body neutrality part II

The last time my newsletter discussed body neutrality was in the summer

- I checked. And, as the weather is getting warmer in many parts of the world, I've noticed many of my sessions have involved conversations about bodies. Body shapes, body sizes, how bodies fit into clothing - or don't - and the emotions involved.

Levels of distress about body appearance have been quite high for a lot of folks recently. Frequently, I hear a corresponding increase in frustration about the phenomenon itself. The pressure to combat negative body stereotypes and to feel "empowered" in unconditional self-love can be yet another opportunity for perceived failure.

Body neutrality refresh - What a body does, not how a body looks.

Body neutrality is “a movement rooted in acknowledgment and appreciation of what your body does, rather than applying value to how it looks”. 1 Body neutrality is a concept that became popularized in part as a reaction to the "Body Positive" movement. The body positivity movement began as part of fat-acceptance and fat-liberation efforts with the empowering idea that "all bodies are good bodies". As time went on, body positivity became used more frequently in a mainstream context that promoted a version of wellness represented by a slender, able, young, white body. 

As a result, popular body justice activists like Virgie Tovar and Jessamyn Stanley began discussing the commodification of body positivity and its lack of intersectionality and began using the language of body neutrality to create ways for folks to relate to their bodies without pressure, judgment, or the feeling that their bodies needed to fit into a wellness space. 

Body neutrality in action

Concentrating even a small amount of attention on the frequency and tone of body critical thoughts and physical sensations can illustrate just how much space this can take up. As an experiment, we can consider noticing not only our thoughts about our bodies but the sensations associated with these thoughts. Common examples might include the sensation of tightness of clothing, the feeling of being full, or the way we experience hunger cues.

Body neutrality creates space for us to reframe the way we interpret these sensations to move away from a lens of body shape or size as a way to evaluate how we get to feel.

Here are some great examples of body neutral reframes from the become project:

my body is my home

my body is where I live, not who I am

my body is allowed to change

my body deserves respect

my body is inherently wise

my self-worth is not tied to my appearance

I deserve to rest

I will listen to my body's needs

health is not a moral requirement

my body is innocent

I am more than a body

This is hard work!

As always, when doing the work of unlearning system-wide messaging, it is important to take care of ourselves accordingly. It is truly exhausting to attempt to combat the fairly constant messaging convincing folks that they are supposed to look a certain way, and the multi-billion dollar diet industry supporting it. Give yourself credit and allow time for rest and recovery.

See my previous post on body neutrality for more information and some additional reading.

Heartbreak part ii

The body

Heartbreak involves our thoughts and emotions, but what happens to our bodies?

It can be natural to invalidate the difficulty of recovering from heartbreak. One of the more common ways I hear this expressed is by diminishing the intensity of the experience - "it's just a feeling, I need to get over it. I was only with them for 6 months, why can't I get my life back together?"

Understanding what happens in our bodies when we do go through a separation from another person - or people - can create more room for healing. In some ways, it can allow us to give permission for recovery.

The Science

Author Florence Williams recently published "Heartbreak, A Personal and Scientific Journey", a book that gathers a great deal of research to explain why separation feels as bad as it does. I've highlighted a few major points here for us today.

• The areas of the brain that light up during partner separation - and during reunion - are notably rich in opioid receptors.

• People have a 23% risk of clinical depression following a breakup.

• Lonely people tend to express more inflammation (that can lead to conditions such as diabetes) as their bodies prepare for fleeing and flighting

• Studies show human neural networks take social pain very seriously, it shows up consistently in areas that are associated with deep human survival

• People experiencing loneliness express a reduced ability to fight viruses, which are spread in groups

Research demonstrates that the brain knows we are physically close to someone through specialized nerve fibers under the skin - they respond to being caressed.

When this happens, human breathing slows, blood pressure drops, and muscles relax. Opioids and oxytocin are released, in turn activating dopamine and serotonin. The more these flow, the fewer stress hormones like cortisol are released. 

Neuroscientist David Eagleman states, "people you love become a part of you - not just metaphorically, but physically. Your brain refashions itself around the expectation of their presence. Your heart rates and respiration speeds begin to synchronize. So do cortisol levels, which tend to align on mornings and evenings in couples who live together."

Going below the surface

What happens on a cellular level? Genomics researcher Steve Cole demonstrates that social connectedness - how emotionally and socially connected people feel to others - alters the activity of two key sets of genes in white blood cells. These turned into divergent immune responses, particularly with respect to viruses, bacteria, and inflammation. He believes that loneliness has been shown to be a significant risk factor for health and early death.

Cole explains,

"It shouldn't be surprising that our immune systems become implicated when we are emotionally crushed still, we don't expect it. We think the damage is all in our heads.

We think of relationship loss and isolation as pragmatic problems because we are overly cognitive beings. Our bodies want what they want, warmth and the feeling of being understood by a partner, and now it's not there. shock and panic set in."

Permission to recover

Wishing that healing from heartbreak would happen fast is very understandable, but not always the case. Compassion can be very empowering when considering what it takes for our bodies and minds to recover. Check out the book linked above for more information.

Thinking of all of you!

breaking up - override pain for pleasure?

Heartbreak

A breakup, the path to divorce - truly and absolutely the worst. The pain and grief of this parting can cause intense dysregulation and disrupts almost every part of life. When coping with such sorrow, it's normal to be faced with a series of choices - when to see the person you were once so intimately involved with? Would it feel good to text? Should one send an email with a full explanation of emotions? What is closure and does it require a phone call to that person you are missing so much? Do you need them to really, really understand just how angry you are? Would it feel good to have sex with someone else? Do you go to that dinner when you know they will be there, and if so, what do you wear?

Living through pain

The common thread in these questions is the pain felt in the aftermath of a loss. We can see the desire to combat this pain by connecting with that person who is so dearly and desperately missed. 

As social beings, we coregulate to great effect on a regular basis. Closeness to friends, family, and loved ones is an incredible way to feel grounded, calm, supported - emotionally regulated. Community is hugely meaningful. 

When we are talking about regulation -  managing and responding to the emotions occurring within oneself - it's really important to acknowledge just how hard some of these emotions are to feel. Emotional pain can be tremendously devastating, and it is only normal, human, and adaptive to try to numb, heal, and dampen that pain. 

