iVillage - On the Couch

Talking To Kids About Sex

Fri, 09 May 2008 09:40:56 -0500

On May 23rd, I will be doing a segment on the Today show on how difficult it is to answer some of your kid's questions on sex. Actually, for some parents it's difficult to bring anything related to sex and bodies up with their child. Some parents have trouble broaching the subject; others are great until their adolescent asks them if oral sex is really sex. Whether it's naming body parts, starting "the talk" or answering those tricky questions later about intercourse, sexually transmitted diseases or when it is OK to engage in sexual activity.

I would like to hear your questions! Please leave a comment with your questions about how to discuss sex and sexuality with your child. In addition if you have any particularly tricky moments that stumped you, please write them down too. I will try to cover as many as possible in the 8 o'clock hour of the Today show on May 23rd.

Leave your questions or concerns as a comment below!

Please remember that when you post a comment to this blog, your comment and the name under which you submit it may be viewed by the public.

More from Gail Saltz

Talking to your adolescent about sex

To Fake Or Not To Fake?

Thu, 01 May 2008 09:49:47 -0500

Most women have sometime in their sexual lives faked an orgasm. Not only that but they also have likely faked being aroused in the first place, or possibly faked experiencing what their partner is doing as feeling good. There are many reasons women fake it. Most women will tell you it is to please their partner. Women feel tremendous pressure to preserve their partner’s ego and fear he will be crushed if they don’t appear to orgasm. Women also think that in order to hold onto their man (keep him from finding a more satisfying partner) they have to appear very hot in bed which they believe translates into having an orgasm all the time. Some women fake it for other reasons. Many women are self conscious about the amount of time it takes them to climax. Rather than being uninhibited about how long, how much stimulation and what kind they need, a woman may chose to just fake it and not have to “expose” her needs to her partner. There is also a group of women who really don’t know how to have an orgasm. They feel very inhibited and have not been able to explore what work for them, let alone tell or show a partner how to help them climax. This group will often fake orgasms to avoid revealing what feels like a “defect” in their body or sexuality.

The problem with faking it is that it becomes a real vicious cycle. Once you fake it, he thinks he is satisfying you and therefore has no reason to try new things or ask you what would feel better…after all you appear to be feeling about as good as it gets. In the meantime, you may be feeling increasingly angry at missing out as well as hopeless about ever getting to experience what you are missing. The angrier and more dejected you feel during sex, the less likelihood you have of feeling truly connected to the sexual experience. As you distance yourself your chances of being really aroused diminish.

Should you ever fake it? In a nutshell, NO! Some women describe on occasion that they don’t feel like expending the energy it may take them to have an orgasm on a particular night. In this case, tell him that orgasms are not the end all be all for you and that sometimes the closeness and intimacy of sex is just what you are in the mood for. In other words, be honest. So what can you do if you have been faking it in your relationship and now feel stuck?

1. Come clean without hurting him. If you say, “You know all our great sex for the last decade, well I’ve been faking it…” you will really devastate him. I don’t recommend that. Instead tell him you have been having more difficulty achieving orgasm lately and would like to experiment with some new things. Then stop moaning and screaming unless you really feel that aroused. Next you have to tell him what you think would be worth trying to see if it works.

2. Give specific directions. If he has been left in the dark you really have to give him specific directions. “To the right, that’s great, a little softer…” The man cannot read your mind so tell him or show him what works.

3. Give yourself more time. It does take more time for many women and if you are in some race to beat the clock you probably will cave in and fake it. If you ask him, he’d probably say he would be happy to work at it with you all night. Many women think things like.. “he must be getting bored.” Or “he’s wondering what’s wrong with me”. These are your thoughts ladies, not his. Most men find sex to be loads and loads of fun and would be very pleased to spend as much time stimulating you as you would like.

4. Educate yourself. If you don’t know how to stimulate yourself, it will be difficult to tell him how to. First learn how to touch yourself and reach orgasm then you will be able to show him what works.

5. Communicate. Tell him that orgasm is not the only goal for you in lovemaking and that sometimes you are really quite content to enjoy the affection and closeness. Make it clear you will let him know if you do want to have an orgasm and that you will help him to help you. In the end truly pleasing you will bring both of more pleasure and closeness.

Please share your thoughts by leaving a comment below.

Can You Have Too Many Choices?

Thu, 24 Apr 2008 14:25:50 -0500

A surprising new study indicates that having too many choices may actually be bad for you. Expert Dr. Gail Saltz was on the Today Show to talk about the drain of decision-making.

Watch the segment from TODAY

Consumers often have the overwhelming sensation of having too much choice in the grocery store: do I pick tartar control toothpaste, whitening toothpaste, minty flavor, and does any of it matter in terms of getting clean teeth? The recent study shows that a simple everyday decision such as that can actually tax your brain, and leave you with less energy to do other things.

Do you find it difficult to make choices? Leave a comment below.

