Gender and Sexuality CPD trainings coming up in January 2017 – Cambridge and Edinburgh

Need some CPD?  Would you like to to update your skills and knowledge?

In 2017, as part of London Sex and Relationships Therapy, I am offering trainings on Gender and Sexuality in the therapy room, and other related subjects.

In January I will be in Cambridge and Edinburgh, facilitating:

Gender and Sexual Diversity in the Therapy Room

Drawing on the book Sexuality and gender for mental health professionals: A practical guide (Richards & Barker, 2013), this training provides a basic outline of good practice when working with issues of gender and sexuality. Attendees will be encouraged to reflect upon their own ideas and assumptions about gender and sexuality, and those implicit in their therapeutic approaches. We will consider various ways of understanding sexuality and gender, and their implications for therapy across client groups. Specifically we will focus on the issues which can be faced by those who fit into normative genders, sexualities and relationship structures, as well as for those who are positioned outside the norm.

If you would like to attend, please follow the links below for bookings:

Relate Cambridge – Saturday 14th January 2017 (10-4pm)

Information about this training and about Relate

Relationships Scotland – Saturday 28th January 2017 (10-4pm)

Information about this training and about Relationships Scotland

If you would like further training

If you are looking for training on this subject or something related, please contact me and either I or one of my colleagues will come back to you.

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Am I kinky? And is this a problem?

screen-shot-2016-11-16-at-10-07-38Due to media stereotyping, unhelpful labelling with words like ‘paraphilia’ and ‘perversion’, and the assumption of mental illness or pathology – if you identify as kinky (or feel you may be) you sometimes wonder if there is something wrong with you.

You may have felt unable to share your feelings with anyone else. And you may also have avoided going to therapy, even for something entirely unrelated to your identity or lifestyle, because you fear either being treated as ‘sick’, or having to spend many hours justifying yourself.

For a start, kinky does not equal bad or weird

For some people, being drawn to BDSM (Bondage and Discipline, Domination and Submission, Sadism and Masochism) dates from their oldest waking thought or memory. Others discover it later in life. We live in a time when what you might call identity essentialism (‘If you weren’t born this way it’s fake’) is being questioned. Identities and orientations can evolve over time:

  • For example, from a young age you might have found yourself wishing to be restrained, or were aroused by certain scenes on television or in books, or took a specific dominant or submissive role during play with others. You may have put these thoughts and feelings away for years.
  • Or perhaps, as you grew up, you never felt right doing what everyone else seemed to be doing sexually, but weren’t sure how to articulate it, and just carried on doing things that didn’t really do much for you. Or stepped away from intimacy altogether. 
  • Or later in life you felt exciting changes coming on and, like Alice down the rabbit hole, you tumbled into a whole new world that you never wanted to come back from.

Secondly, it’s far more common than you think

And, even more importantly, studies (see the links at the end of the article) suggest that the kink identity correlates with a number of positive attributes.

A spectrum rather than a binary

I find it preferable to open up the definition rather than narrow it. Do you find greater release in giving or receiving extreme sensation? Do you experience something deeper when you give yourself over to another person, or take power over them? Do these experiences make you feel more fully you?

There are an almost infinite number of ways to express your kink

You do not have to join a particular community, or love leather or rubber, or spend your evenings in underground play spaces. For some it may be about handcuffs and a blindfold, for others total enclosure, for others extreme sensation. For others it could have nothing to do with physical sensations and everything to do with psychology. It could be about taking control, or giving up control, with no pain or restraint at all. 

For one person, it may be spending thousands on rubber clothing and dungeon furniture. For another, a simple phrase sent in a text message and a 24/7 household setup that others would have to guess at. It might involve going out to events, like clubs or munches, with others who share the same interests. For some people, no act, however apparently extreme, counts as kinky unless there is an exchange of power. 

It could be mild and playful, or it could be extreme and unusual, or combinations of all the above.

Does it have to be ‘all about sex’?

For some kink is inextricably linked with genital sex. Other people very clearly separate the two, and others are fluid in their approach. So however you feel, however you see yourself, there is no ‘one true way’.

