Episode Transcript
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Speaker 1 (00:14):
Welcome everyone to a brand new episode of On Call
with k B. I'm your host, Kap and we have
a delightful segment today where we're going to give you
the t all on season two, episode eighteen of Gray's
Anatomy called Yesterday with my I Heart next up, cohort,
colleague and just a divine human being who understands truly
(00:37):
what it means to walk through life with purpose and intentionality.
And she's just a gem and a delight. So please
welcome Prianka. Oh my gosh, Kabe, that was so sweet.
That was so sweet. Thank you so much. Um. Okay, well,
I am smiling like a goofball but luster. But it's
(01:00):
it's really nice to be here, and I am really
happy to be able to talk to a fellow super
fan about this because, as you said, it is a cult.
Like I am, I am completely caught up on the
entire show. I literally watched the like the newest release
the other day and then I watched the episode that
(01:22):
we're going to be talking about, and I was like, oh,
they've got me. Like I'm going to follow this world
for as long as it makes sense. I mean, for me,
it stopped making sense, but I'm still going to keep going.
So before we dive in, you know, Prianka, where were
(01:44):
you when you first fell in love with Grays And
when did you realize like you were going to be
a lifer in the in the Graces cult? Oh my gosh. Yeah,
So I was in college. I was in my sophomore year,
maybe junior year, I can't remember. It was a poor
seasons in and I was just looking for a show
(02:04):
to watch. I can't even remember, like what's streaming platform
or anything like that. I was like, Okay, you know what,
I'm gonna give this a try, and I was immediately
hooked on it just from the simple fact that it
is a sexy drama, like it's it's literally just hot
people who are in this really mysterious and alluring professions
(02:28):
such as like being a surgeon, right, and they have
all these just wild personal lives and I think, you know,
that's that's like the show still to this day and
for me this is kind of I don't always volunteer
this information. So I really appreciate UKB for inviting me
(02:49):
on because I don't really get a chance to talk
about this a lot um. But during that time in
my life, my dad had actually he was in the hospital.
He had had a really bad accident work, and so yeah,
and so he was in the hospital for a really
long time. His recovery was really long. And I don't
know if when I was making that choice to watch
(03:11):
Gray's Anatomy, it was like a conscious decision to watch
a medical drama even though, like I was having this
medical emergency happening in my life. I think, as I
reflected over the years, like there's definitely something there um
And then yeah, I got hooked on for the simple
fact that like it was just fun to watch. And
then I realized that what this show is doing is
(03:34):
world building, right, Like we are getting invested in these
characters and their lives and the relationships in between them.
But also there's this real human element to all of it, right,
Like these characters are really messy. And also I think
this episode that we're going to talk about really highlights
(03:56):
that sometimes like things just don't work out. And thinking
back on that time in my life, thinking back on
what was happening with my dad's accident, I think I
needed that passive affirmation that even though life can be
totally shit, there's always an opportunity to reflect, and I
think that that's something that that show has done really
(04:19):
well over the years. Well, thank you for sharing, and
I am glad that your your dad is doing much
better now, but you know, very sorry that that had
to happen. Um. Now, this episode is a relationship heavy one.
I mean, like Burke is really upset with Christina because
she essentifically lied about keeping her apartment. Um, Alex and
Izzy are just having sex, but like Alex often pretends
(04:42):
like he doesn't have emotions or feelings, and this is
one of those episodes where you know he's doing that. Uh. George.
George is a sweetheart, but I often find that he
is kind of oblivious to other signals that people give.
And Meredith essentially ignored him all the time. She she's
actually not like she doesn't panther to do him often,
(05:04):
and I'm kind of like, I think that's your answer, George. Um,
and Mark Mark comes in, you know, being um the
hot plastic surgeon, and really he's just there because he's
heartbroken and he loves Addison and she left and she
doesn't come back to New York. She's trying to save
her marriage to Dare, which He's like, it's over, It's over.