Related content from Dr. Gail Saltz:

Weight Gain and Marriage

Mon, 21 Apr 2008 11:22:45 -0500

I hear often from both men and women who say that they have abandoned their sex lives as a result of the loss of attraction to a mate who has gained significant amounts of weight. Weight gain can, in certain instances, be a result of a medical problem, but more often than not it is an emotional or psychological issue that keeps a person unable to either diet or exercise enough to keep weight off.

Watch the segment from TODAY

The issue of attraction to one’s partner is very complicated and rarely is it simply a reaction only to weight gain. Spouses not making the effort to lose weight may be doing so because they are already unhappy in the relationship, they are avoiding sex and intimacy, they are depressed for other reasons or they really have no idea how their mate feels because it has not been discussed. A partner can make a huge difference in one’s ability to lose weight, as well as getting in the way of dieting. That does not mean it is the partner’s fault if the mate doesn't lose weight, but it does mean the partner can act as an ally and help the situation, or they can be a saboteur and block dieting. Bringing junk food into the house, encouraging indulgence, eating high calorie foods in front of your partner and being inactive together are methods of inhibiting weight loss for your partner.

I got a huge amount of email from readers on this topic with responses ranging from:

Marriage is for better or worse and it is unacceptable to leave a partner due to lack of attraction or sex.
Beauty comes from within and it shouldn't matter what you weigh.

Men are visual creatures and can't be expected to be attracted to an obese woman; he should leave her.
If you care about your partner and yourself you should lose the weight.

The responses ranged from one end of the spectrum all the way to the other BUT the anger for almost all responses was quite palpable. Both "sides" were actually quite enraged, at each other for their opinion, and at me for not voicing their opinion. The problem was that you readers are not able to see my email and therefore you don't know about the other side of the argument.

So, I am posting this today because it seems to me this is both a common and heated problem and perhaps it would be helpful for each of you to talk about and hear the other side.

Post your comments here and try to be constructive, because it is helping your mate to understand how each side feels that creates empathy. It is empathy that allows one to feel understood and allows one to make real headway in communicating. It is real communication that makes change possible.

Related content from Dr. Gail Saltz:

Is your partner making you fat?

Fri, 18 Apr 2008 14:44:11 -0500

Dr. Gail Saltz was on the Today Show to talk about the connection between your partner and your weight. Is your partner making you fat? A recent study shows how much your significant other can have to do with your diet. Gail Saltz and nutritionist Joy Bauer have details.

Watch the segment from TODAY

What do you think? Do you think your partner contributes to weight gain? Is there a connection? Leave a comment below!

Related content from Dr. Gail Saltz:

Public humiliation

Thu, 17 Apr 2008 10:30:01 -0500

As I am sure many of you have noticed, there appears to be a rise in people choosing to show the worst of themselves or of someone else in a public forum such as Youtube.

Last week a group of girls videotaped themselves beating up a classmate and this week a woman airs her marital grievances as well as her accusations of infidelity and impotence.

Why is this happening? There was a time when no one would have dreamed of revealing such awful behavior and would avoid public humiliation. But the new millennium seems to have brought with it an ever-increasing threshold for public display, shame and exhibitionism.

Watch the full segment on TODAY

Humans by nature have exhibitionistic and voyeuristic wishes, but society generally helps them control those urges. Parents tell their children that it is wrong and act as role models of the proper way to behave.

Unfortunately, exhibiting shameful behavior has become sport, from reality TV to Youtube to Myspace ... Screens are blasted with image after image and we are all watching. We have become increasingly desensitized to the taboo of exhibitionism and to the taboo of sadism. Sadism and masochism are also parts of human nature but usually kept in check by a community that wants to keep each other safe and moral. Today, watching sadism has become in vogue, whether watching a chef torture wannabes or watching the humiliations and razor-sharp criticisms of American Idol, or everyone going to the boxing match to see the knockout, not the fancy footwork.

The risks are that the next generation will have an even harder time keeping the more primitive aggressive drives and wishes in check. Children learn from what they see and they will do as you do, not just as you say. Talk to your child about what they are seeing and teach them why this kind of public humiliation sadly helps no one and for many will be very destructive.

Related content from Gail Saltz:

The Non-Divorce Divorce

Infidelity: Danger Signs and Myths

Marriage S.O.S.

Attention Defecit Disorder In Adults

Thu, 10 Apr 2008 14:01:25 -0500

Attention Deficit Disorder is a collection of symptoms usually thought about in terms of children who are struggling in school, children who seem impulsive, easily distracted and fidgety. Increasingly, children are getting a diagnosis and then one of their parents becomes shocked to realize that their child's symptoms are the same as his or her own from childhood. Instead of being diagnosed with ADD and benefiting from treatment, this earlier generation was told they were difficult kids, losers, dumb or simply bad. Sadly, many of them/you grew up believing that all that was true and it shattered your self-esteem and became a self-fulfilling process as you struggled with underachieving at work and having difficulty in relationships.

But the diagnosis in children has liberated some adults to go back to find out if what they thought was simply being a difficult person was really ADD.