Our society has a very poor record on acceptance of sexual diversity and many remain closeted just to feel safe

Perhaps you feel shame when reflecting on your fantasies or activities, and have never told anyone about them. You may also be struggling because:

  • What you like may have a more extreme taboo edge or safety element to it.
  • You may fear that you might hurt someone non-consensually.
  • You are happy for it to remain in fantasy, but want to be sure you are okay.
  • You have been paying for kink services and are wondering if this is okay.
  • You fear you are doing it too much, or thinking about it too much, and need reassurance that you are sane and not an ‘addict’.

If any of this troubles you, it may be helpful to talk to a therapist

Psychotherapy can help you look at the emotions underlying your current situation, and help you with any difficult feelings you may be experiencing.

It’s worth choosing carefully, however. There has been a tendency in traditional therapeutic schools of thought that any activity that is not 100% heterosexual, monogamous or vanilla (ie non-kinky) must stem from a pathology, or possible early-years damage. I have gone further into the problems with this viewpoint in a piece for Lancet Psychiatry: BDSM, Psychotherapy’s Grey Area.

I never discount the idea that this could for some people be the case, that a response to a past difficulty has evolved into a kink or fetish. And people do sometimes eroticise past experiences. But past experience may have meaning here or it may not. Be very wary if someone wishes to turn detective and start ‘uprooting’ your kink or trying to convert you.

You are not sick – you may just need to be heard. Rest assured you are not alone.

Where to find a kink friendly therapist

Further reading and research

On the subject of orientation and identity, there is an interesting discussion around this post by Clarisse Thorn: BDSM As A Sexual Orientation, and Complications of the Orientation Model

These two studies may also be of interest:


Sex work and the transactional nature of human relationships

Sonnenschirm_rot_redNew essay in Lancet Psychiatry

My latest piece is called Sex work – society’s transactional blind spot.

In the article I explore the transactional nature of human relationships and how we are encouraged to bargain with others, from a very young age, for social and emotional survival. I have focused on sex work because it is a significant cultural issue that polarises opinion and inspires much clichéd and harmful representation in art and media.

Sex workers also report poor experiences in therapy and within the mental health system as a whole.

The opinions and experience of those who actually do it are often ignored or marginalised

Even if you cannot imagine doing sex work yourself, or think you don’t know anyone who does it, it’s worth reflecting on it as an issue of labour rights, self-determination and consent.

Political support for change

Just after the piece was published, the UK Home Affairs Select Committee declared in a report that there was a very strong case for decriminalisation. Amnesty International reached a similar conclusion in 2015 which has now become policy. This move has also been supported by the Lancet.

If you are affected by any of the issues here and would like to explore them further in therapy, please get in touch.

[The image above is by Usien and can be found at commons.wikimedia.org]


Are you stuck on the Sex Escalator?

tg-1-27Today I’m talking about the repetitive sexual conveyer belt that we can find ourselves on if we pay too much attention to cultural influences and not enough to our own needs.

I’m calling it the Sex Escalator because you can sit on it and it will take you somewhere that feels vaguely elevated over and over again – and you need not think about it, ever.

Remember the ‘Relationship Escalator’?

You may well have heard of the ‘relationship escalator’, an idea that originated in non-monogamy research circles and promoted in excellent article about polyamory that I have linked to before. It’s about how relationships are culturally encouraged to follow a tried and tested formula – essentially meeting, dating, becoming a (preferably heterosexual) couple, becoming exclusive and monogamous, moving in together, getting married, buying property and having children.

This model suits many people for many reasons – but it also has a purpose, namely to uphold social cohesion and provide a foundation for a very specific way of having a family. It does not deserve to be rejected outright, but it does deserve examination because many people fall into it before realising it is not what they want or need at all. And this is when relationships can become damaging.

As with relationships, so with sex

Discussing this with friends and colleagues (and working in communities where we talk about these issues a lot), even highly creative sexual adventurers will admit to having sat on the escalator at some point in life. The process goes something like this:

  1. Kissing
  2. Manual stimulation
  3. Oral sex 
  4. Penetration (preferably PIV)
  5. Peak genital orgasm
  6. The End (someone falls asleep)

People base entire marriages around this paradigm. Any deviations from this become treats, exceptions or outliers, or simply never thought of.

