In Your Pants with Dr. Susie G - Occupational Therapy for Sex, Love, and Butt Plugs

Episode Date: March 14, 2022

The moments in life that bring you the most joy in your day (the things you would not skip or live without) is what grounds us and makes us feel powerful. In my conversation with Dr. Sakshi Tickoo, founder of Sex, Love, And OT, and a queer Occupational Therapist and Counselor actively working in the areas of sexuality, intimacy, relationships and mental health across lifespan, we're reminded how there is no normal. From sex to relaxation, what does your personal pleasure practice look like? Maybe it's your morning coffee or conversing with your partner over dinner; recognizing that pleasure is not only synonymous with sex opens up a world of possibility, play, and happiness. Dr. Sakshi also reminds us that the conversations we have with others validates our experiences, helps us become more comfortable talking about sex and sexuality, and challenges our assumptions on pleasure. Prioritizing building the intimacy and connection you have with yourself and your partner(s) is an exploration that you can do anywhere and everywhere with the five love languages. ☕️ Questions you want to ask, options you want to sort through, or deciding on what you should do? Schedule time to chat with me: https://drsusieg.com/pelvic-pain-specialist-15-minute-call 💻 Pelvic Pain Relief Program: learn about your body and concerns in the comfort and privacy of your own home. With video demonstrations of hands-on treatment techniques, lessons on the science behind why you hurt, and exercises that will help you navigate out of pelvic pain: https://drsusieg.com/pelvic-pain-in-men-online-program This information is not intended to substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a healthcare professional with any questions you may have regarding treatment, medications/supplements, or any medical diagnoses. This information is intended for educational purposes only and is in no way to substitute the advice of a licensed healthcare professional.

Hey friends, Dr. Suzy G here and welcome to another In Your Pants podcast. Thank you so much for being here. We have a fierce episode for you today. where the occupational therapists and the physical therapists unite in their passion and mission to embrace and help others embrace sexuality across the world. I have Dr. Sakshi Tikku with me, pronouns she and her, and we discuss topics of incorporating sexuality, sexual health and wellness into the rehabilitation realm. We talk about pleasure mapping, body mapping. We also discuss some cases, real cases and applications of combining physical therapy and occupational

therapy to enhance someone's sexual wellness and sexual health. So without further ado, let me formally introduce to you Dr. T. Dr. Sakshi Tikku is the founder of Sex, Love, and OT. she is a queer occupational therapist and counselor actively working in the areas of sexuality intimacy relationships and mental health across the lifespan she has worked in school-based home health outpatient settings and currently caters to clients globally through telehealth care she believes in advocating an education for everyone with or without disabilities whether straight or queer to experience filling, satisfactory, consensual, pleasure-centric, and exciting relationship irrespective of their physical and or mental health conditions,

sexual orientation, and gender identity. So I had so much fun with Dr. T on the show. I am so excited to share this episode with you all. I hope you really enjoy it. And if you do enjoy it, please be sure to subscribe, to comment, to rate us, to like us, and to share with all of your family and friends. This is one certainly you don't want to miss. Enjoy. Hi, Dr. T. Thank you so much for being on the show today. My pleasure. You know it. I love it. Well, I'm super excited to have this beautiful collaboration. It's the first time ever on the in your pants podcast that I am interviewing an occupational therapist who also specializes in

and has a passion for sexual health, wellness, and education. So let's start there. Can you describe to us like what the role is of an occupational therapist in rehab and sexual health and wellness? Wow, this is a fun thing. I love it when we have to describe our role as in this field especially. I have a very fun way of describing our role going away from ADLs. So usually that's how I think people are familiar with occupational therapists. We focus on ADLs, which is activities of daily living. And we try to focus on the daily living occupations and how people can engage in these activities in a much better way. And sex being one of them. However, interestingly, I stopped using the word sex

and sexual health and I started using sexuality instead because when we say that occupational therapy not only is there to improve but we are also there to prevent in the first place so if sex is an occupation that we're engaging in sexuality is our overall experience and that is where occupational therapy steps in to make sure that you have a more enriching experience you try to adapt to that experience in a much better way um be it you know understanding the gender be it and expressing your gender in various ways what kind of clothes you want to wear how do you want to adapt to uh trans masculine or trans feminine equipments that you want to wear what are the options out there how can you adapt to sex toys how can you make this activity much

more comfortable for you and there's just so much more and that is that is where that's what basically all occupational therapists do that's just just insects the same things just to help you have better sex right right pooping peeing and sex are all every like physiological functions and are very important as part of the as part of the health paradigm and as you're saying sexuality identification connecting with oneself and partner partners i can't imagine that traditionally at least not in the united states that sexual health and wellness or sexuality is part of the curriculum for rehab practitioners it isn't uh i think um we had this conversation where i told you uh it was only in I think 2015 or 14 that I even actually saw the entire image of clitoris and I was already

