128. Erectile dysfunction part 2: The mind/body connection with sex therapist Justin Paulsen の全文書き起こし

and I'm also a registered clinical uh sexologist. 00:04:36.399 --> 00:04:47.120 So I basically work with individuals and groups on mental health challenges, but a lot of relationship dynamic challenges and a lot of sexual challenges. 00:04:47.279 --> 00:04:51.519 And my background history and that is doing research in what I call penis problems. 00:04:51.680 --> 00:05:04.639 So anything from uh erection concerns to ejaculation concerns to you know performance anxiety, those sorts of things, um, you know, all the things that people with penises kind of come up against in their sexual challenges. 00:05:04.720 --> 00:05:12.959 And so I did a lot of research there and then now really less research and more actively working with folks, which is much more my style. 00:05:13.439 --> 00:05:24.480 And I think like just to set the stage, like I would say that there's not that many people that would come in for a physio appointment with their primary concern being erectile dysfunction. 00:05:24.639 --> 00:05:26.560 I'm gonna say ED a lot just because it's easier to say. 00:05:26.720 --> 00:05:32.079 Yeah, but um that not many people would actually make that their primary symptom. 00:05:32.240 --> 00:05:37.920 They might come in, maybe referred by their urologist because of like bladder concerns. 00:05:38.079 --> 00:05:44.639 There's, you know, they're maybe kind of feeling frequency or incontinence. 00:05:44.800 --> 00:05:51.279 Maybe there's been some sort of prostate treatment, and then and then ED will come up in my questioning. 00:05:51.519 --> 00:05:56.319 Um, can you talk a little bit about for yourself? 00:05:56.639 --> 00:06:00.560 How does this usually um I'm trying to formulate my question? 00:06:00.639 --> 00:06:04.720 Do you find a lot of people come in with that primary concern? 00:06:04.959 --> 00:06:05.360 Yeah. 00:06:05.600 --> 00:06:09.839 Um, yes, yeah, for sure, because of it's kind of really what I specialize in. 00:06:09.920 --> 00:06:11.120 So they've found me. 00:06:11.199 --> 00:06:16.480 And often I'm might not be the first stage in their care journey, right? 00:06:16.639 --> 00:06:21.120 They might have seen a physio or they might have gone a lot of times gone to a medical doctor first, right? 00:06:21.199 --> 00:06:28.800 And assumed that there's something medically wrong with their situation in psychology and their and their mind frame or mindset hasn't really come into play. 00:06:28.959 --> 00:06:30.720 So they're getting referred to me. 00:06:30.959 --> 00:06:39.839 But there are the odd times when um I'll see a couple or I will see an individual and it'll it'll present as things like low desire or sexual avoidance. 00:06:40.000 --> 00:06:49.040 And then when we dig into where that's coming from, it is a fear or an experience of ED in the bedroom that is then causing them to withdraw from sex, right? 00:06:49.120 --> 00:06:53.519 So there are some times where it comes in and sneakily with uh with other things. 00:06:53.839 -->

00:06:54.480 I think so. 00:06:54.560 --> 00:07:04.800 I'm gonna picture that someone comes into you, whether they're by themselves or with their partner, and they come in and you kind of start explaining some of this stuff to them that um, you know, what what is ED? 00:07:04.879 --> 00:07:10.000 Can you just talk a little bit about how you might actually then explain that to the person in front of you? 00:07:10.319 --> 00:07:10.959 Yeah. 00:07:11.439 --> 00:07:19.759 So I like to talk a lot about the nervous system and bring the body, um, the body into the talk about the mind, right? 00:07:19.839 --> 00:07:24.079 Obviously, when we say like psychological ED, like what even does that mean? 00:07:24.319 --> 00:07:33.040 And so I like to kind of link how something in your mind can then shift your nervous system and therefore shift how you sexually function, right? 00:07:33.199 --> 00:07:39.120 And so um I talk about erections as kind of having two main ingredients. 00:07:39.360 --> 00:07:42.639 Really, the first one's the only necessary one with a supplemental one. 00:07:42.800 --> 00:07:44.959 So the first one is relaxation. 00:07:45.120 --> 00:07:49.519 Your body has to be in a state of relaxation in order to prioritize sex. 00:07:49.680 --> 00:07:52.560 That's just like evolutionarily important, right? 00:07:52.720 --> 00:08:02.560 If we were back in times where we didn't, you know, weren't civilized and didn't have homes and things and we were just in the wilderness, um, procreation mattered to our to our nervous system. 00:08:02.720 --> 00:08:05.199 We wanted to keep going with our with our genetics. 00:08:05.279 --> 00:08:12.560 However, if a bear pops out of the woods, you know, we're not going to be thinking about sex, and erection would get in the way, if anything. 00:08:12.800 --> 00:08:20.399 So we need to prioritize safety and you know, comfort in those moments before we would prioritize sex. 00:08:20.800 --> 00:08:23.519 We now don't live in the wilderness. 00:08:23.600 --> 00:08:28.959 So what our brain codes is that bear popping out of the woods might be various different things, right? 00:08:29.439 --> 00:08:42.399 But um, what can happen with folks experiencing performance anxiety or just ED issues that are non-medically related is something they're experiencing is being coded as a threat, right? 00:08:42.559 --> 00:08:47.120 So their body is no longer in a state of relaxation and it deprioritizes sex. 00:08:47.279 --> 00:08:54.000 And the way it does that is through the pelvic floor and through the nervous system, you know, moving blood to where it needs to go, right? 00:08:54.080 --> 00:08:55.919 By adding tension in certain places. 00:08:56.000 --> 00:09:03.840 And so I would go through, you know, how that works, where the pelvic floor tightens, how that restricts blood flow, and how that can hurt things. 00:09:04.000 --> 00:09:09.279 And so that's that first, you know, place of helping them understand that relaxation is really

important. 00:09:09.440 --> 00:09:14.720 And if you're not feeling relaxed, your body's you're fighting an uphill battle around trying to get an erection. 00:09:14.960 --> 00:09:17.279 Secondarily is stimulation. 00:09:17.440 --> 00:09:23.120 So, like the information we're giving our body that an erection is meant to happen, that this is sexy time, right? 00:09:23.279 --> 00:09:27.440 And so sometimes anxiety can get in the way of that. 00:09:27.519 --> 00:09:38.320 You know, you've got a beautiful partner, whoever you're attracted to, and maybe they're naked and you're really excited, but then you're thinking about, oh, am I gonna get an erection or am I gonna perform well or am I gonna do well? 00:09:38.559 --> 00:09:45.440 My guess is that, you know, these these people with penises, like they're not turned on by thinking about their own erections and whether they're gonna get it or not. 00:09:45.519 --> 00:09:46.639 It's not a sexy thought. 00:09:46.799 --> 00:09:57.919 So now this beautiful person that's in front of them that's really sexy to them, they're not even able to focus and actually get that stimulation to their brain to tell them that it's sexual time, right? 00:09:58.320 --> 00:10:04.159 And so that's kind of how I formulate like, okay, are we dealing with a relaxation issue? 