5 practices for body acceptance

Healing a difficult relationship with food and body image takes time, and it’s not something that can be fixed with a listicle. (But I wrote this listicle anyway, just in case it helps.) If you’re struggling, seek out a therapist, dietician, or doctor who specializes in body image and eating disorders.

This post is a bit advice-y, and if anything feels like too much that’s okay. It’s your body, and you can take this advice or throw it out the window. 

1. Ditch your scale

Seriously, throw it away. Or you could smash it (and then throw the pieces away). You can also find a body positive doctor that won’t weigh you at appointments. In the Triangle, Mosaic Comprehensive Care is a great option. 

2. Look at pictures of diverse bodies

We are inundated with pictures of thin people. From advertising, to TV, to pornography—we mostly see images of people in small bodies. Looking at pictures of people who find joy in their body at any size can be revolutionary. There is a thriving body positive community on Instagram. If you’re looking for some accounts to follow, here are 5 to check out: 

@nonairbrushedme

@bodyposipanda 

@effyourbeautystandards

@iamlshauntay

@thecurvyfashionista

3. Buy comfortable clothes that make you happy 

I used to wear a lot of navy and black because I thought they were the most “flattering” colors. When I started to do my own work in therapy around body image, I realized that I actually loved bright colored clothing. I bought a pair of leggings with a bright pink and purple pattern. I loved them! Now I wear lots of patterns and bright colors. (I don’t mean to throw shade on black and navy, I still have a plethora of both in my wardrobe. And if those are your favorite colors then awesome!)

Ask yourself: what clothes make me feel good? What clothes make me feel happy? What would I wear if I didn’t have to think about something being “flattering”? A jumpsuit with little lemons on it? A swanky blazer? Sweatpants everywhere?

Also, if you have clothes that don’t fit or suit you anymore, give them away. Donate them to a thrift store or host a clothing swap for friends. If you’re not ready to give them away, put them in a box in your closet. Try to have clothes on your hangers (or in your drawers) that make you feel great! 

 4. Try a body-positive meditation 

Whether it’s fashion magazines, sitcoms, or advertising—we frequently hear that are bodies are incorrect. Many people have also heard critical comments from family members or peers. It’s easy to internalize these messages. This internal voice is called “the inner critic.”

Doing body positive meditations can make you more aware of that inner critic. With awareness, you can recognize the inner critic for what it is—just one voice. You don’t have to believe everything it says. Here is a body positive meditation I like. If that one doesn’t resonate with you, there are a lot more meditations out there.

5. Check out the literature about Intuitive Eating and Health at Every Size (HAES)

There are some awesome dieticians who work with chronic dieting, disordered eating, and eating disorders. If you live in the Triangle, Lutz and Alexander is a great agency. They have offices in Durham, Raleigh, and Chapel Hill. 

If you’re interested in learning more about intuitive eating from books or podcasts, check out the Food Psych podcast with Christy Harrison. If you want to read a first-person account of someone healing their relationship food, I recommend The F*ck it Diet by Caroline Dooner. 

This blog post should not be substituted for medical care from qualified health professionals.

A little-known fact about libido

Hey there! Maybe you’re reading this blog post because you’re struggling with low libido. Or you’re reading this because you want a fun fact to share at dinner parties. (Sex, always a neutral topic!) Either way, welcome to the blog.

When thinking about libido, there are two different types of arousal. One is “spontaneous” sexual desire and one is “responsive” sexual desire. Spontaneous sexual desire goes something like this: you look at your partner and think about how attractive they are. You get turned on. You initiate sexual activity.

Spontaneous desire is often portrayed in the media. In a movie, the two leads share a smoldering look, make out, and clothes come off. (Then the two leads wake up wearing pants and strategically placed sheets.) These media portrayals can make spontaneous desire seem normal or like it’s “the gold standard.”

Spontaneous desire feels even more “normal” because it’s often present at the beginning of a relationship. During the first two years of a relationship, it’s common that couples want to tear each other’s clothes off at any opportunity. But spontaneous desire often fades over time. This doesn’t mean that anything is wrong. It’s also completely normal if spontaneous desire fades for one partner but it doesn’t fade for the other partner. If you want to read more about mismatched libidos, check out this great podcast episode from Therapist Uncensored.