enrolled in a bachelor's in occupational therapy and I do not know what a clitoris looks like so yeah that's that just explains what we have been taught right right and I'm in the same boat dr t like no one talks about i mean medical or not like the there's such a lack of sexual health education and even just anatomy and understanding our body and how it functions such a stigma and taboo so what you're doing is so unique and so needed and and such a service to the world that i am in awe and you're such an inspiration so i just want to say that because you are breaking the mold when it comes to occupational therapy or any type of rehab practice to be honest with you because not a lot of physical therapists um you know it's pelvic health but yet sexual health is

or sexuality is kind of somewhere over here like yeah we know it's part of it but we're just not going to talk about it you know they're actually a handful of physical therapists that i think actually pursue pelvic health um so yeah i think we are the ones who are breaking the let's not just high if we and if we were in person i'd totally high five you right now virtual high five well i i want to talk about some juicy stuff i want to talk about pleasure mapping because that's something i do in my practice yeah fingers for those who are listening yes we're we're doing some jazz hands here and fingers um how so how do you incorporate pleasure mapping into you know rehab with your patients so maybe and i have a couple of questions with that

let's start with maybe what are some what is pleasure mapping for let's just start there what is pleasure mapping so it's it's pretty straightforward actually just split the two words um you are trying to map what feels most pleasurable right and by pleasure we mean that um so occupational therapists love sensory integration we talk about sensations all the time right we have we have such groundbreaking research in sensory integration and yet we forget that there's so much sensation happening when it actually comes to sexual activities so pleasure mapping was just whatever i had learned in a pediatric setting lean of life to sexuality and everything else. So in pleasure mapping, we use different senses to

map how we experience pleasure. It's actually that simple. I love it. I love it. And you're applying it to all parts of the body. As you're saying, you know, how do we experience pleasure and joy and that sensation, right? And how, like when you're with your patients, like, because pleasure can be defined in many different ways so how do you bring up that first of all how do you bring up this conversation with folks when you're working with them as far as introducing pleasure mapping but for their sexual organs i usually have this uh one one question about whenever i i have my history taken but whenever i have this kind of questions when we talk about how their sexual practices are and what everything else is so I usually ask them this question about

what what does your pleasure practice look like and they all most of them have a very confused look as to what the what the hell is she asking about and I mean that is how we take the conversation forward because as you very rightly said pleasure is quite subjective right and I ask them what's at one part in a day or in a week that you and you know that brings you most joy that's just so pure that you cannot skip it you cannot live without it and most people have the most obvious answers which is like having a cup of coffee or you know just cuddling with my pet and some some brilliant answers like that you know it's a common thing right and then I'm like you know what this is something that you go back to to ground yourself right so what is it that you do with yourself or

your body that helps you reconnect better and you know have that sensation that wow i'm a goddess i'm a god i'm absolutely amazing you know that yes feeling that just you know queen you're killing it that vibe and that is when they start thinking that you know i haven't uh and it's a very good way of self-reflection as well because we find partners along the way we find fun along the way but we forget the connection that we share with ourselves or even with our relationships for that matter and this is a very good reflection of you know things that we have missed out things that they enjoyed doing or you know that they missed out in their lives something that they left along the way and this is something that we call in occupational therapy language is activity

activity analysis we are sort of analyzing the whole thing and it's not just the present but also the past and it's the best way of saying that you know this is what you know this is what we mean by pleasure this is what the pleasure practice could look like and this is how you need to be focusing on you know maybe you know let's start there you can pinpoint some some practice you know I used to love that bubble bath or something of that sort you know I love journaling or you know I just love the way that I apply lotion to my body or you know I just love dancing around naked even if there are these parts which bring them pure pure joy which helps you reconnect and feel you and you know help you feel a little bit more human that for me it becomes

a pleasure practice because you know that this is the body that i love this is the person that i fell in love with and this is the moment that i appreciate and embrace a lot so i think that we begin in a very very non-sexual way first just to understand that that is that's the first step of the journey most of the time everything what comes to all forms of sex becomes a lot more easy once we are comfortable in our own skin in our own space that just that that's the beginning of having these uncomfortable conversations I just love that again you're taking it from a global broad perspective getting the person to feel like you said human again connect with themselves in a way that makes them feel powerful not powerless right so you're you're you're bringing back that

sense of agency self-efficacy independence um because because for a lot of folks there's you know whether it's pain or chronic illness or a change in their body in some way or function there's a lot of grief and loss with that process as well and so you're just gone you're you're like the the the number one fan you know like let's do this let's see how we can make it work it doesn't mean it's the end just because things are different and and just yeah I just love that I love how you're kind of using all their senses and everything in their world to help them connect to their own humanity and identity um and also then bringing funneling funneling it in is what I'm hearing you say is like into that sexual realm slowly so we're not just starting with okay let's work with the

