#2 Avoid being overly passive. You may think it’s fun or easy to lie on your back and let your partner do all the work, but pretty soon he or she is going to catch on to your little trick. Believe me, lying there like a piece of sushi isn’t going to make either of you like sex any more.

#3 Avoid forcing your partner to do anything. Even if you say, “Pretty please with sugar on top,” it isn’t nice to make your partner do something they don’t want to do. Don’t try sneaking, either. Give your partner more credit than that!

#4 Avoid bad timing. If your partner has had a bad day and lying on the sofa like they’ve just finished a walk through the Sahara, it’s probably not a good night to expect sex., no matter how good an idea you think it is.

5. Avoid bad technique. Don’t push your tongue all the way into the back of your partner’s throat. Don’t use your partner like a trampoline. Don’t let your hands rove over your partner like two limp potholders.

#1 Take time to relax before you make love, either alone or with your partner. Do what you need to do—listen to music, take a bath, ask for a massage—to turn off your mind and tune in to your body.

#2 Find out how active a role your partner would like you to take, and follow through. Or take the initiative to be more active, even if it feels awkward, and then get feedback about how your did.

#3 Negotiate for what you want before you get into bed. Tell your partner if you’d like oral sex or to be on the bottom. If your partner says no, accept that and say that you’d like for this to happen soon. If your partner objects altogether, find out why. See if they will do something else for you, or if you can trade off, so that you are doing something for him or her that you’re less than excited about.

#4 Find out when your partner is more likely to be in the mood for sex and how you can help to create that mood.

#5. There’s no excuse for bad technique. Don’t use porn to figure it out. A good sex manual or a teaching DVD is a better idea. Best, though, is to take your time, slow things down, and learn just how your lover likes to be made love to.

Today I was alerted to an article in Glamour Magazine online on painful sex that I thought might be helpful to my blog readers. It involves a quiz that can help women figure out why they are experiencing painful sex and some suggestions on what to do about it.

A large number of women who visit the Institute experience painful sex, but simply accept it as part of life. Unfortunately, sex that starts out mildly uncomfortable or painful can sometimes become worse over time. Sex therapy can be a helpful part of treatment for various types of painful sex in the following ways:

1. Concrete suggestions for coping with painful sex.

2. Helping spouses cope with a partner’s painful sex.

3. Helping couples change their sexual routines that can make sex fun again.

4. Some women have found hypnosis to be a helpful adjunct. (An “adjunct” means that hypnosis is used in addition to medical and psychological treatment, not in place of it.)

5. Helping with some underlying psychological causes. Not every woman who has experienced painful sex has been sexually abused or assaulted, but a large number have, and we can help with that.

6. Make referrals to physicians who are expert in this area.

BTW men also have painful sex, and a psychotherapist can be helpful with that, too. Would love to see some comments from men and women on what they have found helpful.

As an article in the Los Angeles Times reports, people are staying sexually active as they age. And why not? Today’s 70-year-old, if in good health, is much more vital than even a few short decades ago.

What is the key to staying sexually active into your later years?

1. Take good care of your physical health. Keeping your weight low, watching your blood sugar and cholesterol levels, and exercising so that you have energy and stamina are important ingredients in maintaining your sexual health.

2. Talk to your physician about any sexual concerns that you have. For men, this may mean ‘fessing up to having erections that just aren’t what they used to be. (Besides, ED can be a sign of heart problems, so letting your doctor know this is a problem is critical.) For women, it’s dealing with the hormonal issues of menopause that can make sex uncomfortable.

3. Have realistic expectations. It may take you longer to get aroused and to have orgasm. Or you may decide that intercourse is too athletic an endeavor, and that manual sex seems like a better idea.

Your sex life may not look like it did in your 20s as you age, but it doesn’t mean it must fade altogether!

For some people, pornography is viewed as a healthy addition to an individual’s or couple’s sexual menu – it can help them feel sexual and provide an important release when they’re alone, or can help educate and stimulate a couple as they explore and experience sexuality with each other. However, as with anything that excites our brain chemicals, use of porn can become excessive and problematic.

If you’re concerned about your use of pornography, perhaps it’s time to examine why you look at it, and what affect it is having on your life. There is much controversy in the psychological community about the use of the words “sex” and “addiction” together, but as an experienced sex therapist and addiction counselor, I have helped many clients whose use of pornography, talking in sex chat rooms, or even using prostitutes or other sexual activities, can looks very similar to other clients who have developed problems with alcohol and drugs.

