Relationships at Christmas

Christmas time is a yearly test for relationships, it’s a stressful time on both time and wallets. This is amplified if your relationship is already strained. A recent Facebook study reported that most breakups occur two weeks before Christmas. Having realistic expectations of what you can and can’t do, and making time to practice self-care such as exercise, enough sleep and relaxation, can relieve stress levels which, in turn, will reduce strain on your relationship. Here are some other tips on how to decrease stress at this time of year.
·  Communicate: Set your boundaries and make them clear. Talk to your partner about what you may need over this Christmas period; space, extra TLC, support with family.
·  Articulate your stress; Be mindful of how you are talking to each other.  If you want to voice a concern, try saying ‘I’m feeling stressed because’ rather than ‘you are stressing me out’. Try and communicate clearly but ask yourself do you really need to say this, if it can wait let it wait.
·  Manage expectations; Remember that Christmas throws up circumstances that aren’t present at other times of the year. So, remember that the holiday relationship stress is contextual.
·  Plan in advance; Try to openly discuss plans and details for the Christmas period making sure that you are both prepared for what may arrive; arguments about family, planning out who goes where, what’s expected for gifts

Negative thoughts effect Erections

How do negative thoughts effect your erections? Just as we are not always conscious of the way we walk or how we drive a car, we are often not aware of our thinking. Some of our thinking is so habitual that it is automatic, and just like driving, when things are automatic, we might not be conscious of them. Negative thoughts perpetuate performance anxiety and therefore sexual dysfunction. It has been researched that men with Erectile Dysfunction present negative automatic thoughts during sexual activities. These thoughts tend to be; “I am not achieving an erection”, “I am not able to keep an erection”. Alongside the fixation of the possibility of disappointing their partner and thoughts around shame. Finally; fear and anxiety about penis size and body image can also play a role in performance anxiety. Capturing and documenting negative thoughts is a great way to start looking at what is happening to you sexually.

Dear clients....

Dear clients,

We hold space for you outside of your 50 minutes. We think about our sessions, reflect on ways we can provide further support, and hope you're doing OK.

Love from,
Your therapist.

Challenging the Inner Critic

Challenging and changing that harsh voice, is like changing a habit you've picked up and carried on for years.
It takes time, understanding and a whole heap of self-compassion.
It's no easy feat but practicing daily, even in little ways is conducive.
Some tips;
1. Give it a different name. Most inner critics aren't even us but originate from childhood years or society.
2. Make it sound funny/weird (for example give it Homer Simpson voice!)
3. Use the "what would I say to a friend" tool. It helps externalise.
4. Strengthen your compassionate voice, get it louder. Practice outside of times you feel triggered.
5. Mindfulness is a wonderful tool to help. @headspace have an exercise to help engage with self-compassion.
6. Be curious. Try to understand what tends to lie underneath the critical voice; fear of rejection, not being good enough, dismissal? So learn what your triggers may be to aid moving forward.

Abortion Rights in Ireland

Today I am talking about how much work we still have to do as a nation for, free, safe, legal and SPEEDY abortions to be accessed. It was an incredible occasion voting to Repeal; pivotal and beyond vital for this country. As much as I don't want to diminish the movement and progress we have made, I still want to draw on the changes that need to occur that result in people having to travel abroad to access basic health care.

I read the legislation and numerous reports and wrote up in the most succinct way possible what needs to be adjusted. There are aspects under The European Court of Human Rights that have pointed to changes that still need to be amended in the legislation.

I also want to create space to say, that the recent news from Texas (and I believe it is the 9th state to pass the bill) is very worrying and my thoughts are with those in America fighting for access to fundamental, basic healthcare.

Emotions are always present

I thrive off metaphors and use them constantly in my practice. This is one of my favourites because emotions are ever present. Even the state of "emotionless" is an emotion; apathy, indifference, passivity. Which can draw parallels in the weather eg; a non-descript, lustreless day.

This metaphor is a handy way of normalising how we feel and getting a better understanding of how we can cope:
•Just like the weather, emotions are changeable.
•Just like the weather, emotions are needed.
•Just like the weather, emotions can determine plans.
•Just like the weather, emotions pass.
•Just like the weather, emotions; through the acknowledgement and acceptance, are the most helpful ways to work through them.

So here is a trick to draw in the parallels;
•When its raining, I know I need to wear a coat. When I feel frustrated, I know I need to talk to someone.