And of course, parts of this sequence may be missing altogether because they were never there in the first place.

This is not to judge anyone or criticise this as a way of having a good time together. Over time you may have discovered the most efficient way to orgasm with one person – and after all it’s pleasure and connection you’re after. You may be frequently tired and you may be busy and you may have family to take care of.

The problems start when you’re increasingly unhappy – but you’re not doing anything about it.

Communication as taboo

The problems start when communication ends. For many people, unaccustomed to stating even the simplest needs, useful communication will stop as soon as mutual liking is discovered. For many people this may even come as a relief. In the UK we have a popular trope of two people getting drunk together on a date, waking up in a relationship, and then being delighted that it need never be mentioned again, perhaps for several years.

As with emotions, so with sex.

A package deal of conditioned behaviours and expectations

On the Sex Escalator:

  • Anything else doesn’t really count as sex, or is weird.
  • It’s vital to have a goal, and that goal is ‘full sex’ because the rest is just ‘foreplay’.
  • If you miss out the genital penetration, the sex is incomplete and has failed.
  • If the escalator doesn’t arouse you that much, you should keep quiet about it so as not to create disruption.
  • If the escalator doesn’t arouse you that much, you may need to seek outside help, because the problem is your fault.
  • If the escalator doesn’t arouse your partner that much, you should tell them to seek help, because the problem is their fault.
  • Obviously the penis owner will have an orgasm, because they definitely enjoy penetration. (Go here for a longer discussion on why a number of people actually aren’t into penis-in-vagina sex. Go here for a rather more brutal takedown of this sexual trope from a feminist perspective.)
  • The vagina owner really ought to have an orgasm because otherwise they must be dysfunctional and the penis owner won’t like them any more due to their imperfect functioning. 
  • You dare not discuss any of this with your partner in case they are offended or think you are about to criticise them.
  • Deviating from this pattern in any way is terribly adventurous and needs masses of preparation and expense.

I would like to think that the generations that have grown up with the internet will have found a better way, but looking at what young people seem to be learning, I am not so sure. And although this feels like a strictly heterosexual/cis model, any pairing of genders and sexualities could technically enact this. 

I also have a suspicion that this conveniently boxed scenario keeps people more heterosexually confined than they would ideally wish to be.

If the Sex Escalator isn’t working for you

If you keep on ending up having sex like this, and you’re not enjoying it, or you feel that there’s something missing – ask yourself some questions. If you have a partner, ask each other some questions.

  • Am I or my partner truly consenting to any of this?
  • Have we actually ever discussed it?
  • Do either of us really want it?

And if you’ve said to yourself and/or each other: ‘Well, this is okay enough, and if we don’t do these things it doesn’t feel like we’ve actually had sex – ‘

STOP!

If you want something different, here are some things to remind yourself about:

  • Sex does not need either a goal or a destination.

  • Genital sensation does not need to have primacy.

  • Specific activities do not have to have primacy over others.

  • There are no rules about which parts of the body should be included or left out.

  • Orgasms are nice but they are not obligatory.

  • Communicating your needs is vital. 

  • Focusing on breathing can add a whole layer of experience.
  • There is a whole world of sensation waiting for you in many areas of your body that you may not have considered.

  • Have you talked about your fantasies? Have you even thought about them?

What if you went right back to the start and asked yourself – or asked each other – what do I/we really want?

Am I overstating this? Judging by the responses I encounter when someone (or two people in a relationship) realises there is another world of sexual connection out there I am, if anything, understating it.

In a future post I’ll go into more detail about ways to expand your sexual experience.

If you’re concerned about anything I’ve raised in this post and would like to explore this aspect of your life in more detail, you can contact me here.


Bisexual life – hiding in plain sight?

2000px-Bi_flag.svg

Pink Therapy conference 2016

Last Saturday I spent the day with colleagues at Pink Therapy‘s annual conference for therapists. This year’s theme was Beyond Gay and Straight

‘There are gay bars and straight bars, but where are the bi bars?’