When considering the series of choices above, it can help to question the function of emotional regulation in these moments. 

Let's play out a scenario - the thought of texting the person you are missing is almost impossible to ignore, so present in your mind it's hard to focus on anything else. Potential reasons you've identified for the text - returning a favorite book, a generic check-in, a deeper explanation of a thing you said during one of the many breakup conversations that is haunting you. All of these are real and valid reasons to possibly send the text, but before doing so, let's try to identify the underlying emotion first. 

Emotions that I often hear clients express at this moment - very relatable - are:

feelings of abandonment
fears of some type of forever-loneliness
an unsettled feeling that time has been wasted

In this scenario, it would be really normal and understandable to override these emotions to try to find some relief through a text. The question we want to ask ourselves is,

What do I want to do with these emotions?
What would help?
What feels aligned with who I am and what I want moving forward?

When we override, or repress, or ignore, some of the feelings we are having, the engagement that we have with our own regulation changes. We are not as attuned to what's actually happening, and that can lead to choices that might not feel the best for us outside of that one moment. 

To be clear, I'm not really talking about any "right" or "wrong" when it comes to texting an ex - there is no right or wrong thing to do in these scenarios! I am talking about figuring out what feels best for each one of us in times of pain, sorrow, and bereavement, and how we can best regulate ourselves when it is extraordinarily hard to do so. 

Self-determination of post-romantic relationship style

Societally, there are some standards for what post-romance relationships look like. The rules that go with these relationship examples are generally fairly narrow and limited.

While also paying really close attention to what feels regulating and healing, what might it be like to ask yourself what, in a perfect world, you would want your relationship with this person or persons to look like?

You get to decide what this looks and feels like, and honoring your own wisdom in this scenario is a wonderful way to continue listening to yourself, identifying and coping with your emotions, even when difficult, and moving forward into a new type of relationship with yourself and those you have been with.

Thinking of all of you!

overextension of personal responsibility for the emotions of others

Empathy and Attunement

I am lucky to work with a lot of really caring, empathic people who are frequently attuned to the experiences of others around them. This is an amazing quality, a superpower. What we often find ourselves talking about, however, is the experience of being overly responsible for the anticipated emotional experience of others.

This can look like fear around emotional conflict, internal stories around perceived judgment from others, and a feeling that it is up to you to please everyone.

Connection and self-protection

There are a lot of reasons why folks might have a protective emotional response that impacts emotional connection:

• Lived experiences involving difficult emotions or trauma

• Past relationships with painful attachment

• Experiences with oppressive systems and people

• Fear around anticipated rejection or abandonment

• Discomfort and worry around emotional intimacy and closeness

• High emotional stakes around a relationship - fear and attempted control around potentially losing this connection

• Relationships that required the adoption of a caregiver role at a young age

Creating meaning out of worry

When a feeling of safety and security is missing, it is nearly impossible to be open to emotional connections from others. When considering some of the experiences that can lead to self-protective impulses, it is easy to see this for what it is - a remarkable adaptive quality. 

When folks are hyper-attuned to all the things they might need to protect themselves from, it can be difficult to see and feel the ways in which others might be open and available for connection. 

A common scenario might include a catastrophic narrative about someone else's disappointment or unhappiness, even when that other party has given no direct communication to indicate that is how they feel. 

Another typical protective response is the preemptive cut-off - perceiving rejection or bad behavior from the other person even when they didn't communicate that - and ending things with a fight or shutting things down before they can progress into a space of emotional closeness. 

Caring for self-protection when it seems to get in the way of emotional intimacy

I feel really strongly that self-protection should not be pathologized in any way. It is survival and resiliency, it is a sign that bodies are doing what they are supposed to do. Additionally, there are many legitimately unsafe situations folks encounter, to suggest otherwise would be gaslighting.

With compassion and respect for this self-protective impulse as a starting point, there is also room to work with some of this protective instinct if it seems to be getting in the way of the types of relationships and intimacy folks are seeking.

As a brief thought exercise, recall the last time you noticed a strong reaction in yourself when in conversation with another person, someone you care about.

• What was happening in that communication?

• If you could identify an emotion you were experiencing at that time, what would it be?

• What cues were you picking up on in the other person that let you know there was something to be upset about?

• Were you feeling fear or anxiety? If so, name what you were afraid of.

• What was the worst thing that could have happened at that moment?

• What actually happened?

• How did your body and/or mind try to protect you, if at all?

• What cues existed that let you know that you could feel safe, even though you were feeling big emotions?

We can begin to attune ourselves to cues of safety, even when being aware of cues leading to a protective response. Allowing emotional intimacy at a rate and pace that feels safe and comfortable can be a really effective way to increase connection and decrease the focus on the emotions of those around us.

Thinking of all of you!

radical acceptance and distress tolerance

What are radical acceptance and distress tolerance and why are they always coming up in session?
 

DBT, or Dialectical Behavior Therapy, is a popular mental health intervention originally developed to better understand folks diagnosed with Borderline Personality Disorder. In recent years, the creator of DBT, Marsha M. Linehan, shared her own story with Borderline Personality Disorder, shifting the narrative around those in academic spaces who create evidence-based treatments. A very valid critique of many mental health interventions involves the acknowledgment that those creating and testing these methods are frequently quite separate from the actual lived experience of those on the receiving end of these therapies.

DBT aims to help folks connect with a non-judgmental and compassionate way to understand the emotions that they are experiencing while enhancing forms of coping to help in difficult scenarios. This can be particularly impactful when a person's adaptive, protective response includes self-harm and when someone has experienced trauma. However, the foundational concepts of DBT can be successfully applied to an incredible amount of scenarios, and can be supportive and freeing for many. 

Mindfulness

DBT, including radical acceptance and distress tolerance, draws heavily on a Mindfulness perspective. A note about the adaptation of Mindfulness without contemplative religious context - these ancient practices have been used in Mindfulness-Based Stress Reduction and Pain Management techniques developed in white, secular settings often divorced from meaningful connection to the cultural teachings and meaning of these practices. We can strive to work with individual emotional and autonomic responses while connecting with the systems, community, and spaces around us. We are all connected.

Radical acceptance 

Radical acceptance is a wonderfully inclusive concept that encourages an acceptance of the current moment without judgment. This includes and validates difficult moments, specifically when the environment and systems we live in fail us. 

