Take this test:

1. Where exactly is your lover’s clitoris?

2. What is its purpose or function?

3. How far behind a man’s arousal is the average woman?

4. What usually indicates a woman is aroused and ready for penetrations?

5. How do you tell if a woman is having a real orgasm?

Answers:

1. Above the urethra.

2. Pleasure-stimulation.

3. About 20 minutes.

4. Vaginal lubrication.

5. Sex flush on the chest & body hair erects.

Well, even knowing all or most of this unfortunately won’t guarantee that you are a great lover, but at least you show an interest in matters sexual, and that is a good base.

The truth is that we guys can be a great lover with one woman, and less so with another, or even on occasion with the same one who usually makes us feel great. Yet we want to be perceived as a good, even great, lover. It makes us feel warm all over if we know our partner respects our lovemaking and generally is open to, and eager for, us.

To be or become a good or great lover takes dedication, and an acceptance that while our sexual drive is inborn or innate, how we express that drive is a learned skill. To learn well requires an open mind, and in matters of love, an open heart.

Unfortunately, ingrained in the male psyche is the notion that men need to prove themselves sexually. That is a sad truth. Sad, because it creates pressure on men to perform.

I say to all my patients: sex is not a performance; it is adult play, and a (potentially) profound form of communication.

I say to men: if you feel the need to prove yourself sexually, you are then either with the wrong partner, or with the right partner at the wrong time. The ideal would be for a man (or woman) to go to bed with a partner and not to know whether their loveplay will lead to intercourse. They will flow with the moment and enjoy whatever unfolds.

In my view, the essence of being a great lover is the same as what makes a person a find, mature human being.

Among the important ingredients are: authenticity, congruence, empathy, communication ability, creativity, spontaneity, playfulness, and self-confidence.

These are not qualities we are necessarily born with. Nor do we really reach an endpoint where we say O.K., now we have arrived, “we’re great.” It’s a process rather of becoming, evolving toward these objectives. And, by the way, the same qualities apply whether you are a man or a woman.

Let’s briefly look at these ‘greatness’ ingredients…

Authenticity implies the ability to be real. This is hard to define, but people in contact with you have little difficulty sensing it. An authentic person seems solid, well-grounded, secure. It is the opposite of the poseur, the image conscious cool man, or woman, pre-occupied with how they come across. The authentic person rejects the popular saying ‘image is everything.’

Congruence is a cousin of authenticity. It means that you talk the talk, and you walk the walk. Your mouth and your body say the same thing. You act in accord with your feelings, and you are in touch with those feelings you are expressing.

Empathy is a crucial attribute of mature functioning. Your ability to feel what another person is experiencing, or has gone through, enables you to be a moral person. This helps one to make right choices. Without empathy, morality and thus civilization could not exist.

The ability to communicate is fundamental to nurturing relationships. This applies especially to feelings, and unfortunately is again not a ‘natural’ ability of every man or woman. Yet, we have feelings all the time, but the ability to identify, label and express them can take a lifetime to develop. Certainly, those lucky enough to have had parents or teachers who listened and validated feelings through their growing-up years are very fortunate.

Creativity is a welcome attribute in many human endeavors, and sex is no exception. Unfortunately, many of us growing up don’t get enough support or encouragement to be creative. Indeed, school and life often teach that conformity is the safest way to get by, if not ahead. Further, it does not help that the most readily or easily available models for sexual activity come from porn. These materials, produced factory-like by actors paid to perform on cue, are regrettable and at times harmful sources of ‘sex education.’ Yet, I see many men (and some women) whose sole access to sexually explicit information came from porn videos and magazines. There are better quality, yet still explicit, materials emerging that validate male-female intimacy, and downplay the ‘sex is a performance’ notion, but they are still rather hard to find. A helpful resource on the Internet is drsommers.com.

Spontaneity and playfulness can be considered together. They are the salt and pepper of a good intimate/sexual relationship. With this attitude, lovers can go beyond set times and places for playful erotic interactions, thus creating an atmosphere of surprise and the thrill of the unexpected.

Joanne, an attractive, 35-year-old executive, came to see me with a common problem — she wanted to be able to orgasm with a man. Her last relationship — a 5-year marriage, ended when her husband left her with the complaint: I can never satisfy you. But, she says she actually liked having sex and never complained — yet her husband remained unhappy. He needed to know that he made her come, and thus feel he was a good lover. This attitude is regrettable. Joanne was, and is, an intelligent, sensuous woman who can turn many a man’s head. Of course, the more pressure she felt to come, to perform to expectation, the harder time she had to surrender to her feelings and experience orgasmic release.

So guys, let’s lighten up. We’re not, nor should we expect our partners to be, trained seals, or sex machines with a variety of buttons to be pushed. In truth, no one can make anyone else ‘come.’ Each person allows ‘it’ to happen. If not, this too can be learned.