genitals now right because in a way yeah I think in a way that that makes them much more comfortable knowing that you're not sure to put a label or and you know just carry forward with whatever diagnosis they have been given right but you're here to understand them as an individual and and the concerns that they present it's not symptom-based even if they might be having a fabulous sex life it might not have affected them in any way there's a fair possibility of that right but my job here is to evaluate that even if they are having fabulous sex lives or they are still they still have the ability to orgasm they're still feeling human and still feeling amazing about those orgasms i love it i love it that's right feeling human and feeling amazing with

those orgasms yes oh my gosh so let's talk about some pleasure myths that are out there what are some of your like you cringe when you hear them can you share some of those with us the biggest one I think you know this too oh so I owe this I owe this to my partner I have to do this I need to get better so that my partner feels satisfied yeah or they do not cheat on me or it's linked to penetration or it it has to be linked just it has to do something with the genitals um i think yeah these are the common ones which i just i'm going to be like come here this is my hand he's with your cheek let's do the work that's right i didn't do that in practice i wouldn't imagine you did but i hear you i mean

you're fierce you're fierce and it's in your dismantling uh these stigmas and taboos and sexual scripts negative sexual scripts that we often hold you know we often kind of want have the standard or expectation that we have to follow it and when it's not happening then the whole world comes crashing down right because we've been working so hard at trying to meet and match these expectations sexually that when there's a slight little change in anything it's very distressing and legitimately so i don't want to undermine that in any way it is certainly distressing but i think the toxicity is from what uh culturally socially just what we've been fed over time um that really shaped these lenses and this this negativity around sexuality

that's the point i think even i would keep the culture aside because i think it was the entire human race that took the liberty of dismantling and you know just molding it around in a way that suited them the best so even though i think this this comes a lot and i think even you must have heard it india is a very conservative place but people are very conservative about their sexual practices if we were as conservative as you would want us to be we wouldn't have one of the most highest population in the world so they're definitely doing it right but when we look back and you know I keep saying this a lot it's the culture it's the culture it's the culture to be very honest we have such amazing paintings saying that you know monogamy is bullshit there

were there were people who actually practiced polyamorous relationships kingdoms flourished because of that they were actually talking about how to enhance pleasure what what is the art of sex it's not just about having acrobatic postures and whatnot that they were actually talking about pleasure what can you do with regulating your breathing how is the way that you can meditate and you know find that calmness and grounding exercises so that you can have better sexual better forms of sex and that is something that that's so interesting because even though we have been said this you know that our culture says that you have to do this and you have to do this but we also are talking about pleasure and this is somewhere down in what 15th century

15th century people they do writing things about pleasure and we have we have sort of missed that entire thing just as human race because we found it's the society i would want to blame and not the culture because i think they did such a beautiful job absolutely no and well said well said to reframe that i so appreciate that perspective because it's so true right it's like when did that all all of a sudden change and fall off the face of the earth right not entirely And what I'm hearing you say is that it's such an important part of our sexuality and our sexual health and health in general. And on that topic, Dr. T, what else do you feel is important for our sexuality? I guess, what are some of the key components that one should reflect on or embrace or work

on or fill in the blank as far as, you know, for our sexuality and our sexual health? So when we talk about sexuality as a whole, we speak of it having five circles, actually six, in which like the core circle is about your values and beliefs and who you are as a person, right? That's the center. and then there comes other of these circles which talk about sensuality which is primarily what what we were speaking of when we speak of pleasure when you speak of sensation that's the circle that covers all the sensual part where you just try to connect with yourself

when you try to understand oh this is who I am I'm so amazing and you know that that snap of you know this is who i am then comes the circle of um intimacy which again is such a beautiful thing and again a very beautiful thing that's been lost and art that's been lost because we are all busy with everything um now with steady hairs now with virtually and everything else but here's uh this is another very very important thing that that i love to speak about is intimacy because there are so many things that we can do in that area just to help build that desire forget about arousal let's just keep that thing aside but the the need for people to even have sex or any form of sex or to get even naked to even masturbate to even touch themselves the primary inner motivation

that's that's desire that we're talking about that itself is lost and i think once we are trying to even approach towards a pressure practice or any other practice for that matter to understand sensations there needs to be a first step of first inner drive and intimacy is something that helps in building that desire that inner drive so much in understanding that there is things that we need and for for building intimacy i think the best bestest thing that that we have done as humans in research is um the five love languages yes it's beautiful it's beautiful right it's the best way of developing intimacy without having to focus on genitals without having to focus on performance knowing that we have to put in so much effort no it's just so easy this we can talk

