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M h. 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, Dr Joy hard and Bradford, a licensed psychologist in Atlanta, Georgia. For more information or to find a therapist in your area, visit our website at Therapy for Black Girls dot com. While I hope you love listening to and learning from the podcast, it is not meant to be a substitute for relationship with a licensed mental health professional. And y'all, thanks so much for joining me for session one oh one of a Therapy for Black Girls podcasts. In today's episode, we're chatting about how you can increase your confidence related to sexuality and how a lack of confidence sometimes leads us to feeling less aroused. For this conversation, I was joined by Dr Pia Halleck. Dr Hollick is a psychotherapist at Resilien Psychological Services in Chicago, Illinois, where she specializes in working with minority populations in the areas of sexual dysfunction, relationship concerns, and trauma. Doctor Hollick received her Doctorate of Clinical Psychology from the Chicago School of Professional Psychology. During this time, she trained at Rush University Medical Center's Marital and Sex Therapy Department, where she gained specialized training and working with couples and treating sexual dysfunctions. She completed her clinical internship at Mount Sinai, St. Luke's and Roosevelt Hospitals in New York, New York. Dr Hollick and I discuss some of the issues that can chip away at our confidence related to sexuality, some of the concerns that lead to sex being less pleasurable or even painful, how you can talk with your partner about getting your needs met, and she shared how she uses sins sate focus therapy with couples in her practice. If you hear something that resonates with you while listening, be sure to share it with us on social media using the hashtag TVG in Session. Here's our conversation. Well, thanks so much for joining us today, Dr Pa, Thank you so much for having me. Yes, I'm so excited to have you here. So for those of you who are not following Dr Pierre on i G, you definitely have to because she has this feature that she calls just the Tip Tuesday, which you're super fun and 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 definitely check out her. I g thank you. 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. Absolutely, I feel like people often lack the verbiage of how to talk about sex. Right. A lot of us weren't talked about sex, whether that was in school or in our home environments. 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 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 then, well, you know, look at your body if they're more voluptuous. All of these different factors impact a woman's discomfort with you know, talking about sex with other people. That is a great observation that apia because you know, I think we see a lot of conversations online and there's I think even been 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. Correct, 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 or have knowledge about what they prefer or don't prefer. And are there particular um 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 meek 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 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 X that you feel like they have more of a stigma than others. Absolutely, so I think that there is still it is not as greatly as it used to be with there is still a huge stigma around oral sex and who you're gonna give oral sex to, who you're going to allow to perform oral sex on you. I think the new biggest thing now is a taboo around anal sex, not wanting to have conversations about that and what that might mean about you if you're 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. So, of course, I think conversations like this really help people to get a verbish 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 as, but just the idea of talking about it. 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 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, follow some podcasts, follow some things on i g. To see how other people are communicating about sex, to allow yourself to have an open dialogue with either your girlfriends or your partner, etcetera. And you mentioned like following different like accounts on social media. I know you and lots of other sex therapists are very active on particularly Instagram, but I think also Twitter and Facebook. And giving information. Do you think that that kind of stuff is helpful? I do because I think it normalizes what they might be going through. A lot of times when women come into my office, they have such a feeling of shame and things 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 this is something that a lot of people experience. There's more of a comfort to ask more questions or to learn more knowledge. 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 benefit would it be to come and meet with a sex therapist if you're not actually in a sexual relationship? 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 relationship 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 try to figure out, you know, what's what's creating these barriers. Sometimes that's an impact of sexual trauma and 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 that 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 I do with that? So how can I be you know, a more fulfilling partner and being more fulfilling relationships? And so what are some of the things that you will introduce to somebody who comes in and say something like that, like where would you start? M hm? So I start with this shrual history to you know again and 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 vaginousness, which is a contraction of the pelvic floor and 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, etcetera. So sort of reviewing some of those things and putting a name to symptoms and which women because of like, wow, 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, I what's that about? I usually don't have orgasm. Sometimes the conversation ends up being organic that leads us down the road of exploring their sexuality. I'm wondering how often it 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 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? You know what I think that right now it's been happening is people are coming in under the guise of anxiety, and society is so prevalent that even like scheduling the initial session, they're unable to see 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, 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 I'm seeing people who don't necessarily intend on coming in for that, right 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 the whole person, right absolutely. And I think when you asked earlier, why aren't people talking about sex and why aren't therapist 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 or you know, get additional training in. So there's you know, there's just again not the verbage of how to have these conversations. Right. So you mentioned a couple of sexual disorders that I want to follow up about, um 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. Yeah. Absolutely, So female sexual interest or arousal disorder pretty much means of reduced interest in sexual activity or you know, or reduced interests and thoughts or fantasies, um a lack of excitement or pleasure during sexual activity and 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. I sometimes joke with folks and say, like, this is like heterosexual woman watching ghosts on Power and having you know, it's like watching paint dry. There's no reaction to the stimulus at hand. 