Now, Joanne, after some treatment, has developed the ability and confidence to have one or more orgasms. She recently met a man she finds very sexy. After a number of dates, she felt comfortable to invite him to stay the night. He was, she says, hungry, a bit “like a bull in a china shop.” With her newly acquired knowledge and confidence, she gently started to guide his hands and convey to him clearly how and where she found his touch most pleasurable. Since she found him open to her feedback, even (wisely) thankful for her guidance, she found the whole initial lovemaking attempt satisfying, though she did not orgasm. No matter. She learned not to become a prisoner of expectations, hers or her lover’s. She now knows that good, gentle guidance, and open communication is the way to establish a mutually satisfying intimate relationship.

The situation with men is no different. Stan, 26, was a stud and proud of it. Tall, slim, athletic, he wore a winning smile and had the gift of the gab. Women were drawn to him and his major problem was whom to choose as his bed companion after an evening out with his buddies at a well-known neighbourhood singles bar.

When I saw him, he was strikingly handsome, but not smiling. In fact, he was downcast, almost crying, as he complained about his failure to perform one night with a ‘hot number.’ He felt devastated and desperate. “Why did this happen to me?” he asked, and “will it ever come back?”

Based on experience, I was able to reassure him that if he goes through treatment and conscientiously does my assignments, he’ll regain his ability to function. But I made it clear that our aim was not to make him able to perform as a stud. Eventually, he came to realize that his previous behaviour was rooted in basic insecurity, which constantly needed reassurance.

Going through the treatment program, Stan learned to realize his potential as an intelligent adult lover able to give up the compulsive need to prove himself, and to live up to some perceived ideal. He became more selective, and was surprised to find sex much more enjoyable.

So, after 30 years of treating couples and single men and women with sexual difficulties, it is clear that sexual health is a complex interaction of physical and psychological factors. Neither can, nor should, be neglected. For example, no matter how considerate a partner you are, how well you communicate, if your personal hygiene habits leave something to be desired — forget it.

What makes sex so fascinating is that it is the ultimate mind-body experience. Sometime, experiment and explore. Touch your lover’s face as you look into their eyes and try to breathe in tune with them. Another time, make complimentary remarks in a low, murmuring voice, such as “I love the way you smell (move, etc.).” Try to make a point of sharing your feelings with your partner, and encourage them to do the same. Above all, remember that developing an exciting sexual relationship can, and usually does, take time. And once you achieve it, it takes tending to, nurturing.

Those without a partner now need to use this valuable time as preparation to become a great lover. Develop those attributes in yourself that will make you a mature adult, and thus a desirable love partner. By doing this, you will send out signals that will attract more suitable, complementary partners. Then together, you will embark on one of life’s most joyous, rewarding activities. You will be dancing among the stars.

One final point to ponder. There is only one organ or body part in females (and none in males) whose sole purpose or function is pleasure. It is called the clitoris. Great lovers never forget this.

- Dr. Frank Sommers

He has been having difficulty getting and keeping erections for the past year or two, with the problem getting gradually worse. He and his girlfriend of 3 years called it quits recently. He felt sad, angry, and hurt, especially when she said in frustration, “you can’t even get it up.”

His past history was also not unusual. Around 18, shortly after starting intercourse, he noticed a creeping ‘fear of performing.’ A need to prove himself as a capable, skillful lover pushed into his awareness more strongly with each new relationship. Especially, if the girl was attractive.

He has been to doctors. Some told him “it’s just anxiety, you’ll get over it.” One prescribed Yohimbine (he was 19), and it helped a bit, but only for a short time.

A highly advertised ‘sex clinic’ taught him how to inject his penis, and then switched him to Viagra. These gave him erections, along with headaches and altered vision, plus cost a bundle. (I jokingly call it ‘sex tax.’)

He keenly wanted to be free of medication, but had difficulty recalling when he last had intercourse without medication.

Significantly, he awoke with firm erections often, and had no difficulty masturbating to ejaculation.

He liked sex, and women, and exercised 3 to 4 times a week. He also did weights. He had a secure job, which he liked. He hoped to someday marry and have a family.

Well, several weeks into our treatment program, using no medication, John is well on his way to being a changed man. Some of my patients say a miracle has happened. I don’t argue with them, but only wish more people would realize that help for sexual problems exists, without the need for drugs. But you have to take the initiative to find a reputable specialist who knows what they are doing.

I hope to offer some help (or at least motivation) to readers like John within the limits a column like this offers. But, I recognize many single men (and women and couples) have all kinds of issues they are dealing with which don’t require a therapist. How to please a woman, how to communicate effectively, how to get a couple’s desire in sync are just a few of the many issues we can explore.

Everyone has to get to know some basic facts about sexuality. Education is a major key to a happy sex life. Most people don’t realize that our basic sexual attitudes are formed at a very early age. If we are lucky, we have parents who feel comfortable with their own sexuality and teach children from the ground up, in age-appropriate ways not only accurate information, but also attitudes. For example, being comfortable about nudity within the family will help children feel a sense of comfort about their own changing bodies as they grow.