So what was your kind of favorite relationship driven seeing
(05:27):
this episode and whose character relationship drama made you cringe
the most, because it's definitely George for me. Yeah. So
for me, what was so sad about seeing George pining
over Meredith is that at this point, I have gone
through therapy and I have made peace with all the
times I have pined over someone who has no interest
(05:50):
in having a consistent relationship with me. Right, Like, I've
been there. I've been on the other side of that,
and it took some like deep internal work to realize
at I was just chasing myself, Like I was just
trying to fill a void within myself by trying to
exert control over a situation that I wasn't seeing clearly,
(06:11):
Like that's to me, what's really happening there. And I
think that it's so easy to put expectations on people
that we think we know, and maybe we do know,
like in one capacity, but to be romantically involved with
someone is a completely different relationship. And I think like
(06:35):
that to me is also why the whole George Meredith
situation is cringe just because it's like it's it's just
two humans who are not coming from a place of
unconventional love or anything like that. Like this is literally
just a pattern of people who have unprocessed feelings about
other things and then being in the wrong place at
(06:57):
the wrong time for each other. Yeah. I mean, like
Meredith is not dealing with her trauma, which she does
consistently on the show for the first few seasons, and
George has his own trauma from being legitimately run over
by his family. I mean, his family just treats him
so poorly, which we find out kind of in later seasons,
and that's part of the reason why he's not picking
(07:19):
up on this queue with Meredith, right, Like so many
people treat him poorly in his life, and he's just
kind of used to that behavior. Yeah, but I do
kind of find that, like everyone is kind of so
wrapped up in themselves in this episode that they're not
able to focus on what the other person is thinking,
except maybe Christina. And I only say that because by
(07:41):
the end of the episode, she's willing to give up
her apartment and start fresh and start to like truly
trust him in love. Yeah. Yeah, that's that's a huge, huge,
huge distinction for me about Christina from all the other
characters is like, yes, like she is also emotional and
(08:02):
has really like reactionary behavior, but at the end of
the day, like, there is something I think to be
said about being able to see things from a logical
point of view, right, And I think with Christina, like
her ability to shut down her emotions as at times
actually in this episode, is what allowed her to see
(08:25):
things from a different perspective, because at the end of
the day, like, if you can put your emotions on
the side, it doesn't mean that you're neglecting them, It
just means that you're you're taking up less space. And
I think that that's something that Christina can do, given
that she does control her emotions in that way good
and bad. And what's coming up for me right now is,
(08:48):
uh so, I'm queer, and I have been in polyamorous
relationships before, I have been the primary partner. I have
not been the primary partner. I am currently in a
monogamous relationship. But I'm thinking about how communication or lack thereof,
happens in this episode and with some of the characters,
(09:12):
the Dirty Mistresses, if you will, um are very direct
in their communication and in their non verbal communication as well.
And then I think what's interesting is that you see
how those channels of communication are completely mismatched. And I
(09:33):
I think that that type of tug and poll also
creates a type of I don't know, like, do I
want to use the word attraction? I guess yeah, Like
I think it does create some sort of attraction for
the people receiving it that maybe feels a little bit addicting,
(09:53):
especially in the chaotic environment that they have to thrive in.
M M, yeah, you know. I think it's true. Like
Mark is actually quite direct in his communication style. And
I did find myself feeling bad for Mark because he
says in the show that he lost everything while the
two of them still have it. And it's true he
lost his best friend, because what did Derek do? Instead
(10:14):
of addressing this head on? He moved to Seattle? Like okay,
what does Addison do? She stays with Mark for a
little bit, then says, Okay, I'm gonna try to fix
my marriage. She moves to Seattle. Like Mark is in
New York City by himself, the only one willing to
communicate and talk through any of this, and the people
that he needs to have these conversations with literally ghosted
(10:36):
him like, yeah, so I just um, I just think
it's it's complicated, but you're right. And I think that's
why Mark is so refreshing, honestly, because he's like, I
just need you to take the emotion out of it
and just look at it for what it is. Derek
moved to Seattle. He's also not even talking to you
(10:58):
right now, and y'all still live. You'all live in the
same house. Like He's like, if he's not willing to
do it, then you should be thinking about yourself and
what it is that you want, because Derek is thinking
of himself in this moment. Absolutely, let's talk a little
bit about end of life because one thing I do
a door about Grayze or the parallels, and you know,
(11:19):
Meredith has this patient who has a tumor, and so
he is just letting it rip with these videos. He
is telling everyone in his life how much he hates
everything that they did. He's not holding anything back, and
you know, he's literally dropping like truth bomb after truth
(11:39):
bomb because he thinks he's dying. But when he's cured
and they cure him, he still wants to send the
tapes because he said he doesn't want to live life
holding it all in. And I think that like Meredith
does this consistently on the show. While at this stage,
right sheilds everything in, she doesn't really actually say what
she means or field of time. She talks about what's acceptable,
(12:03):
and I think a lot of that has to do
with her relationship with her mom. She doesn't have the
freedom to just kind of speak her truth. She's so
caught in her own head about being perfect at everything,
doing things a certain way, getting her mother's approval, that
she's not doing it. And so she learns a lesson
from this man who is no longer dying but still
has the balls to be like, I'm still sending them anyway,
(12:26):
that girl, you need to start doing this, And so
that kind of catapults her to going and see her father.
