In Your Pants with Dr. Susie G - Social support for men with pelvic pain

Episode Date: December 3, 2019

Social support is crucial for well-being and solution-oriented problem-solving. Men don't tend to have outlets to feel heard and understood, or a safe space to be vulnerable. Sociocultural taboos and stigmatization are major barriers to men seeking and receiving support, especially when it comes to their most prized parts. On today's show, I've invited psychologist and sex therapist, Dr. Teresa Johnson, to chat about the barriers and challenges that men face with sexual health issues, intimacy, and pelvic pain. We dive into the importance of social support and connection when facing these challenges. We also have some exciting news to share with you, so be sure to listen to the entire show. Thanks again for listening, enjoy!

You're listening to In Your Pants with Dr. Susie G, the physiotherapist for your private, helping you get in the know down below. Hey guys, it's Dr. Susie G here and welcome to another In Your Pants podcast episode. Today we're going to be talking about all the complexities of what men are dealing with when it comes to sexual health issues and intimacy and how pelvic pain really impacts social support and the need for connection with other fellow men to find that sense of community, that sense of safety, to be able to be vulnerable and express how they feel, particularly when dealing with pain, sexual issues, and intimacy. And to help me do this, I have Dr. Teresa Johnson.

And Dr. Teresa Johnson is a licensed psychologist in North Carolina and New Hampshire, and she's a certified sex therapist. She works primarily with individuals and couples to address sexual intimacy issues, including desire, performance, pelvic pain, and anxiety. And we know that all of those issues do come up for people who are experiencing any type of distress or pain, particularly related with their genitals, can be a really scary thing. So I'm so glad to have this openly candid conversation with Teresa today. And without further ado, I welcome Teresa Johnson to the show. I hope you guys enjoy. Hi, everyone. Welcome. Thank you so much for being here on the show. This is Dr. Susie G. And I've got Teresa Johnson, sex therapist,

psychologist, and we're going to be chatting to you about sexual health issues, particularly for men and men who struggle with, you know, pelvic pain or other intimacy issues. So back to Teresa, thank you so much for being on the show today. Thank you. I'm excited to be here. Thank you. So tell us a little bit about how you got into this work. Oh, okay. Let me think of a short description of a long path. But I guess what I would say is it started with just an interest in sexuality years and years ago and really seeing that within our mainstream culture, we don't have a lot of healthy messages. and so I've just been excited to find some way of helping people connect with their sexuality with their sexual selves because I believe we all have some aspects of ourselves that

are innately sexual and we can be more or less connected to those aspects which I think impacts in so many places in life and so when I was in grad school I got excited about the possibility of becoming a sex therapist because I had a supervisor who was practicing sex therapy, teaching a sex therapy class. And then I discovered there were lots of another long path to become a sex therapist. So I kind of gave up on that. And not too long after I started my practice through my professional organization, I joined the committee and the woman chairing the committee said, I'm a sex therapist and I will be retiring soon. So if anyone is looking for supervision, this is what I'm doing now. And it felt to me like the universe just aligned in

this like, oh, this is meant to be, here's this amazing opportunity I thought I would never have that I'd given up on years before. So I kind of feel like it fell in my lap that what I was really seeking just showed up so I was able to do supervision under Dr. Judy Rowan which was amazing and and so it's just from there has been more like this deepening what aspects of sex therapy because that's so broad what aspects really draw me where the needs what change can I help bring what a wonderful story well we're so thankful and grateful that you love the work that you're doing because it is an important aspect to everyone's well-being honestly I mean when you're talking about our into about intimacy and about relationships and our private parts not

just from a biological point of view but from a psychological and sociological point of view that is really the crux of the foundation of you know our being really and from an evolutionary standpoint right like you know from an evolutionary standpoint i always say this that you know pooping and sex are pretty are pretty foundational aspects for survival and for our human species um it's a big deal and i'm glad we're having this conversation particularly because you've recently kind of expanded your work into groups group settings for communication and engagement um let's let's talk about that a little bit social support and i i kind of want to take it with um in context of of men and social support and health taking and connection behavior um

we kind of go there what what have you seen um how important is it to have social support and the right kind of social support because it can you know either help you or inhibit you but let's let's kind of go there. Yeah, yeah, absolutely. I, this is, I think a really critical piece. So just as a therapist, what I see often is in initial conversations with clients that they are seeking a safe place to talk about the most important aspects of their lives. And for men, even more so than for women, so many topics are taboo among friends and which is so much about what we're taught in our culture, how we're socialized, that men are really limited in the social support that they are allowed to receive or that is considered okay to ask for. And so