It is a natural tendency for many of us to focus on what could have gone differently in the past, or all the things that might go wrong in the future when we are in a present moment that is distressing. Acceptance around the present moment allows room for connection with the body and mind, to allow for observation and non-judgmental awareness.

Distress tolerance

Distress tolerance refers to the idea that folks can be empowered to engage with systems of emotional and physiological regulation, even during difficult moments. This idea includes space for the very normal and valid emotional reactions to a challenging or painful experience while also encouraging connection with internal and community support.

It is extremely common to experience a stress response during difficult moments - fight, flight, or freeze, self-harming or self-sabotaging coping, the desire to run or avoid - all of these responses are protective, adaptive, and very understandable. The body and mind are doing what they are supposed to - try to protect and cope. Distress tolerance creates space for additional ways of coping - feeling a sense of agency and ability to focus on what is supportive for self and others.

A brief practice to try

An easy and accessible way to practice the foundation elements of radical acceptance and distress tolerance is by practicing neutral observation during tough moments.

Begin by noticing what is happening in your body during a moment of stress - what sensations do you notice? Observe your thoughts - what is your mind saying? Instead of drawing a conclusion, simply notice, acknowledge, and accept what is happening within you.

To learn more, read some of Marsha Linehan's work - a complete workbook is linked below.

1. Marsha Linehan DBT skills training handouts and worksheets

Thinking of all of you!

what is body neutrality?

what does body neutrality mean?
 

Body neutrality is a concept that became popularized in part as a reaction to the "Body Positive" movement. The body positivity movement began as part of fat-acceptance and fat-liberation efforts with the empowering idea that "all bodies are good bodies". As time went on, body positivity became used more frequently in a mainstream context that promoted a version of wellness represented by a slender, able, young, white body. 

As a result, popular body justice activists like Virgie Tovar and Jessamyn Stanley began discussing the commodification of body positivity and its lack of intersectionality and began using the language of body neutrality to create ways for folks to relate to their bodies without pressure, judgment, or the feeling that their bodies needed to fit into a wellness space. 

Observation without judgment, trauma

Another way body neutrality has been used to change the narrative around the narrative folks have about their bodies is to remove the idea that a person "should" feel good about their bodies all the time. Neutrality is a way to recognize that there are many ways to observe and respect our experiences within our bodies, especially on days that we don't feel "total self-love" and an ability to embrace parts of ourselves we have complicated feelings around.

OBSERVING NOT HOW OUR BODIES LOOK, BUT HOW THEY ARE FEELING, is a great first step towards a space of body neutrality. Many people have had some type of traumatic experience involving their bodies. This can look many different ways for each individual, and might include the ways in which bodies are referenced in media, mistreatment and discrimination in the medical system, chronic pain, loss, and violence.

A normal, protective, adaptive trauma response can be to distance or disconnect from our bodies. It can feel overwhelming, or possibly painful, to force that connection. Compassionate body neutrality creates a space for folks to take care of their bodies without too much attention or value judgments on days in which that is simply not the right expectation.

What a body does, not how a body looks

Body neutrality is “a movement rooted in acknowledgment and appreciation of what your body does, rather than applying value to how it looks”. 1 

Practicing non-judgmental curiosity around how our bodies work and feel can allow folks to be more connected to what is happening inside, acknowledge how our bodies support us on a daily basis, and be more attuned to what is working.

Some days feeling incredible, radical self-love may feel really accessible, but other days this does not. Body neutrality is a wonderful way to respect and honor our bodies without pressure, with a realistic understanding that our bodies do not always work the ways we want them to, and with an acknowledgment of the systemic difficulties related to body acceptance. 

To read more

To read more about the ways the body positivity movement lost sight of the importance of body justice, changing systemic racism and discrimination, and centering fat bodies, check out these articles.

The Fragility of Body PositivityHow a Radical Movement Lost Its Way
by Evette Dionne

Body Positivity Has Lost All Meaning in 2020
by Marie Southard Ospina

1. Maya Richardson https://www.mayarichardson.com/

Thinking of all of you!

polyvagal exercise for connection

In polyvagal theory, developed by Dr. Stephen Porges, the process of neuroception refers to the ways our autonomic nervous systems observe what's happening inside our bodies, in the environment outside of our bodies, and in connection with people around our bodies. This observational process is happening at all times, and is primarily going on without thought from us - neuroception "happens below the realm of conscious thought and outside of awareness". 

Neuroception occurs to support our survival and is essentially the assessment of safety and danger. Although we may not be aware that neuroception is happening, we are likely attuned to the biological response that happens in our bodies. For example - a change in breathing, how the throat feels, a smile, or a frown. 

An observation of safety can feel calm, grounded, and connected, while an observation of danger can feel like increased anxiety, a feeling of dread, and a feeling of disconnectedness from those around us. For folks who experienced an unpredictable or chaotic environment, the autonomic nervous system might be more protective and hyper-attuned to cues of danger. This can mean that a person's system might be in a state of perceived danger, even if the emotional environment might be safe. 

Fortunately, we have the ability to work with the ways cues of danger and safety are observed to bring things back into alignment, connecting with feelings of safety and security. The first step towards this is through greater awareness of our own bodies and a deeper understanding of neuroception in ourselves.

In her book Polyvagal Exercises for Safety and Connection, clinician Deb Dana shares a helpful chart in understanding this concept. She uses the metaphor of a river to create the flow of a person's lived experience, starting with neuroception at the mouth of the river.

In this way, we can easily see how our own experiences, the environment around us, and the way our system is observing safety and danger can impact how we feel in our lives. How does it feel to check-in with yourself first "upstream", rather than way "downstream"?

Let's try an exercise developed by Deb Dana to increase safety and connection. This exercise is an excerpt from the book above and is called "Reflecting with Compassion".

The exercise draws on the tradition of Lovingkindness meditation, which comes from Theravada Buddhist Mettā meditation. These ancient practices have been used in Mindfulness-Based Stress Reduction and Pain Management techniques developed in white, secular settings often divorced from meaningful connection to the cultural teachings and meaning of these practices. We can strive to work with individual emotional and autonomic responses while connecting with the systems, community, and spaces around us. We are all connected.

