Connection: The Viagra for Women

Connection:

The Viagra for Women

By Mallorie Sorce, LMFT

Ever wonder why there is no such thing as a Viagra pill for women?

The answer lies behind the Dual Control Model developed by Erick Janssen and John Bancroft at the Kinsey Institute in the late 1990s: “The Dual Control Model of sexual response goes far beyond earlier models of human sexuality, by describing not just ‘what happens’ during arousal—erection, lubrication, etc.—but also the central mechanism that governs sexual arousal, which controls how and when you respond to sexually relevant sights, sounds, sensations, and ideas” (Nagoski, 2015). Now, this is where the science comes in, so bear with me: our brain and spinal cord (the central nervous system) are made up of many different partnerships of accelerators and brakes, similar to the pairing of your sympathetic nervous system (“accelerator”) and your parasympathetic nervous system (“brake”). What they discovered is that if this is true for our nervous system, then it must also be true for the brain system that coordinates sex—thus we have a sexual accelerator and a sexual brake. 

Sexual Excitation System (SES)

The Sexual Excitation System is the accelerator of sexual response; it takes in information about sexually relevant stimuli such as the things you hear, see, smell, taste, touch or imagine in the environment. Then, it sends a signal from the brain to your genitals that tell them to “turn on.” The SES is constantly busy at work scanning your context for sexually relevant stimuli including your feelings and thoughts. This system is working far below the level of consciousness, which means you are not aware of this until you are turned on and pursuing sexual pleasure. 

Sexual Inhibition System (SIS)

The Sexual Inhibition System is your sexual brake. Research suggests that there are actually two brakes that reflect the different functions of an inhibitory system. One of the brakes works in a similar way that the accelerator works, which means it takes note of all of the potential threats that exist in the environment such as all the things we hear, see, taste, touch, smell, or even imagine. It sends a signal that says, “Turn off!” Similar to the accelerator, the brake is continually scanning the environment for reasons not to be aroused right now. Some of these reasons may be social consequences, risk of pregnancy, risk of STDs, stress, etc. This is generally a good thing because it keeps us from becoming aroused at an inappropriate time—for instance, when we are at dinner with the family or in an important business meeting. It also hammers down the “off” switch if, say, your child walks in during “sexy time”. 

While the first brake is associated with fear of performance consequences, the second brake is associated with fear of performance failure, such as worry that you won’t have an orgasm or that it may take too long. This brake isn’t as touchy as the other so although it might be on, you can still achieve sexual satisfaction; it might just take longer and use more resources. There is no need to know which brake is being hit in order to figure out how to stop hitting it. One of the common mistakes people who are struggling with orgasm or desire make is the assumption that there is an issue with the accelerator when, in fact, it is usually that the brakes are hitting too often. 

So what does all this mean? 

We all know that men and women are different when it comes to arousability. Men tend to have more sensitive accelerators, while women tend to have more sensitive brakes. However, it is still important to remember that we are all very different and this can vary between men and women. For instance, some women may have a more sensitive accelerator than brake and vise versa. The reason Viagra works for most men but not women is because when men’s genitals become erect from the medication, it sends a signal to the brain that they are aroused and should pursue sex (but, again, this may vary for men as well). However, most women’s genitals do not communicate to the brain this easily.  An important factor is the relation between these two mechanisms and the aspects of each person’s psychologies, such as mood and anxiety. The goal of this is not just to understand what men are like and what women are like but also to understand that women’s arousability depends just as much on context as it does on the mechanics of it all. 

