Sex, Love, and Light

Social-Dating Anxiety-The Dr. Joe Show

May 5th, 2013

Social Anxiety is a disorder defined by intense fear in social situations. Sometimes it can encompass specific situations (ie-dating anxiety) and sometimes it can be generalized to broad situations (ie-leaving the house). In either case the general course is to avoid the situation that triggers the anxiety-hence living with avoidance to varying degree.

Anxiety of this sort often has its roots in early life and may have manifested in various symptoms, mostly separation anxiety. Later it can show co-morbidity with other anxiety disorders (panic, PTSD and generalized anxiety), psychosomatic ailments, substance abuse-use and depression.

Treatment occurs at various levels. Medication can treat the symptoms (anti-anxiety or antidepressant in most cases) but psychotherapy is recommended. Therapy can take the form of symptom reduction (cognitive behavior, hypnosis/meditation/EMDR/stress management) or looking for the root of the initial anxiety via more traditional methods.

Here Dr. Joe Rabinovitz and I have an opportunity to speak with Scott Heide, subject of the online video SoFloDude86 and a recent edition of MTV True Life. You can view the episode here http://youtu.be/Jb0LPInfCDY?t=1m22s

Tiny Tweaks can lead to Big Changes

May 3rd, 2013

I’ve had the opportunity, on more than one occasion, to watch Amy Cuddy’s Ted Talk on Body Language. The research she did along with her colleague at Berkeley, showed that its not that our body language is a reflection of who we are but that who we are is a reflection of our body language. They came to this conclusion through a series of experiments where participants were asked to engage in a behavior (gamble) after engaging in a low power or high power pose for two minutes. Objective testing of hormones found that high power posturing raised testosterone and lowered cortisol and low power posturing lowered testosterone and raised cortisol. They also had their effect on the outcome-gambling.

Body language and power/non-power positions are crucial in communication and communication is central to relationships with others and with ourselves. It’s central to connection and central to negotiation. I love her talk for not only its content but because she is exactly what she says is important-present. it’s not so much what you speak about but how you do it (which, BTW, is the case for much of life and interactions in general).

I also love the talk because she says “tiny tweaks can lead to big changes”. Although much of life is that we get what we put into it-there are instances where the ‘big bang for the buck’ phenomenon comes into play. You can access it here: http://www.ted.com/talks/amy_cuddy_your_body_language_shapes_who_you_are.html

Another personal favorite-also in the ‘presence’ family-is meditation. Therein also I apply the tiny tweaks can lead to big changes philosophy. Also at Harvard, where extensive research has and is being done on meditation, did they find that daily meditation for eight weeks found changes in the amygdala as found on MRI. There are many forms of meditation-to include guided, silent, walking and even eye-open meditation. I ask my patients to invest 5 minutes twice a day for three months minimum in ‘mini meditation’, noting the cumulative changes in their internal state (or ‘vibration’). (I also ask them to place no assessment on their personal therapy until they are twice weekly for three months). While, unlike these Harvard researchers who used a laboratory, I have not measured nor scientifically analyzed the data, I have heard, even from skeptics, that this is effective.

So what do posing and mini-meditation both have in common-they are both tiny tweaks that can lead to big changes.

You are welcome to access this meditation directly on my website.

Couples Tip #1 – Don’t tell all!

March 6th, 2013

For most of us it is easy to go through your day, start to finish, on autopilot. There is alot to accomplish-between work, kids, parents, pets and household matters . . . it can be quite consuming. In the midst of things, staying connected to your partner/spouse is vital to keep the core temperature of the relationship stable.

Periodic Reconnections, as I refer to them, are tantamount to the maintenance of the connection. A text ‘hello’ or’ I love you’ or yes even ‘thinking about how hot you are’ can be quite the connection and the flirt as well. Sexting is great within the bounds of an intimate relationship. Animated emoticons are my personal favorite, and lately, photos taken. A picture tells a thousand words!

A few days ago my 14 year old was home sick. Knowing I had (not well) hidden some chocolate treats yet full well knowing that they were off limits, I received a photo of him smiling as he was opening the jar of treats with a “well . . hello!”. I have to admit-it made me smile.

Yet despite the need for these ‘reconnections’, we tell too much.

With all of the attachments to wires, phones, computers and communication devices, there is an endless accessibility to relate. By the time most couples (and families) reunite at the end of the day, or whenever they get back together, they have told all. He/she knows how many dirty diapers there have been that day or every nuance of what little Johnny did on the playground.

For years I have had couples tell me that when they reconnect at the end of the day they are typically in separate rooms doing separate activities. While that is commonplace today and there is room for that, there is no, if any, face to face time which is the critical element that builds the connection.