•When there is lightning, I know I need to stay inside. When I feel sad, I know I need to show myself compassion.

•When it's sunny, I know I need to wear suncream. When I feel overwhelmed, I know I need to do some mindfulness.

The weather is a part of life, just like emotions.

Can you think of any examples?

Ps:
Little side point, that I found really useful
last week. I was reading some Hermeneutical Phenomenology and Heidegger was referring to our sense of being and how as people we are never NOT doing anything. It really blew my mind! I just LOVED knowing that even when I feel I'm doing nothing, I'm actually doing something! Now I have reframed achievement in such a compassionate way.

Inner Dialogue

My final part for mental health at Christmas is how "shoulds" effect self-care. The word “should” has is a fixture in our everyday inner dialogue. We use it in conversation with others, as a way of motivating ourselves or keeping ourselves in check. The word "should" can be insidious. When we use it we’re distorting reality. It's raising self-criticism and pressure by reinforcing the idea that we are not doing something we feel we ought to. As a result it leaves us with feelings of regret, disappointment and guilt. It feeds into any doubts of our self-worth and damages our mood while increasing anxiety. During the Christmas period the pressure to be festive, spend time with friends or family and ultimately make the most of the festive time can be relentless. If you're thinking about what you should've done in the past, you usually feel upset with yourself for not adhering to your future self's expectations. It's imperative that actually, if you want to avoid stress, pressure and guilt you must start with taking accountability over your own self-care. Making the decision to; not go to that party, spend Christmas day with family who make you miserable, remove people from social media who make you feel low, or not buy gifts. Is no easy feat. But perhaps starting with changing your inner dialogue could be the first step. Should undermines your ability to do what you want to do.
•Sometimes "should" has a good purpose, but sometimes it exists because it's part of someone else's purpose. So try think about WHY you're using the word. Who is it for?
•So instead try changing "should" to "could" or "would like to". •Think about what your "shoulds" are and see if you can reframe them in a positive way.

What is Chemsex?

I have just finished the first year of my Doctorate Programme, where the focus of my research will be on Chemsex in Ireland. I have read over 80 articles (I know as I have just handed in my literature review today and my references say it all!) and I feel very anxious about posting this.

I feel anxious because this is a treasured topic to me: Men are dying due to these drugs, that men are feeling alone caught up in the scene, men are being sexually assaulted when they are vulnerable. But I also feel anxious because this isn’t an area that is known about enough in this country; it’s misunderstood, stigmatized and demonized. I want to do it justice SO MUCH, while equally knowing a handful of slides won’t suffice.

I am thankful for people who have inspired me, supported me, listened to me on this topic, particularly over this last year. I am INCREDIBLY lucky. A special shoutout to @adlerss @silvanevespsychotherapy for words of encouragement!

Also @robbielwr @beninldn @tophertaylor @zacharyzane_ I implore you to listen to them and learn from them. There is so little space for Gay and MSM, sexual health, education and pleasure on this platform.

And to the wonderful @davidastuart, a generous, humble soul, who ignited the spark in this area for me many years ago (and who coined the term!). His tireless work has had resounding ripples throughout the world, I don’t believe there were even 1 of those 80+ research papers that didn’t quote him!

I'm hoping that the next few years of my research can help support those struggling with chems, educate therapists and help impact societal changes.

Intent vs Impact

When the impact of our words, behaviours or inaction, are hurtful others, it's important to stop take and take note. Even if we may not have intended to.
Think of it this way; if you accidentally step on someone's foot, you hadn't INTENDED to, but you still have caused them pain-that's the IMPACT. I'm imagining (hoping!) you'd still apologise: "I didn't mean to," doesn't cut it!

But what we could also reflect on is; what may it be like if we looked at the impact first?
Understanding that we all listen and absorb through our own filters, perspectives, and experiences. We can't ever guarantee how someone may take what we say or do. However, we could reflect on how our words/actions could land and adjust accordingly. Focusing on impact first could be pivotal, so thinking; 'How may this be heard?' or 'How could this be perceived?' 'Could this be hurtful or upsetting?'

If you have upset someone unintentionally here are a few things to try:
1. Listen actively and with an open-mind.
2. Accept their experience and feelings.
3. Own up to your mistakes.
4. Apologise without caveats.
5. Motivate yourself to learn from it.