we can cuddle we can just have a candlelight dinner we can just sleep right and just be and be okay in that in that um space right um and that just feels like there's so much pressure that just falls off of our shoulders when we embrace that type of mindset around intimacy or sexuality and how it just ebbs and flows it's not like a dualistic like it's here's intimacy and then here's sex right like no it ebbs and flows kind of like a like a wave that just you know rises and falls to and crashes on the beach like it's part of the same water you know um and it and it gets overlooked so i'm so happy dr t that you're bringing this to light and and sharing the importance of intimacy and connection on an emotional level not just the physical level

although it impacts the physical level as well because emotions you know and physicality are processed one in the same right so um that brings me to talking about some of the the negative emotions that might arise when someone is engaging in pleasure activities, particularly when it comes pleasuring around sexuality, maybe I should say that, or exploring their sexuality in the way that you're describing or that we're talking about. For a lot of my patients, I have, the themes are shame, guilt, embarrassment. If it's a Christocentric, you know, religion, sometimes it's, you know, a sin, right? So how can we navigate or how do you work with your patients to help them navigate these feelings that are very common? I think they're also very natural

to have because of everything we're talking about so how do we normalize these feelings but also don't kind of get stuck in in those feelings so I think we um there was another another thing that I was going to add another adjective to it it was boredom that is something that I've recently 100 thank you yes we recently realized that i did at least um it was having happened out of boredom um so what shame and guilt um and boredom as well i think the primary reason when it happens is that so when when i was speaking to more people with or bodies with penises the the fact is that it's we assume we have that assumption that oh they masturbate often they know what they're doing they start young they start early they have exposure to porn um anything can arouse

them uh they they they won't experience this kind of um concerns with you know uh i probably do not have any problem with lubrication uh they don't have to worry about these things they just have to get a wank and just move on and right these these are the assumptions that everybody makes even people who even bodies with penises have these assumptions about other bodies with people this is not something that goes out right and so this this script around you know this is normal and this happens with everybody is something that's been passed on nobody is having those genuine conversations when um when until if you see um people with vulvas who come together they communicate you know oh this is what this what you experience i experience the same and

suddenly there's a validation in that fact oh you oh you masturbate i masturbate too but there's the validation again right sometimes it's just assumed that people with penises will know everything about themselves and for them to experience shame and guilt is not something that's happening i i do understand how the scripts have come for bodies with vulva because we didn't even know what theater just looked like until like what 10 years ago that's it but everything but every other research that's been available out there is for bodies with penises however the research on how do you actually pleasure and i'm not saying masturbation or touching yourself but actually experience pleasure for bodies with penises is still a research that's not

being done right or at least not being communicated well and when that's not done and when that kind of empower empowerment is just lost in the entire translation of you know there has to be a pleasure activism we need to be having equal orgasms and everything else i think this empowerment should also come in the form of you know this is what people with penises can do there are other techniques for them to do these things and it shouldn't be limited to the fact that you know there needs to be some kind of enlargement right there needs to be some kind of lengthening they do need some special toy to experience something sometimes the joy can be as simple as you know probably wearing some some disposable uh soft silicon rubber gloves would still give a very

good sensation with adding a good amount of lubricant you can still have a very good sensation you can um just use uh dip your hand in cold water and then again try to do that it's a very good temperature player right um i think the way that we connected in the first place with the the reel that I made you know you can go ahead touch your balls massage them you can do so many fun fun things with balls right yes touch your balls they're there for a reason I love it even the intersection some people are not okay with anal play but there's the intersection of between uh which we call as the perineum there's a great intersection happening there you can touch it you don't have to go inside if you do not feel comfortable yeah and i think these

conversations need to happen much more casually without a frown on our faces and and i think that that helps a lot because we know that this is a this this is a script that like i said the shame guilt and boredom uh was when i speak of people with penises this is like a common theme which i is that they are restricting the entire pleasure practice to their penis and ejaculation and it's done right in two minutes performance yeah just the performance yeah exactly and so that is something that i think particularly happens in people with penises when it comes to people who involve us oh where do i begin we know how we we actually know it's the patriarchy we um we have also in a way sort of um we also in a sort of way have feed into people's egos that

you know or into a partner's egos when we fake orgasms when we say that you know this is pleasurable or you know a small point voicing out what we actually want or if we want it in the first place or not i think that is something something very negative that we have done which in turn causes us more guilt and dissatisfaction with how we experience pleasure and i think that that in itself needs to change because for us we for bodies with vulvas we need to spend some more time in front of the mirror and we need to see our vulvas more often we need to see our bodies more often because there's just so much insecurity there there's just so much shaming hidden in every single part of the body we it's looking at our breasts we it's looking at our