But even what we see when she sees her father
is that she still can't even be truthful with him, right,
Like she can only kind of allow herself that kind
of halfway mark of saying something, but she doesn't even
say everything that she's feeling. And so I'm like, I
(12:47):
don't know, would you take this approach in life? Would
you ever do something like this at the end of
at the end of life, just be like, listen, I'm
gonna tell everyone everything I've ever felt about them. I
in the past few years have made a very concentrated
effort to be as vulnerable as I can be with
the people in my life, specifically because I don't like
(13:11):
having unresolved feelings. UM that stems from my my own trauma,
but it actually plays out in a like an inverse
way to Meredith's trauma where Meredith freezes up as we
see UM and in the newer episodes too, it's interesting,
like I'm what's coming up for me is just thinking
(13:31):
about her like current love interests, and how she's playing
that situation out at times, and how it really does
mirror these you know, patterns of behavior where it's hard
for her to freely express how she's feeling. And for me,
growing up, I had parents that we're not as emotionally
(13:51):
communicative as maybe like what I wanted I needed as
a child, And through all of that, I have developed
a very earnest need to have that emotional verbal communication
with people because it was something that was like really
lacking for me growing up. So the way that it's
(14:11):
manifested now is boundary setting, basically, and I think that
that's something that Meredith is having a really hard time with,
like boundaries for herself, boundaries for her like romantic situations.
And I think in that scene where she visits Thatcher
and his response is like not like dismissive, per se,
(14:36):
but very much like what do you need from me now?
Like I'm not going to have this conversation with you,
Like that's a very clear boundary. No one is saying
that it's even an empathetic one or one that's like
appropriate for the hurt that your daughter is clearly facing
in the moment, right Like that's not what I'm saying.
But what do you do when you don't have that
(14:59):
strong sense of self and you're being met with someone
that you want something from but they're not going to
be able to give it to you. Like that's the
reality is that she has to find that acceptance herself,
and I think she really wants to, but we can
tell that like she's not there yet. And also, you know,
it's hard because a lot of this trauma is from
(15:21):
Meredith's early childhood, and there's a lot of things that
Thatcher is saying without saying in that scene, and a
lot of it is I can't go back and change
the decisions that I made. So I think that's also
why he really like leans into what can I do now?
So there's nothing that I can do to change it.
(15:42):
I can be as apologetic as I want to be
now or as you need me to be now, but
it won't change how things played out, and it won't
change kind of the other additional layers um of trauma
that came, you know, by her mother's hands, because her
mother was also um going through a lot and when
you know, Richard ended their affair, and how distant her
(16:03):
mother was and now you know, we know when her
mom had Maggie and gave her up for adoption. There
was also a lot of other things happening with her
mother too that she wasn't even conscious or aware of
that we're impacting her day to day life. And so
it's just one of those things with that or that
you can see the you can see the regret in
his eyes, but you can also see him being like,
(16:25):
I don't know what else to do, but um, you
know that's not really the only parallel obviously is he
is having the best sex of her life. Right now
with Alex and so she's finding it hard to create
a boundary um, but she's trying very hard to make
it seem like she doesn't. And then her patient comes
in and is having these spontaneous orgasms where she wants
(16:48):
those two stop so she can do normal things and
not have to, you know, be worried about whether or
not an orgasm is going to arise. So did you
really feel like this was a realistic case for the show,
and was this the case that interest you the most?
Like was it realistic from a medical perspective as someone
who is not in healthcare, As someone not in healthcare.