I often see men who are saying, I've never talked with anyone about this, whatever the topic is. I don't have friends I can talk with about this, or my spouse is the only person I can talk to about this, or this is about my relationship with my spouse, so I can't talk with my spouse about it because it doesn't go well, or I have shyness, so I don't want to talk to my partner about this topic, especially when we get into sexuality. Often, even when I have men who have strong social support networks, it's not so much about emotional support. It's not so much about talking about the issues that they're dealing with, what's on their minds. It's more about spending time together, which is really important that they have quality time together. But there's this

aspect that I think women are able to access much more easily than men are in being able to process the hard things. And when we're not able to process with another person, often just loops in our mind. We can ruminate on how difficult something is or tell ourselves we should be able to get through something on our own, especially if our culture tells us, if you were strong enough, you'd be able to handle it if you were smart enough you would be able to figure it out and that's just not true we're social creatures we're intended to be interdependent and so in our culture we're we are told to be independent and handle everything on our own or else there's something wrong with us so a piece of the work i think is is untangling that unhealthy message

even just to begin to receive support yeah what a powerful message and the one one thing that some of my patients will say like man up man up and i always wonder i always thought about where do these beliefs come from how did how did that even happen and unravel um this psychotomy of you know this is you know this is that you're this these are roles we play in terms of gender um we're all just human beings and we all have our struggles and um knowing that we're not alone in those struggles can really create a powerful connection on a bigger scale versus it's just scary when you feel hopeless helpless and isolated you were talking offline but there you know the statistics are out there the more hopeless and helpless you feel about a given situation

the darker things can get in your world and that unfortunately can lead to increased this for suicide um so yeah it's such an important important topic um now you mentioned we're talking about social support and we were talking about this offline too i think it's just so good but let's talk about the type of support that may matter and particularly when when there is a struggle whether that's with intimacy and sexual sexuality or or pain i know a lot about pain and the type of support that in your in your practice in your experience what are your thoughts about the kinds of social support because it could go either way right yes certainly so uh support that is helpful involves receiving empathy compassion understanding right those those

three aspects are crucial for what we're receiving to actually feel supportive. What we often receive if we go to a friend or someone in our lives and talk through something, it's not uncommon to receive advice or to be told, oh, it'll be okay, right? Something that's placating, not supportive. As we were talking about earlier, a lot of times when we're trying to find support around issues where there's not a lot of support in our individual lives, people go online. So a lot of support is virtual support nowadays. And a lot of that cannot feel so supportive either. So that may be that you get into conversations with people on forums where everyone is just talking about how bad things are or how frustrated they are with the medical system or how discouraged

they are with their ongoing struggle. And I see clients really suffer from that. So not only are they not getting the treatment that they need early on from providers who aren't specialized and educated in the areas, especially with pelvic pain, but then when they're going online to try to find out what's going on with my body and how do I handle this, a lot of that then brings them to a lower place. And often they come in really discouraged and overwhelmed and not feeling hopeful in part because of the kind of support, I want to say in air quotes, support that really wasn't useful to them. Yeah. Right. And that's across the board, not just from, like you're saying, social media or that, but even healthcare providers not getting support, you know, doctors

not listening or not validating the person's experience, you know, it's all in your head, Or there's nothing that we can find, you know, take this pill or take those antibiotics. And, you know, it's, it's unfortunate. It's unfortunate because that is, that is a circumstance that most men will find themselves in time in and time again, until they finally reach that point of, you know, I've got to do something different. I've got to explore other avenues. And the internet is a beautiful thing in that,

that they will oftentimes find the help that they need. but it is going through a lot of the trials and tribulations prior to that point that unfortunately does create a greater emotional learning pattern because there comes a point where pain is no longer like tissue driven per se it's never like just tissue driven but it kind of moves away from that from the body to now an emotional learning a memory trace a patterning a neurological change structural change in your brain that happens as you know with memories the experiences failed treatments lack of support that sort of thing so it's anyway I'm on a tangent but there's there's biological and neurophysiological changes that