Raising children with “penis pride” and “clitoral consciousness,” as my eminent colleague Dr. Yates puts it in her classic book, “Sex Without Shame,” would help to nurture a sexually healthy society, I believe.

If Mary and Steve, an attractive couple in their early thirties, had come from this kind of positive background, their five-year marriage would not have been close to ending when they came to see me. Mary was turned off sex, and Steve was climbing the walls. Along with her sex-negative upbringing (“be careful with boys, they’re only after one thing,” her mother used to say), Mary dreamed that “saving” herself for marriage will fulfill all her sexual longings. Unfortunately, Steve’s sex education came mostly from watching porn videos, and he was puzzled at Mary’s turn-off at his “expert” technique.

My treatment of this couple went back to fundamentals and, after about ten sessions, both felt re-born, re-committed, and in love. I treasure the picture of their baby they sent me about a year later.

Certainly, over 25 years of practice, I have seen how relieved people can be when they realize their problem is not unique, and are happy to find there usually is a solution. I feel gratified to be working in a field where I can offer help to people in such a sensitive area as their sexuality and love life.

I invite you to send in sexuality and relationship questions, make comments, share your interests and concerns. Chances are you will discover that you, too, are not alone.

- Dr. Frank Sommers

The fact is, anyone can experience a sexual problem, and many of us do from time to time. Fortunately, it’s usually temporary, very temporary, and in no time at all we resume SOP. Reassured.

It’s very important to remember this — especially for men, who seem to be much more vulnerable in their ability to function sexually. Please note, I deliberately avoided writing “perform” sexually. The road to sexual health begins with not thinking of sex as a performance. Lose that word, erase it from your vocabulary with respect to your sexual life. The words we use can have a powerful effect on how we feel, and function. In my practice, patients are told from day one never to say ‘sex’ and ‘performance’ in the same sentence.

It is interesting, and reassuring, that women usually do not think that they couldn’t perform sexually, if the big “O” didn’t happen for them. It’s not the end of their world. They know there is always the next time. Usually.

But the ingrained insecurity in millions of men feeling less masculine if they “can’t do it” is driving a thriving, growing industry.

The flavour of the year, of course, is Viagra (chemically known as Sildenafil). This little blue pill has taken the world by storm.

I recently returned from an international conference in Europe. A whole week of sex talk by doctors, scientists, therapists and educators from all corners of the world. The company that makes Viagra was there, and so were numerous doctors they brought in, often from far away. A major problem with doctors is that many don’t feel comfortable raising the question, “how is your sex life?” out of the blue. And patients visiting their doctor often feel uncomfortable asking for help in this area for fear of embarrassing their doctor. Now you know the rationale behind those powerful black-and-white television ads showing a man at his doctor’s office for his annual check-up and neither the patient nor his physician are willing to talk about his sexual health problem.

Talking about what is shown on TV reminds me of a session at this conference where I showed one of my adult sex ed videos, “Enjoyable Lovemaking.” In the discussion afterward, two doctors said they could not show this in their country. One came from Indonesia, the other from Saudi Arabia. Clearly, we still have some ways to go to achieve global freedom to receive sex education. Especially in the perilous age of AIDS, this should be a basic human right.

Certainly, ED is a reality. We, especially men, need to change our thinking. The Pfizer TV ads can help to do that. But men also need to recognize that erectile dysfunction is not always a ‘stand alone’ problem. It can be the first presenting symptom of atherosclerosis, or heart disease, among others.

Further, men need to know that the little blue pill taken orally is not always the best or only solution to ED. There are a variety of methods modern sex therapy can offer to help relieve this problem and restore natural functioning and sexual contentment.

Unfortunately, most doctors are still unaware of many of these methods, as their own training rarely prepared them. Thus, here again it is up to you, as an educated health care utilizer, to request of your doctor, alternatives to often expensive medication. If he can’t help you, then ask for a referral to a sex therapist, or search one out on your own. Most Yellow Pages now can be quite helpful, as could a phone call to your local hospital or medical association. Remember to check the credentials of the sex therapist you go to, and if you don’t feel comfortable with them, go somewhere else. Trust your instincts. By the way, the impression I receive, more and more, is that urologists prefer not to deal with sexual problems.

Just to give you a glimpse into the future (it’s usually good to know what is coming down the pike), at the same conference another company was beating the drums for its new product, not yet released in North America. It is touted as more convenient than Sildenafil, as it acts much faster, about 20 minutes after taking it sublingually, versus the usual one hour for Viagra, a pill that is swallowed.

Beyond these, research is actively exploring further possibilities. It is fair to say that human sexuality is now under the microscope. Probably, other doors will open relatively shortly, and our knowledge-based approach to helping people with sexual difficulties will continue to grow dramatically. (No pun intended.)

As a final note: Please realize that these novel medications produce erections only if you feel desire. They do not create desire. They are not aphrodisiacs, and they will not solve sexual problems in a relationship, where a man does not want to have sex with his partner. This is seen as a desire disorder problem, and while help can also be obtained for this condition, usually from a therapist experienced with these kinds of problems, the solution is not in pill form. At least not yet. And from my point of view, that’s a good thing.

