The Rational Basis® of Happiness Podcast

The Selfish Path to Romance. Download chapter one for free at DrKenner.com and Amazon.com.

Of course, I love her, but it's a different kind of love. I mean, it doesn't burn with the passion and intensity of a Tristan and Isolde, but it's more comfortable, more familiar. Maris and I are old friends. We can spend an afternoon together—me at my jigsaw puzzle, she at her autoharp—not a word spoken between us, and be perfectly content.

You're having problems with your sex life. You and your partner are really having problems. And your doctor says, "Well, why don't you go to a sex therapist?" And you look at one another, you and your husband, or you and your wife, and you think, "Oh my gosh, a sex therapist? We have to talk about what's going wrong. We don't even talk about it with one another." What goes on behind the closed doors of a sex therapist's office? With me today to discuss this is Barry McCarthy. Dr. Barry McCarthy is a professor at American University. He's a certified marital and sex therapist, and he has a private practice in Washington, DC. He's presented over 150 workshops around the globe on a range of relationship and sexual problems, and incredibly, he's very prolific. He's written many, many articles and books, book chapters, and with his wife, he's co-authored eight books on relationships and sexuality, including a book, Rekindling Desire. Dr. McCarthy, it's a pleasure to have you on the show.

Well, I'm glad to be here, and I always like talking about sex therapy and talking about what it really is, as opposed to the myths about it.

I can imagine the myths that people have. If somebody told me, say, 30 years ago, "Ellen, why don't you and your husband go to sex therapy?" I would think, "Oh, my God, are they going to make us practice in front of them and show them what goes wrong? Do I have to talk about an orgasm? Oh, my God, this is so embarrassing!" And I'd be flushing already. I know a lot more about it now. But can you explain what is the procedure if, say, my husband and I were to come to you, or a couple were to come to you through your doors? What would happen?

Well, usually, sex therapy is approached as a couple problem, so you get away from the blaming about who's at fault. "Am I at fault? Is my spouse at fault?" You think about it as, "We have to work together to develop a comfortable way of being sexual." And there's never any nudity in the office. You never do anything sexually in the office. That's a very important thing to understand, and sex therapists are certified by an organization called the American Association of Sex Educators, Counselors, and Therapists. For those people who use the web, get an asec.org.

How do you spell that? A-S-E-C-T.org, and I'll give you certified sex therapists in your area.

And then, after the initial couple session, what then happens is that each of you has one individual session. You get a chance to tell your story—how you learned about being sexual. What are the strengths of your sexual relationship? What are the problems with it? So, the therapist's role is not to make you do something you're uncomfortable with. In fact, the therapist in the central field tends to be very respectful of individual value and cultural differences. It works within your value system.

Assuming it's not abusive.

Right. There are lines that you're definitely not going to be supportive of anything which is harmful to you or to anyone else. But we work within your value system to try to develop a way, a comfortable way of thinking, talking, and experiencing sexuality in your life so that it plays a healthy role in your life rather than being such a source of stigma and such a drain for you personally and a drain in your marital relationship.

Now, I think just taking a sexual history would be eye-opening for almost everyone because how many people sit down and actually assemble all of those thoughts of, you know, where did my problems begin? When have I been most aroused? What are the types of questions that you would ask in a typical sexual history?

Hey, I got to interrupt this because we've got to pay some bills. 30 seconds, that's it—a very quick ad, and then Ellen will be back.

Romance. Oh, I wish guys knew more about what we want from a relationship. Boy, I wish I knew more about what I want. Where's that ad I saw? Here it is—the Selfish Path to Romance, a serious romance guidebook. Download chapter one for free at selfishpath.com and buy it at Amazon.com. Hmm, the Selfish Path to Romance, that is interesting. What are the types of questions that you would ask in a typical sexual history?

Well, we start off with histories talking about how the person learned about sexuality. Did they learn it from their parents? Did they learn it in terms of sex education classes? Did they learn it through their religious organization? Did they learn it on the street? What have been the healthiest learnings? What have been the most unhealthy learnings? What are the things that they went in their life? Did they feel best about sexuality? When in their life has it been the most difficult or the most problematic? So we want to talk not just about problems; we also want to talk about what are their positive learnings and positive resources. We also want to talk about issues that are particularly sensitive, whether those issues had to do with child sexual abuse, sexually transmitted diseases, or unwanted pregnancies, or feeling sexually embarrassed or humiliated. So you want to give the person a chance, and you listen in a respectful, empathic way to their story. You also want to hear where sex now sits in their lives and what are their hopes and wishes and desires for themselves and their relationships, actually, and what are some of the concerns that they have about their partner.

You know, it's interesting that women, by and large, find couple sex therapy much more helpful and much easier than men do, especially men with erection problems or desire problems. Why do you think that's the case?

Because men generally are thought of as sexual experts. They know all the answers. It's not masculine to ask questions. Now, one of the best examples of that is males who are really upset about their erection functioning, and they often won't tell anyone, or they'll go on the internet and get a prescription medication like Viagra or Cialis or Levitra and hope that magically does it. And don't mean tell their spouse that they've done that. Where the approach in couple sex therapy is to think about the problem as a biopsychosocial problem. So you want to look at medical factors, psychological factors, as well as related. But you help them to open up a lot more. So if they're hiding secrets, like, "I'm taking Levitra" and not telling you, you want that to be not a shameful secret that the husband's hiding or the male partner is hiding, but something that he can say, "Hey, I need to use this a little bit," and not make it a self-esteem issue, not make it something that he's afraid to talk about. So a sex therapist would work with him to normalize it.

Well, not only that, but also, rather than to hope that the medication, which I think I'm in favor of, the problem is that they over-promise in their advertisement. That you're hoping—the man's hoping he's going to go back to be sexual the way he was in his teens, in his 20s.

So somebody in their 50s or 60s may think that, "Oh, great, Levitra will give me that same potency that I had as a kid," right?

And it's also he's not going to ask anything from his partner, where what we say to couples is, "If you're going to regain your comfort and confidence with sexual desire or with erection, you've got to do it as an intimate team." And that's one of the nice things about sexuality, is that the two of you can work together to regain that comfort and confidence. It isn't the medication alone. It's both, right? And I want to thank you so much. I wish we had more time to talk about sex therapy because I know you give homework, and I know that you really encourage the couples, the partners, to open up with one another. I've been talking with Dr. Barry McCarthy, who's written a book, Rekindling Desire. Dr. McCarthy, how can people get one of your books?

Well, they can go to the bookstore or on Amazon, and the two most relevant books would be Rekindling Desire and the other one, I'm a second author with Michael Metz, and we wrote a book called Coping with Erectile Dysfunction, which actually came out in 2004.

Well, thank you so much for joining us today, and thank you.

For more Doctor Kenner podcasts, go to DrKenner.com and please listen to this.

Here's an excerpt from The Selfish Path to Romance, the serious romance guidebook by clinical psychologist Dr. Alan Kenner. Co-author Dr. Edwin Locke, self-esteem is a critical psychological need. It is your evaluation of yourself as a capable and worthy person. Some self-help books tell you to simply accept yourself as you are. That advice cannot work because who you are or are not at this moment may be the problem. Even if you consciously try not to judge yourself, your subconscious will do it for you. It is essential to know the right standards to judge yourself by to avoid suffering unnecessarily. Self-esteem is vital to your happiness, including your romantic happiness. If you do not respect yourself, you will not feel worthy of being loved.

You can download chapter one for free by going to DrKenner.com and you can buy The Selfish Path to Romance at Amazon.com.