September 10, 2025 • 32 mins
We can't let September go by without acknowledging Sex Positive September. Over the years, we've done dozens of episodes exploring sexual liberation, sexuality, and sexual health, so we wanted to pull from our archives to bring you this essential conversation.
In this episode, Dr. Pia Goff joins us to get real about what chips away at our sexual confidence, why some of us struggle with arousal and pleasure, and how to actually talk to your partner about what you need. Plus, she breaks down sensate focused therapy and how it's helping couples reconnect. This conversation is all about reclaiming your confidence and your pleasure – which is exactly what Sex Positive September is about.
About the Podcast
The Therapy for Black Girls Podcast is a weekly conversation with Dr. Joy Harden Bradford, a licensed Psychologist in Atlanta, Georgia, about all things mental health, personal development, and all the small decisions we can make to become the best possible versions of ourselves.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:10):
Welcome to the Therapy for Black Girls Podcast, a weekly
conversation about mental health, personal development, and all the small
decisions we can make to become the best possible versions
of ourselves. I'm your host, doctor Joy hard and Bradford,
a licensed psychologist in Atlanta, Georgia. For more information or
(00:32):
to find a therapist in your area, visit our website
at Therapy for Blackgirls dot com. While I hope you
love listening to and learning from the podcast, it is
not meant to be a substitute for a relationship with
a licensed mental health professional. Hey, y'all, thanks so much
(00:57):
for joining me for session four twenty eight of the
Therapy for Black Girls Podcast. We'll get right into our
conversation after a word from our sponsors. We can't let
September go by without acknowledging sex positive September. Over the years,
(01:19):
we've done dozens of episodes exploring sexual liberation, sexuality, and
sexual health, so we wanted to pull from our archives
to bring you this essential conversation. You know how sometimes
you can feel amazing in every other area of your life,
but when it comes to intimacy, that confidence just disappears.
Where we're talking all about that today with doctor Pia Golf.
(01:42):
In this episode, we get real about what chips away
at our sexual confidence, why some of us struggle with
arousal and pleasure, and how to actually talk to your
partner about what you need. Plus, doctor Pia breaks down
sin save focused therapy and how it's helping couples reconnect.
This conversation is all about reclaiming your confidence and your pleasure,
(02:03):
which is exactly what Sex Positive September is all about.
Press play and let's dive in. Thanks so much for
joining us today, Doctorpia.
Speaker 2 (02:15):
Thank you so much for having me.
Speaker 1 (02:17):
Yes, I'm so excited to have you here. So for
those of you who are not following doctor Pia on IG,
you definitely have to because she has this feature that
she calls just the Tip Tuesday, which is super fun,
but she gives great information about sexuality and to help
you start thinking about how to think differently about your
sexual relationships and just you know, great information overall. So
(02:38):
definitely check out her ig. Becky, Yeah, so I wanted
to make sure that we kind of started, i know,
and when we were talking about planning for the episode,
you share that you feel like there is still a
significant level of discomfort with people even talking about sexuality.
Can you share more about like what you've seen and
why you think there is still so much discomfort.
Speaker 2 (03:00):
Absolutely, I feel like people often lack the verbiage of
how to talk about sex, right. A lot of us
weren't taught about sex, whether that was in school or
in our home environment. It's just there's a level of embarrassment.
There's a level of fear of judgment and shame that
I particularly see, especially with Black women, that oftentimes they
(03:23):
feel that they've been over sexualized, maybe in the media
or maybe even just growing up being told okay, well
you know you can't wear certain clothing because men well
you know, look at your body if they're more voluptious.
All of these different factors impact a woman's discomfort with,
you know, talking about sex with other people.
Speaker 1 (03:42):
That is a great observation a coupia, because you know,
I think we see a lot of conversations online and
there's I think even being research I'm sure about you know,
like really wanting to kind of maybe play down your
sexuality as not to feed into stereotypes as a black woman.
Speaker 2 (03:58):
Correct, you know, absolutely, and so that you know causes
people to be very self conscious about either their appearance
or you know, playing into how they should you know,
quote unquote should I hate the words should, but how
they should present as a sexualized person. And so it
causes folks to not want to explore their own sexuality
(04:18):
or have knowledge about what they prefer don't prefer.
Speaker 1 (04:22):
And are there particular sexual acts or aspects of sexuality
that you find This happens more often with so. I know,
like when I was in college and we even talked
about this, you know, like the idea of like giving
oral sex was a really big taboo, right, Like that
was not something that you did, not something that you
talked about. And I don't know that that still exists,
(04:43):
or maybe not to the same level, but I do
think that there is still some taboo around that can
you talk more about any particular acts that you feel
like have more of a stigma than others. Absolutely, so
I think that there is still not as greatly as
it used to be with there is still a huge
stigma around oral then who you're going to give oral
sex to or who you're going to allow to perform
oral sex on you. I think the new biggest thing
(05:06):
now is a taboo around anal sex, not wanting to
have conversations about that and what that might mean about.
Speaker 2 (05:12):
You if your engaging in anal sex. And then the
next one that I see a lot with women is
a taboo around masturbation and feeling like a feeling of
shame for masturbating, or feeling like they don't need to masturbate,
or oh that's girls, I don't want to touch myself
like that, or wanting to even have conversations with others
about masturbation, oral sex or anal sex.
Speaker 1 (05:32):
So, of course I think conversations like this really help
people to get a verbiage to talk about some of this. Well,
what are some of the other things that people can
be doing to become more comfortable not only exploring and
you know, maybe engaging in some of these ass but
just the idea of talking about it.
Speaker 2 (05:48):
Yeah, so I think first recognizing for themselves what is
causing the barrier. You know, a lot with my patients,
I go through a sexual history review with them to learn, well,
what images did you see growing up regarding sex, What
conversations did you have about sex? How did you build
a stigma around sex? If you did or perhaps you
(06:09):
grew up in a really open sexual environment, so really
learning from them, what is their schema about sex, what
are their thoughts about sex on an individual basis, So
doing some more self reflective work that will allow them
to kind of have some knowledge and tools and skills
about how to talk about sex with others. Then I
often recommend you, know, hey, like read some books about sex,
(06:30):
follow some podcasts, follow some things on ig to see
how other people are communicating about sex, to allow yourself
to have an open dialogue with either your girlfriends or
your partner, etc.
Speaker 1 (06:42):
And you mentioned like following different like accounts on social media.
I know you and lots of other sex therapists are
very active on reticularly Instagram, but I think also Twitter
and Facebook and giving information. Do you think that that
kind of stuff is helpful?
Speaker 2 (06:55):
I do because I think it normalizes what they might
be going through. Times when women come into my office,
they have such a feeling of shame and think like,
oh my gosh, I'm the only one going through this
because they're not talking about it with their friends or
girlfriends or perhaps whatever they're going through. You know, no
one else is experiencing that. So being able to hear
others talk about this it's like, oh wow, okay, Like
(07:17):
this is something that a lot of people experience. There's
more of a comfort to ask more questions or to
learn more knowledge.
Speaker 1 (07:25):
So I think you bring up a great point which
leads me to a question that actually one of our
listeners submitted around the idea of like would somebody come
to see you as a sex therapist if they're not
actively engaged in a sexual relationship? Like what benefit would
it be to come and meet with a sex therapist
if you're not actually in a sexual relationship?
Speaker 2 (07:44):
Yeah? Absolutely, And you know what, that tends to happen
a lot more than folks would think. The main reason
I tend to see folks who are not in a
relationships because they're saying, I don't know how to be
in a relationship. I don't know how to be in
a sexual relationship. And while I'm in my single phase,
I want to figure out, you know, what's what's creating
these barriers. Sometimes that's an impact of sexual trauma and
(08:05):
trying to figure out how do I heal from sexual trauma?