00:10:04.320 --> 00:10:05.759 Are we dealing with a stimulation issue? 00:10:05.919 --> 00:10:07.279 Are we dealing with both? 00:10:07.679 --> 00:10:08.399 Um, yeah. 00:10:08.720 --> 00:10:19.039 I I think it's so helpful because can you imagine if someone like this is such sensitive information that we never talk about at coffee or talk about it when we're walk with our friends? 00:10:19.120 --> 00:10:20.399 Like, this is not something that comes up. 00:10:20.559 --> 00:10:30.879 And so chances are good people coming to appointments with either myself or yourself are not necessarily super excited to come or the information's not flowing freely. 00:10:31.039 --> 00:10:42.320 And so I find that like there's no way when someone comes in, I'm gonna say things like um, almost like accusing, kind of kind of like, I think you have this, or I think you have this. 00:10:42.399 --> 00:10:50.720 And I I think I start the exact same way you do through either a series of models or images on my computer, just first just laying out how it all works. 00:10:50.879 --> 00:10:54.960 Yeah, like this is what the pelvis looks like, this is what the pelvic floor looks like. 00:10:55.120 --> 00:11:06.480 Um, if in this case, obviously I'm working with like um male genitalia, but like um this is the penis, these are how the pelvic floor muscles are, this is where the bladder and the prostate and the rectum are. 00:11:06.559 --> 00:11:12.960 And I usually start by explaining kind of like how the poop system works, how the P system works because it feels less sexual. 00:11:13.039 --> 00:11:14.480 And yeah, it's more clinical. 00:11:14.559 --> 00:11:14.720 Yeah. 00:11:14.960 --> 00:11:22.159 It's more clinical, and then and then talk more about kind of like how erection and everything works, and then usually use other examples. 00:11:22.320 --> 00:11:31.279 Like I've had people that have come in that will describe this or people that will describe this, and then quite often they like to identify, like, I think I'm that person. 00:11:31.519 --> 00:11:36.559 But the number of people then, once you just explain it, that they'll be able to say, That's me. 00:11:36.720 --> 00:11:39.519 Like, I think about some people that have come in recently. 00:11:39.759 --> 00:11:49.120 This one young man that said, Do you think this is related to like I'm going through a really I've I've got this new partner, but I'm going through this messy divorce, right? 00:11:49.279 --> 00:11:51.759 And do you think some of that is like tied up to this? 00:11:51.840 --> 00:11:53.600 I'm like, 100%, right? 00:11:53.679 --> 00:12:02.159 Or I find sometimes as soon as you explain it, it feels less um threatening to people that there's something wrong with them, but more like, well, yeah, that makes sense. 00:12:02.240 --> 00:12:02.720 That I'm not sure. 00:12:02.879 --> 00:12:06.000 Yeah, like your body's actually operating the way it's designed to. 00:12:06.159 --> 00:12:24.000 And that's really what I'm trying to like when you're not dealing with medical ED, when there's not a low testosterone or your pelvic floor hasn't like weakened over time and you actually can get an erection, it means that your body is not being put in an environment where it knows it's supposed to get an erection, right? 00:12:24.240 --> 00:12:30.879 And that means that there's an issue outside of your body, and that sometimes alone is just like a breath of fresh air for people. 00:12:31.120 --> 00:12:31.679 Yep. 00:12:31.919 --> 00:12:33.759 So, what are some of the things then? 00:12:33.919 --> 00:12:39.120 Because obviously there's a whole nother episode that I'm doing that talks a little bit more about the medical aspects here. 00:12:39.200 --> 00:12:41.200 So we won't spend our time talking about that. 00:12:41.360 --> 00:12:47.840 But are you um can you give some examples, like just some different examples? 00:12:47.919 --> 00:12:58.799 Like I said, I know that some people will bring up things like um, I had a gentleman recently that explained that he's like, I just have some attention issues. 00:12:58.879 --> 00:13:00.240 Like I'm always stressed. 00:13:00.399 --> 00:13:03.519 Um, I feel like I can never relax, right? 00:13:03.759 --> 00:13:11.120 Um can you talk a little bit about how sometimes maybe things like porn use come into this? 00:13:11.279 --> 00:13:20.639 Because this is something that I don't always know how to like this is something that people are usually working with someone like yourself with this and they don't share everything with me. 00:13:20.720 --> 00:13:27.120 But can you talk a little bit about how some of these things that we have quick access

to are affecting how our nervous system works? 00:13:27.440 --> 00:13:28.000 Totally. 00:13:28.159 --> 00:13:32.879 And so I want to caveat and and and say right off the bat, I have nothing against pornography use. 00:13:32.960 --> 00:13:37.360 Clients can use that, clients have really healthy sex lives while using pornography. 00:13:37.759 --> 00:13:46.000 Um, where things can go um south for some folks is if it's it's kind of intention of use. 00:13:46.080 --> 00:14:02.080 So if people are in a habit of self-pleasure or masturbation where it is stress-induced, so it's I'm stressed, so I'm using this to relax, um, that can become really challenging when it comes to sex with a partner because do they feel relaxed when they have sex with a partner? 00:14:02.639 --> 00:14:16.480 And if not, then where they're used to the environment and the in the energy that they're used to having when they are experiencing sex with themselves and the body doesn't know the difference, the body still sees that as sexual engagement. 00:14:16.799 --> 00:14:29.120 Uh, if one is involving stress um, like uh to relieve the stress, but the other one is adding to stress, again, we're not gonna have an erection in one and we're gonna have one in the other. 00:14:29.279 --> 00:14:30.879 There's also the stimulation piece. 00:14:30.960 --> 00:14:34.000 So there's that, that's the relaxation component, the stimulation component. 00:14:34.159 --> 00:14:49.279 So if we are consistently being fed information to our body around pornography, specific pornography, maybe I'm always looking at, you know, women with big breasts or something, or very specific kink stuff, or whatever it might be. 00:14:49.360 --> 00:14:51.919 And that's like the only type of porn I'm watching. 00:14:52.080 --> 00:14:57.759 And I'm doing that on the regular, and that is so far removed from the type of sex I'm having with a loved one. 00:14:57.919 --> 00:15:07.200 We're sending kind of mixed messages to our brain that this is sexual over here, and it might find it really challenging to code what you're doing with that other person as sexual. 00:15:07.519 --> 00:15:24.879 And so, yeah, sometimes we make a shift to the type of pornography or the frequency of pornography, or just like the intention behind when we're uh masturbating, and can we slow down that process and kind of make the practice look like the play, make the masturbation look more like the partnered sex? 00:15:26.399 --> 00:15:32.799 Also, too, like I like a lot tied into expectations, expectations and masculinity. 00:15:32.960 --> 00:15:36.080 I would say this is a different, like I find it's interesting. 