What We Can Learn from Equine Horse Therapy

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How can equine therapy with horses help couples improve communication? How can horses support survivors of trauma? What is vaginismus and what are some approaches to managing painful sex? Dr. Maha Nasrallah-Babenko joins Jess to answer these questions and more.

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Rough Transcript:

This is a computer-generated rough transcript, so please excuse any typos. This podcast is an informational conversation and is not a substitute for medical, health or other professional advice, diagnosis or treatment. Always seek the services of an appropriate professional should you have individual questions or concerns.

What We Can Learn from Equine Horse Therapy

00:00:05 - 00:05:12

You're listening to the sacs with Dr Jasser podcast sacks and relationship advice you can use tonight. Hey just a rally your friendly neighborhood sexologist here in Orange County today so just south of Los Angeles. I'm on my own without Brennan but I'm not totally on my own. I am here with psychologist and sex therapist. Dr Maha Nasrallah Benko yes impressed you pronounce it correctly as Rallo Banco actually much more sexy than most people pronounce. It would be pronounced it in your tongue. Nasrallah Benko the way you pronounce his even more sexy than the way out so you are. You're psychologist your sex therapist. You worked worked in lived all over the world you lived in. Beirut Lebanon which is one of my favorite places I've ever visited. You lived in Dubai for awhile. You studied and lived in London England. And now you're here on the west coast and it wasn't New York for a year and a half all right. That's where I met you at the Sexual Health Expo and we'RE GONNA be talking about a number of topics today but I want to begin with this. Eh quine therapy because this is all new to me. Can you tell me what this is? How you got into it and how we can. All you know. Have some takeaways from this therapy with horses? Absolutely and first of all I want to thank you for having me today. I'm really really excited. And I was really glad to see you here. An tenure event I'm a huge fan of yours in case you haven't noticed learn a lot from you even though. I'm an expert quote unquote but I think we are continuously learning and growing and I really really appreciate the information you put out there really. I'm very serious. Thank you A. It's true every event I go do. I am constantly learning. Yeah eat from. Experts and non experts like so always think it's interesting when people say oh. I know all this. How can you know all this? Yeah I studied this all day every day and I feel I mean. I know that I know very little. And Yeah I learned from my clients to just like worrying non-experts horse yeah their insights. I think are often more valuable. Because they're not in their heads. Yeah Same Way. That are so for all of you out there. You are the experts in your absolutely relation. I agree so equine. Therapy or Aucoin. Therapy doesn't matter how you pronounce it. I got into it like a year ago in terms of starting to study it But maybe six months ago or five six months ago or so. I started practicing it Here in Orange County I Dunno I think having a dog we. We had a dog We got a dog two years ago. my husband and I yes. She's adorable I think you having a dog and my love for animals and therapy and all that stuff. I started to kind of think of ways to combine them. I started to do some research and realize that it is a thing already working with animals in therapy so I started A certification on animal assisted psychotherapy. And when I moved to Orange County I connected with Organization working with walk into it. We're a nonprofit and they do equine therapy So it's been so fascinating To practice it and just learn from it on a regular basis and fascinating to see how horses respond to our emotions. Our thoughts our behaviors. Our Body language And give us such important information and feedback in a session that we can use therapeutically to help a client and it can be so powerful at times that you won't get the same result in traditional therapy in an office. Not that that's not valuable. It's obviously very valuable. And I do that as well. And I love it. And it's not for everyone equine therapy but I wouldn't be for Brandon for. Yeah I think he was kicked by a horse when he was young. Oh so he'd have he'd have to therapy. I in order to get the horse. I think that would actually be even more beneficial for him to get over. Those fears Because it is a safe way to do it. You know you're with a therapist and usually also an echo and professional so a horse expert. We're not gonNA do things that are dangerous and we're not going to be working with horses that are that are like severely traumatized that they can't be around people or something like that. You Know Wild Horse. Yeah exactly so. What do you do with the horses? You're not writing them. No I mean occasionally. There might be some writing. I don't necessarily do writing in my sessions with some therapists might but I don't It's groundwork so it could be. It could be not even touching a horse and you could be just watching a horse or a bunch of horses or heard of horses. Interact and projecting your own story onto them Can you walk me through that? So for example. If let's say there's three horses in an arena and the client is like What's what are they doing like they might be nibbling at each other okay And the client might be asking.