Someone made this point during the plenary session. Erasure is something bi people experience on a regular basis. I’ve been told more than once that the word ‘bisexual’ is a bit of an audience killer and best left off publicity materials. This is sadly unsurprising.

Bisexuality and mental health

Dr Meg John Barker reminded us that not enough studies have been done specifically around bisexuality, but what there is – sometimes the B element has to be squeezed out of the side of a larger piece of research – is unequivocal. A bisexual person is likely have worse mental health than someone who is either gay or straight. An aside from another discussion, a good proportion of people diagnosed with Borderline Personality Disorder (who are, incidentally, mostly likely to be women) also identify as bisexual. (For more research and information, see BiUK.)

Prejudice from all sides

Bisexual people experience discrimination from both straight and gay communities. Bi people are seen as fence sitters, greedy, manipulative, unstable, sex-obsessed, and indecisive, perpetually on the way from one place to another but never getting there. Women only ‘do it’ to tease or please men. It is seen as marginally more acceptable to be a bi woman than a bi man, however – bi men are either ‘gay, straight or lying.’ A bi person must experience an exactly balanced 50/50 attraction to men and women (never mind other genders), or they are fakes and must be straight. Sometimes therapists (and partners) offer to convert them, or tell them that their issues will be resolved when they ‘pick a side’.

Charles Neal, author of The Marrying Kind, talked about the lives of gay and bi men married to women, the ‘mixed-orientation marriage,’ and the misery experienced by people stifling their identities in order to remain in a socially acceptable unit. ‘Experience before identity’ was his message – but even nowadays, if you don’t identify sufficiently with one tribe over another, you may feel left out in the cold. (See also How To Support Your Bisexual Husband, Wife, Partner)

Born this way?

Current activism tends to promote sexual and gender identities as self-defined, but it wasn’t so long ago that you had to be ‘born this way’ in certain queer scenes, (and adopt one of a specific set of appearances) or you were seen as a ‘tourist’. You were ‘bi-try’ (for bi or bi-curious women entering lesbian environments) or a ‘stray’ (for bi or bi-curious men entering gay ones). And, on arriving at an event, there was that look from the door person that said ‘Your hair goes past your shoulders – are you here to write an article about us?’

Binary versus fluidity

These attitudes remind us how the desire for a binary universe is so pervasive. If you are not one thing you must be another, because of course there are only two things to be. The idea that a person’s desires may shift and evolve over time seems entirely absent. To be fair, if you have fought for years for your singular identity, you may well feel threatened by any kind of flexibility around this, but this feels increasingly out of step with younger people, for whom fluidity of identity feels as if it’s becoming the norm.

It all sounds very like the dismissive way some old-school kinksters speak of switches, ie people who are comfortable occupying both sub/bottom and dom/top roles, or have a different role depending on the gender of their play partner. And, for that matter, people who cannot accept non-binary gender identities. There is, perhaps unsurprisingly, a high proportion of bisexuality in trans communities. DK Green spoke in detail about both topics. Validation from partners is essential: ‘Does your partner see you as you see yourself?’ (Trans Media Watch has a good resources page.)

Caution around labels

A therapist simply being affirmative may in fact be damaging when a client holds multiple identities, and this can apply particularly if they are intersex. And in a flurry of anti-religionism (for sure understandable given the damage that religion has done to people with minority identities), you may trample over the fact that a queer person is religious and gains comfort from it.

Multiple intersections – multiplied difficulties

Ronete Cohen spoke about the intersection of bisexuality and race, where a bisexual person of colour can be marginalised and objectified in a number of communities simultaneously. Microaggressions are multiplied, and there is far less social support and consequently worse mental health outcomes. She gave the example of a bi person of colour asking for help dealing with stress, and being told to go to yoga. There are a number of reasons why this was inappropriate – western yoga is generally white, middle class, often expensive, promotes a particular body type, and contains potential inherent cultural appropriation.

Elsewhere during the day, someone gave another example of a therapist trying, unsuccessfully, to take mindfulness into communities of colour, having not thought through the missionary implications of this. A therapist may have training around gender, sexual and relationship diversities, but they may not have any cultural competence training around race. (See Bis of Colour for more information and support.)