00:15:36.240 --> 00:15:48.000 I find when you when you compare, um, there's a certain, I would say a lot of like kind of like the female population will come in with a very different um expectation. 00:15:48.240 --> 00:15:52.639 It's almost like they don't expect it to be enjoyable, which is a whole nother episode. 00:15:54.879 --> 00:16:07.039 Versus versus this very kind of like hard on them um personality or per or or kind of feeling when like I should be able to enjoy this or I should be better at this, and this is challenging my masculinity. 00:16:07.440 --> 00:16:12.559 Yeah, yeah, and and the things that they see as their role during sex, right? 00:16:12.639 --> 00:16:18.639 A lot of men see their role as providing pleasure for them their partner and themselves. 00:16:18.799 --> 00:16:25.039 Like they're responsible to make sure their partner orgasms, but they're also responsible to make sure they themselves orgasm. 00:16:25.360 --> 00:16:29.440 And they see very little responsibility on their partner, right? 00:16:29.600 --> 00:16:45.039 Which, whether their partner actually agrees with that or not, they might be going through their own thing and have their own pressures, but to the individual I'm in front of, they're putting the entire sexual experience on themselves, which robs them of the ability to communicate during sex, to ask questions, right? 00:16:45.200 --> 00:16:51.519 Because they have this pressure that I should already know how to please a woman or a man or whoever they're with. 00:16:52.080 --> 00:17:01.440 And they almost have like a very um minimized view of sex as if there's one way to please a person, and every person is pleased the same way. 00:17:01.840 --> 00:17:07.119 Um, and so they rob themselves of just the experience of communicating what's working, what feels good. 00:17:07.279 --> 00:17:09.440 They put so much pressure on themselves. 00:17:09.519 --> 00:17:13.839 And it's yeah, that's usually one of the hardest narratives to kind of shift in the work. 00:17:14.400 --> 00:17:23.920 I just recorded an episode recently with a psychologist where we talked about um purity culture and um just some of the different nuances that come in there. 00:17:24.000 --> 00:17:25.119 And I'm sure like the same thing. 00:17:25.200 --> 00:17:29.279 We again I happen to be talking with a female and she was sharing her experience. 00:17:29.519 --> 00:17:40.960 But can you talk a little bit about some of the other thoughts you have around cultural differences, um, kind of purity culture messages that that that um people get that would influence this? 00:17:41.440 --> 00:17:42.240 Totally. 00:17:42.559 --> 00:17:54.880 Um it can totally impact, like I I would say the one I come up against a lot with this specific subsect is purity culture and around the the idea of being a good, good, nice man, right? 00:17:55.519 --> 00:18:09.279 And um this idea that uh taking what I want or um being assertive with what I want is not okay because in all these other aspects of my life, that's not okay, right? 00:18:09.440 --> 00:18:13.839 I'm supposed to, you know, be a feminist and uplift my partner. 00:18:14.079 --> 00:18:32.480 And so what happens in the bedroom if you're if if I'm with a woman who likes to be taken, likes to be maybe you know thrown against the bed, you've

got these guys that are coming in and going, ooh, like that doesn't feel like I'm staying in this bubble of a nice guy, right? 00:18:32.880 --> 00:18:35.440 Or they all have their own desires, right? 00:18:35.519 --> 00:18:46.559 Maybe the porn that they're watching or what their fantasies are doing is something that doesn't fall within this bracket of nice guy or good pure culture, right? 00:18:46.720 --> 00:18:59.279 And so their fantasies in their brain and their sexual self is running away with these things, but then when it comes down to having sex with someone, they don't allow themselves, they don't give themselves permission to actually play with those realities and those fantasies. 00:18:59.519 --> 00:19:02.400 And again, then the body doesn't respond, right? 00:19:02.559 --> 00:19:07.440 Because the body's not really seeing that as sexy, it's not really true to what they find sexual. 00:19:07.680 --> 00:19:09.920 Uh, and so that's not the only culture. 00:19:10.000 --> 00:19:20.400 There's a lot of cultures, a lot of different things that can come in and say, like, you know, rob people of what can be consensual, amazing sexual experiences. 00:19:20.799 --> 00:19:28.079 Um, but for some reason they're being told, hey, this is wrong or this isn't allowed, or this isn't acceptable. 00:19:28.319 --> 00:19:31.359 And so unpacking that is really important too. 00:19:31.519 --> 00:19:32.160 Yeah. 00:19:32.559 --> 00:19:33.519 What do you find? 00:19:33.680 --> 00:19:39.599 Do you find most people will describe that this is something that comes on suddenly or gradually? 00:19:40.480 --> 00:19:41.200 A little bit of both. 00:19:41.359 --> 00:19:42.720 So you kind of get both stories. 00:19:42.799 --> 00:19:53.039 Um, you'll get the guy who the person with a penis who like has never had any issues with erections and it happened that one time, and then from that time it's just been so challenging. 00:19:53.279 --> 00:20:08.559 Um, usually, maybe not always, because sometimes it could be something medical going on, but usually it's because they had an idea, they had an idea in their head that um they always get erections and therefore they always will, and that's the norm. 00:20:08.720 --> 00:20:12.799 And they don't really understand that erections come and go, and that's normal and that's natural. 00:20:12.960 --> 00:20:18.240 There's a lot of things that impact it, how tired you are, if you've got any cramps in your body, pain, anything. 00:20:18.400 --> 00:20:27.680 And so for some reason, that one time something was going on, maybe they didn't need enough that day or whatever, but they saw that as there's something wrong with me. 00:20:27.759 --> 00:20:40.319 And then it creates this panic immediately and this like uncomfortable experience that they that are then afraid to re-experience, and the fear of re-experiencing it is then what keeps causing it for them, right? 00:20:40.400 --> 00:20:44.079 They're going into sex, feeling the threat of