Context Is More Important Than You Think

Understanding context means understanding that although our body has natural reactions to sexual response, context also plays a huge role in how our bodies react to these sexual responses and stimuli. There are a multitude of psychological factors that may play into your body hitting the brakes such as anxiety, depression, stress, worry about contracting an STD, and worry about pregnancy, as well as past sexual trauma such as rape, molestation, or sexual assault… the list goes on.  Another important psychological factor may be the lack of connection or safety in your relationship. When we do not feel safe, we generally do not feel aroused sexually. Sex is an attachment behavior that reinforces the bond in a relationship. The sad part of all of this is that a lot of women who have issues becoming aroused or struggle with desire tend to write this off as “this is just the way women are” or “this is just the way I am,” when, in reality, there might be valid reasons and psychological factors holding them back from becoming as sexually interested and pleasured as they would like to be. The good news here is that all of this is completely NORMAL and if you do want to become more sexually responsive, aroused, or more easily pleasured, there is a way to work towards this. If this article hit home and you are interested in exploring your accelerator and brakes, therapy can be a great option. Additionally, if you and your partner are having these issues, couples therapy can enhance your connection and build a closer bond, thus leading to greater sexual satisfaction in most cases. 

B.L.A.S.T. - Five Feelings that Impair Decision Making and Lower Resolve

B.L.A.S.T.— Five Feelings That Impair Decision Making and Lower Resolve

By Ben Kroff, LMFT

When discussing in therapy sessions ways to overcome various challenges, it is easy to imagine implementing our new insights and ideas in real-time. Why then, do we find ourselves not applying our well-laid plans long-term? Why, when in the heat of the moment, do we act opposite of what we know would be best?

The following five feelings act like clouds of confusion that can impair judgment and lower our resolve, even after making a decision.

Bored —We can all relate to going to the fridge and looking for “whatever” because we have a gap in our schedule and nothing to do. Kids who get into trouble at school have found creative ways to manage their boredom, whether with spit wads, teasing their classmates, or scratching their names into their desks. What do you do when you are bored? What vice do you entertain to help fill the time? Be careful of this moment in time; you may not be making the wisest use of it. 

Lonely —“No one cares about me anyway.” When we feel isolated, disconnected, or alone, we are more likely to engage in undesired self-soothing behaviors. We may feel at liberty to indulge because there is no accountability, no one to report to, to check in with, or seek validation from. When you are feeling tempted to engage in an unhealthy compulsion, consider who you might call, pay a visit, or reach out to. Connecting with others can remind us that we are cared for and that others support and believe in us. 

Angry — Our limbic or “reptilian” brain takes over when we are flooded with strong emotions like anger. During this time the executive functioning part of our brain, where we make decisions based on reason and logic, becomes inhibited. Understanding this, we are not surprised that such terrible decisions are made in anger. Breaking things, saying hurtful words, driving recklessly, or walking off a job are examples of regrettable decisions that are made when angry. Paying attention to our behavior can reveal our anger and act as a warning sign that we need to calm down and reconsider before acting. 

Stressed — When we’re stressed, it’s surprising how quickly we can consume unhealthy snacks. Have you ever watched a tense movie and found out you not only ate the popcorn in 30 seconds but the bucket is missing as well? Like anger, stress increases our limbic brain activity where we act on emotion and reduces our executive functioning or “thinking” part of our brain. Using grounding and calming techniques like deep breathing, physical touch, or even a quick meditation can lower our stress and shift our thinking back to the present where we can make safer, healthier decisions. 

Tired - Hundreds of recent studies have highlighted the dangerous effects of sleep deprivation. Our brains literally starve when we don’t get adequate rest. Making critical decisions when we are tired can lead to poor outcomes. Before deciding to quit a job, leave or start a relationship, or make that spontaneous purchase, make sure you are rested. Even 10 to 15 minutes of sleep can reset our mood, increase our resolve and help us manage tasks and relationships with increased clarity and confidence.

Remember these five feelings by memorizing the acronym “BLAST”, and consider measuring your status in each category when you find yourself making important decisions. Like a quick pro-con list, this exercise in self-awareness could be the gate protecting you from facing future regret.

Ben Kroff is a Licensed Marriage and Family Therapist at The EFT Clinic in Salt Lake City and Lehi, Utah. If you would like to schedule an appointment with Ben, you can email him at ben@theeftclinic.com or call our scheduling line at 385-695-5949.

The World of the Withdrawer: A Guide to Embracing Interdependence

The World of the Withdrawer: A Guide to Embracing Interdependence

By Dr. Debi Gilmore, LMFT

Have you ever been accused of being emotionally unavailable?