This type of meditation focuses on compassion for the self and compassion for others in order to engage with feelings of safety and security.
There are 4 foundational phrases in Lovingkindness meditation:

1. May I be happy

2. May I be healthy

3. May I be safe

4. May I live with ease

Dana's instructions include:

1. Look at the 4 categories (happy, healthy, safe, live with ease) through the lens of the autonomic nervous system. Find the words that are natural to you and create your own phrases that generate safety and peace.

2. Feel in your body how these phrases are experienced when you repeat them or say them out loud.

3. Say the phrases to yourself and then direct them towards others - "May you be happy, may you be healthy, may you be safe, may you live with ease". Start first imagining those close and connected to you, next, a neutral person, on to a person with whom you have a ruptured relationship, and then finally on to all living beings.

4. Say these phrases to someone else and have them say them back to you. Notice how it feels to give and receive these feelings and phrases in your body. Track your autonomic response.

Thinking of all of you!


Polyvagal exercises for safety and connection: 50 client-centered practices, Deb Dana; Stephen W Porges New York, NY : W.W. Norton & Company, Inc., (2020)

summer podcast recs

Everyone needs a break from work, especially in the context of ongoing loss and trauma. Showing up and being present has been extraordinarily hard work recently, so instead of sending a journal this month requiring more inner intensity, I've compiled a list of podcasts for your listening pleasure. Here are 15 sex-positive podcasts about sex, relationships, attachment, and more.

Inner Hoe Uprising

Sex Out Loud with Tristan Taormino

Polyamory Weekly

Queer Sex Ed

The Sexually Liberated Woman

American Sex

Multiamory

Where Should We Begin?

Disability After Dark

Living in This Queer Body

Why Are People Into That?!

Authentic Sex with Juliet Allen

Off the Cuffs: A Kink and BDSM Podcast

Turn Me On

Doing It!

Thinking of all of you!

how can ocd show up in our sex lives?

CW: Sex Therapy discussed below
 

Although many of us understand OCD (obsessive-compulsive disorder) as an experience focused primarily around handwashing and aversion to germs, this Hollywood version of the OCD spectrum is not an inclusive representation of the unique ways that these thought patterns can look. The spectrum of OCD thought patterns are marked by an anxiety-producing thought (obsession), and a resulting thought or behavior (compulsion) to try to help soothe that anxiety. Unfortunately, these thoughts or behaviors are not effective in soothing these anxious thoughts in the long term, creating a difficult cycle.

An aspect of OCD that is not as frequently discussed is the way these thoughts can impact sexuality. Studies show a high correlation between what would be categorized as sexual dysfunction and OCD thought patterns, with some research showing rates of dysfunction as high as 54-73% in folks diagnosed with OCD.1

The importance of talking about these statistics is not to pathologize any of these experiences, but to normalize how common this can be, and to talk about ways to better understand and support folks coping with some of these frustrating and upsetting dynamics.

For many people who have experiences that exist in the OCD spectrum, thought-based compulsions can be common occurrences. These are sometimes referred to as mental rituals. This could look a lot of different ways, including a repetitive "checking" thought - scanning the body, looking outside around oneself, going over moments or conversations in one's mind.

Sexual obsessions are actually one of the more common types of OCD thought patterns, but much less frequently discussed. These types of thoughts can happen at any point, but can often occur for people during sexual moments. These thoughts are often described as unwanted, very upsetting, anxiety-provoking, and unsettling. They are opposite to what folks actually desire, and can lead to avoidance of sexual connection, fear around sexual connection, and anxiety about sexual connection.

Here are some common examples of how this might be expressed:

1. An intrusive thought around sexual orientation and the resulting checking behaviors - constantly looking at the people around oneself and "checking" if there is attraction, when in a sexual moment with oneself or others "checking" if there is arousal or desire, seeking media to "check" to see what one's response might be. These thought patterns can happen for people of all different sexual orientations.

   • These thoughts can be quite disconnected from a person's thoughts and feelings about sexual orientation in general. Very specifically, this does not mean a person is homophobic.

   • This is so common it has been categorized as "Sexual Orientation OCD", or SOOCD.

2. Upsetting intrusive thoughts around sexual acts that might include content very undesirable and deeply upsetting for folks, including violent acts, sex with family members, sex with animals, and sex with children (another subset so common it is called "Pedophilia OCD", or POCD)

3. Intrusive thoughts around relationships, including sexual connection. In this instance, folks find themselves questioning and experiencing worry around their connections and the quality of their romantic and sexual relationships, leading to anxiety and discomfort, and subsequent checking behaviors.

   • Another subset of OCD so common that it is called "Relationship OCD", or ROCD.

It is easy to imagine how these thought experiences might result in distancing from sexuality in many different forms, and difficulty when in sexual moments. With compassion and understanding, there are a lot of ways to work with these types of thought patterns and physical experiences to find some relief. If any of this resonates with you, there is nothing wrong with you! You are amazing, and there are options.

Some helpful interventions include Exposure and Response Prevention Therapy, Mindfulness, Dialectical Behavioral Therapy, medication, microdosing, and trauma-informed psychotherapy.

If you're looking for more information, feel free to message me, or check out Made of Millions for some wonderful resources around sexuality and OCD.

Thinking of all of you!


Agarwal, S., Das Koolwal, G., Gupta, A., Koolwal, A., Manohar, S. Obsessive-Compulsive Disorder and Sexuality: A Narrative Review. Journal of Psychosocial Health; 2020.
First Published April 2, 2020 Research Article
https://doi.org/10.1177/2631831819896171

a sex therapy tool for us all

CW: Sex Therapy and somatic experiences discussed below

Sensate Focus is a sex therapy technique developed by Masters and Johnson in the 1960s. It has since been adapted, and providers conscious of decolonizing sexology have expanded what this practice looks like. 

Put simply, Sensate Focus is a gradual process that connects folks to their sensory experiences and removes pressure from goal-oriented sexuality. There are some foundational ideas in Sensate Focus that are really powerful, and that I have seen translate really well outside of sex therapy. I'd love to share one of these ideas with you all today.

In the first phase of Sensate Focus, folks are encouraged to relieve themselves of any expectation, judgment, or outcome-based feeling by learning how to be with their own bodies and experience their own touch, without sexuality. This looks like 10-15 minutes of time, without distraction, during which a person allows themselves to notice any sensations that occur when they simply allow one hand to touch their bodies - arms, legs, face, stomach. These sensations include feelings such as temperature, texture, and pressure.

