Dr. Ethan Schwab

Seattle Psychotherapist and Strategic Consultant

Tag: sexuality issues

Valuing and Validating Sexual Differences

December 30, 2017 /

Often, couples and partnerships come into the office because of a desire discrepancy or an erotic conflict. As these differences in sexual interests or preferences can be distressing if unresolved, many clients come in initially and report that their sexual needs are not validated or valued to begin with by their partner(s).

This can be especially common when one person’s sexual needs or preferences are atypical and the other(s)’ are not. Often, leading to someone feeling as though their sexual experiences are less valuable or “normal.”

One of the most challenging issues I see with clients who are in romantic relationships is learning how to validate one another’s experiences and disagree…without feeling as though their character or identity are on trial. When sexual differences exists, this can be challenging. When validation does not happen, it can lead the un-validated party to feel less than, or broken, or that their sexual interests or sexual identity are dysfunctional.

As this is a common occurrence, there are many conflict resolution and communication tools in couple/partner therapy that can provide a structure for understanding the experiences of your partner(s) in a way that allows her/him/they to express their needs and ultimately leave feeling as though their identity is valued.

While this process can seem daunting, learning to validate the sexual interests of your partner(s) shows concern for their experience. Valuing the experience of the other can lead to further autonomy, differentiation, and a more secure attachment between romantic partners.

Do you feel you value and ultimately validate your partner(s)’ differing sexual interests and preferences?

Are you or your partner(s) struggling with validating or valuing one another’s sexual experiences or practices? If you are trying to get on common ground or find common sexual ground, sex therapy can help!

Call Dr. Ethan Schwab today at (425) 295-2189 for a FREE initial consultation. Learn to collaborate and create new opportunities to ensure sex stays a priority.

Defining Sexual Success in Relationships

October 5, 2017 /

Often, clients are referred into the office with an issue around sexual function (e.g., early ejaculation, delayed ejaculation, desire discrepancy, and low desire). When discussing client goals, individuals and partnerships will commonly identify a concrete outcome or level of performance they would like to be at or reach to be sexually healthy again.

Clinically, in many arenas of sexuality, normalcy or sexual function is defined by the individual, relationship, or partnership. Despite clients having the capacity to determine their own levels of sexual health and sexual success, social norms powerfully dictate what we “should be” or “should be doing.” Given the regularity of clients believing they should have one particular type of sexual success, I often encourage people in the office to consider what might be most preferable for them. Could there be alternative to what is socially normative that could be a better fit? If so, what could that look like? Why would an alternative be a more preferable form of sexuality or sexual function?

For example, in the case of desire discrepancy (the most common sex therapy presenting issue), could different types of desire or interest be a strength in the relationship? Do you need to have perfectly compatible sexual interests to have sexual success or health between partners? Can differences open furthered sexual dialog or exploration?

Ideally, choosing one’s own version and creating an alternative narrative around sexual success can be freeing and open the dialog to more preferable sexual interactions. Defining what sexual success looks like for yourself, and collaborating with your partner(s) to create meaningful and pleasurable outcomes can help reorient toward sexual health.

Are you or your partner(s) struggling with defining preferable sexual success? If you are trying to get on common ground or find common sexual ground, sex therapy can help!

Call Dr. Ethan Schwab today at (425) 295-2189 for a FREE initial consultation. Learn to collaborate and create new opportunities to ensure a preferable definition of sexual success.

Establishing Clear and Collaborative Sexual Boundaries

June 2, 2017 /

Many clients at my office come in struggling with boundaries. Often, when something sexual is new and available, we can get a little carried away, over excited, or overzealous prior to establishing clear boundaries around sexual play with our partner(s). This has gotten many relationships into trouble. Erotic conflicts (sexual conflicts of interest) can leave partners feeling alienated, wondering if their sexual needs and wants will be met, or whether their personal boundaries will be respected.

When couples and partnerships come in hoping to bridge the gap between different sexual preferences, are looking to explore a new sexual avenue, or even open their relationship, creating a structure and expectations for individual and shared sexuality is paramount. It is not uncommon for many individuals to have differing sexual needs and desires. Clearly understanding the meaning behind these needs helps to clarify how the relationship can support each individual feeling authentic and alive (sexually), as well as establish what each partner is comfortable with and what they are not.

For instance, if you are newly interested in power play (someone being dominant, another being submissive), establishing the role of each participant, understanding the type and purpose of the play, attaining consent from your partner, and developing clear and collaborative boundaries that protect and ensure the limits of the experience for each person can help the relationship build safety. Without creating a structure and agreed upon set of expectations for sexual play, assumptions can get the better of people and ruin experiences, and at times, even create trauma.

If you find yourself in a new partnership, or in a situation were clear sexual boundaries have not been established, collaborating with your partner to develop limits where each of your needs can be met can help bring clarity to the relationship and lessen sexual pressures. While creating rules, boundaries, expectations, and new understandings of one another’s sexuality is tremendously useful, there are many times where partner preferences or sexual needs are beyond another’s limits. Relationship conflicts can arise. Stay tuned for a brief discussion of mismatched sexual preferences where your partner’s sexual needs are beyond your comfort zone, or are a deal breaker.