People who appear emotionally unavailable are often called avoidant because that is typically how they handle relationships. They often emotionally or physically withdraw in committed relationships and generally avoid intimacy and closeness with their partners and loved ones. 

Those who struggle with emotional openness and closeness often have thoughts such as, “If I anticipate you rejecting me, then I’m going to remain less emotionally invested in you.” However, the people in their world are completely unaware of that painful internal dialogue. Instead they may interpret the person’s avoidance as a lack of interest in them, or a general attitude of aloofness. 

Early relationship experiences influence how we view relationships in adulthood and may contribute to a tendency to emotionally or physically withdraw when tension arises.

As children and teens, we learn about relationships through our interactions with parents, siblings, extended family members, and social interactions at school, in sports, and other gatherings. Those early relationship experiences contribute to a person’s overall attachment style. As a person’s belief system is shaped by relationships, they develop strategic ways to cope with uncomfortable social situations. In closer relationships they adjust to a position in their interactional patterns such as withdrawing and avoiding contact at any cost. 

Withdrawers often find their partner’s needs overwhelming and burdening.

A partner who tends to withdraw in uncomfortable social interactions typically experience painful internal battles. Those internal battles explain why they struggle to be there for their partners when they need them.

Internal Thoughts of Withdrawers or Individuals with an Avoidant Attachment Style:

• If deep down, I feel inadequate and fear I don’t deserve love, then my instincts tell me that eventually, you’re going to find out about me, realize that I’m not good enough, and break my heart.

• “So I love you from a distance. I stay aloof and disengaged. I refuse to give you much of my time because it won’t hurt as much when you tell me you’re going to leave me.”

• “I know it’s coming. The abandonment always happens.”

• “My parents. My exes. They’ve all eventually left me.”

• “I know you will too.”

• “I put up my wall of protection and hold you at arm’s length. I’ve been overwhelmed by rejection, sadness, and feelings of being unworthy before, and it’s not something I can handle after I get close.”

• “At my deepest core, I don’t feel I deserve your love.”

Two Points to Consider:

1. Feelings of inadequacy or unworthiness to be loved cultivate insecurity.

2. To find true security in a relationship partners must cultivate interdependence. 

Avoidance and Independence

People who struggle with emotional connection don’t like hearing what their partner thinks or feels if it’s not what they want to hear. They might feel threatened when they hear that their partner is sad, lonely, disappointed, etc. If their partner says something they don’t like, the withdrawn or emotionally unavailable partner makes it emotionally costly to do so. 

This only makes their more emotionally open partner become more critical, pursuing, and pressuring to make the relationship work, even if it is unfulfilling for them.

Emotionally unavailable people do this because they feel empty. Their pain and sense of emptiness causes them to focus on their unhappiness, and that distraction prevents them from recognizing their partner’s softer emotions of loneliness, sadness, and pain. They believe they don’t have the capacity to devote time and effort to their partner’s needs.

Interdependence

Interdependence is the ability to depend on your partner while also being able to stand on your own two feet. It means taking responsibility for your part of the relationship as your partner reciprocates and does their part to equally invest in the relationship.

Interdependence is a process of being open to your partner’s feelings and needs while working with your partner to get your needs met. The world might label neediness as unhealthy and unnecessary; Interdependence is a very balanced and healthy way to fulfill your partner’s emotional needs while being able to launch into the world with inner security and greater self-worth.

6 EFFECTIVE TIPS FOR BEING MORE EMOTIONALLY AVAILABLE:

1) Become more aware of the beliefs you have about yourself and your relationship

• What causes you to feel you are unworthy of love and belonging?

• Challenge the belief that if your partner gets to truly know you, they will reject you. 

• Sit with your partner and invite them to explore the characteristics they see in you that makes you lovable and deserving of your partner’s affection. Be sure to do the same for them. 

2) Make your partner’s needs and feelings equal to yours

• Doing this requires finding empathy and compassion for your partner’s feelings, needs, and requests for closeness.

