-spouse, lover-lover—boss-employee-if we have that talky-sharing thing going, if it is on-site, we're really lucky. There is another person who ostensibly is willing to listen to us (for free, even).

So if you're in a relationship, then there shouldn't be a problem. The willing ear is built in.

Take an adult married, or domestic partner situations.

A person comes home, someone's already there. One of the two begins to talk and the other is trapped.

Now, this other might have something important to say, too, or might want NO WORDS AT ALL at that moment is still working on something else, using the brain or the body in some way and can't defocus. Pretty soon they're either fighting a covert fight over who gets to talk or one of them isn't listening and wishes the noise would kindly end.

There's a lot to be said for winding down differently at the end of the day. If one of us needs to change clothes, work out, watch TV or eat in silence, then there's something to be said for that. Finding the balance, obviously, is the ticket.  But we're talking about the importance of intimacy, work intimacy, to be precise, talking about our day at the end of the day.

The key, when getting our psychological space, is not allowing so much that one of us is alone in a relationship, or absolutely wanting.  This happens in the workplace, too, between supervisors and employees. The mentoring process can be too distant, but we all have our jobs to do. Yet job satisfaction often hinges upon that relationship. Both the supervisor and the supervisee need to make time for one another.

But that isn't about feeling lonely (although a sense of abandonment might follow). That is about the yin yang of work relationships-- talking to people, yet getting the job done and doing it well.

Certainly being lonely when we're supposedly in an intimate relationship, when we're living with someone else, the whole emotional unavailability issue comes up. My cousin, the psychologist and rabbi, Peter Rosenzweig, wrote a book, Married and Alone.  Not the best feeling.

But all we're talking about here is waiting an hour before the sharing begins at the end of the day, before the discussion of what happened that day begins, what we're calling real work intimacy.  That availability generalizes to on the job intimacy, sharing work issues with those that can solve them at work. It astounds me, when a patient is discussing a work problem, when it has never been brought to the attention of people on the job who can help.

The relationship lesson your mother never taught you: Try to be second in a relationship when it comes to dialogue. It's probably impossible, of course, to always completely sublimate our need to communicate, to let a partner or friend's need to talk come first, but it is a virtual guarantee that the other will be grateful and more willing to listen to us a bit later. At some point it is worth discussing to see if the dominant position can be switched up a bit.

In a mature dyad (any two people), there is a point where it becomes a polite power struggle about who HAS to go first.

There's an old joke about social workers and why they never get home from a conference. They're all in a meeting room and there's one door, and they're all ready to file through. But the people closest to the door are arguing:
YOU FIRST.
NO, YOU FIRST
NO YOU FIRST.
It's funny, and it's about being co-dependent (some say) but it's really a nice way to be co-dependent.  Sublimating that desire to talk first is the best way to build one of the five kinds of intimacy, work or school intimacy.

How does the relationship at home matter in the work place?  Many of us assume that we are capable of close relationships, even though these are best left at home, and in many work places it is preferred, no friendships on the job.  But we are judged if we don't know about the significant people in our lives. When we're asked, maybe even on a job interview, So what does you spouse/partner/significant other/brother/sister/father/mother do/study?  We probably need to do better than I don't know.

Copyright 2006, TherapyDoc

Sunday, May 28, 2006

Emotional Sharing/Intimacy

Emotional Intimacy. How hard could this be? Sharing, trusting, caring, giving and letting others give to you? It is hard. For starters, check out the post on Psychological Space.

Conflict resolution- If you win, you lose

Not exactly Problem Solving Intimacy but you step into the same territory. I indicate in the recreational intimacy post that the actual process of solving problems is so powerful that it is really emotionally intimate in the end. Getting to the end, of course, is a big kettle of fish that I'll talk about some other time. For now, think of it this way. If you win, you lose. Let me know why you agree or disagree in the comments section below.

Recreational Intimacy

The 5 Types of Intimacy. People tend to have very fixed ideas on the subject of intimacy, but there are at least five types. It’s not all touchy feely, which is good, because many people are very uncomfortable with direct, romantic expressions of love.

But because there are five kinds, relationships that are light on one, two, or perhaps even more of these varieties suffer. You sort of have to have it all, to have it all
. Lacking any one of them can be the reason a committed relationship bites the dust. And unfortunately, it's not at all easy to have them all.

We'll start with recreational intimacy. Counselors sometimes suggest that couples go out and find something they like to do together. Not bad advice, but it's not good, either. It's like saying, You guys go out and find a movie you both like .

Maybe your tastes are so different that you can’t even find a movie that both of you can tolerate. Then you try, but the next time that you can go out is on a Saturday night and you've already missed the 7:45. You’re don’t know how to get tickets on-line. The two of you fight the crowds, get frustrated and bored. You can do it, maybe, but why?

What these counselors should suggest is that you work less at finding something you both want to do and more at doing something together. Anything. The catch is having fun. The rule on an assignment like that is to keep it light, try to make it fun. You can still go to a depressing movie, but only if it’s good.

I tell people not to worry about both of you liking an activity. Whatever you choose to do, it can be something one of you likes and the other totally hates, as long as it isn't morally objectionable, disgusting or distasteful.

Games, sports, or the arts work nicely. Even pinball at a bowling alley. The partner who doesn't like the activity still has to have fun for a couple of hours. Two hours is plenty.

This is another misconception about intimacy. It isn’t a quantitative thing. Spending six hours trying to enjoy a Saturday night might be less worthwhile than a half an hour a night every night during the week. We really are talking quality time.