- Dr. Frank Sommers, July 2001

Sandy and Doug are not unusual and there must be thousands and thousands of couples like them. When they met, they both were quite emotionally, not to mention sexually, needy. Their happiness was complete in finding somebody they could really “talk to.” The good sexual interaction, everything but intercourse, since they were good Catholics, was a bonus.

By the time their second child was born, the couple was already heading for trouble. Doug was working late hours trying to establish himself and the business, and Sandy was attempting to be the perfect wife and mother. Since neither of them had any real sex education to speak of, it was really a situation of the blind leading the blind, so to speak, when it came to their intimate life together.

Doug had, and has, a rather strong sexual appetite, and one of the things that he found appealing in Sandy was her willingness to be flirtatious and sexually available. However, eventually they found themselves more and more in disagreements, especially over Doug’s frustration about his unmet sexual needs. Eventually, the more Doug pushed for sex, the more Sandy resisted. This then became a vicious circle and when I got to start treatment with them, they reported that they had not had sexual intercourse for more than a year.

This marriage was in crisis.

While treating a couple like this, I am particularly mindful of the reality of the two children they are raising. Should they break up, no matter how smoothly the breakup goes — and it never really is a hundred percent smooth — those developing kids will be at the receiving end of some very unpleasant life lessons. So we’re all trying to make an extra effort to try to remedy the situation, but how?

In this couple’s case, we started by understanding first of all what influences or controls their sexual life on a physical level, and then proceeded to explore emotional complements which enable physiological mechanisms to either work well or perhaps not at all. For example, how men become erect and women wet.

In this regard, a couple’s ability to communicate in an emotional, meaningfully heart to heart, eye to eye manner is critical. What often unfortunately tends to happen is that unless everyday irritation, frustration, annoyance or anger components of daily life are dealt with maturely by the couple, there is a real danger that resentment will develop. Once resentment sets in, desire flies out the window! You don’t really want to be intimate and close with someone you resent. But many couples find themselves in a bind, and in this state they have no idea how to get out of it. It’s like “you’re in a swamp,” I tell my patients.

Fortunately, there is good news. With careful guidance and attention to some very specific communication skill training, we were able to drain the swamp which this couple’s inability to communicate has created, and got them to dry land. Thus they could begin anew. This time, armed with knowledge, which truly is power, they are able to deal with the inevitable ups and downs that are present in everyone’s life, especially if they are working and trying to fulfill conscientiously the roles of parent and loving spouse.

This couple has made great strides in being able to discuss Doug’s strong sexual needs and his belief that he can obtain great relief by having an orgasm at the end of his tension-filled day. (Anyone else feel this way?) However, Sandy’s job is also quite demanding and makes her eager on getting home, not for sex, but for some time just to herself.

With goodwill a number of options can be explored, and this couple is now starting to discuss their need for private time at the end of the workday, and ways to meet each other’s sexual desires. They’re becoming aware that not all sex necessarily leads or proceeds to intercourse, and not all intercourse needs to become a drawn-out prolonged ‘banquet-like’ affair.

Adjusting to their daily routine, they are now finding productive alternatives to fighting and anger. Doug and Sandy are a couple headed for success in resolving a rather difficult, and potentially dangerous, toxic marital situation. It is important for all couples to recognize that the sooner they resolve these problems on their own, or seek assistance from qualified professionals, the sooner they will get on the road to a much happier and fulfilling life.

- Dr. Frank Sommers

As soon as he used the word “perform,” I kind of jumped on him and told him in clear terms that that word was not allowed to be used in my office. I said “sex is not a performance.” “Sex is a form of adult play and a potentially profound form of communication.” As he continued to tell me his story, it became clear that Alex’s whole social life became significantly constricted as a result of his fear of failure in bed.

Like many men I see with such problems, Alex was handsome, well-toned, intelligent, and had a good steady job and source of income. Also, he felt really keen to have a relationship and relieve some of what he felt were the burdens of single life, like loneliness, at times. Similar to many people who experienced a good marriage, even in part, or a good relationship, they crave and want to recreate that aspect of the previous experience.

Also, as with many patients, Alex’s main problem was not that he could not attract women who might be interested in going out with him. He was quite acceptably handsome and clearly would appeal to some members of the opposite sex. Unfortunately, the fear of having to go to the bedroom at some point in the relationship, and potentially suffering a “failure experience,” so inhibited Alex from even attempting to meet women that his whole social life became very severely restricted.

Eventually, Alex attempted to get help by going to a highly advertised clinic where his penis was injected and a firm erection thereby produced. However, he was reluctant to follow their advice and precede every act of potential intercourse with putting a needle into his penis. In exploring alternatives, he also tried Viagra and this too worked with some effect in him but not consistently, and he reported that he had some headaches as well, and he found timing a problem, having to take the pill about an hour before intended sexual contact.