00:05:12 - 00:10:05

Oh what are they doing Therapeutically we don't always answer the question. Oh they're just playing at because it might mean many different things. Were not percent sure what it means will will reflect the question back to the client and be like well. What does it look like to you? and they could say oh. It looks like they're fighting okay. So that's their story. I might see it as they're playing. They might see it as they're fighting and they see it that way because that's probably their experience That's probably what it feels like to them. that may relate to their life in any way you know what? I mean so they project their own feelings or thoughts or experiences. They're on their own stories onto what they see. Basically that's one way we can work with a horse in terms of protection and other ways Could BE PETTING BRUSHING. Just brushing grooming That could be very therapeutic in terms of learning to be mindful present Focusing on your sensation's being in the moment So there's a lot of grounding and in working with horses as well In addition to that you can do more active Exercises or activities Or structured activities. Like walking a horse through a An obstacle path for example. We could for example. Ask a client and if we're working with couples it's even more fascinating To Walk to create a path. Let's say that represents for example their Their obstacles in their relationship. Okay and there is this props. They have a bunch of props they can pick from and they create a path and pick props that represent the obstacles and so let's say we ask them to walk the horse together through that path and you can totally see how they interact with each other And you see the dynamics in the relationship because basically as therapy and action you see what it's like you don't just talk about it right. Who is the leader? Exactly who is the follower exa- How do they give direction? Huzzah they communicate communicate. Do this exercise without horses. I don't know anything about horse nor do I have accident in downtown Toronto but oftentimes in groups when we're talking about how we receive directions. Who Will Blindfold one partner and the other partner has to walk without touching and talk this person around various obstacles with horse that like blindfolded walking horse and their partner or parent or whatever has to guide them for a belief through a path interesting. Yeah and so oftentimes. We think we're saying one thing. But we're maybe not saying it with as much specificity. Right I think about as we relate this to sex be gentle should be gentle. Alright can you be more specific? Do you want me to do seem. Yeah four fingertips and gently trace them down your spine. Do you want me to take the pat of my thumb and treated in a figure. Eight over your collarbone. The be gentle is so broad even with therapists and experts. They say things like communicate. Hope you feel okay but can we give people the language because it's like saying drive safely okay. But there's a reason we take courses in safe and defensive driving and so I can imagine with a horse because you develop a connection. Yes is there a chemical response between horse and -solutely? It's probably just like having a dog or with your partner as well any Should the OXYTOCIN LEVELS INCREASE You build a relationship like you said. There's a connection there. There's building trust and that's another thing that horses can help us with The you know the more you work with them you build that relationship and trust and so you experience what it's like to build a relationship and to build that trust especially if you find that difficult with people for example you know so you can practice that in a session. Let's say assertiveness is difficult for you? and I and I noticed that in a client because let's say I'm asking her to walk a horse and she's very like you know scared to pull on the rope or Like you know quiet. In the way she's trying to like encourage the horse to walk with her and he's not moving So she can literally practice what it means to be firm and consistent without being harsh or aggressive right so her tone of voice. What would that sound like? If she was a bit louder but not yelling. What would it feel like if she was Just maintaining a consistent pressure on the rope without being forceful you know. What would it feel like And then she would see the result that the horse will eventually trust her and follow and She can achieve what she wants in a kind and firm way without being aggressive or hurting anything.