The Lockdown Easing

On June the 21st England plans to come out of lockdown. I have seen many memes and jokes about what people may wear or do. As much as this is wonderful news for many, it's also terrifying for others. One of the things we know about a time of crisis is that it’s not the event itself but the fall-out. That's why it's called POST-traumatic stress.

If you are concerned about your mental health in the lead-up and/after lockdown, please know that this is completely understandable considering the distress that the pandemic has caused. Remind yourself that this is still an abnormal situation and that your pace is as valid and important as anyone else.

If you are someone who isn't going to struggle once lockdown has been lifted, please still be aware that others may.
Be mindful of your friends and family and their level of comfort in socialising. Try to be empathetic, understanding and flexible.

Mental health professionals are cognitive that the deterioration in mental health could linger long after the pandemic has subsided. Studies suggest that therapists who have been exposed to the same traumatic conditions as their clients can experience long term emotional distress. So let's pace and be gentle with ourselves. With a 31% increase in anxiety in the US and a 9% increase in depression in the space of a year, these stats aren't going to shift dramatically when restrictions are eased.

The knife is still in the wound. And it's not until it's removed that we can assess and treat the damage. So in the meantime let's go easy on each other and ourselves.

Make your own meaning

Every year I post a pic of this tulip that somehow manages to thrive from the side of the driveway against a wall. Today I discovered that there are two more pals with it!
Heidegger (in Hermeneutic Phenomenology) encourages us to make our own meaning in the world: 'being-in-the-world' which isn't about our processes, behaviours or about things, rather an embodiment or essence.
Honing into the way things appear to us and deriving our own meaning. So rather than giving you a spiel about what this tulip may or may not represent; make your own meaning, because that's what life is all about!

"Couples that...."

Something we see quite often on social media is the sentence "couples that.....workout/travel/adventure (etc)......together stay together." (Look up the hashtag and you'll see plenty more examples) But relationship longevity is more complex than a hashtag can determine.

Although aspects of this are true; common goals, values and hobbies, are important in a relationship. This doesn't suffice as reasons to stay together! Relationships are much more multifaceted than that. Plus it's not what you do, but HOW you interact with each other during it.

@gottmaninstitute would say that couples who are attuned, turn towards each other, fight fair, can differentiate, continue to court and choose each other daily. These are some of the ingredients needed for a couple to 'stay together'....it just doesn't sound as sexy in a hashtag!

Finally, I would also remind you that Instagram is a highlight reel, and those highlights include relationships. Please don't compare yourself to other couples, know that you're not seeing behind the scenes.

Diabetes and Erectile Dysfunction

Diabetes and erectile dysfunction: ED is a common issue for penis owners with diabetes, but when I was looking up the stats I found it difficult to find a common, evidence-based one. There are large variances in the statistics on the prevalence of ED with diabetes from 35% to 90%*! This is really down to the differences in methodology and population characteristics. But ultimately when you breakdown the stats you can see that ED is over 25% higher in those with diabetes. And occurs 10-15 years younger.
 ED is a common multi-factorial complication of diabetes it can be due to the damage to nerves and blood vessels and linked with other conditions that may be experienced with diabetes, such as cardiovascular disease, or high blood pressure.
If you have diabetes and are experiencing ED, talk to your doctor. It doesn’t have to be an inevitability, and there are ways to treat it. Alongside this talk to your doctor about other health conditions that may be associated with diabetes and have an effect on ED. This includes looking at the medication you are taking as some meds worsen the symptoms or may have side-effects that impede on your sex life. Finally, there are a multitude of ways that you can get support, one of which is Psychosexual and Relationship Therapy. With COVID occurring the accessibility to therapists online should hopefully allow more flexibility to engage with sessions. *Stats are incredibly difficult to find for Trans or NB individuals. What I do know is that diabetes complications following gender-affirming hormone treatment such as cardiovascular disease and high triglycerides and high LDL cholesterol.
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Gathering thoughts

I try to collect little thoughts that I may have; musings I suppose. I tend to write them everywhere, books I'm reading, notes on my phone, scraps of paper, on different apps, my diary. I often stumble upon a scribble every so often randomly and struggle to make sense of it! I have a special interest in gathering thoughts around connections and relationships. Over the last 6 months, I have been adding to this notebook, collating my scraps of paper and navigating my way through my apps, (there are about 20 pages now!) I've tried to spin them into questions that could be posed to clients, or anyone really, on how to reflect (individually and collectively) on relationship dynamics.