Alex was very relieved when we discussed our approach to treating his sexual problem without any medications whatsoever. Rather, relying on a cognitive/behavioural treatment, which entailed reprogramming the autonomic part of his central nervous system, would then enable his blood vessels to be relaxed and open wide, thus allowing blood to flow to the penis freely and produce an erection whenever he would want.

Indeed, following this 8 to 10 session program, supplemented with readings and homeplay assignments, and looking at carefully selected sex education films and videos, Alex made marvelous progress, like most of my patients.

In one of our last sessions, he related how recently he met on a street near his home a lovely tall blond “with legs up to here,” whom he asked for a coffee after a brief chat. That led to dinner in a nice restaurant and some very exploratory discussion about what each of them had in mind for the future. It turned out that she had also been married once before, and was ready and keen on a serious long-term relationship with children, as was Alex. They both agreed to go slow and to explore each other’s values, goals, and ability to communicate in a meaningful soul-to-soul level. There is every indication now that this relationship will meet Alex’s expectations and even exceed them, and that his long period of solitary life and fear of sexual failure will come to a happy end.

It is stories like Alex’s, repeated many times, in my practice that makes my work so meaningful and rewarding. It is most important that men in a similar position as Alex recognize that these days there are a variety of approaches to help with all kinds of sexual problems, dealing with erections as well as with ejaculation control problems and desire issues as well. It’s most important that people take responsibility when they do have a problem, and seek out appropriate help with a well-qualified doctor or therapist with whom they feel comfortable. If something seems not be working out, do not hesitate to explore alternatives. Do it sooner rather than later, as this makes the treatment program easier. Among resources available to you besides, of course, the Yellow Pages would be preferably referrals from your family doctor and/or a phone call to your local hospital and/or medical society.

- Dr. Frank Sommers

Yet, being sexy was very much part of Mary’s makeup. She had learned how to project an image of being a sexually highly desirable woman and, indeed, her sexual history revealed that she has had numerous boyfriends. Men on the street turned their heads with Mary approaching and she had no difficulty having the pick of the ‘crop’, so to speak.

Many relationships for Mary in the past ended in frustration when the excitement of the new started to fade. Moreover, Mary found that most men she attracted were very much turned on to her physically and imagined her to be a highly responsive, sexually keen partner.

Initially in each relationship, Mary would play the role that she thought was expected of her. She developed a technique to indicate to her partners high excitement which she really did not feel inside. Consequently, much of her intimate lovemaking was a sham. What prompted Mary to come to see me was the total frustration she had come to feel in her life with her current boyfriend, John. She wanted to avoid falling into the same pattern with this relationship, and she resolved to try to remedy her problem. This was a major step for her since John indicated that he was willing to stand by her no matter what.

It’s worth noting that Mary learned to convey or project an extra sense of sensual aliveness and sexual interest, perhaps as a compensation for her deeply felt inadequacy in delivering the goods, so to speak. In subsequent therapy, Mary confided that most men she found not to be too aware of the fact that she was “faking” her sexual interest and response. Her experience of sex was that most guys were primarily motivated to get it on and have intercourse as quickly as possible with the goal of orgasm in mind. Mary’s needs were much more in the realm of affectionate holding, kissing, touching and the feeling of being desired for her own person. Not for the ‘sexy babe’ persona she projected.

There appears to be many Marys out there in the large world who are caught in a bind. They feel they need to project a certain sexy image in order to attract men. At the same time they know they are playing a risky game, because not infrequently, the men they have attracted will be responding to ‘false advertising’. In this game, unfortunately, there are no winners. Sooner or later Mary and the boyfriend will come to a point of frustration, a plateau, where the relationship gets stuck. They are at an impasse. More often than not, the couple will then break up and, sadder but no wiser, will repeat the same cycle in the next relationship.

The good news is that situations like this need not go on and on. Women like Mary and their boyfriends need to learn that this is not such an uncommon problem. Indeed, I think many, many women have great difficulties in coming to climax from intercourse. The answer, which is encouraging, is that most of these problems can be solved rather promptly, through qualified professional assistance. It can be very helpful if women like Mary seek treatment either while single, or with a partner who cares and promises to be supportive.

During treatment, these couples learn that women’s main sexual organ, even more than men, is the brain. It appears that there is a period of heightened sensitivity for the induction of the orgasmic reflex. If this ‘window of opportunity’ is missed, then it may be a harbinger of difficulties to come in developing the ability to orgasm. It’s possible that young, post-pubertal women’s brains and nervous systems need to be exercised with this ‘orgasm reflex’ in order for those connections to be made and to be able to peak more easily. This is only part of the story. We know from experience that women’s arousal is considerably slower than that of men, and unfortunately, because most men’s sexual interest is highly goal-oriented towards the attainment of orgasmic release, many women often find themselves in the frustrating situation of being behind their male partner in arousal intensity.

In my work with such clients, I try to remedy this problem first of all by having the couple become aware, and acquire a different knowledge base about how men and women truly function sexually. Then through a series of graduated exercises, guided readings and videos, I help these patients to reprogram their nervous system, as it were, in order to enable them to function in a more fulfilling way, first of all in solo sexual activity, and then in partner sex. Now there are many happy Marys out there, but guys, let’s learn.