00:10:05 - 00:15:00

So that's the beauty of working with horses is that you can practice things and feel the shift I can imagine. It's a bridge practicing these skills. These these communication skills that maybe you're not comfortable with the human but you practice on a horse I and I I can imagine that you must extrapolate much of this research around horses From and two dogs I've seen the research. Where if you look into your dogs. Is they experience a boost in. And you do you do exactly. I'm sure you're not feels like right. I remember with my dog. She wouldn't look me in the eye when she didn't WanNA listen to me because she couldn't disobey me and look me in the eye that cute little thing and it's interesting because we have some research on the benefits of pet ownership like in terms of even just being healthier because you're forced to go out of the house and take care of the dog and take them for a walk and then we have the the flip side which is that of course couples fight about walking responsibilities. You know where the dog should sleep. How much to spend on food and veterinary care and dog sitting and all of those items. But I was thinking that the there's research in workplace settings that the mere suggesting that the mere presence of a dog in group situations is positively correlated with an increase in trust in cooperation in enthusiasm and an intimacy so taking the dog into the workplace breaks down barriers show. And I think when we're working with a horse for example with a couple. It's easier for them to talk about things because the horses there then were sitting in an office face to face you know in a closed room. It's much more intimidating. It's yeah it's more scary whereas when you're outdoors in nature there's a horse there. It's much more light. It's less threatening your calmer because there's an animal around and you're outdoors. It's much easier to talk about sensitive things in difficult things absolutely. I love that Al. Think whether you you seek out equity therapy or you just take this research and inserted into your lives. It could be as simple as if you have to have a tense conversation Do it while you're walking your dog. It's funny 'cause like my husband and is sometimes we argue are not perfect. I our dog Lexie When the tension is heated she will go into her crate because she doesn't like the tension so that's our cue like okay. Maybe we should calm down now. I really appreciate that because I love. The other cues whether they're in your body or in the room Because sometimes we just get so over yet right in we know wants your heart rate is over one hundred per minute you your capacity to be rational to be empathetic. Yeah all of. That goes on so cool. For whom would at line therapy be indicated like I? I'm thinking about trauma survivors. Who WanNa break intergener- generational habits around communication? Who is it? A good fit for trauma is a huge thing when it comes to equal therapy. I think it's absolutely great for trauma. Survivors I would say it's for the majority of people the only times I would say it might not be suitable Are Say someone has like allergies or like severe phobias. They can't it's much more damaging for them to be in that situation than obviously I would not encourage that yet. Maybe they can work on that and then get to a stage where they're more comfortable with that but again. Fear of horses like Brandon for example. That's fine I think that actually might be beneficial for him. It's funny he's not the he'll be around a horse. We want. If I wanted to go on you know horseback ride on the beach on vacation. He'd do it. He just doesn't like horses and his Chinese Zodiac sign is a horse. So He's a Horse Life. Mice steps my stepbrother's fiancee's my sister-in-law owns a horse. And I I guess I always thought of a horse as a distant page or distant because it doesn't live with you. I didn't realize until you got Yakking to her. That this is a really significant bond and I was looking at research around losing a pet and specifically around losing dog and how it can actually be more difficult than losing loved a loved one. Who's a human because the loss is as significant but our socio cultural norms? Don't facilitate everyone's understanding. I have to admit when my aunt lost her because her daughter lost her dog Around Christmas many years ago She she was upset about something else but she was most upset about the fact that the dog died. And I remember thinking like issue really that upset over a dog.