When thoughts wander, folks are encouraged to bring their attention back to that feeling of sensation - temperature, texture, and pressure. It is rare that any of us spend this type of time without distraction just with our bodies, and it is very normal for a lot of thoughts and feelings to come up during this time.

What I love about this practice is how much room it allows for awareness of how the physical experiences in our bodies turn into thoughts and behaviors. Something I hear quite a lot when people try this first phase of the practice is that they notice discomfort or difficult thoughts around certain areas of their bodies that have very specific societal expectations. They notice that they are unconsciously moving their hand away from this area, that their thoughts are traveling towards the very self-critical, and that their mood shifts. It requires a lot of effort to return to the experience of the sensation.

This highlights just how often these thoughts, movement away from parts of our bodies, changes in mood, and likely changes in behavior are occurring, all without us realizing what's happening.

What a superpower - the awareness of what's happening for us in our bodies and the skill of practicing non-judgmental presence with ourselves. With a compassionate and curious mindset, we have the opportunity to unlearn and heal.

What might it be like to spend 10 minutes, without expectation, with your body?

how do you know when you get to feel good?

We each have our own system of evaluating how things feel for us. After working with so many incredible people who feel like they aren't doing "enough", it's apparent that many of these internal systems are simply not working.

How do you know if you get to feel good about yourself at the end of the day? What standards are you judging yourself against?

Let's look at "Sammy". Sammy values their friendships, would like to meet a partner who is looking for a more serious connection, and has goals in their current job as well as longer-term creative goals outside of their role right now. Sammy has coped with periods of anxiety, perfectionism, and depression for a lot of their adult life. Some days these feelings of anxiety or depression are higher and more present, and this means that routines, eating, interactions with others, and work look different.

Sammy finds that on these days, they are hypercritical about their value, feel they haven't "accomplished" anything, and get stuck in a mental loop about what they "should have" done. This leads to a bit of an emotional hangover, causing Sammy to have an automatic painful response to thoughts about how they look, act, and their choices for days after.

This overall feeling of dissatisfaction and shame means that Sammy declines social invites, doesn't feel up to dating, and isn't able to access pleasure.

Sammy is evaluating themselves according to a set of standards that don't really reflect their value or lived experience. Sammy is using ideas of productivity, "normal" emotions, and oppressive physical standards to see if they get to feel good.

If we shift this system of evaluation so that it is connected to the values and experiences that actually matter to Sammy, we get to change the entire narrative. On a day when Sammy is feeling anxiety and depression in a more present way, Sammy can feel good that they were able to tolerate something so challenging, and that had the strength and capacity to do so. Sammy understands that these feelings won't last forever, and commends themselves for having this skill. Sammy rewards themselves for supporting their values of kindness and understanding by adjusting their expectations for the day accordingly. Sammy knows that the food we eat doesn't define us, and sees the strength in a flexible mindset. Sammy is not shut off from the meaning around them. Combatting shame is hard and incredibly important work.

We all have automatic systems of judgment and evaluation. Is yours working? Is it based on external, socially sanctioned standards or is it about you? What does feeling good about yourself feel like in your body?

what happens when we go back to “normal”?

I've heard a lot of my clients share a similar narrative around the very real changes to our lives that have been a result of the pandemic over the past year. It usually sounds something like this- "Sometimes the choices and decisions I've made in the past 10 months make me feel anxious - everything has been happening in a pressured bubble, so how do I feel comfortable about how my life looks when things go back to normal?"

This narrative comes up when discussing relationships that started or accelerated during the pandemic, when considering career changes, and often when processing major lifestyle shifts, including the way we socialize. I definitely understand this thought process - "will this relationship that has been working so well when I don't have to introduce my partner to my family or friends still work when things go back to normal?" Or, "Is the reason I decided to start exploring pregnancy because I've been lonely, and when things go back to normal I won't want to start a family right now?" And even, "Do I still like the same things? Have my interests changed? What happens when things go back to normal?"

Some of the decisions made over the past year might feel wildly different than what we might have expected, perhaps even risky.

There is no denying that for most of us, our lives are different today than they were last year. For those of us who have experienced loss during the pandemic, our lives might always look different than they did last year.

I want to suggest that although the conditions of the pandemic are different than life before, that doesn't mean that we have been living on pause. Our decisions have not been divorced from our thoughts, feelings, and identities. As we have faced changes, challenges, and choices that previously weren't on our radar, we have been developing. There is growth in change, and if we understand much of 2020 as only a strange blip, and not our lives being lived, then we risk invalidating all of our actual evolution.

When my clients are sharing some of these really valid and relateable thoughts, what I see is a courageous and sometimes even radical reckoning with the challenges life can bring. I see flexibility and adaptability, and a lot of personal and community progress. For most of us, the "normal" that we are looking forward to will not be the same "normal" that we had before the pandemic - we will not be the same, we have grown. While we don't know what choices we might make when COVID-19 management looks different and many of the restrictions we live with now have lifted, we don't need to feel fearful.

What challenges have you faced during the pandemic, and how have you survived them? What might you be proud of when you think about your growth in 2020? What qualities do you and your community have that you might take comfort in when you think about the unknowns of 2021? Did you take any risks? If so, what did you learn?

infertility and sex

How does the experience of infertility impact our sex lives?

One in Four Couples

The World Health Organization estimates that one in every four couples in developing nations has been affected by infertility, an estimated 48.5 million people worldwide (Mascarenhas et al., 2012). While this number is based on the commonly used biomedical definition of infertility, “1 year of regular, unprotected heterosexual intercourse without conception” (Shreffler et al., 2018), infertility refers to so much more. Folx who engage in fertility treatment at home, in complementary and alternative practices, or in a medical setting using Assisted Reproductive Technology (IUI, IVF, and more) are a diverse group of people. Queer couples and families, those pursuing parenthood without a partner or partners, and many others depend on medical infertility interventions to help start a family. 

Infertility and Sexual Satisfaction

A simple web search will result in a wealth of information about the process of commonly administered Assisted Reproductive Technology like IVF (In Vitro Fertilization) but less about how this process feels emotionally, affects relationships, and even less about how this affects a person’s sex life. Sex is intertwined with fertility, and sexuality is an important part of well-being. Healthy sexuality looks very different for each one of us, and the baseline for every person is unique. We do know that the experience of infertility does seem to lead to a decrease in sexual functioning and satisfaction, regardless of baseline. When a person loses connection to their sexuality, it can lead to some painful emotions, and potentially a loss of pleasure in life. 