Years ago I began telling couples, stay connected but don’t tell all. Keep it short, sweet, vague and if you have to recite a monumental event, at least save the details for later! There is nothing like face to face contact that builds the connection. And don’t forget the eye contact as well!

Sex Addiction – fact or fiction?

February 6th, 2013

Sex Addiction is a term more loosely used in the media in recent years. Tiger Woods, Eliot Spitzer, David Duchovny, Charlie Sheen and Russell Brand.
There are women too; the press has not been limited to men.

Like many definitions of mental health, Sex Addiction has two camps. Those who believe and those who do not believe in the “addiction” model as it applies to excessive or problematic sexual behavior.

Addiction by definition has two components: 1. The need for increasing amounts of the substance in order to achieve the same effect (however one defines effect) and 2. withdrawal in the presence of substance abstinence. Many of the articles I have read have not addressed these two aspects. They speak of negative sexual behaviors with negative consequences.

In the height of the addiction movement Patrick Carnes popularized “sex addiction” in his work “Out of the Shadows”, which by the way, while making many relevant and applicable points has no empirical basis. He defines sex addiction as “any sexually-related, compulsive behavior which interferes with normal living and causes severe stress on family, friends, loved ones and one’s work environment.” A very open ended definition at best and one in which, if applied improperly can have devastating impact on an individual’s self definition and on a couple’s relationship. If applied properly, the addiction model can be useful.

If you think you might be a sex addict or have ever heard that term define you take this test: http://www.recoveryzone.com/tests/sex-addiction/SAST/index.php. A tentative measure at best, the Sexual Addiction Screening Test (SAST) might find many false positives as many sexually healthy people might score high on this assessment measure. If anything it will help you consider aspects of your sexuality that might be causing problems for you and your relationships.

Marty Klein, marriage and family therapist and media expert. argues against the use of the term ‘sex addict’ referencing “it’s someone who is unhappy with the consequences of their sexual choices, but who finds it too emotionally painful to make different choices.” Provoking and thoughtful, it can be found here; http://thehumanist.org/july-august-2012/you’re-addicted-to-what/.

I take no stance. There are instances, a low percentage, of people who truly suffer from an addiction or sexual compulsivity. There are many more instances where our sexual decisions have had a negative impact on our lives. In either case I utilized multiple modalities of classical psychotherapy with some sex therapy. In all cases the development of our erotic moments, rooted in childhood and adolescence, are connected to later decisions and it is through the work on these that healing is achieved.

I cannot claim to diagnose anyone who I never met nor can I comment on these highly publicized celebrities. One never knows what is really goes on the bedrooms of others unless they let you in and much of what is touted may be inaccurate. Nevertheless it seems to me that Tiger’s biggest challenge may be living up to his name . . .Tiger.

Male Erectile Dysfunction

November 12th, 2012

Check out this article by Jaleh Weber, on Male Erectile Dysfunction. She said that it received more hits than any of the others! The article can be found here: http://voices.yahoo.com/male-erectile-disorder-interview-dr-barbara-6125616.html?cat=70

Jaleh is the author of Making Marriage a Success, 2011, available at Amazon.com.

Also check out my contribution to the book on what can make your Marriage a Success.

Obesity Economics-Part 1

November 7th, 2012

I’m currently taking a course called Obesity Economics- actually Principles of- the 4 week version of an 8 week course taught by a professor at John’s Hopkins. It’s about just that- the economics of obesity. Its about both micro and macro factors that govern obesity. My interest was-amidst an indulgent society, why are we so fat, particularly when not all cultures are.

Economics is about opportunity cost. It’s about what we are willing to invest in order to get what we want. That’s the key word-what we want. At the end of the day it’s about what’s important to us at what cost. Its about what we value. Do we value health, body image, exercise, good nutrition, sleep, money, time, career, relationships . . . these are some of the elements that come into play when making a decision to engage in any of the behaviors that influence our body/weight/health.

Think of it like this. You work 80 hours/week, eat take out, exercise none and are 50 pounds overweight with impending adult onset diabetes. You value money-it dominates your time. You have full health insurance through work such that medical care has no extra cost to you, although when you have to sacrifice work to go to the doctor that poses a challenge. To date you have not really been challenged with negative consequences so where’s the motivation for self care?

At another extreme-you value your shape and fitness. As a student you pick your classes around your exercise schedule. There is excess time focused on food selection and cooking, so much so it interferes with completing homework assignments. Yet the scale takes priority. Family and social functions are at a minimum as are vacations outside of fitness events.

Its all about what we value-what’s important to us and what we are willing to do to get what we want.

It’s a constant trade-off – giving up what we value least for what we value most.