occur when someone continues down that path of persistent pain or or whether that be anxiety you know anxiety or sexual health issues or dysfunction or intimacy issues those are all pattern neurological patterns that start to you know gain momentum yeah yes yeah all all true absolutely i'm on a tangent i get really passionate about this stuff and it's like i love your passion about this duct tape my mouth okay where's the duct tape okay so so based on that. That's super complex. And I threw that out there, but you know, let's talk about the complexities of what men are dealing with in regards to sexual issues and intimacy. I mean, that's a big topic. We're short of time, but let's go for it. Yeah. So when men are dealing with,

when I'm seeing men who are dealing with sexual intimacy issues, sexual functioning issues, pelvic pain issues, these are all intertwined. Often one of the obstacles is finding the providers, right? So I love that you do this work to put this out in the world so that people actually can find you and find other people who are also doing this work. So often I work with men who had difficulty and took a very long time to even tell their primary care or their urologist that they were having pelvic pain or that they were having sexual functioning issues, because it takes a lot of courage to be that vulnerable, even with a provider, even begin at that point. And so they may have been dealing with some of these things for years

before taking the first step. And then that first step may or may not have led them to helpful care right so i think for anyone who is at this point of saying okay i'm seeking support and treatment around this issue i'm so impressed that you've gotten to this stage because there are so many obstacles to even get to this point uh yeah and and then that i so much of what gets in the way there i think is because of the cultural messages as we were saying earlier about that you shouldn't need care, but we also have these unhealthy messages for men about sexuality, that somehow if you're having a sexual functioning issue or pain, that's emasculating, and that that could go to the core of your identity as a man.

And that I see being a tremendous obstacle to care. So a piece of the work, the psychological work in psychotherapy is working through some untangling some of those pieces, that this does not mean something about weakness. This is just like with any health issue. We have these human bodies and we have struggles with our human bodies. And when we listen to them, then we're able to say, okay, what's my body needing? Now, can I find the support that I need? How do I take care of myself through this difficulty rather than judging and criticizing ourselves for struggling with something physically or emotionally or psychologically. So really working through that piece that especially men are handed that they

shouldn't need support is, is that's a huge piece. And then what does it mean? What do they tell themselves? It means about them that they're dealing with a sexual issue is another significant obstacle, but working through that individually, I see that's so effective in individual therapy or in couples counseling. So I work with couples who are dealing with intimacy issues, but I'm also really excited for the groups. So a huge benefit. Yeah, this is going to be over here on the other side. Maybe you guys can't see me, but I'm like raising up. Yeah. So when we, uh, when we offer support in groups, this is a beautiful opportunity for men to be able to support other men who are dealing with similar issues. And this is incredibly

powerful research shows that having social support from people who have shared experiences is incredibly powerful. So offering groups to create that safe space to support each other is our clients and our patients can receive something that individually as providers, we can't provide, right? What we can do is bring people together and facilitate a healthy the environment and provide guidance and bring in helpful resources and help facilitate conversations that are uplifting and help bring that hope that you may not get in a forum where you might get bogged down, right? But really bringing the positive energy, offering the guidance, but also really just

creating space for men to support other men, to be able to share their experience to whatever level of comfort they have and to be able to support each other to um to be able to validate another person's difficult experience right that is so powerful because as humans we all want to feel seen and understood and there's so few places in our day-to-day lives where we receive that but it's really really healing when we can have it especially around issues that we've been pushing to the side and hiding because we have some shame or embarrassment about it. So I think it's incredibly important around sexual issues that we have those spaces to support each other. Oh my gosh. Beautifully said and shameless plug, everyone. Shameless plug. Teresa and I are

combining forces to bring you this ultimate safe space. Essentially, we are collaborating on creating this group for you so uh yeah so in my practice i work with people across sexual orientations and gender expressions so um i would say anyone who's dealing with pelvic pain um and we want to be thoughtful about this so if you are male bodied and dealing with pelvic pain and if you're if you are not identifying as male though then joining a group for men may feel difficult, right? So I would say if you are identifying across gender spectrums, and you want to reach out to me individually, contact me and we can talk about the makeup of the group and what may feel safe and affirming and whether the group feels like it would be a