- Dr. Frank Sommers

Our family of origin will determine such things, for example, as how comfortable we would be with nudity, and with showing our bodies to others, without shame or guilt. If you’re fortunate to have been born in a family where your parents have become comfortable with their own sexual nature and feel “at home” in their bodies, then usually through the process of osmosis the child will pick up the same basic attitudes towards his or her developing physical self.

This approach of being open within the family with nudity is one that appears to lay the foundations of an easier adjustment later in life to the changing body that the adolescent often experiences with a sense of shock or even dismay.

In extreme situations, a young person who has difficulties accepting his or her changing into a sexually mature person may suffer from an eating disorder, at times even anorexia, a recognized illness that tragically at times results in death.

I usually tell my patients, many of whom grew up in less than ideal circumstances, that there is one generation that needs to make a breakthrough in becoming comfortable with their sexuality. Their children and then subsequent generations coming after them will “naturally” inherit these healthier attitudes.

Basically we can think of people coming from three kinds of homes. The first could be the outright sex negative home which is characterized by a parent or parents making negative comments to their child along the lines: don’t touch down there, that’s dirty, you can go crazy or blind, etc. The sexually neutral home would be one where parents carefully, and studiously, avoid any discussion or reference dealing with sex in the family home. This may also extend to, for example, switching television channels when during family viewing, something comes up that is suggestive of, or involving, nudity and sex. The smallest group, yet most desirable, would be the sex positive home. Here, parents have become comfortable with their sexuality and their bodies, and they convey this in an age appropriate manner to their children. Here, children learn a healthy respect for their bodies, and for privacy, as at the same time, they learn about normal bodily functions and a sense of comfort with their nakedness in front of family members. These children learn to name sexual body parts appropriately and thus are able to talk about any concerns that might arise with parents whom they know are receptive and caring.

Research shows that children who receive positive sex education seem to have a less turbulent time in adolescence, and contrary to some people’s expectation, they are less likely to get into trouble with their sexual behaviour.

Moreover, and very importantly, I think, children who grow up in sex positive homes usually establish a stronger bond with their parents which enables them to communicate about many other issues of concern they encounter during the growing-up years, even unrelated to sexual matters.

It has been shown that infants who do not receive affection, which involves caressing, hugging, and kissing from their care taking adults, can at times fail to develop properly. Thus, once again, it is the parents’ responsibility to become comfortable with showing their care and affection for their children in a physical way that is age appropriate. In general, one can say that hugging and kissing should be the norm in every family, not the exception.

With time, children who grow up with these essential ingredients of development will become sexually mature, integrated adults who feel comfortable ‘in their skin’, and who have integrated their sexuality into a more fulfilling daily existence, better able to share their love on a physical and emotional level with a well-chosen life partner.

- Dr. Frank Sommers

To which her husband remarked: “I like it when a woman does her share of seducing, enticing, initiating. It throws in a bit of variety.”

There is nothing unusual about the differing attitudes to sexual behaviour expressed by this couple. The great thing is that they are able to talk about their feelings. Nor should they blame themselves for having these views. In fact, by the age of 5 or 6 most children’s sexual attitudes are set. Learning from example, children are extremely adept at perceiving what their parents consider right or wrong. These attitudes are then often not re-examined, unfortunately. People just accept some sexual behaviours or acts they feel comfortable with, and with others they don’t. Or with some people they are comfortable doing certain things with, while with others, they would never think of going beyond a certain point. It often takes a major life crisis, like divorce (or widowhood), to cause a person to undertake a conscious re-examination of their sexuality. Yet such a review could go a long way toward finding the path to sexual maturity and contentment.

Informal poll:

I would like to hear your experience or opinion about the effect of watching or reading XXX explicit sexual material on you, especially when you were still sexually inexperienced…

(Add your comments in the form below.)

- Dr. Frank Sommers

I can say with fair certainty that this is a subject that is close to most men’s heart, and unfortunately it becomes a front and centre issue sometime in many men’s lives.

Jamie’s situation is a case in point. He was a mid-30′s father of two children when he came to seek help for his problem of ‘premature ejaculation.’ It turned out that he was separated from his wife for a few months; she ended it after a seven and half year marriage. He told me that when they met, they had a satisfying sexual life with no complaints on her part, and he certainly was content. As they became involved in dealing with usual issues of married life — house, mortgage, children, in-laws, etc. — their sexual connection at times would take a dip in frequency, but she didn’t really complain about the quality of lovemaking until only about a year and a half ago.

It was after the separation that she first let him know that she felt his penis was ‘too small.’ Not only that, but she did not keep this information, or opinion, to herself. Rather, she put the word out among their friends and his co-workers. This led to enormous embarrassment and made his life so miserable that he contemplated ending it.

His voice was filled with pain when he asked me why didn’t she ever complain about this before? Since she was unwilling to attend any sessions with him, I, of course, was unable to get her side of the story.