that experience happening again. 00:20:44.319 --> 00:20:51.839 You also get the guys on the other side who are gradual in the sense of it happens, but it doesn't bother them. 00:20:52.000 --> 00:20:54.160 Like they're like, oh, it was probably just a one-off. 00:20:54.480 --> 00:21:00.559 But then maybe they're ignoring the signals of the things in the relationship or the things that are happening that are causing it. 00:21:00.720 --> 00:21:05.279 So they almost like um, you know, don't look into what could have happened at all. 00:21:05.440 --> 00:21:15.359 And then slowly over time, whatever it is, maybe it's a habit they have or a relationship dynamic they have, that continues on and starts to impact their erections more and more. 00:21:15.680 --> 00:21:21.839 And um, it's not until it gets quote unquote bad enough that they come in to see someone, right? 00:21:22.640 --> 00:21:33.359 I find like if it's someone coming to see me, and and again, I it would probably be something along the lines of I explain how the system works, I'm talking to them about the symptoms that brought them in. 00:21:33.599 --> 00:21:46.640 And then as they feel more comfortable and start sharing some of the things that make them think, oh, this is related, that I might say, Have you ever worked with someone like someone like Justin, or have you ever worked with talked to a counselor about this? 00:21:47.039 --> 00:21:53.119 When do you find like what things would make you say, Have you ever seen a pelvic floor physio? 00:21:54.160 --> 00:21:57.839 Honestly, first couple up uh first couple sessions, regardless. 00:21:58.000 --> 00:21:58.240 Yeah. 00:21:58.480 --> 00:21:59.759 Um, because of the solution. 00:22:00.400 --> 00:22:04.400 To the problem might be both physical and mental, right? 00:22:04.559 --> 00:22:14.799 And so it's very early on because I'm getting guys doing Kegels, reverse Kegels, and I'm I'm suggesting these things from very early on because I like to come at the solution from both ends, right? 00:22:14.960 --> 00:22:19.680 If you're not relaxed, okay, what's causing that distress for you mentally? 00:22:19.759 --> 00:22:25.200 Let's talk it through, see if we can shift some perspectives, but also can you learn to relax your body manually? 00:22:25.519 --> 00:22:25.839 Right. 00:22:26.079 --> 00:22:31.680 And so in response to, oh, I noticed that I'm nervous, my pelvic floor is tightening up. 00:22:31.759 --> 00:22:32.640 Can I relax it? 00:22:32.799 --> 00:22:33.119 Right. 00:22:33.440 --> 00:22:40.799 And for a lot of people, connection to their body isn't always very high, right? 00:22:40.960 --> 00:22:44.720 So I'm getting them to do the exercises, but I'm I'm not physically there. 00:22:44.880 --> 00:22:49.920 I'm not doing the exercises with them in a more intimate setting like a pelvic floor physio. 00:22:50.079 --> 00:22:57.279 And so if they're starting to feel like, I don't know if I'm doing this right or it's not really clicking, I'm like, there are people out there that will help this click for you. 00:22:57.359 --> 00:23:01.519 And that's that's where I refer out to pelvic floor physios almost all the time. 00:23:01.759 --> 00:23:06.640 Most clients are getting that referral, whether they take it, receive it, and do it is another thing. 00:23:06.720 --> 00:23:07.200 But yeah. 00:23:07.440 --> 00:23:07.599 Yeah. 00:23:07.839 --> 00:23:20.079 Well, I think a lot of people, when you just either explain it to them or show them, like I have different um images on my computer that will show the pelvic floor tightening versus relaxing and how it's related to like the male anatomy so that they can see it. 00:23:20.160 --> 00:23:21.839 And a lot of times that's enough for people. 00:23:22.160 --> 00:23:37.200 But um, yeah, just to give people an idea when they come in here, that and this is obviously how I practice, I can't speak for everybody, but I would start first with just visuals and getting them to try things on their body and maybe sitting on a ball or something where they can get that feedback. 00:23:37.359 --> 00:23:43.200 And then I might, if if they're like, oh yes, and that you can just see that they're getting it, that might be all they need. 00:23:43.440 --> 00:23:48.559 For some people, I find I I usually would probably start kind of from external palpations. 00:23:48.799 --> 00:24:04.559 I might go through your underwear or through some sheets that are draping you to be able to touch kind of underneath the testicles or between kind of the anus and testicles where the way I have access to the pelvic floor or kind of between the sit bones, just to get people to feel that. 00:24:04.720 --> 00:24:09.279 But then obviously the only other way in through the male pelvic floors through the anus. 00:24:09.440 --> 00:24:11.920 And and so it just depends on the person. 00:24:12.079 --> 00:24:18.240 I think there's a lot of misconceptions around what has to happen in a pelvic floor physio appointment, which which are not true. 00:24:18.480 --> 00:24:25.599 Um, and and you can tell really quickly from someone's body language what they might may or may not be be comfortable with with comfortable with. 00:24:25.759 --> 00:24:25.920 Yeah. 00:24:26.160 --> 00:24:29.119 And so, yeah, no expectations of what has to be done in the physio. 00:24:29.359 --> 00:24:35.599 Yeah, that's really helpful for me too, to even be able to describe what what can a pelvic floor physio, you know, appointment look like. 00:24:35.759 --> 00:24:36.000 Yeah. 00:24:36.240 --> 00:24:36.400 Yeah. 00:24:36.559 --> 00:24:46.880 And I think I always tell people to do your homework because I think some physios do feel more comfortable with palpation or that not not that it's mandatory, but they may may be more likely to start there. 00:24:46.960 --> 00:24:50.400 But you know, I think people should just know that they can get what they want to out of it. 00:24:50.480 --> 00:24:51.680 They don't have to say yes to

anything. 00:24:51.839 --> 00:24:57.599 Yeah, and there's there's some clients that I know who would prefer, you know, just get the expert into my body and tell me what's going on. 00:24:57.759 --> 00:24:58.000 Exactly. 00:24:58.240 --> 00:25:00.960 Whereas others might go, tell me how I can do it myself. 00:25:01.119 --> 00:25:01.440 Yes. 00:25:01.680 --> 00:25:02.079 Exactly. 00:25:02.240 --> 00:25:03.680 Yeah, exactly. 00:25:04.000 --> 00:25:06.480 Um, what about okay? 00:25:06.720 --> 00:25:10.160 So this is where sometimes I find I don't know who to send to for this. 00:25:10.240 --> 00:25:16.559 So let's say um, let's say um, like what do you suggest is let's talk with about therapy for a second. 00:25:16.640 --> 00:25:23.359 So we've talked about how to explain it and and to people and so that they understand, um, normalize it a bit. 00:25:23.599 --> 00:25:25.279 Where do we start with treatment? 00:25:25.359 --> 00:25:30.400 So we I talked a little bit about the pelvic floor specifically, but how would you explain to people? 00:25:30.559 --> 00:25:32.319 I often say there's like a menu of options. 00:25:32.400 --> 00:25:34.400 Here's some different things that we can do. 00:25:34.640 --> 00:25:38.240 Can you give an example of your menu of options? 00:25:38.880 --> 00:25:40.000 Yeah, there's a lot. 00:25:40.160 --> 00:25:47.599 So it really, you know, you try to gear it towards a specific client and what they're comfortable with and where they're at, right? 00:25:47.759 --> 00:25:49.519 In their own comfort level and stuff. 00:25:49.759 --> 00:26:02.559 But usually some general ones that show up on most people's docket of treatment is gonna be um working with their own self-pleasure practice and and making some shifts there. 00:26:02.799 --> 00:26:10.480 So that could be bringing the pelvic floor into it and having them actively relax the public floor while they're you know stimulating themselves. 00:26:10.640 --> 00:26:19.920 It can be getting comfortable with their own soft penis, soft penis play and noticing emotional response to just like no expectation of erection, no stimulation, right? 00:26:20.000 --> 00:26:25.920 Like no fantasies or pornography and just like light touch on you know, stimulating themselves. 00:26:26.160 --> 00:26:33.839 Uh, furthermore, from that, learning for them to notice pleasurable sensations regardless of high intensity, right? 00:26:34.000 --> 00:26:41.759 Just like what feels nice when you're not thinking sexually, just like as a you know, tissue, what feels like a good sensation. 00:26:41.920 --> 00:26:46.880 So, some sort of stuff with self-pleasure, shifting it and doing some work there. 00:26:47.200 --> 00:26:50.160 Um, obviously, there's the in-session stuff. 00:26:50.240 --> 00:26:54.400 So we will be figuring out, you know, where we want to talk about. 00:26:54.559 --> 00:27:04.960 So a lot of times with clients, we'll be doing things that we call like a sexual development survey, where we together