When sexual functioning and satisfaction is studied, data is often gathered around the following experiences for a person: arousal, desire, lubrication, orgasm, satisfaction with sexual experience, presence of pain, sexual self-esteem, relationship satisfaction, frequency and type of sexual contacts, external and internal shame, frequency of intercourse, and frequency of masturbation. This list is not exhaustive, but these are some ways that we can try to understand how a person is feeling sexually, and how they perceive their sexuality. When studies refer to sexual difficulty or dysfunction, this often means that study participants are rating some of the above areas as challenging, or not where they would want them to be. 

Studies show that the experience of infertility is linked to an increase in stress, grief, anxiety, and depression in women (Zayed & El-Hadidy, 2020). Sex educator and researcher Emily Nagoski explains that stress and negative emotions, including anxiety and depression, can contribute significantly to sexual inhibition (Nagoski, 2015), which can change the arousal and desire process. Simply put, when we feel stressed, down, or preoccupied, we are just not in the mood. This is normal. Infertility also often brings complicated feelings around shame and identity. For many people, difficulty becoming pregnant is a surprise. This can impact self-esteem and the way a person perceives their abilities. In the same way that painful emotions can lead to difficulty accessing desire and arousal, so too can shame and a blow to self-worth. 

The longer folx experience infertility, the higher the rates of sexual difficulty (Gabr et al. 2017). Additionally, women who are experiencing secondary infertility (those who have had one child but are having a challenge getting pregnant a second time) are also at a higher risk of sexual difficulty (Keskin et al., 2011). Assisted Reproductive Technology is an amazing way to help build families, however, the medicalization of infertility might miss some opportunities for common sense compassion. One only has to look to the common phrase “geriatric pregnancy”, a reference to those over the age of 35 hoping to conceive, to recognize some of the internal and external shame that might be associated with the medical model of treating infertility. 

How to Reconnect with Sexuality and Pleasure

So what do we do now that we know that infertility can lead to a decrease in sexual functioning and satisfaction? If you have experienced infertility, it’s so important to understand that you are not broken. And if you have experienced infertility yourself, you are not alone! It is normal for stress to impact the connection we have with our sexuality, and it is common for difficult medical experiences to lead to a disconnect with our physical, somatic selves. 

Introducing compassion, love, and kindness to our bodies and ourselves when coping with infertility is crucial. Working with an understanding of just how stressful and anxiety-provoking this process can be will allow us to take care of our needs, and to be patient and gentle when recovering from Assisted Reproductive Technology or additional infertility interventions. For some people, this process may even be traumatic. Knowing that research demonstrates that the experience of infertility can absolutely affect sexuality allows for a much less judgmental understanding of why we might be noticing some changes in our sex lives. 

Set aside extra time for connection with your own sexuality or the sexual connection within your relationship. When things are tough, it is normal to need some extra time to release stressors, ease into our bodies, and relax into intimacy with others. Ask yourself what might help with that connection and relaxation - what are some ways that you might help yourself feel turned on? What are some ways that you might help yourself demonstrate compassion to your body? How might this work in your relationship? 

Define, or perhaps redefine, pleasure in your intimate life. What feels good to you in your current moment? Too often we get stuck in very limited definitions of what sexual pleasure looks like. Especially when working towards pregnancy, the definition of sex can be very specific and purpose-driven. Expand this definition of sex and pleasure to include a diversity of types of connection, touch, and affection. 

Thinking of you!

References

Boerma, T., Flaxman, S.R., Mascarenhas, M. N., Stevens, G. A., Vanderpoel, S. National, regional, and global trends in infertility prevalence since 1990: a systematic analysis of 277 health surveys. (2012). Plos Medicine. 9(12):e1001356. DOI: 10.1371/journal.pmed.1001356.

Greil, A. L. McQuillan, J., Shreffler, K. M. (2018) Responding to Infertility: Lessons From a Growing Body of Research and Suggested Guidelines for Practice. Family relations, 66(4), 644–658. https://doi.org/10.1111/fare.12281

El-Hadidy, M.A., and Zayed, A. A. (2020). Sexual satisfaction and self-esteem in women with primary infertility. Middle East Fertility Society Journal, 25:13. https://doi.org/10.1186/s43043-020-00024-5

Abdallaha, A. A., Belal, D. S., Dieba, A. S., Faridb, E. Z., Gabra, A. A., Omrana, E. F., Kotba, M. M. (2017). Prevalence of sexual dysfunction in infertile versus fertile couples. European Journal of Obstetrics & Gynecology and Reproductive Biology, 38-43. http://dx.doi.org/10.1016/j.ejogrb.2017.08.025

Baser, I., Coksuer, H., Ercan, C.M., Gungor, S., Karasahin, K.E., Keskin, U. Differences in prevalence of sexual dysfunction between primary and secondary infertile women. (2011). Fertility and Sterility Vol. 96, No. 5, 1213-1217. http://doi:10.1016/j.fertnstert.2011.08.007

Nagoski, E. (2015). Come As You Are : the Surprising New Science That Will Transform Your Sex Life. New York :Simon & Schuster Paperbacks.

and how does it feel in your body?

…and how does it feel in your body?

This is a question my clients must be tired of hearing, lol. But it's a really good one! So much of the work my clients and I do is around the understanding and validation of the communication and language we can develop within ourselves. Not just with our thoughts, but with our bodies and the systems around us. 

Over the past month, I have noticed that I've been having a lot of conversations around this topic. I've been discussing this in the context of:

• anxiety and panic that takes creates a feeling of fear around being out of control in one's body

• a feeling of disconnect during sex or physical touch, feeling "stuck" in one's head

• somatic numbness as a result of the prolonged stress of the pandemic

• activated trauma responses - feeling that fight/flight/freeze happen in response to reminders of the past or very real difficult moments in the present

• experiencing a surprisingly big reaction to someone - a child, a partner, a family member

The first step in understanding what our bodies are trying to communicate is to be interested in the cues we can observe. This investigative data gathering can be really enlightening. Check out this really fantastic list of body sensations created by Meenadchi at Trauma-Informed Non-Violent Communication.