necks we looking at our navel thighs hips every single part that we we know that is like a pleasure spot for us or could be the pleasure spot for all of us is somewhat hidden in shame that you know i do not like this this is a body part i absolutely do not like this is a body part that i would i would like to change while there's nothing wrong with it but there's also a primary dissatisfaction especially because it's gender people who um just you know trying to fit into the molds of this is how we need to be to be worthy of experience and pleasure it's it's the constant idea that we have to be worthy of experiencing this in some way we have to do this to value our pleasure if we do this that is how we experience pleasure instead of just exploring it for us and

you'll be like it's there it's everywhere it's right from head to toe it's everywhere even if we change ourselves even if we do not change ourselves it's gonna be the same it's still and it's always there and accessible it's a matter of are we taking the time to pay attention in a compassionate gentle way with ourselves rather than what you're saying dr t you know all this negativity for our parts you know that i i don't like this i don't like that i'm not enough you know um and and where's this metric coming from like what what are we measuring our ourselves up to and where did that come from you know who planted those seeds who planted those weeds maybe I should say weeds and not seeds

like I said it goes back to those people policing the culture saying the culture teaches us this way I don't think our culture just said you know what be happy don't do bad that's it yeah that's wanted us to do the whole cultural policing just makes it worse and and it's through the generations I think to unlearn all of that again we all want to be ideal kids either we want to be ideal or we want to be rebellious yeah there's no midway right there's no midway when I think even now that I have these conversations I could not have imagined having a conversation with my mom four years back or three years back saying that you know what i masturbate but saying that today having a sex toy next to my bedside or you know having a bottle of lubricant next to the

bedside joking about the condoms and whatnot um it just could not have happened but there have been continuous conversations um conversations where i do not frown conversations where i do not gets angry or you know you don't know this you should just shut up it's okay she does not know i'm gonna give her to be her space of grace i'm gonna keep they keep myself uh like i'm gonna keep a space for myself to understand that you know what it's okay understand they may not be right but that does not necessarily mean i'm i want to make sure and assert that rightness onto them so I think that space of days even for clients and patients just helps some of them just say that you know what we do not want to talk about it and I'm like sure fine I'll back off

this was not to insult you in any way this was not to um you know this was not an assumption I think these are just a standard set of questions I think and I'm not sure if you've encountered such a situation before but oh my god I've had it once or twice and I'm like i'm sorry um i'm just doing my job yeah yeah and that i think is just you know meeting people where they're at um you know you plant we're planting seeds uh we're we're providing permission for folks to talk and to us and open up to us about their we all here's the thing we all are curious beings. We all have questions of, am I normal? Is what I'm thinking about normal? Is this okay? You know, what are people going to think? Like we're constantly in that, you know,

especially around our sexuality. I feel like we've all have curiosities, sexual curiosities that we're wondering, I wonder if anybody else thinks that way or finds this feel really good or pleasurable or likes this or that, right? And what you're saying is, yeah, we're just not having these conversations to validate, to affirm, to reassure, to normalize, right? The fluidity of our sexuality and to brace the diversity in all of that, right? And yeah, I mean, some folks are just, and that's okay too, you know, we're not here to say, hey, you have to be, right, you know, you have to be open to talk about this and et cetera. No, I mean, everyone has their own starting point. I certainly didn't start comfortable and talking about sex and saying, yes, I'm going to

have a podcast called in your pants. And we're going to, we're going to talk about all things going on in your pants or that I'm going to be a sexual counselor educator. I never would have thought, you know, 20 years ago that I would be doing this work. Right. But it's through doing my own work, my own work, and that, that this has opened up my sexual freedom, my sexual voice. um liberation in a way right just liberating myself and it's not an end destination folks like right dr t this isn't like a all right i'm gonna do the work and then it's gonna be over then i'm done forever right dr t i'm just shaking my head no and this is this is something that i also spoke about first you know

it's it's an assumption again that people think that oh my friends and I usually have these conversations they're like oh you talk about sex and everything else your sex life must be great you must not experience any problems navigating everything and I just give them a dumb look because hello hello I I just said I can treat or I can cure I can help I can prevent who made me god of these things nobody i'm still human i'm still gonna make mistakes i i speak if i speak of words of affirmation here i speak of love languages here but then there is gonna be a point in point in time where i'm gonna be like what's this i don't like it just move away i'm gonna be one of those people and that's okay that's completely fine we're still human we are

it's healing that's right and we're we all have our struggles and fears and anxieties over things and we navigate them very differently there's not just one way to do that there are many many paths there's many many different ways to explore and to go through your own journey right and and yeah this is not about right or wrong or um yeah none of that right it doesn't have to be one single way or have to look that way so so glad that you brought that up and like to be very honest I would I would say this I keep saying this but I'm going to say it again because I know awesome people are going to hear this and they I just hope they remember this when we speak of normal in medical language we basically are not saying that you're abnormal or we are not