• At first, this can be challenging. A good first step is to share with them how much you want to be there for them, but sometimes it can be scary and difficult. 

• This open sharing assists your partner in understanding that you do care.

• The next step is to use one of the most powerful questions, “Help me understand your pain.”

3) Choose to follow a “no secrets” policy

• Emotionally unavailable partners often have a secret life—a backup plan for when the relationship fails. You may have someone you reach out to outside the relationship because rejection is inevitable. A secret life with others is a way to avoid intimacy. If this is familiar to you, it is time to consider the barrier this creates preventing you from fully connecting in your most important relationships. 

• Keeping secrets or secret relationships interferes with your ability to connect deeply with your partner. It requires you to offer complete transparency.

• Not keeping secrets requires courage and vulnerability, but it is the only method that allows you to invest in the relationship and feel the love and acceptance you so desperately need.

• Transparency is one of the greatest gifts you can give to someone you care most about. It sends the message that you are fully invested. While this may be difficult, over time you will begin to realize that transparency provides you with security and stability with your partner.

4) Prioritize spending time with your partner

• Place your partner (and children) at the top of your priority list.

• Words are not as powerful as actions.

  • Words might sound comforting to your partner, but without actionable follow-through, they are meaningless. Making time for your partner also requires you to be available and accessible most of the time.

• Often withdrawers will avoid phone calls, ignore text messages, and reply only when they want.

  • They are distracted by their own pain and needs, which makes their partner feel even more starved for emotional connection.

• If you give your partner the reassurance that you are there for them, they will soften and feel more secure because you have given them the reassurance that you are invested in the relationship.

5) Allow yourself to feel and acknowledge whatever emotions appear

• Become more aware of the stronger emotions that erupt when you are upset or hurt such as anger, frustration or even rage.  

• When you are emotionally hurt, an alarm goes off in your body that prompts you to react in negative ways. You might do and say hurtful things that cut to the core of your partner’s vulnerabilities.

• When you struggle with connecting emotionally, another coping strategy might be to find your partner’s weakness and exploit it, so you ultimately achieve the distance you are so familiar with—a quest to find that relatively safe place that actually prevents you from finding what you truly need. 

• Another coping strategy might be to threaten to leave the relationship when you find yourself in relationship distress.

• Using anger and personal attacks can become a way to get your partner to comply or do things your way.

• Avoidance and manipulation prevent you from achieving what you really need.

• Even if you get your way, you are still avoiding a relationship that will change the deeply rooted beliefs you have about yourself.

• A loving relationship requires two people who work together equally.

6) Commit to being more transparent in your communication with each other

• Share your deepest fears. Ask yourself, “What is my greatest fear surrounding our relationship?” Once you have identified that fear, share it with your partner and then ask them what their greatest fear might be. 

• Share your life’s greatest disappointments and your biggest dreams. Ask your partner what theirs might be. 

• Love requires more than physical touch. Love requires emotional touching, including eye contact, using a soft voice, and slowing down a conversation so there are moments of silence and pondering. It requires both your partner and you to let each other see your inner world.

• Over time, allow your partner to get to know your inner self and when your partner shows interest, accept those moments as a gift of love from them. 

Hope for Withdrawers

These suggestions will each be challenging for you and will require consistent courage. At times you might feel overwhelmed, and maybe you will either want to criticize, blame, or withdraw to avoid conflict. When you feel like you can’t breathe from a lack of space, that is a solid sign that you are doing the right thing. You are actually contradicting the negative and damaging belief that you don’t deserve love. In that moment, exercise courage and let your partner know that you are struggling. Find the courage to ask your partner for help as your work to conquer old patterns and ways of coping.

Your childhood and failed relationships may have been a great source of pain, but when you work to challenge old patterns you will open the door to ultimate joy and fulfillment.