How can I be you know, this sexual being with
a new partner when I don't feel comfortable right, So
if there's a sexual trauma or two. If there's someone
who you know hasn't had positive sexual interactions in the
past and they don't engage in self exploration of their body,
so they come in to figure out, well, what do
(08:26):
I do with that? So how can I be you know,
a more fulfilling partner and being more fulfilling relationships?
Speaker 1 (08:32):
And so what are some of the things that you
will introduce to somebody who comes in and says something
like that, like, where would you start?
Speaker 2 (08:39):
So I start with this sexual history to you know, again,
get their background on their thoughts about sex, their past
sexual encounters and any sexual trauma, the age at which
they first engaged in sex, and you know, typically just
how they think about sex, and then we start talking
about it and ruling out any type of sexual dysfunctions.
I see a lot of women who come in with vaginusness,
(09:02):
which is a contraction of the public floor in which
they're not able to be penetrated. I see a lot
of women who suffer from female sexual arousal disorder in
which they just simply aren't desiring sex, whether that's been
you know, lifelong, or it's occurred perhaps after childbirth, et cetera.
So sort of reviewing some of those things and putting
a name to symptoms and which women say like, Wow,
(09:24):
I didn't even know that was a thing, Like I
didn't even know this is something that I could come
in to talk to someone about. And sunny enough, just
sometimes when women come into my office and they see
the books on my wall, they're like, Oh, I was
just coming in for anxiety, but I see that you
have this book about you know, she comes first, like,
what's that about? I usually don't have orgasm. Sometimes the
conversation ends up being organic that leads us down the
(09:46):
road of exploring their sexuality.
Speaker 1 (09:49):
More from our conversation after the break. I'm wondering how
often that does happen either for you and you know,
it would be interesting to even talk with other therapists
about that, you know, like how often somebody will come
in for one thing and then it leads to this
(10:10):
other thing? Or are you seeing that people are presenting
with one thing but really the sex stuff? Is that
what they really want to talk about?
Speaker 2 (10:17):
You know what I think that right now it's been
happening is people are coming in under the give of anxiety,
and anxiety is so prevalent that even like schueduling the
initial session, they're unable to say that they're coming in
for sexual concerns. And then I think coming into the
environment and seeing the books are hearing me first, you know,
put it out there like let's talk about your sexuality,
(10:39):
let's talk about sex. It's like, oh, okay, she's comfortable
with talking about this. I've had, you know, some folks
come in and say, my last therapist they didn't want
to talk about sex, so I felt uncomfortable in doing so.
I didn't know how to bring it up. So by
me initiating that conversation and showing that I feel comfortable
talking about it will help ease them into it. So
I would say more so seeing people who don't necessarily
(11:01):
intend on coming in for that right.
Speaker 1 (11:04):
And I think that's another benefit of you know, so
many therapists being active on social media and giving videos
and information because it does let people know that this
is the thing that can be talked about in therapy.
But as you mentioned, I do think that some therapists
are still uncomfortable, you know, like if they're not necessarily
a sex therapist, that may not be something that they ask,
but it is important because it is a part of
(11:26):
the whole person.
Speaker 2 (11:27):
Right, absolutely. And I think when you asked earlier, why
aren't people talking about sex and why aren't therapists talking
about sex? We're not taught it, you know, we're not
taught it in our graduate programs. How to have these
conversations feel like oftentimes it's something that you have to
you know, specialize in er you know, condditional training. End.
So there's you know, there's just again not the verbage
of how to have these conversations.
Speaker 1 (11:49):
Right. So, you mentioned a couple of sexual disorders that
I want to follow up about, so specifically female sexual
arousal disorder. Can you say more about what that is
and maybe some of the things that may lead to
someone struggling with that?
Speaker 2 (12:03):
Yeah? Absolutely, So, female sexual interest or arousal disorder pretty
much means a reduced interest in sexual activity or you know,
or reduced insents in thoughts or fantasies, a lack of
excitement or pleasure during sexual activity majority of the time.
And you know, this happens over the course of at
least six months to be able to receive such a diagnosis.
(12:25):
I sometimes joke with folks and say, like this is
like a heterosexual woman watching ghosts on Power and having
you know, it's like watching paint drive. There's no reaction
to the stimulus at hand.
Speaker 1 (12:36):
I would imagine that it may be difficult to kind
of gauge like whether somebody is struggling in this area,
like how do you know what normal would be?
Speaker 2 (12:47):
Yeah? And so I tell them, you know, we all
get to decide what our normal is. And oftentimes when
I see women coming in heterosexual women, it's because their
partner might say to them, well, you don't want sex
as much as I do you, And we're socialized to
use men as the default narrative to how frequently we
quote unquote you know should be having sex, And so
(13:10):
working with women to normalize, well, how often do you
desire it? Or what you know, what is the amount
of times that you would feel comfortable having sex? And
sometimes one might say, you know, not at all, And
then it's an exploration of what's causing that lack of
desire to happen. Are we feeling really overwhelmed, are we
feeling really stressed? Are we not having pleasure? Are we
(13:30):
not being able to get aroused during sex? So it's
kind of like, well, I don't want to engage in
this sectivity that doesn't bring me any joy or any pleasure.
Speaker 1 (13:37):
So the understanding is that you should have some arousal.
I mean, because I'm thinking about people who identify as asexual.
Speaker 2 (13:45):
So how do you like make.
Speaker 1 (13:48):
The distinction between like somebody who identifies as a sexual
and someone who may be struggling with like a sexual
arousal thing?
Speaker 2 (13:54):
Right? So I feel like the person who's struggling with
a sexual arousal, they are distressed that they're not.
Speaker 1 (14:00):
Desire, got it. Okay, So that's really the key.
Speaker 2 (14:03):
Right, They're distressed that it's causing conflict within their relationship,
or perhaps they're saying, you know, I used to be
really sexual, and I used to be really warning and
want sex all the time, and now that's just not
happening for me. Okay, Okay, got you.
Speaker 1 (14:16):
So I do think that that can be really delicate, right,
doctor Pia, Because I think sometimes when you're in a
partnership and maybe you're not feeling aroused, or maybe you
used to and you're not feeling anymore, that can be
really difficult to talk to a partner about. So what
are some suggestions you have for like how you might
be able to have this conversation with a partner.
Speaker 2 (14:35):
Sure, I think it comes with first some self reflection
on what's going on for yourself first. Right, So if
we're able to come to our partner and speak in
I statements about what's going on personally for us, it
puts us on the seat of being vulnerable, but it
allows your partner to be a little bit more receptive
to express like, Hey, this is something that I'm going
(14:56):
through and I don't know why it's happening. I'm noticing
this ship. I really want to be more connected with you,
and I'm struggling with that right now. Right, it distresses
me that this is happening. So really figuring out for
yourself what's going on and perhaps why that's happening, and
then bringing that to your partner.
Speaker 1 (15:15):
Yeah, And I think it also is important to make sure,
like you said, like really talking about the fact that
you are struggling with it and that it's not that
you don't care, but you're not sure what's going on either,
as a way of making sure that you're not like
blaming the other person for your lack of interest exactly.