saying that this is how you're supposed to be to act normal when we speak of normal it's because we have seen a population over a period of time researched about it and we are saying that this is common or this is healthy this is not something to be pathological right that is what we mean by normal and so don't try to fit into that mold because we do not know what normal is either right until unless it's not about harming yourself harming others we are not going to talk about normals and so i've officially taken that word thrown it out of my dictionary making making sure my clients throw it out of their dictionaries as well and they just be their weird old selves own it embrace it but yeah just do it who wants to be normal anyway that well that's right right

i mean like you embrace your uniqueness and i thank you dr t again wisdom bomb um for dropping that because that is so important again for folks to hear you're right what is normal right where are we comparing no there's we're all there is none let's let's get rid of it done trash got it cool well let's speaking of i i know we were talking off the air about chatting about a few cases from the ot perspective and i'm so excited to talk about butt plugs that's yeah we're going to talk about butt plug case let's do it dr t okay so this one's the uh so the reason that i chose um to share this case because this is the most interesting one because um butt play is not something that is still legal at least

penetrative anal play is not something that's legal in india yet okay so when we when we speak of anal play and you know people who want to consensually you know explore these things so we we sort of met one of my clients um they identify as male this is gender male uh and um they were suffering from uh erectile dysfunction and we again were starting to look for pelvic therapy and everything else and they actually met me i was like you know what do you want to i have a physiotherapist who works great with pelvic floor and i absolutely do not think that i you need me for a very long run there are some things that i can help you with and then possibly you can continue with the physiotherapist for pelvic floor strengthening

it sounded good and i was like you know what uh this is what we can do um in the first session when we this was all about patient education and everything else this was all happening in the first session and my very very um i was very happy that that that one of my colleagues my physiotherapist uh she agreed and she's like you know what yeah sure let's do it i'm like do you mind uh because ideally in india um your rehabilitation sessions are not covered by physiotherapy or or occupational therapy or insurance does not cover these sessions okay until and unless you have suffered an injury or you have like a prominent illness or a disability where you need to go to a physical therapist that is um that is how the insurance

covers it and obviously ED did not classify like a very important uh dysfunction for them um so yeah even though the person had so many mental health concerns because of that had problems focusing in your own occupation it's still you know insurance companies right yeah they suck so uh when we it was very important that the patient agreed and when when they did um it was so nice because i and the pt got along together for the first session we were like you know what we have 45 minutes let's use it in the best way possible this is how we're going to separate our time and while she worked on pelvic floor exercises i started talking about you know things that um how can you control the sphincter movement how are you going to relax it uh this

is a lubricant you can keep at hand this is going to be good for your anal uh ph this is just going to be fantastic you don't have to worry about it and then oh we in in the meantime we were like you know what would you like to try um you know if the sphincter is not giving you a very good feedback right controlling and pleasing if it's fun giving you good feedback there's something we could try uh would you like to look at butt plugs um or any of the sex toys that you would like to buy you're like isn't that for gay people i was like uh whoever told you that needs to again my hand metaphorically yes yes another stereotype it's bullshit it's bullshit uh whoever's telling you that it is just you know they just want you

to suffer and they they do not want you to experience the maximum way in which you can experience pleasure and then that's when we have these great conversations about you know this is how this is how the same we have the same electrolyte issue this is how it goes for females or peak bodies with vulva and this is how it goes for bodies with penises and then you have this amazing prostate which which has so much power and has shown such great results for people with erectile dysfunction and they were like you know what sure we need to try but if if i if i do not feel comfortable and if i you know just do not use it um is that okay i'm like absolutely nobody's going to force you if you want to you can not go to this step or do not the stage we can still

discard this you can try it with your fingers um but they seem to be quite adventurous agreed to go on an adventure together yeah you already you already awesome adventure of a PT and OT coming together and then against the video and then with butt play it was it was such an adventurous session and uh i think after four weeks uh i followed up i think once they continued with three sessions with the physiotherapist for pelvic floor strengthening uh instinctive control i saw them once a week and after like about four or six weeks they were so happy to even experience um to experience orgasming without erection amazing and this is something that i i don't think a lot of uh people with penises acknowledge that they can still experience orgasm without an

erection being there you sure can oh my god the the the smile the smile the relief um and it just makes you I think everybody wants that validation that you know oh I'm not broken right or oh I could experience this is my body really doing this and for them to have that revelation that I'm sorry for them to have that revelation that my body did this that was huge and and to be very honest they saved so much time they saved money because they did not have to uh come to me all the time i was there to i was there to reflect on how the occupation is being done if i'm going to need another session or not and we could have split the session in such a good way that i know that if you know what my physiotherapist therapist knows kinesiology and pelvic strengthening and