go through their life through the lens of sexual development. 00:27:05.039 --> 00:27:14.400 So, what was it like for them growing up and what did they take in in that time about their body, about boys and girls or narratives around things? 00:27:14.559 --> 00:27:16.319 When did they start learning about sex? 00:27:16.559 --> 00:27:22.079 And did they have any touch experiences when they were younger of a curiosity and those sorts of things? 00:27:22.240 --> 00:27:27.680 And just look at, you know, I'm always as a therapist looking for where did their curiosities stop? 00:27:27.920 --> 00:27:30.240 Like when did things stop being about exploration? 00:27:30.400 --> 00:27:33.119 Because that's essentially what sex is, right? 00:27:33.200 --> 00:27:36.079 It's this feels good, let's see where this can go. 00:27:36.319 --> 00:27:38.240 And for kids, kids get it right. 00:27:38.319 --> 00:27:44.799 Like we don't really like to think of kids as sexual beings, but they're exploring their bodies and they're figuring out what feels good and they're following through with it. 00:27:44.960 --> 00:27:51.759 But at some point, a lot of times, as we get into adulthood, we have shoulds come in, right? 00:27:51.920 --> 00:27:55.920 And so we lose that curiosity and then we feel like there's demands of us. 00:27:56.079 --> 00:27:59.279 And so I'm always kind of looking of when did that shift kind of take place? 00:27:59.440 --> 00:28:17.200 And then we start talking through some of those things and allowing clients to go does this should or narrative or expectation I have of myself really serve me, or could I maybe loosen my grip of it a little bit and and think of the idea of maybe it doesn't matter and maybe I can get back to that curiosity piece. 00:28:17.359 --> 00:28:18.880 So that's another big one. 00:28:19.200 --> 00:28:26.559 But then there, you know, there's a plethora of like at-home exercises and partnered exercises that I do. 00:28:26.720 --> 00:28:26.960 Yeah. 00:28:27.279 --> 00:28:33.599 And I think about when you describe that and you describe it kind of like when in the when in the lifespan did did something happen. 00:28:33.680 --> 00:28:37.920 And I think too about things like a surgery, um, cancer. 00:28:38.079 --> 00:28:39.039 Like, do you know what I mean? 00:28:39.119 --> 00:28:43.440 It could not, you know, just like what what happened physically or emotionally? 00:28:43.680 --> 00:28:48.079 Um, and I it's funny how people people don't always connect those dots till you bring it up. 00:28:48.319 --> 00:28:50.880 Like, oh, having kids is a big one, right? 00:28:51.279 --> 00:28:55.359 Changing your gin, your roles, getting married, moving in together. 00:28:55.519 --> 00:28:55.839 Yes. 00:28:56.000 --> 00:29:02.319 Any major life um act that you disconnect from sex, it's like it's it's all holistic. 00:29:02.400 --> 00:29:04.880 You are a person taking in the world around you. 00:29:05.039 --> 00:29:05.200 Yeah. 00:29:05.359 --> 00:29:06.160 And so, yeah. 00:29:06.880 --> 00:29:24.720 Well, and you make a good you make such a good point that I think a lot of people wouldn't understand is that think about, and especially if if those stresses or if those changes start to to change the function, and then all of a sudden you have the expectation that, you know, oh, the next time it's not gonna be good, this is getting worse. 00:29:24.960 --> 00:29:35.039 Um, and I think when when talking with people, the number of people think that they need to try harder for things like arousal and ejaculation or at orgasm. 00:29:35.119 --> 00:29:38.880 Like when you really achieve exactly when you achieve an orgasm. 00:29:39.200 --> 00:29:40.960 Exactly, instead of allow. 00:29:41.039 --> 00:29:41.599 Yes, right. 00:29:41.680 --> 00:29:48.480 And so I think as soon as you start, um as soon as you start explaining that, people are like, oh my god, that makes sense, right? 00:29:48.640 --> 00:29:50.720 Yeah, you just have to get out of the way, right? 00:29:50.880 --> 00:29:51.680 You have to get out of the way. 00:29:51.839 --> 00:30:03.759 And it really is like, can we show up with curiosity and presence and just noticing, observing what our body is responding to, and and just sitting with that. 00:30:03.920 --> 00:30:07.680 If you stay with pleasure, an orgasm will come eventually. 00:30:07.839 --> 00:30:11.440 It might not come when you want it to, and maybe you don't have the time to get there. 00:30:11.519 --> 00:30:16.480 And so that day we don't reach orgasm, but you still focus on the pleasure, and then who cares? 00:30:17.039 --> 00:30:27.039 Listeners, I know many of you are physios that are perhaps new to the area of pelvic health and feeling like you could benefit from some guidance as the complexity of your caseload goes up. 00:30:27.279 --> 00:30:29.519 I offer mentorship and I'm here to help. 00:30:29.680 --> 00:30:32.240 Let's figure out a structure that works best for you. 00:30:32.480 --> 00:30:36.000 My contact details are in the show notes, so please do reach out. 00:30:36.480 --> 00:30:42.720 As you talk, it makes me think like we're in this this time now where we get like instant gratification. 00:30:42.880 --> 00:30:45.119 We can get things at our doorstep as soon as we want. 00:30:45.200 --> 00:30:50.640 And it makes me think like, do we do we all also have a bit of an issue of just not being patient enough? 00:30:50.799 --> 00:30:52.160 Like a hundred percent. 00:30:52.240 --> 00:30:54.799 I mean, quickies have been around since you know forever. 00:30:54.960 --> 00:30:55.200 Yes. 00:30:55.519 --> 00:31:02.319 But um, but there's this idea of like, well, we always say pleasure-focused sex versus orgasm-focused sex, right? 00:31:02.400 --> 00:31:04.480 Pleasure-focused sex is where we want people to be. 00:31:04.640 --> 00:31:08.799 We want you in the moment and not thinking about this thing in the future, right? 00:31:08.960 --> 00:31:12.559 Because a lot it robs a