Are you and your partner(s) struggling with establishing clear and collaborative sexual boundaries? If you are trying to get on the same page or find common sexual ground, sex therapy can help!

Call Dr. Ethan Schwab today at (425) 295-2189 for a FREE initial consultation. Learn to collaborate and create new opportunities to ensure sex stays a priority.

Scheduling Sex

February 28, 2017 /

Very few clients I see love the idea of having to schedule sex to ensure it has a place in their relationship. It certainly isn’t a glamorous idea…Not at face value. Regardless, many couples and partnerships struggle to find time or energy (whether physical or emotional) to engage in sex play by the end of a long work day. Most people (especially in Seattle) are busy these days. Work, errands, parenting responsibilities, friends, work, family, volunteer opportunities, finding time for fun, and work all can unintentionally take priority over physical intimacy. Everything else becomes a priority. Did I mention work?…

While it can be challenging, there is no reason to follow any social rule about how sex “should be” in a relationship. Few individuals, couples, and partnerships want to admit they feel too exhausted for any sex play. Scheduling a time for sex can provide an open forum for diverse sexual play. Additionally, it can provide a time during the week for novel sexual exploration, giving each partner a turn to bringing something new to the sexual buffet. Many people struggle with the notion of losing sexual spontaneity, and having another calendar item to schedule during the week.

Contrary to common concerns, having a predictable time where sexual play is guaranteed can keep sex on the mind when it might not otherwise be. Often, one planned time and space can help inspire additional spontaneous sex throughout the week. Additionally, creating an opportunity to rid the relationship of anxiety, stress, disappointment, or the feeling of failure around not having regular sex can create space for building further safety around initiating sex (especially if initiation has been infrequent or challenging).

Are you and your partner(s) struggling with low frequency? If you are trying to get on the same page or find common sexual ground, sex therapy can help!

Call Dr. Ethan Schwab today at (425) 295-2189 for a FREE initial consultation. Learn to collaborate and create new opportunities to ensure sex stays a priority.

What if Your Partner has Low Sexual Desire?

December 14, 2016 /

Often, I have couples and partnerships come into my office reporting that all of a sudden (or, in many cases, slowly over time) one partner has lost their drive to engage in sexual play. While desire discrepancy is common, it can be unnerving, especially if bids for affection or sexual initiations on your part have been unsuccessful leaving everyone involved feeling potentially disconnected or humiliated.

In many instances, before a solution can be formulated or you understand the origin of the problem, anxiety gets a strangle hold over the relationship and communication breaks down. Constructive conflicts become quickly triggered fights, and often are not productive or go in circles where one partner expresses their need for sexual connection, and the other seems apathetic about sex or anhedonic (he/she/they do not seem to experience pleasure in life).

Prior to making progress in psychotherapy, physiological issues (e.g., hormone levels, other medical disorders…etc.) and co-occurring disorders (e.g., depressive episodes/mood disorders) should be ruled out or determined to be a part of the cause. Afterword, psychotherapy/sex therapy can commonly be helpful in discovering what is impacting the individual and rebuilding or discovering new or old arenas that provide pleasure in the relationship.

Cases of desire discrepancy are common, and require clear communication of boundaries, expectations and sexual (physical and emotional) preferences of all partners in the relationship to be overt and well negotiated. Rebuilding an open line of communication, with the addition on a number of intervention techniques (e.g., sensate touch, trying new sexual activities, discussing fantasies, attempting to stage a novel sexual scene…among many, many others) to be practiced at home can help reform pleasurable sexuality in the relationship.

Regardless, rigid or strong expectations can be crippling, leading the individual with low/no desire to feel incompetent and valueless, further continuing the potential cycle of initiation/shutdown/disinterest/resentment. Don’t let a lack of clear communication around desire destroy pleasure in your relationship.Low Desire Ramifications

Are you and your partner(s) struggling with a desire discrepancy? Are you trying to get on the same page or find common sexual ground? Sex therapy can help!

Call Dr. Ethan Schwab today at (425) 295-2189 for a FREE initial consultation. Learn to communicate your hopes, needs, desires, and what is pleasurable in ways your partner understands and welcomes.

Identifying the Difference between Kinks and Fetishes

November 3, 2016 /

Often times in my office and in my classrooms, clients, students, and general practice therapists struggle to identify the difference between a kink and fetish. To begin, a kink is any type of atypical sexual play that you enjoy. This can be anything from BDSM (or some type of play using or manipulating power for pleasure purposes) to chastity. Alternatively, a fetish is a type of sex play that is required for sexual arousal or gratification. This typically focuses around excitement toward an object or body part that is not traditionally identified as sexual in nature. A commonly thought of example is a fetish pertaining to feet, where seeing, touching, or smelling a foot (of some particular variety) would be necessary for arousal. Fetishes are wide sweeping and can range from leather to exposing oneself sexually in public (exobitionism).kinks and fetishes

Most fetishes, when play is consensual, are completely legal and not pathological in any way (e.g., with the exception (in WA State) of Frotteurism, Bestiality, Voyeurism, Exobitionism, Hebephilia, Ephebophilia, and Pedophilia).