Speaker 2 (15:32):
And oftentimes what I hear is that a person's partner
might say, well, do you not are you not attracted
to me anymore? Do you not want me anymore? Are
you not physically responding to me anymore? And majority of women,
arousal starts for us in the brain, right. We need
to be intellectually stimulated and mentally stimulated, and a lot
(15:55):
of times that happens via conversations or having date night
or all type of things of that. So part of
having that conversation with the partner can involve well, have
you noticed there has been a shift in the relationship
in general? Is there, you know, feelings of resentment? Or
have we gotten so busy that we don't experience pleasurable
(16:15):
times together like date nights, et cetera.
Speaker 1 (16:17):
And I would imagine that another thing that may really
be a struggle is an internalizing of an arousal issue.
Speaker 2 (16:24):
So is something wrong with me?
Speaker 1 (16:26):
Am I broken? Somehow?
Speaker 2 (16:28):
Yes? Absolutely? That's like the actual word that so many
women use of, like I feel broken it it's not
working anymore? Why do I not desire this person? And
then there's there's again those feelings of shame and embarrassment.
Speaker 1 (16:41):
So it sounds like typically you would see these clients
in your office, maybe after a partner has suggested like, hey,
something's really going on here, yes.
Speaker 2 (16:49):
Yes, Or after a woman has given birth and desire changes,
or perhaps they are adjusting to new psychotropic medication that's
inhibiting them from lubricating like they used to, so they're
stopping to desire sex, or perhaps, like I said, if
they've had vaginismus, there any sort of pain or discomfort
with sex. You know, that's why I'll see them more
(17:10):
so coming in on their own, not just because their
partner has, you know, suggested.
Speaker 1 (17:14):
So can you talk more about vaginismus because I don't
think that there is again another disorder that we hear
about often, and the fact that it is psychiatric disorder,
so it's not necessarily a medical thing, though I think
you know, some of that go exist. Can you talk
more about what that is and what kind of things
may leads to vaginismus.
Speaker 2 (17:31):
Yeah, So, vaginismus is the inability to be penetrated vaginally
during intercourse. A lot of times they see women they're
unable to insert a tampon or even get a finger
into the bulble because the public floor muscles are so
tightly closed. And so this can happen for a variety
of reasons. I see this a lot with women who
(17:52):
have had unconsummated marriages. They're just very scared that it's
going to be painful. I've seen this with women who've
suffered some sort of trauma, whether that be rape or
perhaps when they were a child they fell on a
bicycle and broke their hymen, and how to really distrusting
experience happen in that way. I've seen this happen after
women have given child a birth, and there's just so
(18:13):
much pain associated with thinking about being penetrated.
Speaker 1 (18:17):
Gotcha. So it sounds like much of it is related
to maybe a past trauma or some kind of traumatic
experience that results in this, and or just like.
Speaker 2 (18:26):
An extreme anxiety or fear about penetration being painful.
Speaker 1 (18:30):
And I think that goes back to your earlier comment
right about not even being taught as young people about
like what sex is, and that you know it may
be painful the first time, and you know, like how
do you manage some of the anxiety that may come
later in life? You know, if you decide to become
sexually active, that could be avoided if we were giving
kids the proper information about sex early on. Absolutely more
(18:54):
from our conversation after the break, how would you design
a perfect sex education class where like high schoolers if
you were in.
Speaker 2 (19:12):
George, Oh wait, that's a good one. I think first
teaching you know, proper terminology and anatomy. Definitely teaching consent.
I think that's something that you know is totally avoid
within sexual education and normalizing self exploration and masturbation, and
(19:33):
also normalizing pleasure. I feel that from what I've seen,
sex ed is more so like these are the parts,
this is what happens, This is what your menstrual cycle
is going to be, like, this is what a you know,
a direction is, and then you have sex and baby
coms and here we go. And it really lacks just
providing more information, more real life example information to teenagers
(19:57):
and to talk about what happens in sexual relation and ships,
talking about birth control, you know, other contraceptive methods. I
know there's a lot of folks myself it included I
went to Catholic school, so contraception was never discussed. Pleasure
was never discussed in sexual education. Teenagers are trying to
serve the internet to get that information or you know,
(20:17):
talking to their friends where it's sort of like blindly
in the blind sometimes to disseminate that information.
Speaker 1 (20:22):
Yeah, parents get really freaked out about us giving Kis
lots of information, but how often do we give kids
information about other things and they don't follow us?
Speaker 2 (20:30):
Absolutely? Absolutely, And you know, research is showing us that
providing children with information is not leading them to be
you know, more quote unquote promiscuous or having sex at
younger ages. We're actually seeing that teenagers are having sex
at a later age more historically now based on them
having that information because it's not as taboo as it
(20:50):
once was to talk about it.
Speaker 1 (20:52):
I also really like that you included the idea of
sex being pleasurable for everyone, because we often only hear
about sex being pleasurable for God as one. Of course,
women deserve to receive pleasure as well.
Speaker 2 (21:03):
Absolutely, and just exploring one sexuality and normalizing that absolutely well.
Speaker 1 (21:09):
I don't know very much about it, doctor Pia, but
I know that you practice since saate focus therapy. Can
you tell us more about it?
Speaker 2 (21:16):
Yeah? Absolutely so. Sins focused therapy was first started by
Masters and Johnson. It has now been readapted by Linda
Winer and constant avery clerk, and we use this a
lot when patients are coming in with desire disorders, and
it's just like the name sounds sensate sensations, focusing on
the art of touch. I feel like so often sex
(21:40):
has become this idea of being very procedural, and a
lot of folks when they think of sex, the first
thing they think of is penis and vagina sex, and
that's become like the heteronormative, you know, explanation of what
sex looks like, and we lose the art foreplay and touch.
So what sin sat focus does is it teaches clients
(22:00):
to focus on the sensations of temperature, texture, and pressure,
and it really encourages patients to explore touch without any
sort of motive or any sort of goal or expectation
about arousal or pleasure. Right, Because when someone's coming in
with a desired disorder, they feel like, I'm not performing
(22:20):
how I'm supposed to. My partner is upset because I'm
not doing what they quote unquote expect me to do.
So there's a lot of judgment there, right. So when
I leave someone through as some say, focus exercise, I
invite them to take some time and allow themselves to relax,
get themselves into an environment where they're good with the
(22:42):
temperature of the room, the lighting of the room, there's
not going to be any distractions, and you instruct them
to explore their body from head to toe again focusing
on the temperature whether that's cool or warm, the texture,
whether that's smooth or rough, and the pressure whether that's firm,
and just allowing them to notice what comes up. And
(23:05):
oftentimes folks home, my, oh, my gosh, like I'm supposed
to be touching myself for how long? And you know
this is going to get boring and all of these things.
And so it's encouraging mindful exploration of the body and
to have an awareness that you might have thoughts come
up during this touching exercise and those are distractions there there,
and to acknowledge them that they come up, and then
(23:26):
just turn back to focusing on temperature, texture, and pressure.
Speaker 1 (23:30):
Is this something that you do in the office or
is this something that you're instructing them to do outside
of the office.
Speaker 2 (23:35):
No, no, no, this is definitely something that's done at home.
Speaker 1 (23:37):
Okay.
Speaker 2 (23:39):
I sometimes adapt it for patients, like if someone's coming
in with a history of trauma or a significant reluctance
or fear to engage in partnered sex. I'll have them
complete these exercises by themselves before introducing their partner. So
usually I say, week one, I want you to go
home and engage in this touching exercise for about three
(24:01):
times a week, and that should range anywhere between five
to twenty minutes, focusing on again temperature, touchture, and pressure.
Week one would be doing this with perhaps like pajamazon.
Next week they'll move up to perhaps just like a
bathing suit or underwear. The following week they'll move into
being completely nude exploring without insertion of any sort or
(24:23):
touching the breast or genitals in any way. And then
fourth week you can involve touching of genitals and insertion.