Queering relationships

From the other sessions I attended:

Niki D talked about biphobia in relationships, and the difficulties of being a bisexual person in a relationship with someone who is monosexual.

Meg John Barker, using their excellent zine ‘What Does A Queer Relationship Look Like?‘ talked about queer relationships, and the fact that a high proportion of bisexuals are also non-monogamous. (The ‘Normativity Castle’ is especially pertinent here.)

Amanda Middleton presented on queer identities and offered a breakdown of Queer Theory. She outlined the slippery and paradoxical implications of queer – (for example, if a queer person experiences microaggressions, it can mean they are doing queerness well) – and the fact that identity will inevitably change over space and time.

It’s an exciting time for Gender, Sexual and Relationship Diversities therapy

Thanks to Dominic Davies and the Pink Therapy team once more for a great day and an excellent learning and networking opportunity. There’s a lot of work to do – especially around training – but this community is growing.

For videos of the main talks, go here.

Contact

If any of the issues in this post are affecting you and you would like to talk further to someone, you can contact me here.


Chemsex – film review

Chemsex - A Peccadillo Pictures release Review in the Lancet
There’s a new documentary out, Chemsex, about the cultural phenomenon of sex and drug parties on London’s gay scene. It was previewed at the London Film Festival this autumn, and my review of it appears in this week’s Lancet.

You can find the film’s trailer here. I also saw the play Five Guys Chillin at the King’s Head Theatre in Islington, which is a verbatim drama about a chemsex party constructed from many hours of interviews.

In my review I looked closely at the film itself and highlighted the public health aspects of the story – the potential for the spread of STIs through having unprotected sex while intoxicated, sharing needles when injecting, or sharing toys and lube. Also the fact that it is particularly easy to overdose on GBL.

I’ve also been reflecting on the film more globally and what else it brought up for me.

Double standards
First of all, it’s very easy to sensationalise what some might see as niche or small community behaviours, but which are in fact only more specific or extreme examples of activities that many people do on a regular basis. Plenty of heterosexual people, for example, stay up for two or more days taking drugs recreationally and having sex.

I’m also aware that a film like this could potentially encourage homophobia in those already disposed that way – just as the many documentaries about excessive public alcohol use in town centres (and the consequent taking up of A&E time) has the potential to encourage a form of classism. This despite the universality of drinking culture in the UK.

Fear of sexual agency
Secondly, our culture is obsessed with sex, but simultaneously fights to create rules about who is allowed to be having it, and how. People who actively pursue their sexual desires are very often seen as a threat, or ‘addicted’. (See my recent post on sex addiction and the concerning number of activities/behaviours which are erroneously named as symptoms of it.)

The challenge of sober sex
Finally, it’s very clear that sober sex is very difficult to accept when you’ve been used to the chemically enhanced version. A film can’t cover everything, but this is something that needs to be addressed societally, and not just in the gay community. I intend to cover this topic soon.

Read more of my published work

Find out more about how I work


Low-cost counselling and psychotherapy services in London

London skylineSeeing a therapist in private practice isn’t financially accessible to everyone.

Here’s a list of reduced-fee talking therapy services in the London area. I hope you find it useful.

PLEASE READ THIS FIRST:

 This list is not definitive or exhaustive – it is a work in progress, and I will be adding to it as time goes on. [Most recent changes 17/12/17]

• Being listed here doesn’t necessarily mean I know the service and/or can personally endorse it. It may have been recommended to me, or I may have heard of it a number of times. I am going on what is stated on the organisations’ websites so cannot personally guarantee the content.

• There will be a number of different fee scales and a variety of numbers of sessions offered, from a few to open-ended. The trend is generally towards time-limited work of up to 12 sessions, but some places offer longer. And there will also be a variety of therapy offered. Don’t be embarrassed to ask questions.

• The counsellor you see at some of these services may be in the later stages of their training. Please don’t let this put you off. In order to practise, their trainers, if they are from a reputable college, will have spent time reflecting on whether they are ready or not. Psychotherapy students generally work very hard and have to give very detailed accounts of themselves on a regular basis.