(17:10):
I I have recently found out, unfortunately but recently, that
there are different types of orgasms, like difference. Yeah, and
so like that's something and you know this this is
a whole different podcast, but like the patriarchy and what
we learned in school and women's reproductive rights and fems
(17:30):
and how are represented in culture, like you and I
could go on and on, but again that's beyond the
scope of our conversation today. So with that being said, like,
I think that these events that occur in our body
are super mysterious, and I think that yes, sure, it's
(17:51):
unique and quirky and like fun for the show. But
I have no doubt that somewhere someone in this world
has had something similar where they have had their body
just like operating in a way that completely deters their
quality of life. M hm. I felt bad for her immediately,
(18:11):
and also because they called her father, which is like, Okay,
this is the person that I want here the least
in this moment, is what she's saying. And I get it,
like he's just coming as a parent like, oh, you
were in a car accident, and she is like, I
caused the car accident. But you're right. I mean like
there are a lot of different types of orgasms. And
what we see from Izzy is that she's having so
(18:33):
much fun having kind of these like new experiences with
her body with Alex that she's kind of insensitive to
this woman in the beginning, like how could you not
love this? And it's not until she says, um, I'd
actually like to go to church with my parents, I'd
like to go to the grocery store. I'd like to
go see a movie. Like when you start thinking about
(18:54):
how out of control she really is and how she
just wants to have a semblance of a regular kind
of normal life and then be able to control when
she has these orgasms. It's like, oh, I feel very
bad for her. I also kind of found that it
looked like it was taking the joy out of her
life almost and the joy out of having an orgasm,
(19:15):
because she was just like, I'm sick of this, like
I don't want to do this again. And it's like,
oh no, you know yeah, And I think to um,
sex is still such a taboo topic. It's definitely changed
over the years, as does like any cultural movement, but
the humor of the experience of having an orgasm, like
(19:40):
in public, like that it was something that that sounds
like deeply, deeply, deeply, deeply uncomfortable, like I can't imagine
like going through something that I cannot want control, but
to like having people's reactions to it is like that
type of quality of life is what makes people isolate,
(20:02):
and that's you know, how like depression happens and all
of that. You're right, I mean, obviously, by the end
of the episode, you know, they are able to find
a solution and a treatment plan for her that works
for her, But if they didn't, You're right, it's a lot,
so I did feel really really bad for her. But otherwise,
(20:22):
who's your favorite character this episode? Mmmm, this is a
hard one. I'm going back and forth between Mark and
Dr Webber, and I think I'm gonna go with Dr
Webber just because we haven't really talked as much about
him and his his appearances on this episode. Like, you know,
he's he's not the main character of this but the
(20:44):
times that he is on screen I think speaks volumes
to the dynamics at play um. At one moment, he's
like very very professional, as you know, his like demeanor
around how seriously takes the profession. But then other times
we really see him being the adult, the authority figure
(21:09):
who's still also doing shitty things, like he is still
lying right to Meredith at this point. And also it
is I think, like deeply inappropriate to to like call
a colleague a jackass in the name of like your
(21:29):
friend that that you work with, even though you're the boss.
Like I get it, and I understand again, like that's
part of the drama of the show. But every scene
that Dr Weber was on I just thought was like
a very interesting like foreshadowing of what's to happen. Oh,
(21:50):
I found him to be a complete liar in so
many ways right in this episode. Yeah, I was like,
you are praising Derek for hitting Mark when you can't
even be forthcoming to Meredith about your affair that happened.
What is it like thirty years, twenty years, however many
years ago? And then also, how dare you say, oh,
(22:13):
I'm so glad you put your weight behind it, Derek,
when like, when when you had this affair, did you
want thatcher to put some weight behind a punch to
you two? I mean like, what is it like? So, yes,
I find some trauma. Yes, And he's out here just
stirring up more drama and there's lies at every turn.
And in my personal opinion, Webber thinks he's a good guy, right,
(22:37):
and he's lying to almost everyone. He's wearing a mask
so to speak, in this episode, with everyone that he
is engaging with, in my personal opinion, until it's not
until he gets to ellis any Caesar that you know?
Obviously he takes the masks off and he's like, okay,
well I think Meredith knows. But it's also like Richard,
the stand up thing to do would have been to
(22:59):
tell her as soon as you found out, because as
soon as you found out that she was in this
program and she was, you know, coming to Seattle Grace
and she was going to be your intern, you could
have pulled her to the side then and said, listen,
something that you need to know. I, you know, worked
with your mother. We had a romantic affair. I do
not want that to impact X, Y and Z. But
(23:19):
instead you're hiding it for years essentially until you know
it all implodes. And so I'm like, Richard m So
for me, I'm definitely going with Mark. And that's just
because he is a breath of fresh honesty. That's Seattle
Grace kind of neat at this time. Mark is who
he is and he may be arrogant, but he is
(23:41):
a brilliant surgeon, which he can back up. He does
have a kind heart if people like you know, get
to know him, and he is just very honest about
what it is that he wants. And I like the
fact that he is unapologetic about it. And so I'm like, listen,
it's gonna be marked for me in this episode for sure.
Uh um. But you know, thank you so much for joining.