So that's when you're working with someone just on an
individual basis. When I'm working with couples together and there
isn't a significant trauma history on board, I will invite
them to take turns with one person being the toucher
and one person being the touchy, and so they'll take
(24:45):
turns touching one another head to toe, and that can
be adapted to not having any clothing on. But again
it's kind of staying away from the genitals and breast
as well and focusing on just temperature, touchture, and pressure.
I know, I keep saying it over and over again.
That's what we want them to focus on, versus trying
to explore for pleasure or trying to have any expectations
(25:07):
that sex is going to occur after this. Really just
getting comfortable with touching and the senses.
Speaker 1 (25:13):
It sounds like that could be really important. Sounds like
that could go a really long way in establishing trust
in the relationship without the expectation of sexual such.
Speaker 2 (25:22):
Absolutely, because a lot of times folks who are having
issues with desire, they feel, you know, this expectation to
perform in a certain way, right, and there's a lack
of verbiage right to talk about sex. So engaging in
the sensate focus exercise or moves that pressure right. Because
I also instruct people, look, this should not be an
exercise on what you're talking to one another. I want
(25:44):
you to really focus on just those sensations. And so
clients might ask, well, well, what do I do if
I don't like where I'm being touched or I really
am enjoying that certain area that's being touched, and that's
where reinstruct them to engage in what's called handwriting. So
that's either placing your hand on top of orneath your
partners to either guide them awake from an area that
feels uncomfortable or to invite them to stay on an
(26:06):
area that does feel comfortable. So that helps take away
this pressure to people feel like I don't know how
to talk dirty or you know, I don't know how
to share that I'm really enjoying something. So taking the
verbal part out can be really really helpful.
Speaker 1 (26:20):
Ah, Okay, that sounds like it could be helpful even
outside of this activity.
Speaker 2 (26:24):
M h. For sure, maybe something.
Speaker 1 (26:26):
That would be good for people who have trouble initiating
sex or things like that. Absolutely, you know, as you
were talking, it made me wonder if this might also
be helpful for people who struggle with central arousal disorder,
because I think a lot of times what happens is
that they may be afraid to even initiate any kind
of affection for fear that their partner will expect something
more that.
Speaker 2 (26:47):
Is exactly correct, that is exactly correct. To remove that
idea of expectation of any sort, and to just focus
on what is coming up, right, and during the exercises,
you begin to learn that sex is a natural function.
It's not something that can be taught, right, It's kind
of like breathing that comes natural to us. We might
be able to teach people different breathing techniques, but the
(27:08):
basic tenents of breathing we're born with. Same with sexual function,
We're born with those. Borrowing any dysfunction, we're born with
that as a natural function. So touching for you know,
exploration of the sensations. You're going to begin to notice
your body becoming aroused. What happens? What do you need
in order to have arousal or desire come up? So
we're moving that expectation there.
Speaker 1 (27:29):
So how long might you be practicing sin say focused
techniques with someone before you might see a difference in
their arousal states.
Speaker 2 (27:36):
Yeah, I think that definitely differs from client to clients.
I think that in the first few weeks they begin
to notice different areas of their body that produce the
feelings of arousal. Right, Like I've had women come in
like oh my gosh, I didn't realize, like the back
of my thigh really, you know, brings up these experiences
for me or brings up the feeling of pleasure for me,
(27:57):
or I really don't like it when you know the
small buy back has touched it, so it becomes an
explor explorative exercise for them. The whole course of sensate
focused therapy tends to last between four and six weeks.
Speaker 1 (28:10):
It sounds like it's a pretty structure thing that you're
taking either the person or then with their partner through.
Speaker 2 (28:15):
Yes And the hardest part of it all is that
when they're engaging in this, I ask them to refrain
from having intercourse and people you tend to get really upset.
They're like, wait a minute, I'm coming in here to
have and of course you want to and oh my goodness.
The partners are like, ah, I'm not signing up for this,
but I tell them, you know, it's just like anything else.
(28:36):
Think back to when you first you know, we're having
sex with a partner, that thrill and anticipation and you
know hoping that it'll be tonight that you finally get
to have sex. Right, So it's building that anticipation. It's
like the longest for play ever, right, But it's like
that's what needed to sort of rekindle desire and to
again remove the expectation that we're going to touch and
(28:58):
this is going to lead to suck. So taking that away,
knowing okay, we can't have sex allows the person with
the arouse the disorder to feel more at ease and
more comfortable to engage in that exercise.
Speaker 1 (29:09):
So you're saying that you take sex off this table
the entire time they're working with you on this. Yeah,
so they're saying, Okay, we'll do what doctor p is
saying for the next six weeks and then we'll see
how it goes. Yeah.
Speaker 2 (29:19):
And it's funny like people will come in like week
two or three, like, all right, we got to tell
on ourselves we have sex, you know. And so it's
kind of like, because it becomes this thing you're not
supposed to do, they want to do it right, and
it's like, oh, okay, now you get what we're having
these instructions.
Speaker 1 (29:37):
Yeah, I would imagine that this didn't allow us for
a great conversation about what happened and how we might
be able to reconstruct that for the future. Exactly, got it,
got it, I got to read more about this. This
sounds great. So doctor Pio What are some of your
favorite resources that you find yourself going to and recommending
over and over again.
Speaker 2 (29:57):
Absolutely so, first and for most, I think most sex
therapists will swear by this book. Come as you are,
Doctuli Nagowski, Right, it's just such a great book to
normalize sexuality and you know, teach about sexuality. Then anything
by Barry McCarthy is awesome. I really recommend re Kindling
Desire to my couples and women in particular, also by
(30:20):
Barry McCarthy and Emily car McCarthy. It's a book called
Sexual Awareness. Then when I find couples or individuals who
are coming in who maybe have never had sex or
have really just not had a really good sexual education,
I recommend the book The Guide to Getting it on.
I mean it's a huge book, but you can kind
of flip through and you know, learn about different techniques,
(30:42):
learn about different the sexual response cycle. So it's really
and it's it's written in a kind of like a
joking nature, so it's an easy, easy read.
Speaker 1 (30:50):
And where can people find you online? Doctor Pia? What's
your website as well as any social media handles you
want to share?
Speaker 2 (30:56):
Yeah, so definitely follow me on Instagram at sex Pia,
and then the website for the practice and a part
of is Resilient Chicago dot com.
Speaker 1 (31:06):
And of course all of that will be included in
the show notes so that people can find it easily.
Thank you so much for joining us today, doctor Pia.
I really appreciate it.
Speaker 2 (31:14):
Thank you so much for having me, and thank you
so much for having this platform. I mean, I know
you heard all the time, but it has just really
changed the game for therapy for black women. I'm seeing
so many more people coming in because of your website,
and so I just have to give you eight kudos
to that. Thank you so much.
Speaker 1 (31:36):
I'm so glad doctor Pia was able to join for
this conversation. To learn more about her and her work,
be sure to visit the show notes at Therapy for
Blackgirls dot com slash Session four twenty eight, and don't
forget to text this episode to two of your girls
right now and tell them to check it out. Did
you know you could leave us a voicemail with your
questions for the podcast if you want to suggest movies
(31:56):
or books for us to review, or have thoughts about
topics you'd like to hear us discuss. Drop us a
message at Memo dot fm slash Therapy for Black Girls
and let us know what's on your mind. We just
might feature it on the podcast. If you're looking for
a therapist in your area, visit our therapist directory at
Therapy for Blackgirls dot com slash directory. Don't forget to
(32:17):
follow us over on Instagram at Therapy for Black Girls
and join us over in our Patreon community for exclusive updates,
behind the scenes content, and more. You can join us
at community dot Therapy for Blackgirls dot com. This episode
was produced by Alise Ellis, Indietubu and Tyrie Rush. Editing
was done by Dennison Bradford. Thank y'all so much for
(32:37):
joining me again this week. I look forward to continuing
this conversation with you all real soon. Take good care.
