The Exchanges

Q What are the reasons that people don't speak truth to their partner? I mean, I imagine some of the common ones would be, I don't feel safe doing that, I don't want to hurt them.

A Yup. I don't want to hurt them, or I feel personally so ashamed. About whatever the secret is, or this truth is, that I don't, I don't think I can bear hearing myself say this out loud to my partner. So even if the partner really proves to be truly a loving, non-judgmental partner, that doesn't mean that the self is that understanding. So it could be more of a conflict within the self about why someone can't put words to it. That's why with couples often, um, whether they're, especially if they present with sexual issues, but even if not, sometimes I will do some individual sessions for history, or just for them to tell me a little bit more about a particular problem, because sometimes they really need to feel less concern about an audience, and the partner and I could be a little too much to share some truths, and if they can get it out with me in a, with a safer, Uh, kind of conversation that I can offer that I'm not going to be reactive to what they have to say, like a partner could, um, that then I could help them bring it into the couple, uh, sessions.

AI assessment note: “or I feel personally so ashamed... it could be more of a conflict within the self”

Q But a lot of the people that come to see you for couples therapy have a narrative about the relationship they need to change. Is it a matter of Changing perspective? Is it a matter of replacing the narrative? Like, how do you, how do you think about that?

A It depends on the narrative. Some narratives, when I, when I think about transforming narratives, um, for some people it means dropping one. Many times it could mean replacing one. Like, even with the idea of, let's say, without sexual desire, we're a broken couple. The narratives we're a broken couple, one or both of us don't feel desire, so we can't have sex. Well, if they begin to be even educated that there are these other models way beyond these older models that don't include desire as a starting point for sex, that narrative can begin to be dropped and replaced. So there's some couples who leave therapy with me that even can joke about it. They can say, well, what narrative are we going to do this week, honey? Are we doing Masters and Johnson? Are we doing Helen Singer Kaplan? Are we doing Joanne Loulin? Are we doing Rosemary Besson? You know, and they can joke about it and be fluid about it.

AI assessment note: “It depends on the narrative. Some narratives... for some people it means dropping one.”

Q Does that mean, like, I'm saying something and my partner doesn't understand or doesn't agree with me?

A Yeah, well, see, when you unpack, we need communication help, it can mean, Well, I like apples and he likes oranges, right? We're having trouble with differences, so it might not even be communications really the problem. It's that they're not able or they don't have the skills to be able to, um, hear each other out, to be able to then find compromises, which is a big skill in couples. So it may not even be that they don't even know each other that well, that they're not communicating each other that, you know, about themselves that well. It could be that they don't know how to manage Differences to find compromises, uh, that they may even feel that their differences mean they should be breaking up, that they're not compatible, as opposed to how do you manage to deal with differences? It's a rare couple that everybody is exactly the same. In fact, that probably isn't that healthy if people were like carbon copies of each other. Um, so, uh, but that's the catch-all phrase is it's rare a couple will come in and not have communication be part of it.

AI assessment note: “when you unpack, we need communication help, it can mean, Well, I like apples”

Q What are the common ways that women get aroused?

A Well, you know, it's, I, I don't know if women are that different from men in terms of arousal. Arousal can happen in so many different ways. Um, arousal can happen through physical things that happen, like the hand in the right place with the right pace, whatever, right? It can happen with what happens in our heads, like fantasy, right? Or anything that, uh, either just appears to us, like, you know, your lover comes in and is looking hot, To, like, you just bring in a fantasy of the last time you made love and it was so great, or even the guy down the hall, and that, that turns you on while you're doing, you know, your stuff with your partner. So it could be in, in your mind, um, and it could be, uh, also relational. Like, um, You know, sometimes the old joke, it tells someone, oh, you want to do foreplay, then put the kids to bed. Tell your partner, your wife or your girlfriend, she can go and rest and take a nice bath, and you feed the kids, put them to bed, put out the garbage, clean the, and that's foreplay, right? And now she's really going to be up.

AI assessment note: “arousal can happen through physical things... in our heads... also relational”

Q Is, is it, in couples therapy, outside of sex maybe, um, coming back to that a little bit, is it a matter of saying, You're seeing this through one lens, here's a better lens, and people instantly recognize that?