So, if spontaneous desire has faded (or is greatly reduced) then what is left? Responsive desire. Responsive desire goes something like this: your partner asks if you want to make out. You’re not sure if you’re in the mood but you’re open to the possibility. You start making out. It feels good. You get turned on. Sexual activity ensues.

Responsive desire means that someone does not get turned on until some form of sexual activity (like kissing) begins. This is completely normal. If you want to learn more about it, check out this TEDx talk from sex researcher Emily Nagoski. You can also read her book Come as You Are.

Crucial note: this does not mean that you should pressure your partner into having sex. If someone says no, that means no. Don’t say “oh you’ll like it when it starts, because responsive desire.” People always have the right to say no. People also have the right to say no to anything once sexual activity has started.

For people who frequently feel responsive desire, you can try kissing, touching, etc. and see how you feel. If you’re still not feeling it, then stop. If you start to feel into it, then go from there. It’s crucial that once any kind of sexual activity begins there is no pressure. This includes the pressure to orgasm or the pressure to do any specific sexual act.

Libido is incredibly complex, and this is only one piece of the puzzle. If you are experiencing low libido and it’s causing you distress, reach out to a sex therapist in your area.

This blog post should not be substituted for medical care from qualified health professionals.

5 romance novels for Fabio skeptics

Growing up, I scorned romance novels. I thought they were trashy and embarrassing. I had never actually read one.

I got the message loud and clear from peers and the media: reading romance novels was a shameful act. It took me until my mid-20s before I actually picked up a romance novel (metaphorically, I read it on my Kindle so no one would see the cover). Once I started reading them, I couldn’t stop. 

Romance novels can be a great escape from work stress, the news, etc. True, some romance novels are cheesy and contain problematic story lines. But there are books in all genres with those flaws. I think the stigma around romance novels is tied to the stigma of women’s sexual pleasure. So as a feminist, I will say loud and proud that I think romance novels are great!

If you’re experiencing low libido, reading romance novels can spark desire. Libido is incredibly complex, and I don’t want to imply that reading an erotic book is a magic bullet. I do think romance novels can be a helpful tool. If you’re curious about reading one, here are five books to try.  

1. Erotic Stories for Punjabi Widows by Balli Kaur Jaswal 

Erotic Stories for Punjabi Widows follows Nikki, a young woman living in London. Nikki leads an erotic storytelling workshop to a group of women at a community center. Because of the variety of erotic stories, this book could be a good place to start if you’re looking to dip your toes into the romance genre. 

2. Red, White, and Royal Blue by Casey McQuiston

The Prince of England falls in love with the son of the first female president. Need I say more? I honestly liked this book so much it hurt. 

3. The Proposal by Jasmine Guillory

The Proposal follows Nik and Carlos. The premise is that Nik’s boyfriend of just a few months’ surprises her by proposing on a jumbotron. Nik wants to say no, but doesn’t know how to do it in public. Carlos swoops in to save the day. Cuteness ensues. 

4. The Kiss Quotient by Helen Hoang

The concept for this book was a “reverse Pretty Woman.” Stella is on the spectrum, and hasn’t had a lot of experience with dating. She wants to learn from a professional, so she hires Michael as an escort.

5. Poppy Jenkins by Clare Ashton

This book takes place in a small town in Wales. Poppy and Rosalyn grew up together, but they had a falling out in high school. Now Rosalyn is back, and Poppy has to sort out her feelings for her old friend. 

Happy reading!

The sexual pursuer/distancer dynamic in relationships

It’s very common in relationships for one person to have a higher libido than their partner. Even though it’s common, it can be distressing. The higher-libido partner (or pursuer) can feel rejected, undesirable, and like their needs are not being met. The lower-libido partner (or distancer) can feel pressured and like they aren’t living up to expectations. 

Both pursuers and distancers have valid reasons for wanting more intimacy or more space. Try to avoid placing blame on one member of the relationship. Instead, be curious about the dynamic. 

The pursuer/distancer cycle can be self-perpetuating. The more the pursuer asks for sex, the more the distancer feels pressured. The more the distancer feels pressured, the less likely they are to want sex. The more the distancer declines sex, the more the pursuer wants closeness. 

To change this, both partners need to attempt to reverse the cycle. The pursuer needs to pause pursuing, and the distancer needs to begin initiating. 

The distancer might feel so burnt out at this point that they don’t want to initiate at all. Sometimes the distancer needs to process sexual trauma or shame about their body or sexuality. This can take time. 