lot of people of in the moment sensations. 00:31:12.960 --> 00:31:20.160 But I think that instant gratification is it creates this like we're used to only looking for the big spike, right? 00:31:20.480 --> 00:31:21.839 The big, the big moment. 00:31:21.920 --> 00:31:29.839 And so when we grab our phones or when we go to the TV or when we want something now, it's not that the journey there wouldn't have been pleasurable, right? 00:31:29.920 --> 00:31:42.720 We're just so focused on the highest point of stimulation and and and and dopamine that we are robbing ourselves of enjoying like subtle dopamine or quiet dopamine along the way. 00:31:42.880 --> 00:31:44.960 And this, you know, shows up in every aspect of our life. 00:31:45.039 --> 00:31:47.200 So of course it shows up with sex, right? 00:31:47.680 --> 00:31:50.640 And so, um, and it happens both ways, right? 00:31:50.720 --> 00:31:52.640 One partner is really fixated on the other. 00:31:52.720 --> 00:31:54.880 Like when we're talking about erections, right? 00:31:55.039 --> 00:32:01.039 So we need you to get an erection because we want to start penetration right away, because we want to get to, you know, orgasm. 00:32:01.119 --> 00:32:07.599 And for some reason, people, you know, sometimes assume that like penetration orgasm is the ultimate one, and that's the one we need. 00:32:08.240 --> 00:32:12.559 Um, and so sometimes the pressure isn't even coming from the person themselves. 00:32:12.720 --> 00:32:16.319 Their partner's also like, hey, get that thing up so we can get going. 00:32:16.960 --> 00:32:26.559 And um, yeah, if we actually just like took a sigh, relaxed, go back to like when sex started to become new to us, right? 00:32:26.720 --> 00:32:30.079 Like, we didn't just like hop into bed with someone when we were younger. 00:32:30.240 --> 00:32:35.359 Typically, there was like hand holding, there was hugging, there was kissing, maybe there was even dry humping. 00:32:35.440 --> 00:32:39.680 There's a lot of stuff going on that allowed for arousal to take place. 00:32:39.839 --> 00:32:46.559 And I just don't think we give our bodies the benefit of the doubt that they can get there if we just give them the time and patience, you know? 00:32:47.920 --> 00:32:48.559 What do you? 00:32:48.720 --> 00:32:53.119 I wanted to ask you, and I was talking a little bit about with the urologist as well. 00:32:53.200 --> 00:32:55.279 Like, I think about something like a penis pump. 00:32:55.359 --> 00:32:55.599 Okay. 00:32:55.759 --> 00:33:02.559 So some um, and I'm gonna talk a little bit in that episode a little bit more about different options, like medical options. 00:33:02.640 --> 00:33:06.160 But when it comes to something like a pump, do you teach that? 00:33:06.319 --> 00:33:09.200 Like, I I find like urology appointments, for example, are very short. 00:33:09.279 --> 00:33:12.400 The chances of them teaching them in those appointments are very slim. 00:33:12.480 --> 00:33:20.559 And I think

a lot of people don't feel comfortable like going to YouTube to find like, is that something that you'll actually walk people through? 00:33:21.119 --> 00:33:21.519 Yeah. 00:33:21.839 --> 00:33:26.880 So I typically will actually I shouldn't, I should have explained. 00:33:26.960 --> 00:33:29.440 Can you just before you go, will you explain a penis pump? 00:33:29.519 --> 00:33:30.799 Because it kind of brought that out of left hand. 00:33:31.039 --> 00:33:31.359 Yeah, yeah. 00:33:31.440 --> 00:33:41.039 So penis pump, I mean, it it there's a lot there's you know, a lot of history around people joking around penis pumps, around them trying to like make penises bigger or these sorts of things. 00:33:41.200 --> 00:33:48.720 In the purpose of erections, what it is meant to do, it is it's it's meant to promote blood flow in the penis. 00:33:48.880 --> 00:33:55.359 Like that's just the basic fundamentals of what it's doing, it's using that through suction. 00:33:55.759 --> 00:34:02.240 And um I don't often find clients wanting to use penis pumps, I would say. 00:34:02.559 --> 00:34:10.960 I but I have in the past worked alongside clients that were, but I don't typically do the walkthrough of how to use a penis pump. 00:34:11.119 --> 00:34:20.719 Um, typically, because uh it would be whether they're working with a medical professional or um, yeah, like a specific men's sexual health clinic. 00:34:20.960 --> 00:34:29.519 Um, but what I would do is if they had gotten the information and something feels like a gap, I will help fill in the gaps of what that is. 00:34:29.599 --> 00:34:31.599 So I don't do the initial walkthrough. 00:34:31.679 --> 00:34:34.000 Yeah, but what I will do is go, okay, how are you using it? 00:34:34.079 --> 00:34:35.119 How often are you using it? 00:34:35.199 --> 00:34:37.920 Okay, where are the challenges for you? 00:34:38.079 --> 00:34:40.159 How can we help clear that up for you? 00:34:40.639 --> 00:34:45.599 I'm thinking specifically of the like the prostate um treatment client. 00:34:45.760 --> 00:34:49.199 And I find that this is something that they're definitely hearing a lot about. 00:34:49.519 --> 00:34:58.480 And so um, yeah, some people more comfortable figuring it out themselves versus others, and so yeah, I'm personally I love human information. 00:34:58.719 --> 00:35:03.360 I want to sit in front of someone and them tell me that just makes me feel better. 00:35:03.440 --> 00:35:05.199 So some people are definitely the same. 00:35:05.280 --> 00:35:06.400 So yeah. 00:35:06.719 --> 00:35:08.639 Um what would you say? 00:35:08.800 --> 00:35:23.840 Okay, so let's say I think like you said, a lot of people would maybe go to the medical route first, they go to their doctor, and if they feel brave enough to share this is something that could be better in my life, they're quite often perhaps sent to perhaps a urologist or somebody else to make sure everything's okay. 00:35:24.000 --> 00:35:31.760 And let's say that you then

are sent them, that would be you know that you, you know, medically what's been considered, right? 00:35:32.000 --> 00:35:33.840 What if that goes the other way? 00:35:34.079 --> 00:35:42.000 And you're someone just finds you on your website or Google, and what would you you'd obviously talk about all of this stuff with them? 00:35:42.159 --> 00:35:46.719 What would be some red flags that might make you say, I want you to go talk to your doctor? 00:35:47.039 --> 00:35:50.559 Yeah, well, first off, I would tell everyone to go see a doctor. 00:35:50.719 --> 00:35:59.280 I try to promote, I understand it can be an uncomfortable topic, but I always think that medically it's a lot easier to rule out than it is psychologically. 00:35:59.440 --> 00:36:00.800 Ours is much more nebulous, right? 00:36:00.880 --> 00:36:03.920 Like you're saying, like sometimes it takes a while for people to make the connections. 00:36:04.719 --> 00:36:06.400 Medically, why not get tested? 00:36:06.559 --> 00:36:09.599 Why not know that your testosterone's fine, right? 00:36:09.840 --> 00:36:13.519 So I always kind of market it as that is that it's an easy cross off the list. 00:36:13.599 --> 00:36:20.000 However, uh there are some signs that this goes beyond something mental. 00:36:20.159 --> 00:36:23.280 And so what we would look at is okay, what is your body doing normally? 00:36:23.360 --> 00:36:25.360 So are you getting nocturnal erections? 00:36:25.519 --> 00:36:25.840 Right? 00:36:26.000 --> 00:36:30.239 Do you do you basically do you wake up with morning wood ever, right? 00:36:30.400 --> 00:36:32.480 And if that's never happening, okay. 00:36:32.719 --> 00:36:38.639 Uh, does your erection problem exist in partnered sex and masturbation? 00:36:38.960 --> 00:36:39.280 Right? 00:36:39.519 --> 00:36:49.119 Okay, so that's interesting, is like there's never a place that my erection is coming up because now we're going, okay, even if we're in a safe environment, I'm struggling. 00:36:49.360 --> 00:36:56.239 There still could be some mental stuff around just like sex in general or hangups and or sticky points. 00:36:56.400 --> 00:37:00.079 But we're starting to wonder a little bit more if there could be some medical stuff. 00:37:00.239 --> 00:37:13.119 Whereas if someone's getting nocturnal erections or is able to get an erection on their own, or it's only with new sexual partners that they're not able to get an erection, we at least can feel like it's probably not something medical. 00:37:13.440 --> 00:37:19.360 Still helpful to go get checked and rule it off, but it's most likely not because it's more situational, right? 00:37:19.599 --> 00:37:21.920 So those are some of the red flags I would say. 00:37:22.000 --> 00:37:37.039 Um anytime there's pain, like severe pain with an erection, um, or I will always ask around, it's really important with people who if if someone is circumcised or uncircumcised, knowing if um there's any tugging. 00:37:37.280 --> 00:37:45.360 Like