Welcome to the Therapy for Black Girls Podcast, a weekly
conversation about mental health, personal development, and all the small
decisions we can make to become the best possible versions
of ourselves. I'm your host, doctor Joy hard and Bradford,
a licensed psychologist in Atlanta, Georgia. For more information or
(00:32):
to find a therapist in your area, visit our website
at Therapy for Blackgirls dot com. While I hope you
love listening to and learning from the podcast, it is
not meant to be a substitute for a relationship with
a licensed mental health professional. Hey, y'all, thanks so much
(00:57):
for joining me for session four twenty eight of the
Therapy for Black Girls Podcast. We'll get right into our
conversation after a word from our sponsors. We can't let
September go by without acknowledging sex positive September. Over the years,
(01:19):
we've done dozens of episodes exploring sexual liberation, sexuality, and
sexual health, so we wanted to pull from our archives
to bring you this essential conversation. You know how sometimes
you can feel amazing in every other area of your life,
but when it comes to intimacy, that confidence just disappears.
Where we're talking all about that today with doctor Pia Golf.
(01:42):
In this episode, we get real about what chips away
at our sexual confidence, why some of us struggle with
arousal and pleasure, and how to actually talk to your
partner about what you need. Plus, doctor Pia breaks down
sin save focused therapy and how it's helping couples reconnect.
This conversation is all about reclaiming your confidence and your pleasure,
(02:03):
which is exactly what Sex Positive September is all about.
Press play and let's dive in. Thanks so much for
joining us today, Doctorpia.
Speaker 2 (02:15):
Thank you so much for having me.
Speaker 1 (02:17):
Yes, I'm so excited to have you here. So for
those of you who are not following doctor Pia on IG,
you definitely have to because she has this feature that
she calls just the Tip Tuesday, which is super fun,
but she gives great information about sexuality and to help
you start thinking about how to think differently about your
sexual relationships and just you know, great information overall. So
(02:38):
definitely check out her ig. Becky, Yeah, so I wanted
to make sure that we kind of started, i know,
and when we were talking about planning for the episode,
you share that you feel like there is still a
significant level of discomfort with people even talking about sexuality.
Can you share more about like what you've seen and
why you think there is still so much discomfort.
Speaker 2 (03:00):
Absolutely, I feel like people often lack the verbiage of
how to talk about sex, right. A lot of us
weren't taught about sex, whether that was in school or
in our home environment. It's just there's a level of embarrassment.
There's a level of fear of judgment and shame that
I particularly see, especially with Black women, that oftentimes they
(03:23):
feel that they've been over sexualized, maybe in the media
or maybe even just growing up being told okay, well
you know you can't wear certain clothing because men well
you know, look at your body if they're more voluptious.
All of these different factors impact a woman's discomfort with,
you know, talking about sex with other people.
Speaker 1 (03:42):
That is a great observation a coupia, because you know,
I think we see a lot of conversations online and
there's I think even being research I'm sure about you know,
like really wanting to kind of maybe play down your
sexuality as not to feed into stereotypes as a black woman.
Speaker 2 (03:58):
Correct, you know, absolutely, and so that you know causes
people to be very self conscious about either their appearance
or you know, playing into how they should you know,
quote unquote should I hate the words should, but how
they should present as a sexualized person. And so it
causes folks to not want to explore their own sexuality
(04:18):
or have knowledge about what they prefer don't prefer.
Speaker 1 (04:22):
And are there particular sexual acts or aspects of sexuality
that you find This happens more often with so. I know,
like when I was in college and we even talked
about this, you know, like the idea of like giving
oral sex was a really big taboo, right, Like that
was not something that you did, not something that you
talked about. And I don't know that that still exists,
(04:43):
or maybe not to the same level, but I do
think that there is still some taboo around that can
you talk more about any particular acts that you feel
like have more of a stigma than others. Absolutely, so
I think that there is still not as greatly as
it used to be with there is still a huge
stigma around oral then who you're going to give oral
sex to or who you're going to allow to perform
oral sex on you. I think the new biggest thing
(05:06):
now is a taboo around anal sex, not wanting to
have conversations about that and what that might mean about.
Speaker 2 (05:12):
You if your engaging in anal sex. And then the
next one that I see a lot with women is
a taboo around masturbation and feeling like a feeling of
shame for masturbating, or feeling like they don't need to masturbate,
or oh that's girls, I don't want to touch myself
like that, or wanting to even have conversations with others
about masturbation, oral sex or anal sex.
Speaker 1 (05:32):
So, of course I think conversations like this really help
people to get a verbiage to talk about some of this. Well,
what are some of the other things that people can
be doing to become more comfortable not only exploring and
you know, maybe engaging in some of these ass but
just the idea of talking about it.
Speaker 2 (05:48):
Yeah, so I think first recognizing for themselves what is
causing the barrier. You know, a lot with my patients,
I go through a sexual history review with them to learn, well,
what images did you see growing up regarding sex, What
conversations did you have about sex? How did you build
a stigma around sex? If you did or perhaps you
(06:09):
grew up in a really open sexual environment, so really
learning from them, what is their schema about sex, what
are their thoughts about sex on an individual basis, So
doing some more self reflective work that will allow them
to kind of have some knowledge and tools and skills
about how to talk about sex with others. Then I
often recommend you, know, hey, like read some books about sex,
(06:30):
follow some podcasts, follow some things on ig to see
how other people are communicating about sex, to allow yourself
to have an open dialogue with either your girlfriends or
your partner, etc.
Speaker 1 (06:42):
And you mentioned like following different like accounts on social media.
I know you and lots of other sex therapists are
very active on reticularly Instagram, but I think also Twitter
and Facebook and giving information. Do you think that that
kind of stuff is helpful?
Speaker 2 (06:55):
I do because I think it normalizes what they might
be going through. Times when women come into my office,
they have such a feeling of shame and think like,
oh my gosh, I'm the only one going through this
because they're not talking about it with their friends or
girlfriends or perhaps whatever they're going through. You know, no
one else is experiencing that. So being able to hear
others talk about this it's like, oh wow, okay, Like
(07:17):
this is something that a lot of people experience. There's
more of a comfort to ask more questions or to
learn more knowledge.
Speaker 1 (07:25):
So I think you bring up a great point which
leads me to a question that actually one of our
listeners submitted around the idea of like would somebody come
to see you as a sex therapist if they're not
actively engaged in a sexual relationship? Like what benefit would
it be to come and meet with a sex therapist
if you're not actually in a sexual relationship?
Speaker 2 (07:44):
Yeah? Absolutely, And you know what, that tends to happen
a lot more than folks would think. The main reason
I tend to see folks who are not in a
relationships because they're saying, I don't know how to be
in a relationship. I don't know how to be in
a sexual relationship. And while I'm in my single phase,
I want to figure out, you know, what's what's creating
these barriers. Sometimes that's an impact of sexual trauma and
(08:05):
trying to figure out how do I heal from sexual trauma?
How can I be you know, this sexual being with
a new partner when I don't feel comfortable right, So
if there's a sexual trauma or two. If there's someone
who you know hasn't had positive sexual interactions in the
past and they don't engage in self exploration of their body,
so they come in to figure out, well, what do
(08:26):
I do with that? So how can I be you know,
a more fulfilling partner and being more fulfilling relationships?