But you hate Monopoly? Too bad. You have to either have fun or pretend to have fun. Pretending is one of life's most unselfish challenges. Don’t think of it as being someone you're not. Think of it as becoming someone you want to be. If it’s okay for your spouse, it’s okay for you.

Pretend you're Gerry of Ricky and Gerry (gender nonspecific). Ricky has picked an activity that Gerry hates, golf. Gerry has the hard part-- not-- bursting Ricky's bubble.

Gerry has to think, Ricky wants me to do this. Ricky wants us to have fun together doing this. How can I make it happen? The answer is:

By not complaining. By laughing as much as possible. By letting go of thinking how dumb you look when you miss the ball. By thinking of how funny you look—it's good to laugh at yourself! Try to remember how happy Ricky is that you are there, just chasing after a little ball. Complement Ricky on how well he plays. Let Ricky teach you and don’t get defensive.

Ricky, has a big responsibility here, too. Ricky can't make you feel like a clod. Ricky has to ingratiate him/herself because Gerry is doing what Ricky wants. Gerry is sucking it up, and Ricky will have to do that next time. Sorry, Rick.

Thinking like this is a challenge, no doubt. But it is just this sort of (1) empathy and (2) fake it 'til you make it that is the key to intimacy. It's hard to be happy doing something that doesn't naturally make us happy. It's unnatural by definition and yet. the pay back is amazing.

Recreational intimacy can be hard even when you're doing something you both love to do, too, primarily because the other types of intimacy interfere with the process of your interactions with one another.

That’s why all five plates, all five types of intimacy, have to be twirling at the same time..

Copyright 2006, TherapyDoc

Recreational Intimacy

The 5 Types of Intimacy. People tend to have very fixed ideas on the subject of intimacy, but there are at least five types. It’s not all touchy feely, which is good, because many people are very uncomfortable with direct, romantic expressions of love.

But because there are five kinds, relationships that are light on one, two, or perhaps even more of these varieties suffer. You sort of have to have it all, to have it all. Lacking any one of them can be the reason a committed relationship dissolves. And unfortunately, it's not at all easy to have them all.

We'll start with recreational intimacy. Counselors sometimes suggest that couples go out and find something they like to do together. Not bad advice, but it's not good, either. It's like saying, You guys go out and find a movie you both like.  There may not be such a thing.  And the process of finding one might be more trouble than it is worth, a prelude to an argument.

But the doc says, Do this.  So you choose one, but by the time you make the decision you are late for the  7:45 and didn't get tickets online. You fight the crowds, get frustrated and bored. You can do it, maybe, but why?

What these counselors should suggest is that you work less at finding something you both want to do and more at doing something together. Anything. The catch is having fun. The rule on an assignment like that is to keep it light, try to make it fun. You can still go to a depressing movie, but only if it’s good and one of you can do an imitation later.

I tell people not to worry about both of you liking an activity. Whatever you choose to do, it can be something one of you likes and the other totally hates, as long as it's not morally objectionable, disgusting or distasteful.

Games, sports, or the arts work nicely. Even pinball at a bowling alley. This is a personal bias, I'm going to admit. It could be that I'm showing my age, but video games don't seem to be as interactive as pinball used to be. Pinball was a whole body experience (a little more sexy, I think), the visual field more expansive. You had a whole machine to work. 

Regardless of the game, the partner who doesn't like the activity still has to have fun for a couple of hours, make himself have fun. Two hours is plenty of fun. It won't kill you.

Another misconception about intimacy is that you have to spend a lot of time at it. It isn’t a quantitative thing. Spending six hours trying to enjoy a Saturday night might be less worthwhile than a half an hour a night every night during the week. We really are talking quality time.

But you hate Gin Rummy? Too bad. You have to either make it fun somehow or pretend to be having fun. Pretending is one of life's most unselfish challenges. Don’t think of it as being someone you're not. Think of it as becoming someone you want to be. If it’s okay for your spouse, it’s okay for you. Of course if it's morally objectionable, then it's not okay for either of you.

Pretend you're Gerry of Ricky and Gerry (gender nonspecific). Ricky has picked an activity that Gerry hates, golf. Gerry has the hard part-- not-- bursting Ricky's bubble.

Gerry has to think, Ricky wants me to do this. Ricky wants us to have fun together doing this. How can I make it happen? The answer is:

By not complaining. By laughing as much as possible. By letting go of thinking how dumb you look when you miss the ball. By thinking of how funny you look—it's good to laugh at yourself! Try to remember how happy Ricky is that you are there, just chasing after a little ball. Complement Ricky on how well he plays. Let Ricky teach you and don’t get defensive.

Ricky, has a big responsibility here, too. Ricky can't make you feel like a clod. Ricky has to ingratiate him/herself because Gerry is doing what Ricky wants. Gerry is sucking it up, and Ricky will have to do that next time. Sorry, Rick.

Thinking like this is a challenge, no doubt. But it is just this sort of (1) empathy and (2) fake it 'til you make it that is the key to intimacy. It's hard to be happy doing something that doesn't naturally make us happy. It's unnatural by definition and yet. the pay back is amazing.

Recreational intimacy can be hard even when you're doing something you both love to do, too, primarily because the other types of intimacy interfere with the process of your interactions with one another.

That’s why all five plates, all five types of intimacy, have to be twirling at the same time..

Copyright 2006, TherapyDoc