• Some therapists in private practice do offer reduced fee places. Pink TherapyThe Counselling Directory, and the BACP’s It’s Good To Talk are all good places to start looking.

GENERAL – Clients accepted from all round London

Awareness Centre (Clapham SW4)

The Blues Project at the Bowlby Centre (Highbury N5 – waiting list currently closed at 11/17, but they say they may have spaces again in 2018 – also worth contacting the main therapy team as there may be some therapists there offering lower cost)

British Psychotherapy Foundation (Scroll down for their list of reduced fee schemes. Longer-term work.)

Centre for Better Health (Hackney E9)

Centre for Counselling and Psychotherapy Education (CCPE) (Training organisation in Maida Vale W2. Also runs The Caravan drop-in counselling service at St James’s Church, Piccadilly W1)

Community Counselling (East Ham E6)

Free Psychotherapy Network (Collective of therapists offering free and low-cost therapy, mostly in the London area but also elsewhere)

IAPT (Improving Access to Psychological Therapies) (A long list of London-wide local counselling services, many of which take self-referrals. Otherwise through your GP.)

Metanoia Institute (Training organisation in Ealing W5)

Mind in Camden – Phoenix Wellbeing Service (Mental health charity in Camden Nw1)

Mind in Haringey (Mental health charity in Haringey N4)

Minster Centre (Training organisation in Queens Park NW6)

Psychosynthesis Trust (Training organisation near London Bridge SE)

Spiral (Holloway N7)

WPF (London Bridge SE1)(Fees not really low, but they have a range of types of therapy.)

BOROUGH SPECIFIC

Help Counselling (Kensington & Chelsea W11 – mainly for residents of K&C but not entirely)

Kentish Town Bereavement Service (Kentish Town NW5 – for residents of Camden, Islington, Westminster and the City of London only)

Mind in Islington (Several sites – short term therapy for Islington residents only. Longer-term work also available.)

Mind in Tower Hamlets and Newham (Tower Hamlets E3 – for residents of Tower Hamlets and Newham only)

Time to Talk (Hammersmith & Fulham; part of Mind – likely for Hammersmith & Fulham residents only)

West London Centre for Counselling (Hammersmith W6 – for residents of Hammersmith and Fulham only)

Wimbledon Guild (Wimbledon SW19 – for residents of Merton only)

BME/INTERCULTURAL

BAATN (Black, African and Asian Therapy Network) (Extensive list of free counselling services for BME clients – UK-wide with a good number in London)

Nafsiyat (Finsbury Park N4 – for residents of Islington, Enfield, Camden and Haringey only)

Waterloo Community Counselling (Waterloo SE1 – for residents of Lambeth and Southwark, and London-wide)

CANCER SUPPORT

Maggie’s (Hammersmith W6 – clients from all round London. Also other centres UK-wide.)

Dimbleby Cancer Care (Based at Guy’s and St Thomas’s Hospitals SE1 – patients from South East London and West Kent.)

HIV SUPPORT

Living Well (North Kensington W10 – clients from all round London)

River House (Hammersmith W6 – clients from Hammersmith & Fulham, Ealing, and Kensington & Chelsea only)

Terrence Higgins Trust (Online counselling; Also London and UK-wide in person services)

Metro (HIV prevention and support services in English, Spanish, Romanian, Polish and Portuguese – centres in Greenwich, Vauxhall, Gillingham and Essex)

LGBT

Spectrum Trans Counselling Service (Ladbroke Grove W10 –  free service for people who identify as trans, non-binary or are questioning their gender identity)

ELOP (Walthamstow E17 – clients from all round London)

Metro (Greenwich SE10, Vauxhall SE11, Rochester Kent ME1 – clients from all round London)

London Friend (Kings Cross N1 – clients from all round London)

Albany Trust (Balham SW17 – LGBT+ and anyone with sexual issues/difficulties)

OLDER PEOPLE

Age UK Camden (Camden WC1 – for those registered with a GP in Camden)

WOMEN

Women and health (Camden NW1 – residents of Camden only)

DRUGS & ALCOHOL

REST at Mind in Camden (Camden NW1 – support for people experiencing difficulties due to benzodiazepine dependency)