Speaker 1 (08:32):
And so what are some of the things that you
will introduce to somebody who comes in and says something
like that, like, where would you start?
Speaker 2 (08:39):
So I start with this sexual history to you know, again,
get their background on their thoughts about sex, their past
sexual encounters and any sexual trauma, the age at which
they first engaged in sex, and you know, typically just
how they think about sex, and then we start talking
about it and ruling out any type of sexual dysfunctions.
I see a lot of women who come in with vaginusness,
(09:02):
which is a contraction of the public floor in which
they're not able to be penetrated. I see a lot
of women who suffer from female sexual arousal disorder in
which they just simply aren't desiring sex, whether that's been
you know, lifelong, or it's occurred perhaps after childbirth, et cetera.
So sort of reviewing some of those things and putting
a name to symptoms and which women say like, Wow,
(09:24):
I didn't even know that was a thing, Like I
didn't even know this is something that I could come
in to talk to someone about. And sunny enough, just
sometimes when women come into my office and they see
the books on my wall, they're like, Oh, I was
just coming in for anxiety, but I see that you
have this book about you know, she comes first, like,
what's that about? I usually don't have orgasm. Sometimes the
conversation ends up being organic that leads us down the
(09:46):
road of exploring their sexuality.
Speaker 1 (09:49):
More from our conversation after the break. I'm wondering how
often that does happen either for you and you know,
it would be interesting to even talk with other therapists
about that, you know, like how often somebody will come
in for one thing and then it leads to this
(10:10):
other thing? Or are you seeing that people are presenting
with one thing but really the sex stuff? Is that
what they really want to talk about?
Speaker 2 (10:17):
You know what I think that right now it's been
happening is people are coming in under the give of anxiety,
and anxiety is so prevalent that even like schueduling the
initial session, they're unable to say that they're coming in
for sexual concerns. And then I think coming into the
environment and seeing the books are hearing me first, you know,
put it out there like let's talk about your sexuality,
(10:39):
let's talk about sex. It's like, oh, okay, she's comfortable
with talking about this. I've had, you know, some folks
come in and say, my last therapist they didn't want
to talk about sex, so I felt uncomfortable in doing so.
I didn't know how to bring it up. So by
me initiating that conversation and showing that I feel comfortable
talking about it will help ease them into it. So
I would say more so seeing people who don't necessarily
(11:01):
intend on coming in for that right.
Speaker 1 (11:04):
And I think that's another benefit of you know, so
many therapists being active on social media and giving videos
and information because it does let people know that this
is the thing that can be talked about in therapy.
But as you mentioned, I do think that some therapists
are still uncomfortable, you know, like if they're not necessarily
a sex therapist, that may not be something that they ask,
but it is important because it is a part of
(11:26):
the whole person.
Speaker 2 (11:27):
Right, absolutely. And I think when you asked earlier, why
aren't people talking about sex and why aren't therapists talking
about sex? We're not taught it, you know, we're not
taught it in our graduate programs. How to have these
conversations feel like oftentimes it's something that you have to
you know, specialize in er you know, condditional training. End.
So there's you know, there's just again not the verbage
of how to have these conversations.
Speaker 1 (11:49):
Right. So, you mentioned a couple of sexual disorders that
I want to follow up about, so specifically female sexual
arousal disorder. Can you say more about what that is
and maybe some of the things that may lead to
someone struggling with that?
Speaker 2 (12:03):
Yeah? Absolutely, So, female sexual interest or arousal disorder pretty
much means a reduced interest in sexual activity or you know,
or reduced insents in thoughts or fantasies, a lack of
excitement or pleasure during sexual activity majority of the time.
And you know, this happens over the course of at
least six months to be able to receive such a diagnosis.
(12:25):
I sometimes joke with folks and say, like this is
like a heterosexual woman watching ghosts on Power and having
you know, it's like watching paint drive. There's no reaction
to the stimulus at hand.
Speaker 1 (12:36):
I would imagine that it may be difficult to kind
of gauge like whether somebody is struggling in this area,
like how do you know what normal would be?
Speaker 2 (12:47):
Yeah? And so I tell them, you know, we all
get to decide what our normal is. And oftentimes when
I see women coming in heterosexual women, it's because their
partner might say to them, well, you don't want sex
as much as I do you, And we're socialized to
use men as the default narrative to how frequently we
quote unquote you know should be having sex, And so
(13:10):
working with women to normalize, well, how often do you
desire it? Or what you know, what is the amount
of times that you would feel comfortable having sex? And
sometimes one might say, you know, not at all, And
then it's an exploration of what's causing that lack of
desire to happen. Are we feeling really overwhelmed, are we
feeling really stressed? Are we not having pleasure? Are we
(13:30):
not being able to get aroused during sex? So it's
kind of like, well, I don't want to engage in
this sectivity that doesn't bring me any joy or any pleasure.
Speaker 1 (13:37):
So the understanding is that you should have some arousal.
I mean, because I'm thinking about people who identify as asexual.
Speaker 2 (13:45):
So how do you like make.
Speaker 1 (13:48):
The distinction between like somebody who identifies as a sexual
and someone who may be struggling with like a sexual
arousal thing?
Speaker 2 (13:54):
Right? So I feel like the person who's struggling with
a sexual arousal, they are distressed that they're not.
Speaker 1 (14:00):
Desire, got it. Okay, So that's really the key.
Speaker 2 (14:03):
Right, They're distressed that it's causing conflict within their relationship,
or perhaps they're saying, you know, I used to be
really sexual, and I used to be really warning and
want sex all the time, and now that's just not
happening for me. Okay, Okay, got you.
Speaker 1 (14:16):
So I do think that that can be really delicate, right,
doctor Pia, Because I think sometimes when you're in a
partnership and maybe you're not feeling aroused, or maybe you
used to and you're not feeling anymore, that can be
really difficult to talk to a partner about. So what
are some suggestions you have for like how you might
be able to have this conversation with a partner.
Speaker 2 (14:35):
Sure, I think it comes with first some self reflection
on what's going on for yourself first. Right, So if
we're able to come to our partner and speak in
I statements about what's going on personally for us, it
puts us on the seat of being vulnerable, but it
allows your partner to be a little bit more receptive
to express like, Hey, this is something that I'm going
(14:56):
through and I don't know why it's happening. I'm noticing
this ship. I really want to be more connected with you,
and I'm struggling with that right now. Right, it distresses
me that this is happening. So really figuring out for
yourself what's going on and perhaps why that's happening, and
then bringing that to your partner.
Speaker 1 (15:15):
Yeah, And I think it also is important to make sure,
like you said, like really talking about the fact that
you are struggling with it and that it's not that
you don't care, but you're not sure what's going on either,
as a way of making sure that you're not like
blaming the other person for your lack of interest exactly.
Speaker 2 (15:32):
And oftentimes what I hear is that a person's partner
might say, well, do you not are you not attracted
to me anymore? Do you not want me anymore? Are
you not physically responding to me anymore? And majority of women,
arousal starts for us in the brain, right. We need
to be intellectually stimulated and mentally stimulated, and a lot
(15:55):
of times that happens via conversations or having date night
or all type of things of that. So part of
having that conversation with the partner can involve well, have
you noticed there has been a shift in the relationship
in general? Is there, you know, feelings of resentment? Or
have we gotten so busy that we don't experience pleasurable
(16:15):
times together like date nights, et cetera.
Speaker 1 (16:17):
And I would imagine that another thing that may really
be a struggle is an internalizing of an arousal issue.