if someone has an erection, is there wet with their erection, is there like tightness in any skin or any discomfort or potential discomfort? 00:37:45.519 --> 00:37:50.800 Because that's obviously going to be something that their body is going to deprioritize because of something going on. 00:37:51.039 --> 00:37:56.480 So that those are the ones that come to my mind right now for red flags around medical stuff. 00:37:56.719 --> 00:38:04.559 And when you say that stuff, I think too, like I I actually talked about the pelvic floor, but I didn't talk about some of the other fascial considerations or tissue considerations. 00:38:04.719 --> 00:38:21.760 Like that's also something that we work on is I've had several people recently, there's definitely more of the male population just learning about this and seeking out, but several people that because of different injuries, maybe some people some one person said I got hit with on the left side of my groin as a child. 00:38:21.840 --> 00:38:30.639 And ever since then, my my penis is kind of drawn over to that side, and they definitely had some fascial tension to work on, but they were getting pain with erections. 00:38:31.119 --> 00:38:39.519 Um, sometimes just after surgeries, I find um recently I had someone that shared that after his vasectomy he did not rest. 00:38:39.599 --> 00:38:53.280 And I think he just created a lot of irritation and swelling, and now his tissues and muscles are really tense, but just giving them sometimes different fascial things to do with their testicles or their penis, like we don't just work on the pelvic floor. 00:38:53.440 --> 00:38:58.320 So yeah, and and a lot of these people have already been to a medical professional because that's who they think of first. 00:38:58.400 --> 00:39:03.519 Nobody thinks of a physio first, and so quite often they they go there first and they're very surprised. 00:39:03.679 --> 00:39:06.880 Like, I had no idea that I could kind of work on this. 00:39:07.280 --> 00:39:08.400 Yeah, there's exercises. 00:39:08.480 --> 00:39:09.599 Obviously, there's medical stuff. 00:39:09.679 --> 00:39:17.519 I know there's yeah, there's different treatments to help like break down calcified or anything like any tissue that's kind of causing major kinks or issues in the penis. 00:39:17.920 --> 00:39:23.760 But yeah, there's there's always the medical route, but then there is just the exercise physio route. 00:39:24.159 --> 00:39:31.440 And I think a lot of people unfortunately uh don't understand how helpful your your area can be. 00:39:31.519 --> 00:39:35.760 Like I always say, like, there's a reason that there's physiotherapists just for the pelvic floor. 00:39:35.840 --> 00:39:39.199 Like there's so much that that one field can do. 00:39:39.760 --> 00:39:44.400 Um, just how I say, like, there's so much just because you're a therapist doesn't mean you work with all these things. 00:39:44.480 --> 00:39:48.960 Like I work specifically with this because there's so much we can do, and there's so much that could be going on. 00:39:49.119 --> 00:39:49.679 Yeah. 00:39:50.079 --> 00:39:50.800 What do you think? 00:39:50.960 --> 00:39:57.760 Because obviously in this area that we work in, it's not that every not everybody shows up um ready to work on this. 00:39:57.920 --> 00:40:06.559 They might a lot of people, one of the reasons I started this podcast is I know a lot of people like to listen and just consume some information before they feel comfortable reaching out to somebody. 00:40:06.800 --> 00:40:07.679 What do you think? 00:40:07.760 --> 00:40:13.360 Um, something simple, someone could start with doing today if they don't feel comfortable seeking help? 00:40:13.519 --> 00:40:18.480 Like just any messages for someone listening that's like, oh, I need to go for help, but I'm just not there yet. 00:40:18.719 --> 00:40:19.519 I'm not there yet. 00:40:19.679 --> 00:40:21.840 Yeah, it would be okay. 00:40:22.800 --> 00:40:25.039 And they're not experiencing erections when they want. 00:40:25.199 --> 00:40:27.280 So I would probably go first. 00:40:27.440 --> 00:40:31.440 Step I'd go, okay, do you know, do you know how to check in with your body? 00:40:31.599 --> 00:40:50.400 And if not, look up YouTube videos or or different apps that are around like body scanning and mindfulness stuff, where it will have you kind of in a relaxed state, connect and notice tension or or relaxation in your body, and just do it throughout your whole body first and just get used to that process. 00:40:50.559 --> 00:41:00.320 And then when you feel ready, try to connect that to your pelvic floor, try to connect that to the areas around your penis and just notice is there anything that feels tight? 00:41:00.480 --> 00:41:02.960 Is there anything that feels tense? 00:41:03.280 --> 00:41:07.039 Um, and I would say that's a really good first place to start. 00:41:07.119 --> 00:41:08.159 Start knowing your body. 00:41:08.239 --> 00:41:15.360 And if your body doesn't feel safe to you at the moment, maybe looking at um your thoughts, right? 00:41:15.519 --> 00:41:17.920 Looking at the belief that you have around sex. 00:41:18.079 --> 00:41:29.760 You can simply maybe get a journal out and write down like, what is the expectation of men, what is the expectation of women or my partners in sex and and write, just write it all out. 00:41:29.840 --> 00:41:35.519 What's all the stuff that you think is is required or expected, all those shoulds that you might have, and just write it out. 00:41:35.599 --> 00:41:37.360 You don't have to do anything with it yet. 00:41:37.599 --> 00:41:41.519 Just simply kind of try to acknowledge where some of these beliefs might be. 00:41:41.599 --> 00:41:50.480 And if there's any that stand out to you as like, hmm, that one makes me a little uncomfortable, or that one maybe is really getting an emotional reaction out of me. 00:41:50.639 --> 00:41:59.039 Just kind of sit with that for a bit and just