00:15:00 - 00:20:04

It's just a dog and then I got my dog and I was like Ooh that things a big part of your life and I know horses can be the same. So horses The difference in horses and dogs going back to how they relate to each other. There's obviously very similarities. That you can take from the relationship with horses and the relationship with dogs but the difference is that horses are prey. Animals and dogs are predators so the reason why horses can be so beneficial in therapy because their prey animals. Their senses are so heightened because they have to be very aware all the time of what's going on around them because they WANNA assess for danger. They want to keep themselves safe. That's their first priority. So in order to do that they have to be fully present all the time. They can't think about the future they can't be in the past. They have to be right here right now. They have to be hearing. What's around them seeing? What's around them smelling? What's around them? And so when we come into their space they're sensing our emotions our thoughts our energy our body language to assess whether or not we're safe so that's why like their their responses or reactions to what we do or what we say is really useful information. So if let's say you're feeling sad inside about something but you're acting really happy horse is going to call you out on that I mean in different ways. But they're they're going to either. Let's say walk away from you. Nibble at you. Or they're going to do something to tell us. Basically that something is is going on here so the horses like how. Can I trust you if what you're saying doing is different than what you're feeling right so interesting really need to feel safe right? So if we're coming into their space with anything that might make them feel like. I'm not sure about you. They're going to do something to to show us that. That's the case right. So safety is number one for them and number two is they need connection. They can't survive on their own. They're herd animals so they communicate with each other all the time they have like a You know her dynamics as well so when we enter their heard that's why it really shows us. The relationship dynamics is well like it shows how we are in a herd right. So that's why horses are a little different than dogs when it comes to working with them as therapy animals. Are they smarter? I don't know to be honest. They're very smart. I'm sure pissed off my dog. Smartest dog my golden retriever is on the honor roll and I have a bumper sticker. Chris Kirksey I imagine. They're poking fun at people who put their honor roll stickers for their kids. I think that's more of an American thing than a Canadian thing. I don't think I've seen that in Canada so if people WANNA learn more about aucoin therapy obviously they can check out your website well. My website is changing to sexual healing. Doc DOT COM. Okay so we'll we'll link to your instagram and just generally where do they go? Is there an overarching or supervision? Supervising Organization E gala is more the I Guess Training Organization. How do you spell E. A. G. A. L. E. H. E. A. L? All right so folks can check that out and I want to switch gears because we have you. Yes and you have multiple specialties including working with people who are struggling with painful sacs or vaginal a type of painful sex. Who can can we switch to that and can you tell me a little bit about what Virginis is? Yeah absolutely so. That's a really good question because that definition is changing too So and there's I think a couple of definitions. I'm going to tell you the definition that I like. I like to look dismiss. Which is now called Genita- pelvic pain disorder in the DSM five They classified like all the kind of Vaginal painful sex Dysfunctions into kind of one chunk I like to view it as less of the muscle spasm and more of the weather. It's the fear of penetration or any difficulty with Penetration whether it's a finger penis tampon despite the desire to do so so my definition is when a woman wants to have sex or insert attempt on that say She has a desire to do so but she's finding it difficult either because there's fear or there is an actual like physical like her legs or you know tightening up or Or her or her vaginal muscles. Or You know. Pelvic muscles are Tensing up but I'm focused less on the muscular more on the emotional psychological part you know right because it is a psychogenic respond exactly and so it can be very severe Folks with edginess miss.

00:20:04 - 00:25:00

It can feel as though you're hitting a brick wall but sometimes they don't even get there is my point. They don't even get to the penetration to feel like. There's a brickwall a lot of times. There isn't even the physical attempt of penetration. They want to have sex but they're not even able to allow their partner to penetrate because of the immense fear. So that to me. It's not maybe not technically Virginis. Must but I still would treat it in the same way. Okay so we it begins with fear. Yeah the physical symptom is the inability to penetrate or extremely painful penetration. And why would you WANNA do anything unless you're pain? Which of course is a separate discussion. If you're into pain that's totally cool. But this is an unwanted. Pay unwanted pain exactly. And it's a the muscles do clamp To the point that there's no way to put anything in yes right exactly so the new research. What are they suggesting as treatment The treatment I've been kind of following his pretty much. The same haven't changed much because again. I look at the emotional psychological part. And that's I would say that that's similar now than it was maybe ten years ago you know. I don't think that that's changed much. Maybe the classification of this order has changed but treatment wise at least for me. I haven't changed much in terms of my approach. Okay so we know that folks obviously should be a public floor therapist. Well here's the thing. I do encourage that for sure but my only concern was that it with that is that there's too much. Focus on the physical right and not enough focus on the emotional or psychological. Which is that fear. So for the lack of arousal and the relationship or the Yeah the the lack of attraction or whatever it is or lack of trust. That's a big part of it. Lack of trust So if you're just addressing the physical part and loosening up your muscles that's not enough for a lot of people you might be able to insert tap a Tampon in that situation. But you're still not going to be able to have sex with your partner necessarily because if you don't trust them or if you're not aroused by them You might not want that and your body's going to respond or you might be able to have sex because your muscles are more relaxed but are you enjoying that. Is that what you really want? You know. There's a lot more complexity here. So I would just caution in terms of like yeah work with pelvic floor therapist. If you really feel like it's just your muscles that are you know Inhibiting you're preventing you from having the sexual relationship you want. But sometimes that's not enough. I would think that the pelvic floor therapists would work in tandem with a sex. There's some start. Sometimes they don't okay I I mean I'm sure some some do value the psychological part and some maybe view it just as a muscular issue right so I would hope so I would really hope so. So where do you begin? From a psychological. I would begin with Education so a lot of times people. Like you've said many times in your podcast and your work that we don't have enough education growing up about sex or the right education or education at all right Or we have all of these Misconceptions about sex or myths. That we believe or that have been told growing up and negative beliefs about sex and shame associated with sex. So how do we dismantle shame with the right education I would say is the number one step so challenging a client's beliefs or myths about sex for example A woman shouldn't have pleasure. You know it's just very amounts pleasure. That's a myth right or belief that some people still have and we need the challenge that or that sex is going to be painful or it's okay for it to be painful right So we need to challenge those beliefs. Where did you get that from Who who's who told you that. Where's the evidence for that You know so. There's there's a lot of questioning and challenging. I would say starting that conversation and providing them with resources reading books. There's a couple of books that I usually recommend one for women one for men that I loved. The book for women is called. Becoming orgasmic My Julia Hyman. Even though it's specifically for women who have difficulty having orgasms. I think it's really useful book for Women in general when it coming asthma yes sexuality and just getting in touch with your sexual your body in getting more comfortable with your body so number one is education right number two is I would say connecting with your own body. Can I just back for a quick start? Which is the book.