Speaker 2 (16:24):
So is something wrong with me?
Speaker 1 (16:26):
Am I broken? Somehow?
Speaker 2 (16:28):
Yes? Absolutely? That's like the actual word that so many
women use of, like I feel broken it it's not
working anymore? Why do I not desire this person? And
then there's there's again those feelings of shame and embarrassment.
Speaker 1 (16:41):
So it sounds like typically you would see these clients
in your office, maybe after a partner has suggested like, hey,
something's really going on here, yes.
Speaker 2 (16:49):
Yes, Or after a woman has given birth and desire changes,
or perhaps they are adjusting to new psychotropic medication that's
inhibiting them from lubricating like they used to, so they're
stopping to desire sex, or perhaps, like I said, if
they've had vaginismus, there any sort of pain or discomfort
with sex. You know, that's why I'll see them more
(17:10):
so coming in on their own, not just because their
partner has, you know, suggested.
Speaker 1 (17:14):
So can you talk more about vaginismus because I don't
think that there is again another disorder that we hear
about often, and the fact that it is psychiatric disorder,
so it's not necessarily a medical thing, though I think
you know, some of that go exist. Can you talk
more about what that is and what kind of things
may leads to vaginismus.
Speaker 2 (17:31):
Yeah, So, vaginismus is the inability to be penetrated vaginally
during intercourse. A lot of times they see women they're
unable to insert a tampon or even get a finger
into the bulble because the public floor muscles are so
tightly closed. And so this can happen for a variety
of reasons. I see this a lot with women who
(17:52):
have had unconsummated marriages. They're just very scared that it's
going to be painful. I've seen this with women who've
suffered some sort of trauma, whether that be rape or
perhaps when they were a child they fell on a
bicycle and broke their hymen, and how to really distrusting
experience happen in that way. I've seen this happen after
women have given child a birth, and there's just so
(18:13):
much pain associated with thinking about being penetrated.
Speaker 1 (18:17):
Gotcha. So it sounds like much of it is related
to maybe a past trauma or some kind of traumatic
experience that results in this, and or just like.
Speaker 2 (18:26):
An extreme anxiety or fear about penetration being painful.
Speaker 1 (18:30):
And I think that goes back to your earlier comment
right about not even being taught as young people about
like what sex is, and that you know it may
be painful the first time, and you know, like how
do you manage some of the anxiety that may come
later in life? You know, if you decide to become
sexually active, that could be avoided if we were giving
kids the proper information about sex early on. Absolutely more
(18:54):
from our conversation after the break, how would you design
a perfect sex education class where like high schoolers if
you were in.
Speaker 2 (19:12):
George, Oh wait, that's a good one. I think first
teaching you know, proper terminology and anatomy. Definitely teaching consent.
I think that's something that you know is totally avoid
within sexual education and normalizing self exploration and masturbation, and
(19:33):
also normalizing pleasure. I feel that from what I've seen,
sex ed is more so like these are the parts,
this is what happens, This is what your menstrual cycle
is going to be, like, this is what a you know,
a direction is, and then you have sex and baby
coms and here we go. And it really lacks just
providing more information, more real life example information to teenagers
(19:57):
and to talk about what happens in sexual relation and ships,
talking about birth control, you know, other contraceptive methods. I
know there's a lot of folks myself it included I
went to Catholic school, so contraception was never discussed. Pleasure
was never discussed in sexual education. Teenagers are trying to
serve the internet to get that information or you know,
(20:17):
talking to their friends where it's sort of like blindly
in the blind sometimes to disseminate that information.
Speaker 1 (20:22):
Yeah, parents get really freaked out about us giving Kis
lots of information, but how often do we give kids
information about other things and they don't follow us?
Speaker 2 (20:30):
Absolutely? Absolutely, And you know, research is showing us that
providing children with information is not leading them to be
you know, more quote unquote promiscuous or having sex at
younger ages. We're actually seeing that teenagers are having sex
at a later age more historically now based on them
having that information because it's not as taboo as it
(20:50):
once was to talk about it.
Speaker 1 (20:52):
I also really like that you included the idea of
sex being pleasurable for everyone, because we often only hear
about sex being pleasurable for God as one. Of course,
women deserve to receive pleasure as well.
Speaker 2 (21:03):
Absolutely, and just exploring one sexuality and normalizing that absolutely well.
Speaker 1 (21:09):
I don't know very much about it, doctor Pia, but
I know that you practice since saate focus therapy. Can
you tell us more about it?
Speaker 2 (21:16):
Yeah? Absolutely so. Sins focused therapy was first started by
Masters and Johnson. It has now been readapted by Linda
Winer and constant avery clerk, and we use this a
lot when patients are coming in with desire disorders, and
it's just like the name sounds sensate sensations, focusing on
the art of touch. I feel like so often sex
(21:40):
has become this idea of being very procedural, and a
lot of folks when they think of sex, the first
thing they think of is penis and vagina sex, and
that's become like the heteronormative, you know, explanation of what
sex looks like, and we lose the art foreplay and touch.
So what sin sat focus does is it teaches clients
(22:00):
to focus on the sensations of temperature, texture, and pressure,
and it really encourages patients to explore touch without any
sort of motive or any sort of goal or expectation
about arousal or pleasure. Right, Because when someone's coming in
with a desired disorder, they feel like, I'm not performing
(22:20):
how I'm supposed to. My partner is upset because I'm
not doing what they quote unquote expect me to do.
So there's a lot of judgment there, right. So when
I leave someone through as some say, focus exercise, I
invite them to take some time and allow themselves to relax,
get themselves into an environment where they're good with the
(22:42):
temperature of the room, the lighting of the room, there's
not going to be any distractions, and you instruct them
to explore their body from head to toe again focusing
on the temperature whether that's cool or warm, the texture,
whether that's smooth or rough, and the pressure whether that's firm,
and just allowing them to notice what comes up. And
(23:05):
oftentimes folks home, my, oh, my gosh, like I'm supposed
to be touching myself for how long? And you know
this is going to get boring and all of these things.
And so it's encouraging mindful exploration of the body and
to have an awareness that you might have thoughts come
up during this touching exercise and those are distractions there there,
and to acknowledge them that they come up, and then
(23:26):
just turn back to focusing on temperature, texture, and pressure.
Speaker 1 (23:30):
Is this something that you do in the office or
is this something that you're instructing them to do outside
of the office.
Speaker 2 (23:35):
No, no, no, this is definitely something that's done at home.
Speaker 1 (23:37):
Okay.
Speaker 2 (23:39):
I sometimes adapt it for patients, like if someone's coming
in with a history of trauma or a significant reluctance
or fear to engage in partnered sex. I'll have them
complete these exercises by themselves before introducing their partner. So
usually I say, week one, I want you to go
home and engage in this touching exercise for about three
(24:01):
times a week, and that should range anywhere between five
to twenty minutes, focusing on again temperature, touchture, and pressure.
Week one would be doing this with perhaps like pajamazon.
Next week they'll move up to perhaps just like a
bathing suit or underwear. The following week they'll move into
being completely nude exploring without insertion of any sort or
(24:23):
touching the breast or genitals in any way. And then
fourth week you can involve touching of genitals and insertion.
So that's when you're working with someone just on an
individual basis. When I'm working with couples together and there
isn't a significant trauma history on board, I will invite
them to take turns with one person being the toucher
and one person being the touchy, and so they'll take
(24:45):
turns touching one another head to toe, and that can
be adapted to not having any clothing on. But again
it's kind of staying away from the genitals and breast
as well and focusing on just temperature, touchture, and pressure.