(24:03):
I truly had a great time. This is a really
good episode because I do think it balanced kind of
heavy relationship and trauma things with humor, because you know,
they were trying to dabble in the humor with this
woman with her spontaneous orgasms. They're trying to dabble in
more humor with Izzy and Alex. But also just I
don't know, I feel like there are a lot of
(24:23):
character shifts that happened in season two that I kind
of miss in these later um you know, kind of
seasons of the show that I really really enjoyed watching
and so it was a delight to rewatch. But before
we leave, I have to take this opportunity. You have
to tell everyone about your upcoming My Heart show. Thank you, QB,
(24:46):
thank you so much for having me on. It's always
fun to revisit, like you said, these older shows and
compare and contrast. Um. Um, So, my my show is
called We the Product, and it's lated to launch December
six of this year across all streaming wherever you get
(25:06):
your podcasts. Uh. It's about surveillance capitalism, which essentially talks
about how we interact with technology via our personal information,
and my podcast specifically looks at how that personal information
of ours is categorized and stored mostly for advertisers. I
(25:26):
also talk with my community members about what are the
ramifications of our data that is being sold and transferred
across all these businesses that are trying to sell us things,
and what does it look like when our world is
being built by algorithms. I cannot wait to listen. I mean,
(25:48):
you know, when I first found out about your show,
I was like, this is so intriguing because the way
we use data now is just so ingrained in kind
of our day to day I mean, honestly, I don't
even think that we are truly thinking about it. That's
how much we use it right, Like it is just
happening to us versus us taking kind of a more
active participation in it, if that makes sense. And so um,
(26:12):
I am super super excited to hear you know your
show once it launches. Cannot wait. So everyone you know
December six market on your calendars, since that will be
when me it will be when the first episode comes out, right,
not the trailer? Yeah, correct, perfect, awesome. Can't wait. So yes,
just thank you so much for joining on call with KB.
(26:34):
Can't wait to listen to your show. And now a
quick break before we dive into our chat with our
expert about this episode. I am joined by the brilliant
Dr Caleb Jacobson. Welcome to on call with KB. Well,
thank you so much for having me. It's such a
pleasure to be here and to talk about Gray's Anatomy.
(26:57):
You know, everyone's watching Gray's Anatomy, so to find only
get to talk about it's gonna be pretty exciting. Listen,
things are wild and Seattle Grace very very wild, particularly
in this episode. And I asked Dr Jacobson to join
today because of their expertise in clinical psychology and specifically
sex therapy, because we are talking about a sexual disorder
(27:20):
specifically in this episode. So you know what, I always
asked every single guest that comes on what their own
personal relationship is with Grey's Anatomy. You know, when did
you become a fan if you are a fan, or
was this the first episode you watch? Because you know,
I will be honest, I have had experts on here
that have never seen an episode until they decided to
(27:40):
do the show. So it's really interesting to get different,
you know, perspectives on how everyone came to be when
it comes to Gray's Anatomy. Alright, so Cuba Boom music.
This is the first full episode I've ever seen of
the show. But to be fair, let me take you.
To be fair, my mother was a big fan of
the show, So I've known about I mean, the show
(28:01):
has been out forever, right like it's it's nineteen seasons.
I mean, that's you know, half of my life almost.
Uh So, it's you know, I know the show. I
know of the show, and she watched it regularly. And
you know, I know a lot of people who watched
I've I've I've heard about it, I've been around it.
I've just never sat down and watch a full episode
(28:22):
until you were kind enough to invite me on this
great podcast. Oh my goodness, So how did you feel
about this episode? I mean, listen, give me some of
your best highlights character moments, because listen, you know about
the show, but you're kind of getting into, like a
very juicy episode from a core relationship standpoint of these people.
(28:44):
So you know what worked what didn't work for you?
Tell me all about it. So there's a lot going on, right, Like,
there's a lot with infidelity, not only among some of
the doctors, but Meredith talking to her mother about her
sex life, and that was very interesting to me, is
to see that that was the theme that they played
on is parents and sex. So you have Meredith, who
(29:08):
you know, she didn't like here and her mother talked
about her sex life. You have the girl who doesn't
want her father. He's in the room while she's having
her quote unquote episodes, feeling very uncomfortable, and it made
me really think about how that really is a common theme.
A lot of people have a lot of UM they're
not really comfortable expressing or talking about even talking about
(29:30):
sex with family, and so it was interesting to me
that they included that in the episode. You know, it's
wild to be honest, one of the reasons why I
fell in love with Gray's uh is just because of
the parallels that each episode holds. And you're right, you
know this kind of theme of like parents and sex,
family and sex, and then also just you know, how
(29:51):
we respond to sex when we have UM really kind
of i'd say, traumatic things happen to us. And I'm
speaking specifically about Eric in this instance. You know him
and his wife and how that trust is broken not
just between him and his wife, but him and his
best friend, and what that looks like for him, because
Derek is is very kind of closed off about it
(30:12):
even with Meredith, and he's not really allowing space for
healing at all, like what Derek actually needs as a therapist,
yet he's not going, which is so interesting to me. Uh,
you know, here's this big hotshot neurosurgeon who is just
focused on being a surgeon and he thinks he's okay,
but really any of them are thinking about a future
at all. It definitely need to see a therapist for sure. Absolutely.