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? Yeah, And so I tell both, 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. 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 working with a woman 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 we might say, you know, not at all. And then it's a 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 not being able to get aroused during sex? So it's kind of like, well, I don't want to engage in this activity that doesn't bring me any joy or any pleasure. So the understanding is that you should have some arousal. I mean, because I'm thinking about people who identify as a sexual. Um, you know, so how do you like make the distinction between like somebody who identifies as a sexual and someone who may be struggling with like a sexual arousal thing? Right? So I feel like the person who's struggling with a sexual arousal, they are distressed that they're not experiencing desires that it okay? So that's really the key, right, Their 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 morning and what sex all the time, and now that's just not happening for me. Okay, Okay, got you. So I do think that that can be really delicate, right, Dr 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. 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 ice statements about what's going on personally for us, it you know, 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 through and I don't know why it's happening. I'm noticing this shift. I really want to be more connected with you, and I'm struggling with that right now. Right, you know, 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. 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. 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? You know, are you not physically responding to me anymore? And majority of women you know around us all starts for us in the brain, right, We we need to be intellectually stimulated and mentally stimulated. And a lot of times that happens, you know, via conversations or having date night or all types 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 times together like date nights, etcetera. And I would imagine that another thing that may really be a struggle is an internalizing of you know, an arousal issue. So is something wrong with me? Am I broken somehow? Yes? Absolutely, that's like the actual word that so many women use it like I feel broken? It just it's not working anymore. Why do I not desire this person? And then there's those again, those feelings of shame and embarrassment. So it sounds like typically you would see these clients in your office, maybe after a partner has suggested like, hey, you know something's really going on here, yes, yes, or after a woman has given birth and you know, desire changes, or perhaps they are adjusting to new psychotropic medication that's you know, inhibiting them from lubricating like they used to, so they're stopping to desire sex, or perhaps, like I said, if they've had vaginousness or any sort of pain or discomfort with sex. You know, that's when I'll see them more so coming in on their own, not just because their partner has you know, suggested. So can you talk more about veginismus because I don't think that is again another disorder that we hear about often um and the fact that it is psychiatric disorder, so it's not necessarily a medical thing, though I think you know some of that co exists. Can you talk more about what that is and what kind of things may leads to vaginismus. Yeah, So vaginousness 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 bulbil 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 have had unconsummated marriages. They're just very scared that it's going to be painful. I've seen this with women who have suffered some sort of trauma, whether that be rape or perhaps when they were a child they fell on a bicycle and broke their time in and had a really distressing experience happened in that way. I've seen this happen after women have given child birth, and there's just so much pain associated with thinking about being penetrated. Got you, 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 an extreme anxiety or fear about penetration being painful. And I think that goes back to your earlier comment right about you know, like 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 essentially active, that could be avoided if we were giving kids the proper information about six early on. Absolutely, So what kinds of things do you think, um, you know, like how would you design a perfect sex education class for like high schoolers if you were in charge. 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 also normalizing pleasure. I feel that from what I've seen, sex ad is more so of like these are the parts, this is what happens, This is but your menstrual cycle is going to be like this is what I mean, you know, interaction is and then you have sex and the baby comes and you know, here we go. And it really lacks just providing more information, more real life example information to teenagers and to talk about what happens in sexual relationships, you know, talking about birth control, you know, other contraceptive methods. And I know there's a lot of folks myself included. I went to Catholic school, so contraception was never discussed. You know, pleasure was never discussed in sexual education. So you know, teenagers are trying to serve the internet to get that information or you know, talking to their friends where it's sort of like blind leaving the blind sometimes to disseminate that information. Yeah, parents get really freaked out about us giving keys loss of information, but how often do we give keys information about other things and they don't follow us? Absolutely absolutely, And you know, research is showing us that, you know, providing children with information is not leading them to be you know more quote unquote promiscuous or having sex at younger ages. Were 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 once was to talk about it. Awesome. Really like that you included the idea of sex being pleasurable for everyone, because we often only hear about sex being pleasurable for guy as one. Of course, women deserve to receive pleasure as well. Absolutely, and just exploring one's sexuality and and normalizing that. Absolutely. So I don't know very much about it, Dr Peter, but I know that you practiced since sate focused therapy, can you tell us more about it? Yeah? Absolutely so. Since I focused therapy was first started by Masters and Johnson and UM, it has now been readapted by Linda Winer and Constance Aprick Clark, and we use this a lot when patients are coming in with desire disorders, and it's just like the name sounds since sensations UM focusing on the art of touch, I feel like so often sex has become this idea of being very procedural, and a lot of folks and 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, uh for play and touch. So what since they focus does is it teaches clients 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 desire disorder, they feel like I'm not performing how I'm supposed to. My partner, you know, 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 lease someone through, since they focus after exercise, I invite them to take some time and you know, allow themselves to relax, get themselves into an environment where they're good with the temperature of the room, the line 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 soft or firm, and just allowing them to notice what comes up. And oftentimes folks tell me, oh my gosh, like, I'm supposed to be touching myself for how long? And you know this is gonna get boring and all of these things, and so it's it's 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 those are distractions there there, and to acknowledge them that they come up and then just turned back to focusing on temperature, texture and pressure. Is this something that you do in the office or is this something that you're instructing them to do outside of the office. No, no, no, this is definitely something that's done at home. So you know, and I sometimes adapted for patients, like if if someone's coming in with a history of trauma or a significant reluctance or fear to engage and 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 times a week, and that should range anywhere between five to twenty minutes, focusing on again temperature touch during pressure. Week one would be doing this with perhaps like you know Projamazon. Next week they'll you know, 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 touching the breast or genitals in anyway. 