I know, I keep saying it over and over again.
That's what we want them to focus on, versus trying
to explore for pleasure or trying to have any expectations
(25:07):
that sex is going to occur after this. Really just
getting comfortable with touching and the senses.
Speaker 1 (25:13):
It sounds like that could be really important. Sounds like
that could go a really long way in establishing trust
in the relationship without the expectation of sexual such.
Speaker 2 (25:22):
Absolutely, because a lot of times folks who are having
issues with desire, they feel, you know, this expectation to
perform in a certain way, right, and there's a lack
of verbiage right to talk about sex. So engaging in
the sensate focus exercise or moves that pressure right. Because
I also instruct people, look, this should not be an
exercise on what you're talking to one another. I want
(25:44):
you to really focus on just those sensations. And so
clients might ask, well, well, what do I do if
I don't like where I'm being touched or I really
am enjoying that certain area that's being touched, and that's
where reinstruct them to engage in what's called handwriting. So
that's either placing your hand on top of orneath your
partners to either guide them awake from an area that
feels uncomfortable or to invite them to stay on an
(26:06):
area that does feel comfortable. So that helps take away
this pressure to people feel like I don't know how
to talk dirty or you know, I don't know how
to share that I'm really enjoying something. So taking the
verbal part out can be really really helpful.
Speaker 1 (26:20):
Ah, Okay, that sounds like it could be helpful even
outside of this activity.
Speaker 2 (26:24):
M h. For sure, maybe something.
Speaker 1 (26:26):
That would be good for people who have trouble initiating
sex or things like that. Absolutely, you know, as you
were talking, it made me wonder if this might also
be helpful for people who struggle with central arousal disorder,
because I think a lot of times what happens is
that they may be afraid to even initiate any kind
of affection for fear that their partner will expect something
more that.
Speaker 2 (26:47):
Is exactly correct, that is exactly correct. To remove that
idea of expectation of any sort, and to just focus
on what is coming up, right, and during the exercises,
you begin to learn that sex is a natural function.
It's not something that can be taught, right, It's kind
of like breathing that comes natural to us. We might
be able to teach people different breathing techniques, but the
(27:08):
basic tenents of breathing we're born with. Same with sexual function,
We're born with those. Borrowing any dysfunction, we're born with
that as a natural function. So touching for you know,
exploration of the sensations. You're going to begin to notice
your body becoming aroused. What happens? What do you need
in order to have arousal or desire come up? So
we're moving that expectation there.
Speaker 1 (27:29):
So how long might you be practicing sin say focused
techniques with someone before you might see a difference in
their arousal states.
Speaker 2 (27:36):
Yeah, I think that definitely differs from client to clients.
I think that in the first few weeks they begin
to notice different areas of their body that produce the
feelings of arousal. Right, Like I've had women come in
like oh my gosh, I didn't realize, like the back
of my thigh really, you know, brings up these experiences
for me or brings up the feeling of pleasure for me,
(27:57):
or I really don't like it when you know the
small buy back has touched it, so it becomes an
explor explorative exercise for them. The whole course of sensate
focused therapy tends to last between four and six weeks.
Speaker 1 (28:10):
It sounds like it's a pretty structure thing that you're
taking either the person or then with their partner through.
Speaker 2 (28:15):
Yes And the hardest part of it all is that
when they're engaging in this, I ask them to refrain
from having intercourse and people you tend to get really upset.
They're like, wait a minute, I'm coming in here to
have and of course you want to and oh my goodness.
The partners are like, ah, I'm not signing up for this,
but I tell them, you know, it's just like anything else.
(28:36):
Think back to when you first you know, we're having
sex with a partner, that thrill and anticipation and you
know hoping that it'll be tonight that you finally get
to have sex. Right, So it's building that anticipation. It's
like the longest for play ever, right, But it's like
that's what needed to sort of rekindle desire and to
again remove the expectation that we're going to touch and
(28:58):
this is going to lead to suck. So taking that away,
knowing okay, we can't have sex allows the person with
the arouse the disorder to feel more at ease and
more comfortable to engage in that exercise.
Speaker 1 (29:09):
So you're saying that you take sex off this table
the entire time they're working with you on this. Yeah,
so they're saying, Okay, we'll do what doctor p is
saying for the next six weeks and then we'll see
how it goes. Yeah.
Speaker 2 (29:19):
And it's funny like people will come in like week
two or three, like, all right, we got to tell
on ourselves we have sex, you know. And so it's
kind of like, because it becomes this thing you're not
supposed to do, they want to do it right, and
it's like, oh, okay, now you get what we're having
these instructions.
Speaker 1 (29:37):
Yeah, I would imagine that this didn't allow us for
a great conversation about what happened and how we might
be able to reconstruct that for the future. Exactly, got it,
got it, I got to read more about this. This
sounds great. So doctor Pio What are some of your
favorite resources that you find yourself going to and recommending
over and over again.
Speaker 2 (29:57):
Absolutely so, first and for most, I think most sex
therapists will swear by this book. Come as you are,
Doctuli Nagowski, Right, it's just such a great book to
normalize sexuality and you know, teach about sexuality. Then anything
by Barry McCarthy is awesome. I really recommend re Kindling
Desire to my couples and women in particular, also by
(30:20):
Barry McCarthy and Emily car McCarthy. It's a book called
Sexual Awareness. Then when I find couples or individuals who
are coming in who maybe have never had sex or
have really just not had a really good sexual education,
I recommend the book The Guide to Getting it on.
I mean it's a huge book, but you can kind
of flip through and you know, learn about different techniques,
(30:42):
learn about different the sexual response cycle. So it's really
and it's it's written in a kind of like a
joking nature, so it's an easy, easy read.
Speaker 1 (30:50):
And where can people find you online? Doctor Pia? What's
your website as well as any social media handles you
want to share?
Speaker 2 (30:56):
Yeah, so definitely follow me on Instagram at sex Pia,
and then the website for the practice and a part
of is Resilient Chicago dot com.
Speaker 1 (31:06):
And of course all of that will be included in
the show notes so that people can find it easily.
Thank you so much for joining us today, doctor Pia.
I really appreciate it.
Speaker 2 (31:14):
Thank you so much for having me, and thank you
so much for having this platform. I mean, I know
you heard all the time, but it has just really
changed the game for therapy for black women. I'm seeing
so many more people coming in because of your website,
and so I just have to give you eight kudos
to that. Thank you so much.
Speaker 1 (31:36):
I'm so glad doctor Pia was able to join for
this conversation. To learn more about her and her work,
be sure to visit the show notes at Therapy for
Blackgirls dot com slash Session four twenty eight, and don't
forget to text this episode to two of your girls
right now and tell them to check it out. Did
you know you could leave us a voicemail with your
questions for the podcast if you want to suggest movies
(31:56):
or books for us to review, or have thoughts about
topics you'd like to hear us discuss. Drop us a
message at Memo dot fm slash Therapy for Black Girls
and let us know what's on your mind. We just
might feature it on the podcast. If you're looking for
a therapist in your area, visit our therapist directory at
Therapy for Blackgirls dot com slash directory. Don't forget to
(32:17):
follow us over on Instagram at Therapy for Black Girls
and join us over in our Patreon community for exclusive updates,
behind the scenes content, and more. You can join us
at community dot Therapy for Blackgirls dot com. This episode
was produced by Alise Ellis, Indietubu and Tyrie Rush. Editing
was done by Dennison Bradford. Thank y'all so much for
(32:37):
joining me again this week. I look forward to continuing
this conversation with you all real soon. Take good care.
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