I'm not into resolutions, and definitely won't be making any this year...except to make sure I pass my first Doctorate year! But I think I will try to be more mindful to write down these thoughts in this notebook from now on. It may happen, it may not! Maybe I'll do something with them, maybe I won't! The fact that they're in the notebook is all that counts right now!

I also wanted to add in a book. As a visual learner and someone who finds metaphors really insightful and helpful. This little book by @thichnhathanhsangha is invaluable

Struggling with PE?

Premature ejaculation is prevalent between 15-25% of men.* It is the most often reported sexual complaint in those with a penis who are under 60 years. In penis owners with PE, the ejaculation occurs before they wish it to.
Some people complain of PE although they last 5–10 minutes and some others consider their ejaculation time normal even if it is between only 1–2 minutes. So really it’s about you and your feeling towards it and whether it’s causing you upset.

There are LOTS of ways to get help with PE.
Some medications, for example SSRIs (antidepressants) can be used off the label and often help. Please attend your doctor and have a conversation with them about your options.

Numbing creams and condoms may help to reduce sensations.

Kegal and pelvic floor exercises can be done daily to help.

I recommend mindfulness too: @calm and @headspace are great apps.

If you have been struggling for a while and find it distressing or having an impact on your sex life then maybe sitting down with a Psychosexual Therapist and getting support could be a good idea.
There can be exercises given (Stop/start technique or Squeeze technique Self-sensate is a great tool also). Working alongside some CBT and gaining an understanding as to what may be happening for you.
Alongside this, couple therapy can be of great benefit with Sensate Focus being used to take the pressure off ejaculation, decreasing anxiety and cultivating intimacy alongside helping with communication.

McMahon CG, et al. An evidence-based definition of lifelong premature ejaculation: report of the International Society for Sexual Medicine (ISSM) Journal of Sexual Medicine-2008; 5(7)
*this study was limited to cis-gendered men.

Stretching ourselves

To give, to receive, to tolerate, to empathise, to fear, to love.... When we stretch our emotions it can give us the capacity to connect with ourselves and release emotional turbulence. We can expand our ability to relate and foster our growth with others too. When we sit with our discomfort (our shadow self), reaching in deeper, we give the opportunity for it to expand us, hindering the possibility of emotional atrophy.
Imagine how much more we can achieve and be!

Spectatoring

Spectatoring' was a term coined by Masters and Johnson in the 1970s which describes someone being focused on themselves in the third person, rather than free in the moment.
Spectatoring disrupts our central nervous system and creates detachment and anxiety. And anxiety and sexual pleasure aren't great pals.
Practicing mindfulness is a great tool so as to not judge thoughts popping into our heads and analysing them. Another great way to get back in the moment is to bring yourself into your awareness; what can you see? What can you feel? Name 3 things of each.

What is intimacy?

Something I work on regularly in therapy sessions is intimacy. Intimacy usually denotes mutual vulnerability, openness, and sharing. It can refer to a single interaction between two people, or to a long-term pattern of closeness and warmth. Intimacy can help people feel less alone and more loved. However, also requires a great deal of trust and vulnerability, and some people find this frightening and overwhelming. Many people struggle with intimacy, and fear of intimacy is a common concern in therapy.

When you're not in the mood.

When one person isn’t in the mood, it doesn’t mean connection and intimacy has to stop. It doesn’t need to result in feelings of rejection, tension or distance. Instead perhaps ask “what would you like to do instead?” or "instead could we.....?" Intimacy can be cultivated in many ways, not just isolated to the bedroom. In fact, looking at alternative ways to connect can foster the sexual relationship too. Cuddle up on the couch, give a massage, spend some time kissing.  
So next time one of you isn't in the mood for sexual intimacy, instead of turning away from each other, try conjure up a way you can still connect.

Sex, women and aging

Public Health England survey of more than 7,000 women last month found that half of the respondents aged between 25 and 34 did not enjoy their sex life. The percentage dropped to 29% among 55- to 64-year-olds, suggesting that sex for women gets better with age.
Here are a few reasons as to why that is believed to be true:
1. People get more confident with age.
2. Genital primes are much different to sexual primes.
3. Married/long-term relationships=better sex.
4. Sexual satisfaction increases with age.
5. You get to know your body better as you get older.