(30:36):
And when you have a situation like you have in
this episode where there is infidelity and there's broken trust,
uh you know, I know one point in the show
he tells Addison, he says, you know, your husband doesn't
really want you back, he's just interested in his intern.
You need to realize that. Um, it's hard to be
vulnerable and open after that trust has been broken. Now
(31:00):
it's a lot of work. Can that be reestablished? Absolutely
if you put in the efforts, and therapy is definitely
the place to do that. Yeah, agreed. Okay, So my
question for you really is, you know, kind of first,
have you ever encountered, just personally in your work, persistent
genital arousal disorder UM, and if not, kind of what's
(31:21):
the most common sexual case that you get to help
treat and help people through. So I have not, and
part of the reason is is because it is such
a rare disorder UM. I think studies have shown that
less than one percent of women worldwide likely have it UM,
so it's it's very rare. I haven't had any clients
(31:44):
who have presented with this UM. And there's there's reasons
why the statistics are a little complicated because some people
simply with all sexual issues don't like to talk to
a physician right like they're embarrassed. It's humiliating that don't
like to talk about sex. I always say sex and
relationships are the source of some of our greatest joys
(32:06):
and happiness in life, but they're also the source of
some of our deepest pain and hurts and humiliation. So
people don't talk about those things. So I have never
seen anyone with PEGAD, but UM commonly, I do see
sexual dysfunctions for for women. For example, UM, it could
be genital pelvic pain and penetration disorders, which is like
(32:30):
painful sex, whether it's vaginismus or dysprunia, something like this um.
The inability to orgasm is frequent female arousal disorder where
where women are unable to get aroused about sex whatsoever.
This is common with men, I see issues like erectile
dysfunction and early ejaculation, delayed ejaculation, And with couples, I
(32:54):
see a lot of like mismatched desire where maybe one couple,
one person in the in the in the relationship wants
to have sex more than the other or trying to
navigate those issues. So those are all very common and
often seen in therapy. I will say, I also see
a lot of religious clients, so that's a fun thing
to navigate. Is the intersection between sexuality and religion and
(33:18):
how religious backgrounds influence their thoughts about sex and can
even lead to certain sexual dysfunctions. Uh, and I see
some more rare type sexual disorders like minor attractive persons
and things of that nature. Yeah. I mean, we we
could talk all day about how religion has a play
when it comes to UM, shame and guilt for a
(33:40):
lot of people when it comes to you know, sexual
desire and actually having sex and what that looks like.
For sure, So I am definitely sure that you have
some intriguing, intriguing clients in in that regard. Um, So, Um,
you know, in this episode, you know, one of my
biggest points of contention is that we've really didn't know
(34:00):
where this came from. But because the case that we're
going to discuss, um says that you know, their p
gad UM stemmed from sexual trauma, I want to talk
about that a little bit, um, you know, in a
respectful context of course, So, as a provider in sex therapy,
how do you delicately handle patients whose sexual issues may
(34:21):
stem from sexual trauma? So? Unfortunately, trauma affects so many people,
right Um. It impacts not only our self esteem and
the way that we view sex and intimacy, but trauma
kind of effects and shapes the way that we view
our world and how we form relationships with other people.
And this could be very problematic, right Um. There are
(34:43):
two forms of therapy which are extremely effective with trauma,
especially when that trauma leads to PTSD, such as E
M d R, which is I movement desensitization and reprocessing,
and a R T therapy which is accelerated resolution therapy.
These are both very effective ways to give the clients
(35:05):
some immediate relief. Also with trauma clients, somatic body work
is also very helpful in introducing whether it's perhaps breathing
exercises are movements. This is especially helpful when it's couples
who come to therapy and there has been some area
of trauma. And you know, we all respond differently to trauma.