The distancer can try thinking about what turns them on. Is it a date night? A clean house? Lots of foreplay? The distancer can also pinpoint what turns them off. Negative body image? A stressful day? A bad night’s sleep?

The pursuer can think about what sex means to them. For example, sex can make the pursuer feel attractive, loved, and close to their partner. These are all understandable feelings, and sex is an important part of a relationship. However, the pursuer can also think about other ways they could feel close to their partner. Perhaps quality time, long conversations, or compliments could help the pursuer feel loved and desired. The pursuer might also need to work on self-esteem and body image, so they can feel confident even if their partner declines an advance. 

Keep in mind that these dynamics can change over time. For example, someone might be a pursuer in one relationship, and be a distancer in another relationship.

Sexuality is incredibly complex. If you’re struggling with the sexual pursuer/distancer dynamic, I recommend seeking out a sex or couple’s therapist in your area. Know that whatever you’re experiencing, you’re not alone. 

Celebrate vulva diversity

A lot of people feel uncomfortable with their vulva. In a Refinery29 Poll* of over 3,500 women, 48% said they had concerns about the appearance of their genitals. Labiaplasty (plastic surgery on the vulva) is the world’s fastest-growing cosmetic procedure. In 2015, 400 girls under the age of 18 received labiaplasty.

One of the reasons that people feel uncomfortable with the appearance of their vulva is media representation. When people see genitals, it’s usually in pornography. Porn can be great. However, mainstream porn usually only shows a certain kind of vulva that is pink, hairless, and has small labia.

For anyone wanting to feel more comfortable with the appearance of their vulva, here are some ideas.

1. First, know that genitals come in a range of shapes, sizes, and colors. Try looking at this series of 100 photos of vulvas by photographer Laura Dodsworth.

2. If you’d rather look at illustrations, The Vulva Gallery has an Instagram page with hundreds of watercolor illustrations.

3. Listen to this amazing story from Durham resident Natalie Rich. Natalie shares how her job as a test subject for medical students performing gynecological exams helped her accept her vulva.

4. If you feel comfortable, try looking at your own vulva using a hand mirror.

Body image issues are usually not changed over night. Negative messages, sexual trauma, or religious shame can all affect how people view their genitals. If you’re struggling, reach out to a therapist in your area who has experience in sexuality or body image.

*I’m not sure about the rigor of Refinery29’s sampling methodology, but sadly scientific studies on these topics are limited.

This post should not be substituted for medical care from qualified health professionals.

Why can't I orgasm with my partner?

Many people can orgasm by themselves but not with a partner. Factors such as communication, feeling comfortable with your body, and past trauma can all contribute to this phenomenon.

In this post, I’m going to focus on a factor that you might not think about: internet porn. I don’t want to hate on porn, it can be part of a healthy sex life. However, if someone regularly uses porn from a young age it can affect their ability to orgasm with a partner. 

To illustrate, I’ll create a fictional person: Greg. Greg started watching porn every night at age 12. There was a certain kind of pornography he was into, and he became accustomed to watching it. He met his first boyfriend in college when he was 19, and they had sex. Even though he was attracted to his partner, he couldn’t orgasm. Whenever they hooked up, he would start thinking “Am I going to come? Why can’t I do it? What’s wrong with me?” They dated for a year, and he could never achieve orgasm. He felt distressed, and he didn’t know where to get help. He tried googling the phenomenon and mostly found articles about women not being able to orgasm. This made him feel isolated and even more confused.

Okay, so let’s discuss how porn might be a factor for Greg. Internet porn is free, readily available, and extremely stimulating. Different sexual acts flick by rapidly on screen. If something becomes boring, it’s easy to fast forward or click to another video. In addition, pornography often caters to sexual taboos. These taboos can be highly erotic, but they are unlikely to play out with a real-life partner. Sex with a partner has a different kind of stimulation than masturbating to porn. Partnered sex is often less story-based and less visual. It relies on different senses and different bodily stimulation . 

Pornography also depicts unrealistic standards of sexuality and bodies. Men’s bodies are toned, their penises large, and they can last for thirty minutes. Women are thin, large-breasted, and hairless. 