00:25:00 - 00:30:02

Sorry for the men for the convenience penises sometimes do love it. It's an old book. But ironically call called the new male sexuality Bernie Zuber God. Yes that's very important. Yes absolutely I do love that book. sorry penises. Didn't mean to ignore you there so we begin to understand. Our bodies relinquish sexual shame. Yes and then what? And so. I I start with Like I call Solo exercises Which is a stab you know a progressive program of Self sense eight meaning a woman. I starts to look at her body in the mirror and we talk about how that felt what came up for her. What what did she her body parts of the she like parts that you not like And then the more they practice that the more accepting of their bodies they usually become And then they move gradually towards Exploring her genital area of first by looking at it and then eventually By touching it not necessarily in a pleasurable way but more just in discovering curiosity exploratory. Where Way Right And then eventually moving towards inserting a finger her index finger and then eventually some people actually begin with a Q. Tip some people begin with cute. I remember working with clients. Where the with the Q tip was as you said. It's not about the muscular contractions without the intense fear. Yes and that intense fear makes acute seem very scary and the thing to remember what that is a lot of times. You know what that's like when it comes to fear when we're afraid of something we avoid it right. So what happens is when you attempt sex and you're afraid of that You avoid it. And that's reinforcing your fear and I definitely don't encourage people to just go for it and they're the pain no. There's a progressive gradual safe way of doing. It has to be done in a safe way. Even if it's safe there's going to be a level of discomfort right. So it's about overcoming that level of discomfort one step at a time until you reach the level of being able to have penetrative sex or if that's what you want or whatever it is that you're looking for and learning to take pleasure. I would think is because I talk about this all the time. So we have a course online called mindful sex and I think that this mindful sex program could address. So many of the sexual and relational will we have because it's just about learning to be touched at M and I. Maybe I mentioned this too much. I'm not trying to sell them. Because you can do a lot of this on your own but just the capacity to allow your partner to caress your face for fifteen to twenty minutes without the pressure to reciprocate is overwhelming for so many of us. I can tell you even for me because I'm almost I'm in a space right now because I'm traveling all the time working so much and I'm you know every everyday's a flight and podcast and and a speech that Kinda just want to get things done am not doing things mindfully like I'm not eating mindfully and even when I run home or get to see Brandon. We're having what I call and you were at my vent the other night so joked about it. Maintenance we're we're not really tuning in and that's okay. I'm okay we're just getting it done. We're getting it done. And it feels good nice release and I feel connected to him and you know. It helps me to let go of some of my frustrations but I have to retrain myself for example when I go home this weekend when I actually have time I have to retrain myself to take my time to really enjoy. And if we don't do that in any realm of our lives. Why are we going to do that in sex? Yeah we don't have the skills to tune into eating if we don't have the skills low things down tune into a conversation And not to play multiple roles right not to be looking in on the conversation as a spectator it. But just really be here. If we don't have the capacity to just enjoy the sounds in our life like the. It's at the time of the year right now where the little birds are. All I think building nests above my house is probably not a good thing but I love the way they sound in the morning and there are mornings where I take a moment to notice it. It's not you know ten minutes of listening to the birds necessarily and there are amenities when I don't notice it. So we're moving so mindlessly through life that we need to retrain ourselves that is a very important point absolutely being in the moment. Yeah Just allowing yourself to enjoy immersing yourself in the experience slowing things down you need like absolute and it. It's a challenge for a lot of US NOWADAYS. Yummy for sure okay. So am I interrupting relevant shooting themselves and then what's net So so after learning or becoming more comfortable with inserting a finger they move onto practicing inserting fingers.