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 turns touching one another head to toe, um, and that can be adapted to, you know, not having any clothing on. But again it's kind of staying away from the genitals and rust as well and focusing onjust temperature, touchure, and pressure. I know, I keep saying it over and over again, but that's what we want them to focus on, versus trying to explore for pleasure or trying to have any expectations that sex is going to occur after this. Really just getting comfortable with touching and in the senses it sounds like that could be really important. It sounds like they could go a really long way in establishing trust in the relationship without the expectation of sexual such 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 so um, you know, and there's a lack of bourbage right to talk about sex. So engaging in the sense of focus exercise removes that pressure, right, Because I also instruct people like, this should not be an exercise in what you're talking to one another. I want you to really focus on just those sensations. And so clients might ask, well, well, what do I do if I don't you know, like where I'm being touch or I really am enjoying that certain area that's being touched. And that's where we instructs them to engage in what's called handwriting. So that's either placing your hand on top of or underneath your partners to either guide them away from an area that feels uncomfortable or to invite them to stay on an area that does feel comfortable. So that helps take away this pressure to people say like I don't know how to talk dirty or you know, I don't know how to you know, share that I'm really enjoying something. So taking the verbal part out can be really really helpful. Okay, that sounds like it could be helpful even outside of this activity, for sure, maybe something 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 sexual 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 they're partner will expect something more that 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, do 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 basic kinds of breathing we're born with. Same with sexual function, we're born with those you know, 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. So how long might you be practicing since a focused techniques with someone before you might see a difference in their arousal states. Yeah, I think that, you know, definitely differs from clients to clients. Um. 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 coming like, oh my gosh, I didn't realize like the back of my thigh really you know, you know, brings up these experiences for me, or brings up the feeling of pleasure for me, or I really you know, don't like it when you know the small of my back is touched it, you know, So it becomes an explorative exercise for them. Um. The whole course of senseate focus therapy tends to last between four and six weeks. It sounds like it's a pretty structure thing that you're taking either the person or them with their partner through. Yes. And the hardest part of it all is that when they're engaging in this, I asked them to refrain from having intercourse and people you tend to get really upset there, like wait a minute, I'm coming in here to heaven of course, and oh my goodness. The partners are like, I'm not signing up for this, but I tell them, you know, it's just like anything else. Think back to when you first you know, we're having sex with a partner that through real and anticipation and you know, hoping that it will be tonight that you finally get to have sex. Right, So it's building that anticipation. It's like the longest four play ever, right, But it's like that's what's needed to sort of rekindle desire and to again remove the expectation that we're going to touch and this is gonna lead to sex. So taking that away knowing okay, we can't have sex allows the person with the arousal disorder to feel more at ease and more comfortable to engage in the exercise. So you're saying that you take six off the table the entire time they're working with you on this. Ye, so they're saying, okay, we'll do with dr if is there for the next six weeks, and then we'll see how it goes. Yeah. And it's funny like people will come in like week two or three like, all right, we gotta 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 why we're having these instructions. Yeah. I would imagine that this then allows 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 gotta read more about this. This sounds great. So, Dr Po, what are some of your favorite resources that you find yourself going to and recommending over and over again? Absolutely so, first and foremost, I think most sex there visible swear by this book, Come as you are by that Nagowsky. Right, it's just such a great book to normalize sexuality and you know, to teach about sexuality. Um, then anything by Barry McCarthy is awesome. I really recommend for kindling desire to my couples and women in particular. Um. Also by 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, um, but you can kind of flip through and you know, learn about different techniques, learn about different sexual response cycle. So it's really and it's it's written in the kind of like a joking nature, so it's an easy, easy read. And where can people find you online? Dr Pia? What's your website as well as any social media handlers you want to share? Yeah, so definitely follow me on Instagram at sex dr Pia. And then the website for the practice I'm a part of is Resilience Chicago dot com. 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, Dr Pia. I really appreciate it. Thank you so much for having me, and thank you so much for having this platform. I mean, I know you hear it all the time, but it has just really changed the game for therapy for black women. I've seen so many more people coming in because of your website, and so I just I have to give you big kudos to that. Thank you so much, thank you. I appreciate it. I'm so thankful Dr Halleck was able to share her expertise with us today. To find out more information about her practice, or to check out the resources that she shared, visit the show notes at Therapy for Black Girls dot Com slash Session one oh one. Remember that if you're searching for a therapist in your area, be sure to visit our therapist directory at Therapy for Black Girls dot com slash directory, and be sure to check out our online store at Therapy for Black Girls dot com slash Shop. There you can find our guided affirmation track, break up journal, or you can grab a Therapy for Black Girls sweatshirt or T shirt. Thank you all so much for joining me again this week. I look forward to continue in this conversation with you all real soon. Take it care, Okay. The