A It depends, because some of the things, like, let's say we have a communication problem as a couple, and then I say, tell me what you mean by communication problem, and give me each of your versions, because they could be different. And let's say they say, well, what really they mean by communication problem is, you like, you like Chinese food, and I like, ah, hamburgers, so see, we're not compatible. We shouldn't be together. So sometimes what they mean is, We have a communication problem because he's too different from me, and we just can't make it work. And then, because differences are bad, and differences mean we're not compatible. So let's say an alternative narrative is, actually differences are to be expected, they're not bad, and actually even differences could be complementary. They don't have to be not compatible. You start to unpack how they feel certain differences are, mean that we really don't, we shouldn't be together, and that perhaps it means that You, we need to normalize differences, and maybe learn some skills, and how do you manage differences, right? And they might then change a narrative, that we're not so not compatible, we don't have to break up, or we shouldn't have gotten, you know, together in the first place. So, and sometimes that will happen fairly rapidly, almost like a cognitive process, because part of offering, ah, alternative narratives is a…

AI assessment note: “It depends, because some of the things, like, let's say we have a communication problem”

Q What are the common recovery skills, if you will?

A Listening is a really, that helps. A lot of people can't listen very well, I notice, in general, in society, but in couples, you know, when a partner's starting to say things that, that trigger us, Some people have to have the retort ready, so by the time they're, even if they don't interrupt, some people just interrupt and shut up the partner, or talk over them, or start yelling or fighting, but let's say they don't do that, in their minds they could already be developing the retort, they're not even listening to what the partner said in the first place. So there's like a real, very common kind of couple dialogue that couple therapists can do that speaker-listener method, you've probably heard of it, but where you just force the couple to say, alright, you know, John has five minutes, And Mike has to be quiet and let John speak, right? And you can't say anything, Mike. And then after John stops, you have to paraphrase back to John what he said. So, so John knows you understand. And that to show empathy or to show understanding doesn't mean you're agreeing with what your partner said. You're only demonstrating that you heard him or her, that you listened to them. So that expressing, like, Empathy or understanding doesn't mean I agree with you, because then you'll have your chance to say what your perspective is, your subjectivity is, which could be very different. And then the …

AI assessment note: “Listening is a really, that helps... speaker-listener method... speaking's a skill”

Q Is the communication a skill, as in people are lacking this skill, or communication is, um, just a general term for all the problems that people are having?

A It's more the latter, I think, at least initially. Once I help people begin to unpack that and understand, what do you mean by communication? Because when people say, we need help with communication, I don't say, oh yes, I understand what you mean. I often say, tell me what you mean by that. And I might even say, you tell me to one of the partners, You tell me what you mean, and you know, if you have a different definition of communication, that's fine too. Very early on, no matter what the presenting problem is, I usually want them to each tell me their definition of whatever that presenting problem is, and start to normalize, and even encourage that there could be two different perspectives on it, so that people can begin to, if they're not that differentiated, it's called, that they can learn how to be more differentiated, which means really say what your truth is. Even if you're afraid it's bad news for your partner, let's create the safety here to get it out, because whatever way you're not saying truly what you need, or what you don't want, or whatever, is creating probably why you're in my office in the first place.

AI assessment note: “It's more the latter, I think, at least initially.”

Q Can you walk me through how people typically explain sex and then expand our definition of sex?

A Yeah, almost everyone Uh, and it doesn't matter whether they're lesbian, gay male, heterosexual, trans. Most people, because that's the, the narrative we're taught, is, uh, usually the definition of sex is genital. It, it has to involve the genitals, sometimes has to involve penetration, not always, and has to end an orgasm. Those three components usually are the most common when people say, we're not having sex, we want to have more sex, usually I don't say, oh yeah, ok, we'll work on that. I'll say, what do you mean by sex? And then I'd ask, you tell me your version, you tell me your version. And then there's a, actually, um, something I suggest the couples do when I work with them called, ah, the sexual menu. And I often like to make jokes about, you know, comparing food to sex, but it's like, how broad, you know, can, ah, your sexual menu be? So it's great to have intercourse, nothing wrong with penetrative sex or things that end in orgasm, but there's a whole lot more you could do with a body. Um, that, ah, that involves more than just genitals, um, or orgasm even. And so, um, first, I help people actually deconstruct sex, develop, and I might say, you know, just like with food, would you want to have a hamburger every night? Maybe, but maybe not. Could get boring. Or you might prefer hamburger, I might prefer Chinese food. Can we kind of mix it up, and one night we, we go…

AI assessment note: “usually the definition of sex is genital... there's a whole lot more you could do”

Q Is that healthy? Does it cause anxiety? Is there security and safety issues? Like, how, how do you?