However, I’m happy to relate that we are well under way to resolving his problem of rapid ejaculation and restoring some sense of self-confidence. The subject of penis size, however, can raise and retain lingering, ongoing doubts, and the fact that a number of people he works with or has contact with socially have raised this have made his life extremely difficult.

It is interesting to speculate why this subject of penis size is so apparently crucial to many men. When it comes to sex, most of us have very little factual information come our way. Sex education programs are often hit and miss in availability, and even those that exist rarely deal with such an intimate issue as size of genitals. The old concept of sex being a performance in which you have to prove yourself is one that promotes the idea that you have to be endowed in a particular way in order to please your partner and to prove yourself as a good lover. The most readily available source of ‘sex education’ for most males was, and alas still is, sex videos and so-called adult magazines. These are inevitably put together with unrepresentative, far from the average appearing women and out of the ordinarily endowed men; sometimes, way out. Indeed, some actors in the adult industry have been bestowed star status on the basis of the size of their penis.

Unfortunately, the average boy growing up, in the absence of valid information, can easily get the idea that somehow he does not measure up to most other males.

Furthermore, the subject of penis size does not usually emerge in discussions between men and women. If they are going to discuss the quality of their sexual life at all, it often has to do with issues other than penis size.

In reality, men need to remember that in the overwhelming majority of situations the size of penis is not a significant factor in determining how skillful a lover they are. If one were to take a survey among women about their male lovemaking partners, I would guess that penis size would be rather on the lower end of the list, if there at all. Far more frequently, one would see 1) taking time, 2) allowing oneself to be vulnerable and talk about feelings, and 3) a sense of genuine excitement towards one’s partner, as issues of concern.

With respect to penis size, there are a number of facts that need to be kept in mind, so that a realistic approach to this almost universal question of male insecurity can be maturely approached. Only the outer third of the average woman’s vagina has sensitive nerve endings. In addition, the most sensitive part of women facilitating arousal, as hopefully everybody knows, is the clitoris. Have a good look at your partner’s genitals, an exercise which is a very useful one at some point in your love life, and you will notice that the location of the clitoris is not inside the vagina, not even at the vaginal opening, but actually, as I sometimes say, in the ‘suburbs.’ By that I mean the clitoris is located quite a ways above the vaginal opening. Now try to visualize the mechanics of vagina stimulation in the standard man on top position, a practice probably of the majority. The inefficiency of this system of stimulation of the most sensitive part of the woman is, in a word, enormous. It is small wonder that many, many women, the majority, report that they do not reach orgasm from penis vagina intercourse alone.

In this regard, the size of the penis is really not very relevant. It is far more critical how you, as the owner or ‘captain’ of your penis, ‘maneuver’ during lovemaking. Try to visualize in what way can your partner’s clitoris receive maximum stimulation by the penis. The sad reality is that, unless you take very special care and move in a way to maximize contact between penis and the top of the vagina, the resulting friction or stimulation is not going to be sufficient to enable your partner to reach orgasm.

Accordingly, my recommendation is to pay far more attention to other ways than penis in vagina if you want to achieve maximum clitoral stimulation in your partner leading to orgasmic release. This may involve manual or oral stimulation, before, during, or after penetration.

In spite of this reality, usually women do enjoy having the feeling of the penis inside the vagina. But the feeling of pleasure and fulfillment appears to come from the psychological closeness or bonding this provides, as opposed to mounting clitoral excitement.

So putting all this together, you can see, gentlemen, that preoccupation with penis size is really wasted effort. Most men are perfectly well endowed enough to be able to have penis vagina intercourse leading to the kind of satisfaction that seems to satisfy most men, and, at least in part, women.

But remember that honest, open communication with your partner is the real solution for this physiological reality of differences between male and female orgasmic satisfaction. Paying attention to this will assure many more satisfactory, exciting lovemaking sessions for both you and your partner.

- Dr. Frank G. Sommers

Judy and John met ten years ago, were in their mid-20s, and they soon hit it off after being introduced by a mutual friend. They started dating and within a few weeks their relationship blossomed into the physical expressions of affection. Both were extremely content and happy and they thought they had found the person with whom they wanted to spend the rest of their lives. Within six months they agreed to move in together and their pleasant association continued unabated. Within two years they had become a married couple with the approval of both their families. About a year later they decided to start a family and Judy became pregnant very promptly (on second try). In the period leading up to the pregnancy, they have noticed that, while they remained friendly, sexual interest in each other started to diminish. They enjoyed spending time together and they had some joint interests but the physical aspect of the relationship was nowhere near as vibrant and energetic as it was in the first twelve months of their relationship.

With the arrival of their first baby, their sex life took an even steeper turn downhill. They were very pleased with being parents. Blessed with a healthy young son, they became doting mommy and daddy. More and more of their affectional needs got pushed into the background but neither of them paid too much attention to it because they felt that this is just how things were meant to be. Occasional flair-ups of some sexual frustration, especially on John’s part, occurred, but they tended not to talk, or deal with it in a meaningful way. About two years later they had their second child which wasn’t entirely planned. However, neither were unhappy about this turn of events. As you can imagine their sexual life took an even steeper turn downhill after the family’s newest arrival. This state of affairs continued for some six years and no improvement in sex life occurred, nor did they attempt to seek any professional assistance.