How to Support Moms Pre, During, and Post Pregnancy

How To Support Moms Pre, During, and Post Pregnancy

By Misty DeMann, LMFT

Maternal Mental Health disorders, like perinatal (during pregnancy) and postpartum depression, anxiety, and psychosis are the number one most common complication of pregnancy and childbirth. During this time women are more likely to experience a mental illness than they are to develop gestational diabetes or preeclampsia. With mental illness being the most common complication for pregnant and postpartum women, you would think that doctor’s offices and hospitals would screen for Maternal Mental Health Disorders. Unfortunately, little is being done to assess for and treat these complications.

It is likely that someone close to you—perhaps even yourself—has experienced some sort of shift in mental health either pre, during, or post pregnancy. Whether it is the “Baby Blues”, postpartum depression, anxiety, psychosis, or another emotional disorder, there are things you can do to help a struggling mother in your life.

Consider the acronym SNOWBALL from the Utah Maternal Mental Health Collaborative (now PSI-Utah):

Sleep

Nutrition

Omega 3s

Walk

Baby Breaks

Adult Time

Liquids

Laughter

SLEEP: We all need sleep to be able to function physically, mentally, and emotionally. Offering to watch the baby during the day so that Mom can get a decent stretch of sleep can go a long way for her mental and physical health.

NUTRITION: Vitamins and supplements help ensure that Mom is getting all the nutrients she needs in her diet, especially if she is breastfeeding. Balanced and nutritious meals are another way to help Mom maintain her physical and mental health, but preparing meals require time and energy, something not always readily available for a new mother. Help a mom meal prep or bring her a nutritious meal to share with her family.

OMEGA3s: Encourage Mom to take a fish oil supplement which can prevent and treat anxiety and depression.

WALK: Take Mom for a walk or invite her to do something active. Exercise improves not only physical but mental and emotional health and gives new moms an opportunity to get out of the house.

BABY BREAKS: Offer to watch the baby, even if it’s for a short time. Doing this gives Mom a break and time to focus on herself and engage in some precious self-care.

ADULT TIME: Invite Mom do to something with you and other adults. We need social interaction, outside of children, to share how we feel and find connection. 

LIQUIDS: Remind Mom to drink and fill up her water for her. Dehydration can escalate symptoms of anxiety and depression. 

LAUGHTER: Send Mom a funny video, talk with her lightheartedly, and remind her to play. Laughter can help alleviate symptoms of anxiety and depression (Utah Maternal Mental Health Collaborative, 2015).

If you or someone you know is experiencing symptoms of a Maternal Mental Health Disorder, reach out to a Mental Health Professional or Medical Doctor. If you or someone you care about is in crisis please consider calling these available resources:

UNI’s Crisis Line:  (801) 587-3000

National Suicide Prevention Lifeline: 1-800-273-8255

Postpartum Support International HelpLine: 1-800-944-4773 or Text Message: 503-894-9453

Utah Maternal Mental Health Collaborative (2015). Moms mental health matters. Retrieved from  https://www.psiutah.org/wp-content/uploads/2015/05/UMMHCWellnesstips.docx.pdf

How Your Attachment Style Influences Your Relationship

How Your Attachment Style Influences Your Relationship

By Joanna Alvord, LMFT, MBA

“We're only as needy as our unmet needs.”- John Bowlby, Founder of Attachment Theory

At the core of attachment theory is the assumption that we all are wired for connection. This primal drive to connect is wired into every human being, shaped as a survival mechanism over millions of years of evolution. We connect to survive. Hence emotional isolation can register as a life or death situation in the most primitive and fastest-to-act part of our brain, the amygdala. Some call it primal panic.

Add the fact that the reason we may feel the alert—such as needines— is not just because our adult needs are not being met; it can also be the result of our childhood needs that were not met. These unmet needs can be associated with what happened many, many years ago, but the pain of not having them met has remained trapped in our body. And when triggered, the pain can come and surface in the present.