A Well, what I often tell people is, this isn't a moral question, it's like, it's a, it's a high maintenance activity if you're gonna do it well. Because imagine, ah, even like the way I think of it, right, if all sex is group sex just with two people, now throw in a girlfriend or a boyfriend, or throw in like, you know, whatever someone is gonna be, you have your boyfriend and your husband at the Thanksgiving table, now you've got three sets of, you know, histories to cope with, or four, or five. So, certainly I think it's more complicated. There are more moving parts. I think it does at least consciously make people have to deal with jealousy much more upfront. They have to deal with envy more upfront. Competition. These are tough feelings to have in general. Um, but that, I don't think that, um, either form of relationship is inherently more or less, uh, healthy. I do think some therapists believe that. They believe that people who are in open relationships or polyamorous arrangements are less mature. You know, I've heard some colleagues say, oh, that person just wants to have their cake and eat it, too. Why can't they just live with the changes, you know, what you have to give up to be monogamous, and I don't see it that way. I see, I see it as actually more challenging, I think, to have an open relationship for all those reasons. You know, how are you going to navigate that …

AI assessment note: “I don't think that, um, either form of relationship is inherently more or less, uh, healthy.”

Q Why do you think we're not more honest about that?

A Well, some of the secrets, unfortunately, that's why I think it's important to have some individual sessions with partners, is some people aren't under the impression that the secret's going to be so devastating. And some of them could possibly be, let's say, if it's finally a gay man who maybe has to leave his wife to, to be happy. Um, but that's more, a little more extreme. But let's say it might be a sexual difference that really could be Negotiated, or sometimes it's a sexual difference that a partner may assume that their partner can't handle, and they never gave the partner a chance because they kept it a shameful secret for so long. Like with some kink things, or there could be all sorts of different, um, let's say sexual preferences people could have. They never, they have so much self-judgment about it, or they were shamed about it with other partners prior to this partner, that they don't even take the chance to share it. And that's my job, is to say, can I help you maybe bring this into the couple's work, or the sex therapy work, in a way that, um, might actually not be as disparate, you know, an outcome as you think it would be.

AI assessment note: “they have so much self-judgment about it, or they were shamed about it”

Q That was my next question. Like, how does arousal change during the course of a relationship? I mean, when you're 19 and 20, does it look, I'm assuming it looks a little bit different than when you're 70?

A It can, but I usually find, yeah, there are generalizations. You can say that as people age, um, does arousal become, um, more, um, does it diminish over time? But for some, it depends on the individuals. For some people, the, uh, in a long-term relationship, they might even be more aroused by their partner in their, I work with some people in their eighties. It's so great to work with the eight-year-olds because for some people, they love, they fall in love with their partners more as they get older. Because the love for them, and even the turn on is about everything they've gone through. It's such a rich, lived life through all the real ups and downs, that they so love that person, and they so want to pleasure them, or they're still so turned on. And also, sometimes, some studies will say, you know, being able to remember how hot it was when you were 20, when you're 80, doesn't hurt either. In other words, that's where fantasy could come in.

AI assessment note: “For some people, the, uh, in a long-term relationship, they might even be more aroused”

Q The more they go out of their way to demonstrate how happy they are, basically. Um, but then there's the narrative that each partner in that relationship has about not only themselves, but their partner, and then their relationship as a separate entity. Talk to me about, uh, can you expand on that?

A Yeah, there are all these levels of narratives, and if anyone wants to read about it, or I'm very, there are many theorists about narrative therapy. It's been around for a long time, but one of the favorite One of the people that I draw a lot of my work from and my writing and my presenting is Michael White's work. I don't know if you know him, but Michael White was, unfortunately he's passed away, was, um, a family therapist, uh, from Australia, and he, um, developed, uh, first with Michael Epstein, and then he did a lot on his own of a narrative therapy and family therapy, and, uh, and he talked more about how our narratives can be generated from more political or social outside of ourselves, Society tells us that we internalize, and then, ah, can make us feel broken, or dysfunctional, or less than. Um, but when you think about it, the family is a community, too. The family can impart narratives onto a child, right? Or, um, or even a relationship can impart narratives onto a couple, or partners in the relationship. Like, I'm very curious how people, ah, the minute I meet them, and I say, why are you here? They're gonna begin to tell me their narrative, right? They're gonna tell me a story. They're gonna say, we're a sexless couple, or we can't communicate, or we're not compatible, or whatever, right? So, and then that's a story, but then I want them to unpack that, that narra…

AI assessment note: “there are all these levels of narratives... or even a relationship can impart narratives”

Q Could be a really positive thing, right? You had these, Uh, you know, 30 years together, and they were amazing, and you have really good memories, but now it's time to.