Many individuals, couples, partnerships, and play partnerships regularly enjoy both kink and fetish play. Working toward incorporating this play can be challenging if a partner is inexperienced, the play is new, or there is confusion around the impact of the play on the relationship.

If you are struggling through working on identifying, negotiating, or learning about a kink or fetish by yourself or with a partner, sex therapy can help.

For sex or relationship therapy, Call Dr. Ethan Schwab today at (425) 295-2189 for a FREE initial consultation.

A Little Quick on the Trigger (Struggling with Early Ejaculation)?!

September 21, 2016 /

A wildly common case in sex therapy practices is early ejaculation (formerly known as premature ejaculation). While the thought of orgasming with your partner too early during sexual play can seem embarrassing, shameful, or leaving you worrying about his or her enjoyment, know that you are not alone and are not a rarity.

While there is generally not one specific cause for all early ejaculation cases, psychological and physiological factors may be impacting performance. I always recommend to all men, that prior to beginning (or at the beginning of sex therapy) to visit your urologist (if you do not have one, either your primary care provider, or myself can make a recommendation) and rule out potential medical issues. Examples of physiological causes are: pelvic floor issues, hormonal imbalance, and inflammation of the prostate. When early ejaculation is psychological in nature, anxiety, relationship issues, pressure to perform, or even erectile dysfunction can be in play.early ejaculation premature ejaculation

If you worry about performance and subconsciously rush to complete sex, orgasm can happen quickly. Additionally, the expectations of your partner can have a great deal of impact on remaining mindful and present mentally during sexual experiences.

Given the range of potential reasons early ejaculation may occur, ruling out either biological or psychological issues in initially paramount. After, many interventions exist that are evidence-based and time proven to delay ejaculation.

The following are just two of a handful of strategies that are commonly prescribed by an AASECT certified sex therapist to aid in building control over ejaculatory response:

Edging: Masturbating up to just before orgasm and stopping prior to ejaculation, taking a break (letting the erection subside a little), and then starting masturbation again. This allows you predict when you are close to orgasm and being able to identify when you need to slow down or take a break prior to continuing masturbation (and inevitably sex). This also allows the opportunity to delay ejaculation as you become more familiar with sensations, ultimately desensitizing your experience with masturbation and sex. This can replicated during oral or penetrative sex by stopping penetration and taking a break or focusing on your partner.

Pause/Squeeze Technique: Masturbating up to just before orgasm (like above), but instead of stopping masturbating and taking a break prior to restarting, here you will grab and hold the shaft of the penis snugly (just below the head) just prior to ejaculation. This helps stop orgasm through dulling sensation. After, either masturbation or sexual play can continue…lengthening the sexual play.

If you have found yourself struggling with Early Ejaculation and want to work toward building strategies that will be effective for delaying ejaculation, sex therapy can help.

For sex or relationship therapy, Call Dr. Ethan Schwab today at (425) 295-2189 for a FREE initial consultation.

Experiencing Different Levels of Sexual Desire?

April 15, 2015 /

What happens when you find yourself in a position with your partner(s) where he/she/they don’t have the same sexual intensity or drive as you? What do you do when you desire more frequent sex, or kinky sex, but your partner(s) doesn’t or is indifferent?Desire discrepancy. Sex Therapy. If you’ve felt alone and isolated, you aren’t as abnormal and unique as you might think. Desire discrepancy is a common process between couples and partners when one party doesn’t possess the same drive as you. While physiological changes across the life span can impact anyone’s desire for sex (e.g., menopause, low testosterone…etc.), many life transitions can too…like becoming a parent (and being exhausted…all…of…the…time), or learning that what is or would be fulfilling sexually now is different than when you started dating or were first married.

I consistently see couples and partnerships where one partner has either a much higher drive for sex in general, or has the desire for a type of sex (often kinky sex) that the other(s) just aren’t into, or have never considered. Remember…variety is the spice of life, and despite differences in what is pleasurable between partners, it doesn’t mean that your relationship will or has to end. Regardless, it can be terrifying to hear that your partner(s) is unsatisfied with the frequency of sex or really wishes that you would be more domineering or sexually adventurous. Being in this position isn’t uncommon, and when you think about the scope of time you’ve been with your partner (especially if it’s been years), things can become stale, uninspiring, or no longer preferable.

If you have found yourself in this position, there are plenty of directions therapy can assist with. I have seen many couples who have renegotiated the nature of their sexual relationship, often to a better, more pleasurable, and more fulfilling position than it ever was at the beginning of the relationship. It is never too late to save, fix, or rediscover your sexual relationship, scripts, and chemistry with your partner!

Are You Struggling to Get on the Same Page as Your Partner Sexually?

Are you and your partner(s) struggling with a desire discrepancy? Are you trying to get on the same page or find common sexual ground? Sex therapy can help! Call Dr. Ethan Schwab today at (425) 295-2189 for a FREE initial consultation. Learn to communicate your hopes, needs, desires, and what is pleasurable in ways your partner understands and welcomes.

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