About one year ago, Judy began to urge John to start considering doing something about his ‘premature ejaculation’. John had been concerned that his ejaculation was too fast for the past four or five years but again thought since no one complained about it, it was not a major issue. By the time I saw this couple they confided that not only was their desire low, and John probably had premature ejaculation, which left Judy very frustrated, but on top of everything else, Judy hardly ever had an orgasm, certainly not in intercourse. History also revealed that Judy had considerable sexual experience prior to meeting John, yet she generally underplayed the importance of her having an orgasmic release experience. She generally saw men as pushing and wanting sex rapidly anytime, almost anywhere. She just accepted this is how men were. On meeting John she was taken by his more gentle, easy-going manner and by the fact that he made no demands on her sexually. “He seemed like a gentleman,” she said. When asked if they feared the marriage was in danger, both answered “yes.”

Sarah and Sam, another couple recently seen, had been married some seven years. They came from different cultural and religious backgrounds with Sam being Caucasian, and Sarah from Asian background. On meeting, both of them were quite taken with each other and found a common language and soon felt ‘in love’. Even though Sarah’s willingness to be open to sexual interaction was considerably less than what Sam had been used to from previous girlfriends, he hoped that with time this situation might improve, and both of them pursued the idea of getting married. Their life together was not without frustration because while they got along reasonably well, with time, cultural differences quite frequently made themselves apparent in what they each expected from the relationship and from what the other partner should provide and deliver to make it work. However, this did not stop this couple from having a child, and they both rejoiced in the arrival of a healthy baby boy. Sarah became totally absorbed with taking care of the little baby to the point where she stopped work and devoted her full-time attention, 24/7, to being a mother. And she was and is very good at it. Sam appreciates this quality in Sarah but felt further and further their relationship as lovers slipping into the distance. Their arguments tended to increase as Sarah experienced more and more fatigue taking care of a newborn infant that is naturally accompanied by severe bouts of sleepiness or sleep deprivation even, and being confined to one’s home for much of the time. Eventually, Sarah rejected any interest in being physically involved with Sam. Sam’s resentment grew and he started to turn more and more inwards into solitary activities with television watching or playing on his computer. This of course distanced the couple even further and by the time I saw them this marriage also was in serious difficulty. Both of them felt estranged from each other, and coolness and indeed anger started to darken most of their interaction.

What is evident in the stories of these two couples and what became clear to them as we discussed their initial interview after intensive history taking was that neither couple was realistically prepared for what it entails to be a new parent, but also what is involved in making a marriage work. This is not surprising.

The sad reality is that most people have next to no preparation or training for coping with the reality of a close, ongoing living together relationship or marriage. When people become parents a whole new set of responses and expectations can enormously change the dynamics of the couple’s relationship, even for a couple who were functioning well together before. It is a sad commentary that for such an important task there is so little preparation available in our society.

(Sam and Sarah did attend a pre-marital course through their church, which they found quite redundant and not really addressing their needs.)

As I like to put it when you get together with a person in marriage, you’re agreeing in a sense to climb Mt. Everest together. Clearly, such a task takes preparation starting with a realistic assessment of your abilities and an immense commitment to support each other not matter what. Not to know what to expect, or perhaps worse, having unrealistic expectations, is like going through a forest without a compass, or travelling in unfamiliar country without a roadmap.

The most important step that can be taken to prepare for such an endeavour is to learn how to listen carefully and how to communicate accurately what you’re feeling. This is not as easy as it sounds. You need to learn to listen, as I sayk with the third ear, which means listening between the lines. Constantly asking yourself, “what is my partner feeling?” You need to pay attention also to the so-called meta-communication, that is, the tone of voice, rhythm of speech, choice of words, etc. These often reveal far more about your partner’s intentions than actual words spoken. This again is not an easy task, but the good news is that the skills needed can be learned.

The same applies to parenting. Here is an enormous responsibility for which most of us have had almost no training. Indeed, most people end up parenting their children either the way they were parented themselves, which frequently had left something to be desired, unfortunately. Or they end up parenting their children the exact opposite way, trying to avoid the same mistakes their parents made with them. Neither of these approaches is necessarily the best. There are other options but we need to recognize that it takes some education or training.

In conclusion, one needs to accept the fact that most of us are illiterate when it comes to keeping a relationship’s spark alive. And most of us can use some help in becoming better at parenting. Once again, help is available, either in the form of self-help books, provided they are recommended by respected reviewers, or from professional educators or therapists who again have established reputations in your community. Taking care of these matters is probably the best preventive step any person can do in preparation for probably life’s most glorious achievement: a satisfying marriage, and contented parenthood.

- Dr. Frank G. Sommers