00:30:03 - 00:35:12

And all of these steps are done in pretty much a similar fashion It's going to be uncomfortable at first There has to be a level of discomfort that they're willing to bear if it's too uncomfortable than we need to modify it and maybe take it a step back and not painful definitely not painful. I if the if there's pain you should not do it Uncomfortable in terms of like emotionally like. It's it's either they feel it's shameful or they feel it's scary But as long as it's again it's a manageable level. We're talking about here that they're willing to go through. It's not too much that it's going to cause damage whether it's emotionally or physically right there. A lot of breath work involved Definitely learning to breathe take Long deep breaths progressive. Muscular relaxation is as one Tool they can use also. Can you describe that? Yeah so So it's basically learning to take long deep breaths and mentally. There's different ways of doing it with the way I do it as mentally checking in with all of your muscles From your head down all the way down to your toes and relaxing them so takes a few minutes if you go through all of your muscle groups basically from your head forehead is cheeks jaw neck shoulders arms hands fingers chests back belly hips legs. You know all the way down to your feet and toes so you just gradually go through them all and relax your muscles wild breathing deeply and it's interesting because so many progressive relaxation and body. Scans SKIP THE PELVIC The Way I do it I do it backwards do it to- to head And I did it last night when I'm trying to go to sleep I didn't make it. I fell asleep but I I We might host And then I relaxed them Yeah you can either physically relax your muscles or just mentally do that and then I tense up my feet. I'm doing it right now. Yeah I mean you can do Qigong exercises and then you get up there. But we do he more attention to our pelvic. I noticed myself recently like a few months ago. That what standing up my pelvic muscles tight and I'm like why am I doing this? I consciously hat to relax and I still do that. Check in I'm like why am I tense? And I just Kinda give myself a moment actually consciously relaxed my public muscles. Yeah we don't notice that we're tight intents and I'm sure it's the same with other parts of our bodies like our shoulders right or me my job or jaw eggs. I'm always doing weird stuff with this job. Yeah so fast. Even I am once in a while. She's doing weird stuff. My jaw so you aggressive relaxation breathing. it might be just putting the tip of the pinky finger in Ans- and taking a few debretts and that might be all you do one day exactly and the trick here. The most important thing is to not take it out too soon so you WanNa basically bear the discomfort until you are more relaxed and then you can take it out because if you take it out when you're uncomfortable you're just reinforcing. The avoidance cycle creating that anxiety examination And so if you can just hold the tip in there take a deep breaths what will happen is the muscles will begin to relax the muscles. Relax your mind starts to relax. And you're creating a neutral exactly if not positive. Yes but a neutral association yeah as opposed to a negative one. Yeah and once you've gone through at least feeling neutral about it. Then we can work on the arousal and pleasure and enjoyment right so they work through one two three fingers basically and some people work with dilated. I don't I prefer a woman actually being more in control of her finger and feeling her body interesting But that's just a personal choice that you know there's no right or wrong here And then once she feels confident empowered comfortable with her own body and having Inserted three fingers then they can move onto the partner doing that so him starting with one finger than two fingers three fingers and so it's also progressive way with the same kind of you know the breathing relaxation. Not taking it out too soon before. She is relaxed and again. They might sometimes need to take a step back if it's too much so it's very tailored according to her needs each client's needs and it takes time. Of course you've been struggling with this for so long my time you come to a therapist and I've worked through through this with many people including someone who's close to me in my life who join me on the podcast. Yeah to talk about it. Yeah and she had a pelvic floor therapist. Yeah well it was just a small part of the of the process the conversation but it takes some time. So how long would you say on average? It's taking for your clients to let's not even focus on intercourse but to get comfortable with some pleasure in penetration and I want to also add the caveat that some people don't love penetration? Yeah like you know a lot of us could go without it.