* a quick note about this compilation - I loved this because it was so creative and expansive, but that might not be the right vibe for you. No worries - we are simply tuning in to sensations - temperature, texture, pressure, tension.

We are empowered to listen to what we notice in our bodies. We can breathe and stay with the sensations, we can interpret and process them to give us more information about what's happening to us, we can learn more about what we need, and we can even create new responses.

I think a really great place to start is by doing a quick somatic inventory twice a day. Running through your bodily sensations perhaps in the morning and evening, or even trying midday, just out of curiosity.

Thinking of all of you!

modern family questioning

I'm lucky to work with clients who have had the courage and interest to live their lives in ways that are creative and don't follow the status quo. This approach to life can bring a lot of joy and pleasure, but it can also mean a lot of emotional labor around decisions that are not simply taken for granted. When every choice is carefully considered and examined, the weight of the decisions can feel quite heavy.

I frequently hear my clients question what they would like their future personal family to look like. Today, I bring this up in the newsletter to simply validate the difficulty of this emotional work and the complicated experiences around these choices. There are so many pressures to sort through when deciding what feels right in family planning. And if one comes to the point of deciding that being a parent feels like the right option, then the list of valid and good ways to do this is long - to do this without a partner, with a partner, with multiple partners, with a partner without a romantic relationship, and so on.

In our work together, my clients and I try to understand what feels important and meaningful when considering the possibility of being a parent and then we take the next big step to learn about all possible options. Being informed about options is one of the hardest and most important parts of this process - this allows us to make choices, instead of feeling like choices are being made for us.

It is very normal to experience protective avoidance around some of these decisions and to have the unconscious belief that things will simply sort themselves out. This may be true, but it can be really empowering to step into a more active role in determining what one's future may look like.

This can be really tough stuff, and coping with the feelings and tolerating the uncertainty that goes with it all might be rough. I want to give credit to all of you out there who may be going through some version of this thought process! You are definitely not alone in this.

If any part of this message resonated with you, I encourage you to take a moment and give yourself some respect for the work you are doing.

stress and sexuality

It's difficult to fully realize just how much stress many of us have endured over the past many months. Stress impacts us in so many ways, including how we experience our sexuality. Maybe you haven't noticed any change at all, but for a lot of people, stress can affect the process of accessing arousal and desire. This is normal and relatable! 

Emily Nagoski distills the research around this phenomenon into an accelerator/brake analogy. We each relate to circumstances that lead to arousal and desire (accelerators), and circumstances that make getting to that space of readiness more challenging (brakes). Stress, as you can imagine, is generally a brake.

This basic concept is really powerful because it reminds us that there is nothing wrong with our relationship with our sexuality - or our relationship to others - if we aren't feeling as easily connected to desire and arousal as we were during a less stressful time. Within this framework, there are ways to acknowledge and work with the stressors you may be enduring to create an environment that has more accelerators and fewer brakes.

As a brief exercise, try identifying:

• 3 personal brakes

• 3 personal accelerators

To spark the imagination…

Some brakes I've heard include: 

• time proximity to children and family responsibilities

• thoughts of contamination and corresponding anxiety

• financial pressure and how that impacts the sense of self

• sadness around the climate crisis

• fear about the political and cultural landscape

Some accelerators I've heard include:

• time and space to separate from family responsibilities

• feeling connected to one's body after some kind of physical movement

• allowing time for a self-guided fantasy

• connecting with trust and the desired power dynamic within a relationship

• anxiety reduction as a result of a time-out when possible from cultural stressors

Taking time to think about and plan for the type of relationship we'd like with our sexuality can be a good thing. 

Thinking of all of you.

compassion, pleasure, and sense of self

Feeling value and comfort within our identity can be a major challenge on a good day, and it can be even more difficult in the absence of typical external interactions during COVID-19. It can be surprising to realize just how much of an impact our relationships and external validation have on how we see ourselves.

Self-doubt and criticism can be really painful, and the ways we may have previously tried to soothe some of these super harsh voices were probably connected to the feedback we solicited or received from others. This may be helpful for a moment, but it usually doesn't last for long. 

Fighting and challenging these thoughts can be an exhausting exercise. Instead of trying to work with these thoughts in a really intellectualized way, focusing on pleasure and compassion can be a different and really impactful way to connect with your value. 

1. Pleasure as self-worth Allowing ourselves to experience pleasure can be a way of showing ourselves that we matter. Instead of fighting a self-critical thought, recognize that it's happening, and take this opportunity to engage in something accessible and pleasurable. Consider your senses - what can you see, feel, taste, hear, or smell that will feel good? Prioritizing pleasure can feel like a radical redefining of what matters.

2. Compassion as self-value A regular self-compassion practice can be a seriously powerful way to begin to develop a feeling of care for ourselves, and it's not necessary to feel "self-love" to have compassion. There can be quite a bit of pressure around the idea of self-love, and this is not always attainable or relevant. We can exist with complicated feelings about ourselves while also directing love and compassion towards ourselves, respecting, and prioritizing ourselves. 

Try a guided body scan combined with an easy visualization to help. Direct your attention to your physical experience, focusing on each part of your body. Imagine yourself directing a warm ray of light onto each part of your body. This warm light contains compassion and care and is sent to each part of your body as you imagine it. 

our sexual past as a roadmap to our present

*CW: this post mentions sexual development

Processing how we began to understand our relationship to our own personal sexuality can give us a lot of information about why we feel the way we do in the present. Finding out more about the space we existed in, the events happening around us, and the messages we received while we were coming to understand our own sexuality can be super helpful. 

Here is a great exercise to illuminate some of the ways we came to understand and interpret our sexuality - a quick pictogram of your life. This gives us a snapshot of some of what influenced this development, maybe in ways we are only vaguely aware of. 

I'm including an example below - I've intentionally kept this hypothetical person very simple to demonstrate how this exercise works. Certainly, your own map will be more complex than this.

Consider all the possible categories of influence, socialization, and messaging that may have been existing around you. I've included 5 general categories in the example, but there can be as many or as few as are relevant in your life. The arrows demonstrate the direction of influence. There is no "right" or "wrong" here.