good fit for you. Thank you. And we'll have your information and contact information. You guys can reach out to me as well. But yeah, thank you so much. Beautifully said. Perfect. That's why we're connecting guys that's why we're connecting because two two great minds think alike and this is a powerful team this is a powerful team that's coming together to kind of combine all these elements into the healing process for you and essentially like you know Teresa was saying and you were saying Teresa that we are giving you the power we're handing over empowerment self-efficacy autonomy independence so that you can feel resilient resilient in in whatever struggles that you may come with in life these are life skills size this is not just you know

for the current issue these are life skills that will help you throughout your entire life the rest of your life yeah so very very powerful very powerful um we talked a lot about things what let's and we talked about sexual health issues and intimacy um i'd like to kind of take this into the anxiety and depression pieces that may that obviously accompany distress right um and i feel like anxiety gets a bad rap you know anxiety gets a bad rap oh my gosh I'm an anxious person and we start to identify that I'm always an anxious person and you mentioned identity several times but I'm going to hand it off to you let's let's talk about those those components of anxiety and and perhaps depression

in some cases yes absolutely so the majority I want to say all but it's never all most of the clients that I work with who are dealing with pelvic pain are also dealing with anxiety. Anxiety is part of our human condition. So I would say some of us fight against it more than others. Some people can embrace, Oh yeah, I'm a little anxious. And then it just happens in it and it's normal and it's on and right. And then others of us, myself included get caught up in, oh there's anxiety right what does that mean what do i do with the anxiety and anxiety so anxiety itself is actually very normal and natural and we need it so it's part of our motivation to get up in the morning um the work that i do with clients when when we're dealing with anxiety where

it is getting in the way is when the anxiety is really heightened or we have anxiety about having anxiety so this um you might relate this we bring it back to sexuality is if you have performance anxiety then you're having anxiety about what if i'm not able to perform whatever extent i think i should right we have these messages about what what should happen and so there's judgment and there's self-criticism and there could be embarrassment or shame and so the anxiety there really is a fear response, which is a constriction, which is really counterproductive for sexual performance, by the way, because it constricts blood vessels and tightens muscles. And we don't want that during sex. We really want to be relaxed. So no, the brain is saying,

nope, not right now. Right. It's like, it's a rough mode, not a time to create. So a part of this, like when we're dealing with sexual functioning issues is how do we rewind that and get back to a relaxed state rather than a fear state. So when I talk with clients about what's a healthy sexual experience, what's a positive sexual experience, it involves relaxation and connection and pleasure. That sounds yummy. Yeah, yeah.

I feel like that's the recipe. And then the challenge is how do you bring each of those elements, right? Because as humans, we have lots of obstacles to pleasure. We have so many obstacles to pleasure, right? And so many obstacles in our culture to relaxation and also to connection. So connection is about emotional intimacy, which is so much about being authentic and trusting that the person that we're with can really see us and is accepting of who we truly are. And that's really vulnerable. and particularly around sex we can feel especially vulnerable so having a sense of emotional safety

with one's partner is critical be able to relax and feel connected right and you need both of those for a good experience and the relaxation is essential for pleasure so so coming back to the anxiety piece i work with clients around how to move through anxiety how to work with anxiety when it shows up, especially how to work with that around sexuality and sexual intimacy so that you can have an improved sexual experience that feels good to you. That is, I will say, not outcome-based because that's, again, one of the challenges in our culture. And again, more for men than for women, though we all get those messages, is that good sex

is about two people orgasming at the same time. And all of these things about what it should be, it's a pretty boring recipe. so so part of the the lessons that i try to help my clients with is expanding how they see sex what is sex and what what are you looking for when you're having sex what are you what are the rewards of that what are the experiences you want to have and learning different ways to do that rather than what they're traditionally told or what's learned in pornography because that's you know, our most common teacher around how to have sex is pornography. Lots of bad information there.

Yeah, that's entertainment, guys. That's called entertainment, you know, like not reality, unfortunately, which is nothing wrong. Everyone can enjoy entertainment, but know that that's, you know, you're looking at like Michael Jordan or that's Michael Jordan from my day. I don't know if many people know basketball player Michael Jordan. But yeah, you know, not everyone's a Michael Jordan, you know, and that's okay. And you may not enjoy the same things Michael Jordan would enjoy.