00:35:12 - 00:40:05

Yeah I it's part of what we do but it's only one small piece and a lot of focus is on it so it's interesting when you were talking about the mindful sex mindful that you were the the program right You said up to be touched on your face for fifteen minutes without the pressure to reciprocate and I WANNA add the pressure to Get aroused or for it to lead to sex God now right so. That's a big problem when it comes to sex is there's so much focus on the orgasm number one and on penetration intercourse. There's so much more to do and you don't have to orgasm every time you don't have to have penetrative sex every time like I think if we focus more on again the experience the connection the sensations no matter where it leads that would make sex much more enjoyable and more relaxed for everyone. So that's a big part of sex in general and sexual problems in general I would say Going back to your question about how long it takes. I know you've heard this answer before. It's very difficult question to answer because it really depends on how committed the client is and how severe it is to begin with right. So if let's say like you said we have to start with a Q. Tip that's going to take longer than if she can insert her finger after two weeks of starting treatment. You know what I mean right and if it stems from trauma you're going to be dealing with the trauma exact before we even move on exactly right. I think that sometimes people come with a goal and I think that's Great. I wish people would go to therapists goals and be a little demanding of their therapists and having said that. Oftentimes the goal is aimed at overcoming a symptom of a problem as opposed to addressing the Ruth Ashtray. So if you can't you know of penetration is painful and anxiety provoking and that stems from trauma We can't just focus as you said on on relaxing the muscles and everything and getting something in we wanNA. If you're comfortable you WANNA work with trauma informed therapist who can help you to work through that trauma as well. That's very important. Yeah and I love that You know looking at the root cause the underlying issue rather than the symptoms and. That's very much a part of what I do and how I loved approach things. Yeah I'm I'm much more about the connection the the relationship and your relationship with yourself as well And then the rest follows. You know I I see things when it comes to sexual problems That's the result of something. It's a symptom right so going back to like if you go. If you have sex in in a more mindful connected sensative focused way versus focusing on the outcome. The outcome is GonNa be what you want naturally because the process changed right and we have to develop these skills outside the bedroom. That's not as for me the really big thing. I can't move mindless the mindlessly through life and then expect to be mindful all of a sudden in the bedroom. These all of these skills whether it's tuning into pleasure whether it's being a good listener whether it's really being open to to alternative perspectives. These are habits or skills that we develop better practice. They become transferable do sex. I find this really interesting. You're you're writing a book and upcoming on June assessments to put you in touch my publisher. Oh yeah absolutely where it goes so I really am thankful for your perspective on Equity Therapy which is brand new to me A very important topic edginess which I know affects so many people and can be overcome the can and that's a great thing. Yeah it's treatable. It is everything it takes time commitment work but it's treatable dot suffer for long please and you can. You can really make great strides with small efforts. Right if you're if you're hoping to have one specific outcome in a week. That's not realistic. But I think we need to celebrate the small movement toward feeling better better selves and enjoying sex more and more confident in our bodies and happy and our relationships and I know you're doing that in your work so we're gonNA linked to Dr Ma. I want to see her last name just to show off. Dr Maha handles and be sure to check out your work and thank you so much I being you. It was a pleasure. Thank you and thank you to you for listening. Thanks to desire resorts for your ongoing support of this podcast. I am hopping on their south of France. Spain and Italy crews very soon. We're leaving from niece. I believe there are rooms left on this one so check them out at desire experience wherever you're at have a wonderful week. You're listening to the sex with Dr Jasser.

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