(35:28):
So for some people, let's say there was a sexual
trauma in their life, they may revert to UM being
more sexually liberated and sexually active in a way to
reclaim autonomy over their sexuality. They have feel that they
have control over their sexuality, whereas others respond differently. They
(35:52):
may withdraw from sex altogether because it gives them a
feeling of safety and security. So the goal in and
therapy would be to help these clients to be able
to connect with their partners in a way that they
feel safe and that gives them some control over their
sexuality and helps them connect with their partner in a
(36:16):
way that doesn't trigger any of the past trauma, right,
which can be you know, very challenging to do UM
and and very hard I imagine just you know, kind
of being able to kind of navigate that with your
partner and then of course, you know, managing your own
healing um from the sexual trauma. Absolutely yeah. And so
something that you know I found when I was researching
(36:38):
the persistent genital arousal disorder, I did find a case
in the Indian Journalist Psychiatry that deals specifically with the
woman who had unfortunately gone through very harrowing sexual trauma
as a child and who an adulthood was starting to
have spontaneous orgasms or pegad of course in the absence
of any form of sexual arousal. So you know, the
(37:00):
article really dove into how she was on sytylo pram um,
which is widely used in the treatment of depression, and
she was using that to be able to treat and
help manage her peak AD. But it wasn't until she
started taking less of the medication, which come to find out,
was actually an accident and an oversight um that was
the result of another like physical medical trauma. She was
(37:22):
in an accident, something happened to her and as her
body physically needed to heal, they took her off of
the meds and so that's when her spontaneous orgasm started
to come back. So, since she was a child sex
abuse survivor. They mentioned that her peak ad was often
manifested alongside deep feelings of anger. So when it comes
(37:44):
to this case and the unfortunate kind of trauma that
seemed to trigger it, what additional insight or context, UM
do you have or or want to provide, because this
was a very interesting case to go through. And and
also something to mention is, you know, not only had
she gone through UM that physical trauma in the sense
that like she was in physical accident, but she also
(38:05):
went through a divorce. She started to see her son
a bit less because of that divorce, and so kind
of all of these things that are happening to her
UM kind of externally also impacted her internally and that's
when those you know, spontaneous orgasms started to come to
the surface again. So what's really fascinating about that article.
(38:27):
It really demonstrates how little we know about this disorder. So,
as you mentioned, she was on seltopram, which I think
in the US it's um Selexa is the brand name
um and which is an s s R I, right,
This is a selective serotonin reuptake inhibitor and for a
lot of people taking an s s R I does
(38:50):
really impact their sex drive negatively, so they have less
desire for sex, their body doesn't necessarily respond as it
normally would. They have much more difficulties haven't orgasm. What's
fascinating is in this case, and there have been other
examples where people who have stopped taking S s R
s for depression have reported pigad and so it's kind
(39:12):
of makes sense, right, So one of the possible treatments
then would be to give them an S s R
I which dampers their sex drive in libido and their
ability to have orgasm. What that tells me then is
that it really isn't doing away with the pigad. Is
just kind of masking and covering it up, kind of
like viagra or c alist does with erectile dysfunction. It
(39:35):
doesn't clear up the blockages that a man may have
that's having causing him difficulty to have erections. It's just
kind of covering it up and giving them relief from
what they feel that the issue is. You mentioned the
manifestations of anger, those feelings of anger she has, and
and that makes a lot of sense since that one
of the treatments UH for pe gad then would be
(40:01):
to therapeutically like CBT. I believe it's kind of effective UM,
which is cognitive behavioral therapy. This is very helpful. I
know some people have you know, done distraction techniques as
well and helping to overcome this. I also know that
others have gone to like pelvic floor specialists because a
(40:25):
lot of clients who have PIGAD, they complain of feelings
of pressure in the genital area. Obviously, like you would
have when you are about to experience an orgasm, you
feel your muscles start to tense up, and you know,
I mean can you imagine that over and over again
throughout the day without any type of relief. I mean,
it's it's horrible feeling, right, So a pelvic floor specialist
(40:48):
could be very helpful in helping the client to learn
ways to relax there pelvic floor muscles so that they're
not as tense and don't end up having an orgasm.
So yeah, there's several different treatments for this and several
different causes for this, and I always find it interesting
(41:09):
when there is an intersection between the cause and the treatment. UM.
How sometimes medication, for example, like we discussed, can be
used to treat the disorder but can also be used
to cause the disorder, right, And that's something interesting too
that was mentioned in this episode. You know, Pamela's main
concern when they finally were about to take her into
(41:31):
surgery was whether or not she would be able to
have orgasms on her own when she wanted to, you know,
as opposed to, like you said, having this this pressure
and no relief and also having this kind of embarrassment
and shame around it because she's in public, you know,
she's she's around family, she's around friend, she's in college,
(41:54):
so she's literally you know, sitting in her classes in
university and she can't control this and she doesn't have
the ability to control the environment that she's in or
what's happening to her, and so she wanted to know, well,
you know, will I still be able to have this
on my own terms, so to speak? But um, you
would know better than I in terms of if there
are other medications that are not s SR eyes that
(42:16):
you know, could still be used to help aid in this.