Exactly. Your partner might not either. Exactly. It's a co-creation. So part of the work in the intimacy with couples is how do the two people co-create a meaningful and enjoyable sexual experience together? So it's about learning in the moment. And when we're anxious, we're not really learning. We're in fear. We're not curious. So part of the work is shifting into curiosity and being present and mindful in each moment, connected with one's body rather than caught up in all of the fear thoughts and really, really being engaged to even know what you're desiring. how do you want to be touched how does your partner want to be touched you really need to be there to know those things right so that that in itself too is part of bringing down the anxiety

and just showing up and and creating it at the time rather than planning it out ahead of time and thinking you know what should happen because you don't you can't don't write the story before it's been written or like or happen right before it's happened don't write the story before it's happen yes um that's beautiful beautifully beautifully said um Teresa that's really really great and I'd like to add that that those are all yummy components and the recipe for pain as well yes you know um being mindful not being in that fear-driven state or fear-avoidant state incorporating healthy coping strategies and behaviors that allow you to live life and have a meaningful life versus a life that's all about pain and pain is the driver you're essentially

shifting the control so that you can gain calmness and peacefulness despite fluctuation incantations and working with that and find and seeking pleasure and joy so often that is lost and there's a lot of grief there's a lot of grief that happens with persistent or chronic illnesses and pain symptoms and stuff like that and we forget who we once were and i think that's important to go pleasure hunting and define what pleasure looks like for you right now and what what would you like to have it look like in the future and creating a vision you know we lose that sense of self i feel like yeah yeah beautifully beautiful i love it guys yummy you are in for a treat this is as i said the shameless plug again but this group is going to be awesome

because we are going to be diving into detail with these very important topics of intimacy sexual issues connection engagement communication and pain understanding our bodies and not being afraid to explore them with wonderful tools and strategies like you said life skills that will take you not only from this program or in this current moment but for the rest of your life so it's great great stuff great stuff Teresa I'm excited um so tell everyone about your you know your current practice what else you're doing what other wonderful and communities you're serving and how people can connect with you yeah yeah okay so i am uh i am licensed in two states north carolina and new hampshire so i do a lot of remote work telehealth so if you are seeking

individual or couples work remotely and you are living in either of those states you can contact to work together or meet in person if that works for us too. And I also offer groups online and in person. I serve people across genders. So I work with people who identify as cisgender and also transgender, genderqueer. I work with LGBTQ community as well. And I also work with people who are in ethically non-monogamous or polyamorous relationships or a relationship is open in some way. You can find all the information on my website. That's important. So my website is drteresajohnson.com and that is spelled D-R-T-E-R-E-S-A-J-O-H-N-S-O-N.com. yeah so I'm super excited to be um doing this group with you Susie it's I'm so excited for

this I think this is going to be you know an awesome way for men to be able to learn these pieces that are really going to serve them but also have support because it's something that I think is really lacking you know and as a therapist I'm looking for where are the holes that you know we can be helpful in you know filling who needs support that's not receiving it what are the ways in which people need support that they're that are not available to them when our resource is not accessible even if they do exist so i'm excited that we're going to be able to offer this and really make it available for people to to receive what they need absolutely and so many we can reach doing a virtual group um or an online group that this is we can really

take this out further than we can if had we been doing it individual um that's not to say that there's a time and a place for that as well but this is just really again about that communication with social support um being creating that safe space and and you know finding that web of support and those resources and how do we work with those resources um yeah just having a plan or this safe container it just makes things so much different it's different when you have that as an availability versus the paradox of choice and information that's floating around on the internet it's you know you have it under one roof which is really great so awesome awesome and on that note too we're we're we're going to have a webinar that kind of wanted to mention that as

well um i don't i don't i'm not sure if we have um i don't think we have a specific date for that yeah we don't have a specific date yet but that will be coming up in the next couple of months most definitely and um we're looking to launch this group uh in the new year so something to look forward to and we'll be sharing all that information to you guys if that becomes available So, uh, thank you so much for listening to our listeners and also to our guests, Teresa, thank you so much for being here to sit with us today and, and sharing your wisdom and your compassion. Cause I can tell you're so compassionate about this stuff and just so calming about your presence. I don't know if you guys can see it. It's just so it's, um, yeah,

you're very calming and it's great. So, um, thank you so much again for being on the show and for this wonderful collaboration that would be awesome for many people out there in the world thank you so much thank you susan thanks listeners hope you enjoyed this show as always in loving wellness for your pelvis this is dr suzy g signing off until next take care 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, head on over to iTunes, subscribe to the podcast, and leave us a rating and review. We'd love to hear your feedback. Thanks again.

Duct tape my mouth.