This not only holds true in the arena of taking care of our bodies but in all the choices we make in our life. We are constantly in a position of making choices-choices how to spend our time and money to care for our health, relationships, education/career, spirituality and others.

Now that doesn’t answer the original question because these rules that govern behavior apply to all societies, or at least most. So the question still remains-why are we, the US, along with some other cultures, so fat?

Cybersex: Sex in Cyberworld

October 21st, 2012

Cybersex is not the same thing as Sex Addiction but it can be a part of it. Cybersex started with the advent of the Cyberworld-the Internet. People who once in their monogamous relationship were committed and faithful now have an easy access low-expense safe and private way to explore parts of themselves that had forever been hidden. A study from 2000 found that 65% of those who abuse cybersex had no prior history of sexual addiction

If a man wants to find out what it’s like to have sex with another man he can go into a gay chat room or engage live with someone behind his firewall. A disabled person who may have shame about their condition can engage anonymously while an adult can engage with a child. Anything is possible and in cyber-universe..

Cybersex or Cyber-porn is like any other addiction-to some extent. With other behaviors there is always a percentage of those who ‘experiment’ or ‘flirt’ with a substance or behavior and stop; there are those who experience it as a problem for the short term where it gets out of control. There are those who ‘abuse’ something intermittently and then there are those who are addicted. The classic definition of addiction is that it requires ‘tolerance’ and ‘withdrawal’-that it, an increasing amount of the substance to produce the same effect, and, when removed there are symptoms. Like certain drugs, it is easy to become addicted.

While anyone is at risk, the research shows that, like any other problem, those with poor ego controls and a history of other issues/addictions or someone in the throws of transition are at greater risk. People who are unhappy are at risk as well . . . often they are unaware that they are not happy.

Creating a world that you control . . that is a projection of what you want to experience is what happens in Cyberworld. But that is not the only motive. Here are some others:

Cybersex is disease free.
Cybersex intensifies self-stimulation and masturbation.
Cybersex provides instant gratification.
Cybersex provides an escape from mental stress and tension.
Cybersex normalizes sexual fantasies.
Cybersex provides approval and affirmation.
Cybersex alleviates performance anxiety
Cybersex helps cope with the pain of childhood sexual abuse.

If you or someone you know is a cybersexaddict it is critical to get help before the consequences are irreversible.

Let’s Talk Sex-Boca Observer 2012

October 10th, 2012

LET’S TALK SEX with Dr. Barbara Winter

Although 43 percent of American women and 31 percent of American men suffer from sexual dysfunction, it’s not something people feel comfortable talking about. Psychologist-Sexologist, Dr. Barbara Winter is. In fact, she has been ‘talking sex’ for over two decades in south florida. Within the confines of her office, she assists teens to elderly in managing most issues that arise at any stage of the sexual response cycle. She works with common problems that prevent the individual or couple from experiencing satisfaction from the sexual activity, such as low sexual desire, erectile dysfunction and ejaculation issues as well as less common problems such as transgender issues and fetishes.

Physiological/health problems and psychological barriers, ranging from depression, performance anxiety, marital issues and sexual trauma can be the cause.

Sexual addiction and Cybersex are huge issues. “The prevelance of these issues is widespread and a reflection of the absence of intimacy in our world today”.

With her mission to improve emotional, sexual and spiritual health, Dr. Winter treats general issues from anxiety and depression, OCD, loss/grief counseling, anger management and post-traumatic stress disorder. She has expertise with eating disorders, women’s issues and sexual abuse.

In addition to a Ph.D. in Clinical Psychology from NSU and a clinical internship from Case Western Reserve University School of Medicine, Dr, Winter has post doctoral training in psychoanalytic psychotherapy, hypnosis and EMDR and is a Diplomate and Clinical Supervisor in Clinical Sexology.

With EMDR, trauma can be resolved quickly. With Hypnosis Dr Winter can help with all kinds of ailments, including trauma, anxiety and symptoms where traditional therapy has not worked.

Another one of her passions is helping families become effective. Dr. Winter works with families in transition and provides “Divorce Coaching” at all stages of divorce and re-organization including Marital/Family therapy, Divorce Counseling, Co-Parent Counseling and help with Blended Families.

Medical Profile-Boca Observer-2012

October 10th, 2012

Medical Profile-Boca Observer-2012

Tiny Tweaks can lead to Big Changes

Couples Tip #1 – Don’t tell all!

Sex Addiction – fact or fiction?

Male Erectile Dysfunction

Obesity Economics-Part 1

Cybersex: Sex in Cyberworld

Let’s Talk Sex-Boca Observer 2012

Medical Profile-Boca Observer-2012

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