I mean, I guess because they're so little known and
you know, you were saying it's probably less than one
percent of women in the world, Um, have this, But
hopefully there are other medications that are able to kind
of suppress the spontaneous orgasm portion but still allow women,
you know, to pamelous point, to have the orgasms that
(42:36):
they desire, but you know, without the side effects of
having you know, no sexual desire whatsoever. Yeah, So unfortunately,
fortunately there are other medications. Unfortunately, Uh, these medications do
sometimes come with side effects, like for example, antipsychotic drugs
can be used for this. But as if you've ever
(42:56):
known anyone who's been on an antipsychotic drug, I mean,
this changes the way that they even feel like if
their world is reality or not right, like mood stabilizers
and even drugs for like nerve pain, so it lessens
the sensation. Um, but I would say all of them
(43:17):
probably have an adverse effect on sexual functioning. And that's
that's really that's really unfortunate, you know, Um, you know,
I wish there was something that would allow us to
have the perfect balance, so to speak, you know, of
of all things. So listen, I have to ask you
finished your first little episode. Did you find this episode
to be a realistic depiction of the disorder? And will
(43:41):
you be I mean, you have to tell me will
you be watching others. I mean, I mostly want to know.
I would say that from my understanding of the disorder
that this client seemed to get relief after she had
an orgasm, and clients with pigat don't typically have any
relief those contractions. I mean, it's an ongoing situation that
(44:03):
isn't satisfied once they reach orgasm. I mean for listeners
who are tuning in who are trying to imagine that,
just think about it at night, maybe before you're going
to bid, or during the day when you're really stressed
out and you think, I'll masturbate or I'll have sex
that will relieve some stress intention and you do, because
(44:24):
masturbation insects does reduce stress intention But imagine you do
it and then that stress intention still there and it's
not even relieved in any way. It's this is very frustrating,
and so I think that it didn't show the severity
of the condition and didn't show the frustration. I mean,
(44:46):
it talked about how it's a little bit uncomfortable, but
it didn't really go into depth about how the abilitating
it could be for the client. Yeah, yeah, for sure,
I definitely wanted to see more of that. I definitely
needed to see more of, you know, how it was
impacting her, especially you know, she's she's young, she's a
junior in college, they mentioned, and so I can imagine
(45:06):
that had to have a huge impact on her um,
you know, mentally and emotionally, and also, you know it,
it had to have create some some sort of tension
um with family members as well, because I'm sure she
didn't really want to talk about it, and her parents
probably wanted to make sure she was okay, you know,
her father's there. I can't imagine, Let's be honest, imagine
being in college, junior in college and you're having orgasms
(45:29):
in the middle of the class. What does that do
into your social life? And I'm sure there's lots of
guys were like whoa. But at the same time, it
has to be really humiliating and uncomfortable. You don't even
want to go to class. So how is that affecting
her class attendance? How is it affecting her grades? How's
it affecting her social life? The anxiety and depression that
(45:50):
that would would come from that, none of that, I mean, overall,
the girl seemed very adjusted and with you know, a
little shame about her father. That's that was kind of
all yeah, a little too adjusted maybe for this, you know,
for realism's sake. UM, So just thank you so much
(46:11):
for joining the show. I had a great time. And
before we leave, please please just tell everyone um that's
listening about your podcast for sure. So my podcast is
called Sex Therapy. It can be found anywhere and listen.
People are tuning in. That's the name of the show, right,
People are are listening in on what's happening. So I'm
(46:31):
gonna tell you since we're on call, I'm gonna give
you some information that even my own listeners don't know yet,
and that is that I have a new podcast that
will be coming out in January. And the new podcast
is called Uncomplicated Sex. It's going to be a short,
twenty minute podcast and we're just going to kind of
(46:52):
make sex a lot more simple because I feel like
in our world people have over complicated sex and relationships.
And as I say, life is complicated, your sex life
shouldn't be. So they can definitely find that podcast anywhere,
and they could also follow me on Instagram at Dr
Caleb Jacobsen and there's some great sex positive information and
(47:12):
some advice on how to deal with sexual dysfunctions. There's
some great stuff on how to correlate your religious beliefs
with your sex life. There's all sorts of stuff happening
over there, so they may find that interesting, and so
I invite them to join me on Instagram and say hello, amazing,
Well listen, I cannot wait for this new show as well.
Congratulations listen, you're right. Life is complicated in many forms,
(47:35):
and if we can uncomplicate just a hint of something,
that would be a fantastic So thank you again for
joining On Call with KP and just all the success.
I am so excited for you and this new show. Well,
thank you so much for having me. This has been
a lot of fun. Well that's it for this episode
(47:59):
of and Call with Kape. Join us each and every
Thursday for brand new episodes where I chat with an
expert and a super fan about the science behind the scenes.
Until then, listen to On Call with KP on the
I Heart Radio app, Apple Podcasts, or wherever you get
your podcasts. H