kind of reflect on if you do want to speak to someone about these things because you don't have to tackle these things alone. 00:41:59.360 --> 00:42:04.960 Therapy, you know, I don't know about physiotherapy, I'm assuming so, but therapy, like there's a lot of fun. 00:42:05.199 --> 00:42:09.679 It's not all uncomfortable and sitting in the discomfort and pushing you. 00:42:09.920 --> 00:42:12.000 There's a lot of jokes, a lot of dick jokes. 00:42:12.079 --> 00:42:18.159 Like, like there's a lot of fun that we get to have, and and to to to try and add levity to it. 00:42:18.320 --> 00:42:21.199 But um, yeah, those are the first two things that come to my mind. 00:42:21.440 --> 00:42:27.440 It's funny when you talk about when you say get in your body and just listen to you know what your body's telling you. 00:42:27.679 --> 00:42:30.800 The amount, the amount that someone's personality fits into this. 00:42:30.880 --> 00:42:38.400 And I I like I'll see people and you can take two different injuries or two different surgeries, and then you add a personality and and how much it shows up. 00:42:38.480 --> 00:42:41.519 Like, I have a lot of people that are like, I don't listen to anything in my body. 00:42:41.599 --> 00:42:46.800 I just learned to like suck it up, move forward, and just like get on with it. 00:42:46.880 --> 00:42:54.239 So I do not take time to listen to my body, whereas the next person that comes in might be so hyper-vigilant and they listen to everything in their body. 00:42:54.480 --> 00:42:55.519 Too much in their body, yeah. 00:42:55.760 --> 00:43:13.519 Yes, which I think is the fast most fascinating thing about our jobs is that you have to figure out the person in front of you because you're like, man, all the things that influence, like you said, you take not only this timeline and all the things that have happened in your life, but just also are your personality and your tendencies and your beliefs. 00:43:13.760 --> 00:43:19.199 Well, yeah, how you view how you view health in general makes such a big impact, right? 00:43:19.440 --> 00:43:25.119 And so, yeah, you do get those people who are a little hyper-vigilant and they have like a fear response to their body. 00:43:25.280 --> 00:43:31.360 And that's where it's like, can we actually just witness our body without trying to change it even? 00:43:31.440 --> 00:43:32.159 Yes, right. 00:43:32.400 --> 00:43:34.480 Yeah, um, yeah, it's so fascinating. 00:43:34.559 --> 00:43:42.800 And a lot of, you know, I won't lie, a lot of my clients would come in are more disconnected to their body in general with the demographic I work with. 00:43:43.119 --> 00:43:50.079 But it's really cool to see people learn their body or learn their body differently, or learn to relate to their body differently. 00:43:50.239 --> 00:43:50.960 It's really cool. 00:43:51.119 --> 00:43:57.039 The person that you see sitting in front of you changes just on the fact that they exist different in their body. 00:43:57.199 --> 00:43:59.519 That's one of the reasons I love doing what I do. 00:44:00.400 --> 00:44:03.440 Um, because you'd think that you're coming in for sex therapy. 00:44:03.519 --> 00:44:07.440 So, you know, I'm not really gonna see any of the results because that's happening when I'm not there. 00:44:07.519 --> 00:44:12.400 But it's like, no, I can tell when something is clicking for a client just by the way they show up to the room. 00:44:12.719 --> 00:44:13.679 Absolutely. 00:44:14.079 --> 00:44:16.480 Um, I can tell you're good at what you do, Justin. 00:44:16.559 --> 00:44:23.280 And is there anything that you feel like um I haven't asked you that is relevant for this conversation? 00:44:26.079 --> 00:44:32.000 Um, the only thing I can think of is the concept of trauma and trauma's impact. 00:44:32.079 --> 00:44:39.679 And so obviously, when I'm talking about relaxation and stimulation and stuff, like trauma almost feels like its own medical thing. 00:44:39.840 --> 00:44:46.400 It's not, but it is a more severe experience of what I'm talking about. 00:44:46.639 --> 00:44:50.079 And that's one of the things that I personally do not work directly with. 00:44:50.239 --> 00:44:53.599 So I refer out just like I would medical for a lot of these things. 00:44:53.760 --> 00:44:58.000 If there's something like, and again, trauma can be death by a thousand cuts. 00:44:58.079 --> 00:45:06.880 It can be like a small a lot of little things that add up to feel your body really feeling traumatized, or it could be one main event, um, like an injury or an accident or something. 00:45:07.119 --> 00:45:18.000 Um if that's in the room that and we don't address that first, then a lot of the work I'm doing is gonna feel stunted or it's gonna feel like we're just doing the same thing over and over again. 00:45:18.079 --> 00:45:29.519 And so that would be another advice to any listeners is if you feel like or you know that there's a trauma component, remember a symptom of trauma is the want to avoid it completely and never look at it ever. 00:45:29.920 --> 00:45:41.760 But um, if you can then actually start with a trauma therapist, a specific EMDR or just someone who specializes in trauma, that often is a better place to start. 00:45:42.079 --> 00:45:45.280 Or go see both if you feel like you've got the capacity. 00:45:45.519 --> 00:45:52.639 Go see someone who specializes in sex and see someone that specializes in trauma or someone who specializes in sexual trauma, those sorts of things. 00:45:52.960 --> 00:46:07.920 I think how a lot of people will notice that, even if they don't notice before they come to the appointment, is that when we start talking about the ability to let go, there's this wall that just kind of and that no matter how many things you try, that you you can't let go. 00:46:08.079 --> 00:46:20.320 And and um when we talk, and that's what I say is like when you think about it, all and I when I talk about my practice, like the things that I work on, the digestive system, the urinary system, sexual health system, they all require letting go. 00:46:20.559 --> 00:46:23.679 And so you can do all the exercises in the world. 00:46:23.920 --> 00:46:28.559 Um, but if you if your nervous system can't let go, then respectfully. 00:46:28.800 --> 00:46:39.039 Then we have to, yeah, we have to at least let it like learn the safety of letting go first, which yeah, there's a lot of amazing therapists and specialties that really help with that specific thing. 00:46:39.119 --> 00:46:46.239 And then you can come in and we can focus now that new skill that you have on the specific sexual stuff that's going on for you. 00:46:46.960 --> 00:46:47.599 Amazing. 00:46:47.840 --> 00:46:53.679 Well, I look forward to kind of putting this together with the an episode all about the medical considerations when it comes to ED. 00:46:53.840 --> 00:46:55.920 And so I really, really thank you for your time. 00:46:56.800 --> 00:46:57.599 Thank you for having me. 00:46:57.920 --> 00:47:07.760 Yeah, I look forward to um sharing this episode with people and have them having a resource to reach out to because I can hear that um, like I said, that you're obviously really good at what you do. 00:47:08.559 --> 00:47:10.079 And that's a wrap. 00:47:10.400 --> 00:47:13.199 If you enjoyed the show, can I ask you a big favor? 00:47:13.599 --> 00:47:15.199 Would you do one of three things for me? 00:47:15.679 --> 00:47:20.559 Number one, leave a review because we could all use a little positive feedback sometimes. 00:47:21.119 --> 00:47:25.920 Number two, download the episode because it helps me see what people are interested in. 00:47:26.159 --> 00:47:28.400 Or number three, share it with somebody else. 00:47:28.800 --> 00:47:30.320 Because sharing is caring. 00:47:30.960 --> 00:47:31.920 Catch you next time.