John Bowlby’s attachment theory emphasizes the importance of a secure mother-infant bond in development of a person’s well-being and later mental functioning. One of my favorite modern authors, who expanded on Bowlby’s attachment theory, is Stan Tatkin. As a Licensed Marriage and Family Therapist, Doctor of Psychology, and one of the world’s experts on attachment theory, he wrote several books, including “Wired for Love: How Understanding Your Partner’s Brain and Attachment Style Can Help You Defuse Conflict and Build a Secure Relationship”. In his work, Tatkin uses attachment terms such as anchors, islands and waves, rather than the more traditional attachment terms of secure, avoidant (or dismissive), anxious (or preoccupied), or the less prevalent anxious-avoidant (or disorganized).

Anchors, Waves and Islands

The interactions with our early caregivers shaped our autonomic nervous systems. Those interactions determined the way we as infants and children engaged with those around us, and the way we tend to engage with the world now; whether we need interaction, or we need space. As life goes on, our peers and partners eventually take over the role of our primary attachment figure. They become the source of safety and confidence, or they become the source of anxiety and mistrust.

Thus, those who are anchors experienced—or learned later in life about—secure attachments. They learned they could rely on others, that relationships are important, that their needs would be attended to, and in general that the world is a safe place. According to research (Tatkin, 2012), a bit more than 50 percent of people fall into this category. Unlike anchors, islands and waves were raised in an environment where relationship did not come first, and their needs were often not met by their primary caregivers. Therefore, to self-protect and to have their needs met, from a very young age they had to adapt themselves to their environments. 

Now, it’s not that islands and waves do not want relationships. We all do. Islands and waves will just struggle more with trust. Waves tend to believe they are going to be abandoned, that it’s inevitable, questioning if others will be there for them, and so they tend to be more dependent and often cling to others. They may sometimes even look for proof of an approaching abandonment, and this fear activates their attachment need for contact. They tend to seek reassurance about themselves and seek safety from others. On the other hand, islands believe that if they depend on another, their independence will be taken away, and they will feel trapped, or even in danger of being suffocated in a relationship. In order to avoid these emotions, islands tend to seek distance. The fear of engulfment is what causes them to deactivate their attachment need, therefore they diminish the need to connect with their significant other. This deactivation explains island’s distancing behavior.

What Can You Do?

Does your attachment style affect your dating life or your committed relationship? Does your attachment style affect how you communicate with your partner? Does knowing your attachment style, and that of your partner, make your relationship stronger? Yes, Yes and Yes. 

1.  So, get to know yourself! Take an adult attachment style questionnaire with your partner. Get to know how your partner functions and why they function that way. Tatkin often refers to “becoming an expert on each other”. 

2. Own your own tendencies in conflict and recognize your partner’s protective behaviors. While some attachment style combinations may be more challenging, the good news is research shows that attachment is fluid and can change during our life. We are hurt by people and we are healed by people. As paradoxical as it sounds, I truly believe the only way out of insecurity is through a mindful relationship. Knowing your own attachment style tendency and that of your partner makes the healing process easier. 

3. Ask your partner “Am I doing that thing again? Is that what causes you to feel …?” Building a healthy relationship requires frequent safe connections with your partner in order to regulate, so make room for safe connection in your life. 

4. Slow things down. Pay attention. Be mindful. Be present. 

5. Remember, the most primitive part of our brain, the amygdala, acts the fastest, and it may take a bit more time for the newer neocortex and reasoning to catch up so that we can act in a safer, more appropriate and more desirable way. 

6.  And, be patient with yourself! This work can be demanding.

We all long for intimacy, we all long for connection. We may express this longing differently, but that longing is there even if we learned this need can be dangerous and may hurt. Understanding adult love tells us what matters and when it matters. These insights offer us a compass in the reshaping of the interactions between partners. Unlearning patterns that are heavily ingrained will take effort and time. But it is all doable, and these new neural connections are developing as you are reading this. 

Tatkin, S. (2012). Wired for love: How understanding your partner's brain can help you defuse conflicts and spark intimacy. Oakland, CA: New Harbinger.

Joanna Alvord is a Licensed Marriage and Family Therapist at The EFT Clinic in Salt Lake City, Utah, and is currently accepting new clients. Email joanna@theeftclinic.com or call (385)695-5949 to schedule an appointment.