Often men or women come into my office to discuss a specific sexual or relationship problem and our talk leads to a discussion of their habits related to pornography. For this reason I frequently start talking to clients regarding their feelings about their use of porn. Whether my clients have spent ten minutes or ten hours viewing porn in one session, masturbating one time or many, how do they feel about the experience? Was it enjoyable and satisfying, or do they feel badly about the activity?

Frequently, compulsive users of porn feel that they’ve spent more time than they had intended, saw and/or said things that they are not proud of, and ultimately do not feel that it was a healthy experience, worthy of their time and energy. Like the substance abuser, individual often feel deep remorse after their porn-viewing binges.

More to come in Part 2.

Dr. Berman also worked with a couple where the woman had completely lost her desire. Like many women who come into our offices, the woman said words to the effect that “I just didn’t even think about it any more.” What is kind of sad is that she didn’t have much of an understanding of how distressed her husband was. Dr. Berman gave the couple a few pieces of homework, and voila! The problem seemed fixed.

While it was great to see sex therapy realistically portrayed, it was made to be very simple. Sometimes it is, and sometimes it isn’t. As Dr. Berman said, a sex therapist is first and foremost a couples therapist. The dynamics of the relationship need to be understood and addressed in the context of what is happening in the bedroom.

Still, the show was, overall, excellent. I think a lot of couples will be talking about sex tonight, many for the first time in a long time. With 40 million marriages in our country “sexless,” there’s a whole lot of room for improvement!

To your sexual health,
Dr. Stephanie Buehler

Tomorrow, November 3 at 3 p.m., Oprah is featuring the topic of sex therapy, with Dr. Laura Berman, one of the country’s leading sex therapists as her guests.

If you have wondered about sex therapy, then this is the show for you. I plan to peel myself away from my laptop (I’m finishing up a book) and watch the show myself, then give you some commentary later this week.

To your sexual health,
Dr. Stephanie Buehler

I encourage all sexual abuse survivors to reclaim the physical pleasure our bodies were designed to enjoy. As human beings, we are born with the innate capacity to enjoy sex. Consider it a divine gift.

Let’s correct some common misconceptions about sexual assault.

1. Myth: Sexual assault is a crime of passion and lust.
Fact: Sexual assault is a crime of violence. Assailants seek to dominate, humiliate, and punish their victims.

2. Myth: Assailants are usually crazed psychopaths who do not know their victims.
Fact: As many as 80% of all assaults involve acquaintances. An assailant might be someone you know intimately. He may be a coworker, a friend, or a family member.

3. Myth: Persons who dress or act in a “sexy” way are asking to be sexually assaulted.
Fact: Many convicted sexual assailants are unable to remember what their victims looked like or were wearing. Nothing a person does or does not do causes a brutal crime like sexual assault.

We cannot undo history. We cannot dissect out the parts of us we do not like and only keep the pieces we like. What save us is our ability to find compassion for the parts of ourselves we like the least.

Fact: That is sometimes true, but often not. Couples may get along in many areas outside the bedroom, such as finances, parenting, or distributing chores, but still struggle sexually. The reasons for this are varied, but include poor sex education, embarrassment about sex, and just plain old not knowing how to talk about sex with one’s partner.

Myth #2: If there are problems in the bedroom, you just need to fix the problems outside the bedroom and everything will be fine.

Fact: Same thing–sometimes true, sometimes not. The idea is that if you are fighting about things, you aren’t going to one to make love. Stop fighting, and voila! Desire returns and all is right. But what if the couple has sexual problems that have nothing to do with other tensions? That is why some couples go through marital therapy to fix their sex life, only to find that what they really needed was to see a sex therapist. You see, it can actually work the other way around: Fix what is wrong in the bedroom, and some of the every day tensions will take care of themselves.

Myth #3: It’s just a phase, our sex life will get back to normal when (fill in the blank).

Fact: When people put aside their sex life to put their attention on other things, it can be really hard to restart. Couples may feel awkward about seeing one another nude or touching after a long hiatus. Also, there is not much that will cause a couple that likes sex to put it aside that long–maybe a few weeks if everyone in the family is down with the flu, or if there is a death in the family. Sex is a balm in tough times, so if a couple puts it aside for months, or sometimes years, then there was probably a sexual problem in the first place that has been unacknowledged. If you’ve been waiting and hoping for things to just return to normal, perhaps it’s time to stop and get some help.