they can do that much better they they they know how to conduct these exercises that's right up the alley let them do it and then i can i can come there help them how to modify this occupation when they're actually masturbating and that's that's such a fun collab so fun powerful i love it pt ot unite that's great great and it was for the sake again for the sake of the person that was seeking help and and had the courage to seek help for their erectile difficulties right i mean just think about it folks like for someone to even just call you right or call a health provider or to disclose like hey this is really bothering me like is this something you can help me with you know that takes so much bravery to do for anyone exactly and after having

um especially when you go to google and you and you search about erectile dysfunction function or you talk about premature ejaculation there is so much written about physiotherapy there's there's a lot more written about surgeries and medications yeah and um i'm like there is a lot more that you need to do in order to feel better and in this entire time and the reason i think an occupational therapist and a physiotherapist helps is because in this entire time we are still forgetting that it's also their mental health that gets impacted so so much severely their confidence their self-esteem the way that they engage socially forget like i'm a single person i i feel attracted to somebody if i know that i cannot experience this or this

or you know certain things are not uh you know sexually are not in place for me that impacts the way i'm gonna even date or find a partner for myself right and there's there's just so many layers to it and i think that that is exactly why i think having rehab professionals when it comes to uh anything sexuality we need to be there 100 100 100 if we can deal with toileting i'm talking about peeing and pooping and accessibility to go to the toilet that's the most intimidating and we are there we are there we are there and so open to talk about modifications and assists and caregiver training and that includes also sex folks our sexual parts our pleasure our sexuality all of it I speaking of I wanted to talk about

another case with you if you if you have any kind of in your wheelhouse about for those that identify with a disability i mean i know that could be a very broad range um what cases as far as adapt like adaptations modifications that were integrated into sexy time or pleasure exploration right because sometimes you know i'm thinking about like um aids or assistive devices that seem very they're stigmatized to be very medical right and we're taking a spin on those and saying like let's make it sexy let's put let's add that to our pleasure exploration could you share with us like a case or or um or it could be anything that you have on your mind around around that topic oh my god this is so nice okay so um i had i'm gonna give you fun ones

so i had uh they're all fun they're all fun uh so i had uh a cisgender female married uh who had undergone a total hip replacement and was still using a walker for uh just for mobility and you know just one day when we was again like having these conversations i make sure i always ask about sex always tell about contraindications indications this is the position that you can go with um how much do you want to hold off how does the pain medication going to affect the way that you experience things yeah um lubricant recommendations always on the side you know this is in in the entire process i do not want him to feel overwhelmed at any point that oh my god just because this happened my genitals stopped working my body does not understand sex anymore

so so that's that's that's that's my uh that's my jam and then you know i was like uh they were like no i don't want this this is just true it's everything for me i'd always loved the standing position i used to do and you know what this just ruins it for me i do not like that that's the ultimate way for me to experience it i was like you know what just hold up hold up a week in the meantime you can try this alternate position and after a week let me know how your pain is let me know how you are feeling and possibly we can find something out together just in the whole anticipation of knowing that you know what i need to get better i need to know what can be done what can be done i think that anticipation was so great that she was like you know i want to know it what

is it what are we going to do the pain has reduced uh the pain has reduced the ranges have improved and just tell me what can i do and i'm like you know what you were cursing that mobility ate so much now that you've done it now that there's time to ditch it you know before that why not use it to your own rescue right so we took a stool just like a normal stool which is like on a very low height something that adjusts the pelvic range in which she can stand using the walker and voila they can have standing flex again it's not i mean they hated it already right they already hated it they wanted to do it in a standing position now they love it they know that the balance is going to be great they're not going

to have a fall right and it's just like it's a very small modification very small something that does not make you feel that you know i cannot experience this why i still have this pain or i have this limitation i think even um a similar case goes for uh a client um an adult i had actually not even an adult just like in the early 20s with spastic sleeping and they were like you know what my my with hand deformity and saying that you know what i cannot uh i cannot ask my caregiver to um say that you don't give me a hand job this is not something that my caregiver has signed up for um not even a conversation i think most parents here or households have here if they're disabilities um so i was like you know what let's let's have a conversation with

parents about how can we navigate these things together and while they still had an equipment um like a universal cuff just to fit in things right he's like you know what let's let's try a vibrator even if it's just a bullet vibrator you know what we can you know still find an attachment for it so eventually i had to make sure that they get a a different universal cuff so that they can at least have two different sizes of vibrators inserted in there even though they were still bullet vibrators so that they can insert of different lengths different intensities and that not only helps in that vibration not only help in relaxing the spasticity of the hand and then again it's so tricky that we had to sit down for the first two sessions