If you find there are traumatic experiences that might go on this map, take the time and care you need if you want to include them. Sometimes there are areas of our relationship with our sexuality that we may want to unlearn. This exercise may also highlight what no longer feels right for you. I encourage you to also take your time with this. 

comparison as avoidance

As people continue to cope with extraordinarily high levels of stress, it's only natural that defense mechanisms pop up. It can be incredibly helpful to develop compassion, empathy, and understanding of our mind and body's natural protective response to stress.  

Picture the moment you see a friend, colleague, or just someone you follow on socials doing something that creates a feeling of envy in you. You perceive this person to be experiencing something that seems better or more meaningful than what's happening in your life. Staying in this space, sticking with these thoughts, ultimately takes us pretty far away from what might be relevant for us - do we feel there is something we'd like to feel different in our lives? What might that be? What does it feel like to sit with that? 

Anna Freud continued the exploration of her father, Sigmund Freud's, concept of defense mechanisms, and explained the way anxiety may alert the mind to protect from discomfort. Avoidance is a really common expression of the ego defense mechanism, connected to repression. I imagine that we are all familiar with the feeling of choosing a soothing, numbing activity over the thing that is important but difficult. Although it might not be obvious, comparing ourselves to others is often a form of avoidance. 

When we notice difficult thoughts of comparison coming up:

• Address thoughts with curiosity - Notice that you are in a space of comparison, and then inquire, what exactly are your thoughts? What are you saying to yourself? Get specific. For example, you might actually be saying, "They are better than me because they have a partner. I am failing". 

• What's the purpose of this thought? - Why does your mind go to this place? We all learn ways to cope with feelings that are tough. Sometimes these coping methods can shift so they are no longer helping us, and this often happens without us even realizing it. Often our thoughts exist in connection to an emotional reaction. In this case, the emotions might include, "I am feeling different, and this makes me feel sad". 

• Introduce the idea that this might be a protective defense mechanism - We each have our own experiences with what we have learned about how the world works and what is acceptable. Usually, this is a combination of explicit and implicit teaching - what we were specifically told, and what we observed and absorbed. Consider the example - a commonly held belief that might cause anxiety is, "Good people get married, if a person is not in a relationship, it is a failure". 

• Go deeper - what truth about our lives might we be avoiding by spending time in comparison? - Many of the beliefs we carry with us do not actually reflect the life we lead, or what we hold to be true. Getting to that place of clarity, however, can take some time and effort. Perhaps the truth here is related to this journey, "I am not sure what I am looking for in a relationship, or in a partner/s". 

• What might we be protecting and sheltering ourselves from? - We often forget that we can handle the unknown. It is understandable that facing the often complex truth about how we feel, and who we are, feels daunting. It can feel safer, and more comfortable, to stay in a space of self-criticism and comparison, instead of being quiet with what we feel. "It feels really vulnerable to acknowledge that I don't know what's going to happen for my relationships in the future". 

• How might we soothe ourselves if this is difficult? - We cope with the unknown every day, whether we are consciously aware of it or not. Use some of your skills here - if the thought is so painful that you are naturally repressing and avoiding it - take care of yourself. Be kind and be compassionate. 

• How does this feel in your body? - Our bodies are a major part of this process. Ignoring how our emotions are expressed in our bodies can lead to further difficulty expressing ourselves. If you notice there is tension, pain, discomfort, or any sensation that you take note of anywhere in your body, spend a bit of time breathing into that spot. Notice what's going on for you. 

• Shift the narrative to better reflect your feelings and your worth - The statement we started with, "They are better than me because they have a partner. I am failing", no longer works after this process. This feels a lot better - "The social space I was in when I grew up taught me that marriage is the most common form of relationship, and that's what most people do. I don't know if that's actually how I feel, or if that's actually true. Sitting with that does feel a bit tough, but I understand why. I'm going to prioritize taking a walk to help ground myself and reconnect, knowing that being real is hard work. I'm valuable, and I can tolerate taking the time to figure out what I feel". 

how does your stress response show up in conversations?

We find ourselves well into the second month of shelter-in-place, adjusting to life as it has become. We are still teetering between occasional acute stress and that low grade, sustained worry that has become familiar. It's normal in a time of constant stress to have a natural protective response to this - the "fight/flight/freeze" response that can show up with more frequency during times like this pandemic.

What happens when your natural stress response is "fight" - take action - and your partner's stress response is to freeze? What about when your colleague feels "flight: and you feel "fight"? Clients have brought many similar scenarios into their sessions recently, highlighting how challenging it is to navigate these strong, instinctual responses that can easily lead to conflict. How do we connect when it's so easy to fight? 

1. Simply being aware that it is normal and understandable to be experiencing our own response to stress, and considering with compassion that this may be quite different than that of those around us, is a really powerful tool in working with these interpersonal conflicts. 

2. Teach yourself to understand your own automatic response to stress. Common cues are bodily sensations, the feeling that you are speaking without thinking, or what may feel like a bit of a disconnect from your internal conversation. For example, if you notice that you focus on to-do lists, create action plans for all possible scenarios, or feel very compelled to engage your partner in a strategic discussion, your natural stress response might be in the "fight" area. If this is the case, you may also notice muscle tension, a change in your body temperature, adrenaline, increased energy. These are all ways you can begin to learn about the way your body and your mind try to take care of you during these moments. 

3. Activate your natural soothing system. Our body's natural calming system, the parasympathetic nervous system, may not be as active as we want it to be. To engage with this system, one of the most impactful things we can do, especially when trying to calm ourselves in a short period of time, is to work with our breath. Slowing our breath down to a pace of five breaths per minute (use helpful coherent breath audio track to help pace your breath - inhale on the higher tone, exhale on the lower) or utilizing a 4/4/6/2 pattern (inhale for a count of 4, hold for a count of 4, exhale for a count of 6, hold for a count of 2) has been shown to be really effective in achieving calm. 

4. Ask yourself what you need to help take care of your needs in the moment. If you are in a space of "freeze", what would help you feel safe to come out of that? What can you do for yourself? What can your partner do that would be helpful? 

5. Approach your conversation with curiosity around your partner's stress response, challenge yourself to express your feelings clearly and directly, and offer your partner the same. Feel empowered to express what's happening for you in these moments of stress, and to explain what you've noticed about your response system. 

Opening up to the compassionate mindset of caring for ourselves and others in moments of stress while acknowledging our natural protective instincts can create an environment that facilitates connection instead of conflict.