A Yeah, and it's so moving, uh, I try and help people with that frame, to offer that frame, and for them to, if, if, if they can shift to a point of saying, you know what, I really can see why you were in my life, if I, even though we're getting divorced, I would still do it this way, that is an incredible, that would be like one of the best endings, because You know, you could say whether this is a spiritual way of thinking about it or whatever, soul mates, whatever, but there, you know, there are certain people who come into your life, even friends, not just, you know, partners, but that who really are there, who really, through the ups and downs, are real teachers. And, ah, and for some couples, they really can say that they, they're real teachers, but, you know, the lessons need to be done either in, if not together anymore. Ah, or, and even part of the lesson can be to be able to separate Well, and for many people, I think if they feel like, even if one person is really, um, initiating it more, which is always more painful, obviously, or if one person wants to leave and the other doesn't, that's really tough, but in whatever way I can help them stay in a room enough to, uh, understand how calm and to be able, whatever was good, be able to still be part of the, of the separation process, to bring that good that was there when they were both happy, To the separation process, t…

AI assessment note: “I try and help people with that frame, to offer that frame”

Q you don't want to hurt them. How do you work through somebody whose primary motive is, I don't want to hurt my partner, and how is that different from somebody who's, I don't want to reveal the truth to myself? Mm-hmm. Yeah, because I think it is basically, I think, um, Is it like once I say it, it's true, and then if I don't say it, it's not true?

A Yeah, partially. I mean, when you think about, let's say, a person, well, you know, here's a more dramatic moment, let's say you have that homosexual man, the gay man, who got married heterosexually, to try, either because he couldn't bear it, or he never came out, um, or he's hoping it will go away, um, and now it's 20 years later, And either they have no sex life because he really just can't do it, or he's having outside sexual activity with men that he's lying about or keeping secret and feeling terrible about it. I mean, there could be so many different variations, and, um, how is he going to bring that into a long-term relationship with a wife that, as a person, he truly loves and admires and is the mother of his children, and he might have all these other things about his life that mean, that is so meaningful and he doesn't want to lose? Imagine that. That's a pretty rough one. Kind of truth to bring out. Ah, and for many of those partners with those kinds of secrets, that's devastating. For many of the partners, they're like, how could I even have not known this, and what does it mean? This isn't something I can even make better. Like, let's say the big secret was an affair. If he was having an affair with another woman, let's say, at least, um, the wife still could be devastated, but she could think, well, maybe I'm gonna fight for him if I'm not gonna, like, reject him…

AI assessment note: “Yeah, partially. I mean, when you think about, let's say, a person”

Q One of the gender scripts I've heard about, you can correct me if I'm wrong, is that men often don't like to talk about their feelings with their partner. Why is that? Well, is it true?

A I think it really is variable. I think that is another one of those gender scripts that, you know, all stereotypes usually have a little bit of truth in them. Um, men certainly aren't raised. I don't think, even now, unfortunately, I don't think men are raised to feel like you can really be a man and be masked Skillin and manly and be sensitive and vulnerable and share your feelings, you know, and some women put that burden on men. It's not always men putting that burden on men, like the men have to go and they have to be at the bar and, you know, say how many people did they have sex with this week? Some men have to do that to each other. They one up on each other, but some women actually make it hard for men to be more vulnerable. So I do think there's some gender and there's some gender scripts or assumptions that women are emotional messes. And, you know, can't contain themselves and aren't tough, right? I'm old enough to remember the feminist movement making a big change in that department that freed women to be able to be more assertive and, and, ah, and be able to, you know, women can lead a, be a CEO of a, of a company. We don't have to worry that she can't handle it. She can be a mother and be a leader. Um, but we see even now even more contemporary society we still are burdened with. Why? We haven't had a female president in this country yet, really. You know, and I t…

AI assessment note: “all stereotypes usually have a little bit of truth in them. Um, men certainly aren't raised”

Q I was just thinking about asking you that. What is gender if it's not biological?

A Well, you know, scientifically, we would say there's, well, I don't know if we'd use the term gender technically. Some people use the word sex for, um, what one is, whatever secondary sexual or genetic makeups we are. I don't know if you know Anne Fausto-Sterling's work from Brown University. She's retired now, but she, she made an argument that there's more than two genders genetically. I mean, scientifically. Um, and if you look in the animal kingdom, you know, some animals, uh, actually shift gender, some fish, you know, et cetera. So, um, what is gender? Um, gender though, as opposed to sex, anatomical, or what you're born with, or what some, um, trans activists would say is what we're assigned at birth, is that gender socially constructed? Uh, and so that part of the argument is, you know, what are we, what do we assume to have to be once we're born? You know, that's one of the first identifiers. Boy, you're a girl. It's a boy, it's a girl, right? Uh, it's a very central organizing variable gender in our culture, um, but it's being deconstructed.

AI assessment note: “gender though, as opposed to sex... is that gender socially constructed”