just to understand how it feels on different parts of the hand or say probably neck um like places that they find at least in acceptable the acceptable areas in a setting how how can they find it pleasurable what should the intensity be so that the spasticity does not increase something that's relaxing creates a good mobility for the next say 10 minutes or five minutes record the time and let them practice that when they go back home how is that going to be helpful for them uh who can help them navigate even you know having these conversations when we're talking about disability and adaptations which person can be around how much is the caregiver actually ready to um you know support the patient through this and i think navigating even though it's so

much fun sometimes it can also become very embarrassing in situations like these so having accessibility to porn or say erotic media what are they going to choose what's what's acceptable to them what are they what do they want right so that even though they are exploring themselves in despite their disabilities it should not be shameful they already have so much more going on with them so I think yeah this is this is again something so beautiful again so tricky but to to navigate that in a setting like this it's fun absolutely and a trailblazer you are and the people that you're working with how amazing it is to have each other you you know having each other to work with, right? Like, you know, I just feel like even as a, you know,

as a clinician, there's so much that I learn from folks too, with their willingness to explore such intimate topics and conversation and what a privilege it is. And so I say with each other, because it's a power with, you know, I'm always a power with person instead of a power over. And it's it's it's just a beautiful collaboration uh when you're in that third when you're navigating that therapeutic space that alliance therapeutic alliance so absolutely um i'll tell you what my client taught me and i think this stays with me and i think somebody can try it out there as well so um they have rheumatoid arthritis and they have been diagnosed for about two three years and uh they loved how bdsm says and they wanted to explore new things and they were like you know

what i i started using this whip uh but that just caused me an allah deviation so basically a wrist deformity and i was like okay so you know to even go ahead and find out that these are the variations of whips this is a range of motion that they can try with whip which does not cause uh which is not causing allah deviation other ways that they can hold it the ways that they can use their shoulders and elbows to make those ranges that was like a way of strengthening it all together and it was like wow i never thought about it that way right eventually it's still a sexual activity yeah but if it was just me I think I wouldn't have gone back to think you know oh we can use a whip and we can you know shop for a whip like this this is like the more lightweight one this is going to be

more heavyweight one this is how it can impact the person with RA or rheumatoid arthritis or somebody who has any digestive qualities and so that just helps you with analyzing and I think that that's it was one of the times that my clients really facilitated that you know what this is what you can do even though we are trying to incorporate something in the practice for them this is still a valid occupation that they want to engage in and they're just saying that you know what don't just have it play you cannot say that you cannot say that until unless i know that it's absolutely harmful i cannot say that right because that's it's it's a pleasure source for them it's something that empowers them and just to figure that out i think yeah that's that was one of the

another case examples that just you know blew my mind I was like yes they they make me learn so much oh I love it I love it oh my gosh they're so yes such a team I love it so Dr. T where can our listeners connect with you reach out to you I know you have Instagram and a new podcast so share share all the goodies with us so you can always find me on instagram everybody can find me on instagram i always have free resources there i love to connect with people there um and the id is uh sex love and ot uh the website goes with the same name sex love and ot.com you can drop me a mail at sex.love.andot at the rave gmail.com um and i'm just everywhere just google just just just put it there just put sex love and ot and there will be a beautiful face

that pop up that's that's mine and you can reach out to me you can um my dms are always open for people uh unless it's forward uh then again it's the hand and the cheek that's right that's right we will not tolerate that inappropriate behavior absolutely not and i think yeah there's just a bunch of things uh people can find everything on the website they can find everything on instagram as well um i am not a monster i'm mostly very friendly so you're a wonderful human being and they're doing such wonderful amazing work and we need more folks like you um all over the world we really do they need more healthcare professionals like us who can do these things who can come together who

can help expand each other's brains um just hype and you know be like yes i think that hyping and the pom-pom because um yeah that's a good pom-poms i forgot yeah because i think in the entire journey even though we have been uh we are here to serve and care for people there is still a population of people and healthcare workers like us who are still not validated as human and i think this experience is you know having this community having to come together share these experiences and that you know what we're here for each other we're cheering you um and we're going to continue doing what you do and it just it just means that you know everything is worth it because somebody actually feels better that's right that's right someone's world just changes and improves and

yeah and that's just a beautiful thing we're here for each other right and to cherish other people and and not bash them or judge them or criticize them because we're all we're all in the same boat folks so what a beautiful message dr t thank you so much again for being on the show for all the work that you're doing for everyone i have learned so much today from you thank you so much dearly and to all of our listeners and viewers thank you so much for being here with us and until next time my friends in loving wellness for your pelvis this is dr suzy bye thanks for listening to today's episode be sure to head on over to drsuzyg.com where you can get more information show notes and related articles on today's topic also if you like what you're hearing

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