All of these factors can make it difficult for long-time regular porn users to orgasm with a partner. In Greg’s case, he had 7 years to grow accustomed to a certain kind of sexual stimulation. Once Greg became stressed about not orgasming, a negative cycle developed. Greg became anxious, his body tensed, and he wasn’t in the moment with his boyfriend. This in turn made it harder for him to orgasm. This in turn made him more stressed.

Fortunately, there are ways to change this pattern. If you’re having a hard time orgasming with a partner, try taking a break from masturbating and pornography. Start with a month-long break and see how you feel. This can help your brain adjust to different stimulation.  

It sounds counterintuitive, but stop trying to orgasm. The harder you try, the harder it actually is. If you’ve ever heard the phrase “it’s about the journey, not the destination,” this applies to orgasming. Try to be in the moment with your body. Feel the sensations that are occurring—kissing, touching, sounds. It’s okay if you don’t orgasm, just focus on feelings of pleasure. 

Being in the moment is easier said than done. Mindfulness is difficult even for people who meditate regularly. If you want to practice mindfulness, you can attend a local meditation class or download a meditation app like Headspace or Insight Timer. 

This post should not be substituted for medical care from qualified health professionals.  

What is vaginismus, and how do you treat it?

If you’re experiencing pelvic pain, the first thing to know is that you’re not alone. Vaginismus—a type of pelvic pain—can feel isolating and confusing. Many people (including some doctors) have never heard of vaginismus. Fortunately, there are health professionals out there who can help you treat it.

Vaginismus is a condition where the vaginal muscles are so tight that penetration is painful. With vaginismus, the brain and body are caught in a negative cycle. The brain expects penetration to be painful, so the vaginal muscles tighten to “guard” against pain. Because the muscles are tight, penetration is more painful.

For people who have always experienced vaginismus, it’s called primary pelvic pain. For people with primary pelvic pain, it may have always been painful to insert a tampon, complete a pelvic exam, or have penetrative intercourse. I recommend the animated video Tightly Wound for a first-person account of what it’s like to experience primary pelvic pain. Fair warning, it’s not the cheeriest video. However, if you have struggled for years with vaginismus it could help you feel less isolated.

If someone lived for years without vaginismus and developed it later in life, it’s called secondary pelvic pain. Pain may have been brought on by stress, trauma, relationship concerns, or a physical condition. If you’re looking for a first-person account of living with secondary pelvic pain, I recommend the “Sex Hurts” episode from the Bodies podcast.

If you’re experiencing pain with vaginal penetration, see a doctor to get a medical examination and diagnosis. You can call the doctor’s office ahead of time to see if they have experience working with pelvic pain. There are medications that can help, but those might not be the first line of treatment. If you’re diagnosed with vaginismus, the doctor will probably recommend pelvic physical therapy before medication.

Pelvic physical therapy alone might help resolve vaginismus. The PT might recommend stretches, breathing exercises, or dilators. Dilators are a series of phallic devices which are inserted into the vagina. Treatment starts with a small dilator size. Patients insert the dilator and breathe deeply, trying to relax the vaginal muscles. Over time, the vaginal muscles can become accustomed to the sensation of the dilator. Once the patient can insert a dilator without pain, they can work up to a larger dilator size.

Pelvic physical therapy in conjunction with talk therapy can be helpful, which is one of the reasons I decided to rent office space from a Grace Pelvic Health, a pelvic physical therapy practice in Durham. If pelvic physical therapy alone isn’t helping you achieve your goals, trying talk therapy might help.

In our culture, it’s common for people to have anxiety, shame, and guilt about sex. Trauma, sexual stigma, and relationship concerns can all contribute to pelvic pain. Does it feel safe to have sex? Do you like your body? Do you feel like a sexual person? Sex therapy is a place where you can speak about topics that are often taboo.

It’s very common for pelvic pain and low libido to go hand-in-hand. Some people start experiencing low libido and then sex becomes painful. For others, sex becomes painful and that reduces their libido. If you’re experiencing low-libido, all sexual activities (even non-penetrative ones like oral sex) might be unappealing.

Pelvic pain can be a response to sexual trauma. However, there’s a common misconception that pelvic pain is always caused by sexual trauma. For people who experience vaginismus due to something like general life stress, it can be frustrating to have people (such as doctors) assume that this is reason for your pain. Know that whatever the cause of your pain (even you don’t know the cause), you’re not alone.

This post should not be substituted for medical care from qualified health professionals.