Symptoms may look similar to your child's symptoms, or be very different.

Overall, the problem is the sensation that thoughts are hard to hold onto, that you are often distracted by new thoughts before you got to complete the last one.
There is both a distractibility, that makes it hard to follow a sequential line of thinking or task completion, but there also may be a hyperfocusing on something that especially catches your eye, to the exclusion of anything else.
Feeling a rush to impulsively act on whatever comes to mind (in combination with a low tolerance for frustration) means you are a person who may say or do things that don't seem terribly appropriate at the moment.
Overall organization is difficult and so nothing gets completed, just lots of bits and pieces.
A mental and physical restlessness pervades, making it hard to relax without feeling anxious or tied down.

On the flipside many adults with ADD are highly intelligent and creative people, many are high-achievers. They can feel exciting, zesty and spirited in all kinds of great ways. There are a number of treatments available. Most are aimed at coping skills to contend with the weaknesses created by ADD, while boosting the individual's strengths. Sometimes medication is helpful, but often it is not needed, or needed for only a short while. See an experienced psychiatrist who has lots of expertise in treating adults with ADD.

No-marriage Marriage

Tue, 01 Apr 2008 11:38:56 -0500

Dr. Gail Saltz was on the Today show talking about a very hot topic from the iVillage message boards. Many couples are in long-term relationships but have decided that getting married just isn't for them. Brad and Angelina and Kurt and Goldie are just a few of the Hollywood couples who are committed without the paperwork, but more and more people are jumping on the bandwagon. Check out the full segment below.

Watch the segment from TODAY

What do you think about this hot topic? Leave a comment below with your thoughts, and visit the Unmarried by Choice message board to weigh in with other iVillage users.

Health Denial

Wed, 26 Mar 2008 14:00:04 -0500

Are you one of those people who never gets a check up? Do you just suffer and wait for anything medical to go away, rather than go to the doctor? Do you drink, smoke and forego exercise despite the knowledge that these things are bad for your health? Then you may be in “Health Denial”. Sadly you, or someone you love, could be shortening your lives because you won’t go in to see a doctor.

Why do people do this, you might wonder, given the high stakes? Most commonly the cause is fear. The very people who act as though they are unconcerned about their health are really just using the defense mechanism of denial to fend off their raging fears about sickness and death. Deep down it is the terror that the doctor will discover how sick they fear they really are.

Sometimes, too, people cope with their fears of mortality and being fragile human beings by pretending to themselves that they are the opposite: so tough that even doing dangerous and unhealthy things can’t affect them!!

The phenomenon of not seeking medical attention is more predominant in men than women. Many men feel it isn’t manly to need help, that if you are a “real” man you just tough it out. Also, talking about one's body and the things that can happen to it is something many people feel uncomfortable with.

In the end, however, health denial can end tragically. So if you, or someone you love, are ignoring taking care of yourself, here are some things to consider.

Wake up and know it can happen to you. No one is invincible. Everyone needs medical care. Everyone is harmed by smoking, excessive drinking, poor eating and lack of exercise. SEE what you’re doing when you are ignoring those facts.
Question what holds you back. Letting yourself be in touch with your fears generally diminishes them. Your fantasy of disaster is most often worse than the reality, and that will become clear once you let yourself think over what you are really afraid of.
Prioritize your health. You know the old saying, “If you don’t have your health…” It’s true. So, stop procrastinating and get that mammogram or colonoscopy. Many people say, “I don’t have time” but it is all a matter of what you make time for. Lack of time is simply another defense.
What are your risk factors? Do you have heart disease in your family? Cancer? Then you need to be advised on ways to minimize your already increased risk. Today’s top causes of death are heart disease, cancer, stroke, and lung disease.
Examine your lifestyle habits. Is it really worth it to you to smoke, to sit on the couch and eat cheese all day? You can have a big impact on your quality and quantity of life if you decide what habits are worth kicking.

More from Gail:

Why do men cheat?

Thu, 13 Mar 2008 17:37:40 -0500

Statistics (on how many men are cheating) are hard to come by, because, let’s face it, most men do not want to come clean on this subject. However, figures range from 24% to as much as 60%. Any way you cut it, many men are straying from monogamy.

What are the reasons that men do cheat?

Men appear from studies to be more sexually motivated to have an affair than women (who are more emotionally motivated). So, for instance, men are motivated by a desire for sexually experimenting and for having the rush associated with “new sex”. This is their way of prolonging indefinitely the early and intoxicating phase of infatuation in a relationship.

They also do it for control and power in the relationship. If he is an affair with no promise of commitment then he controls his level of vulnerability in that relationship. Some men cheat, in fact, to avoid any real intimacy. Intimacy scares them, so they distance themselves from their wives by cheating on them, and they also never get too emotionally involved with their lovers. This way, they never have to trust, rely on, feel hurt or angered by their partner. This kind of man probably also greatly fears conflict.

Many men strike up an affair when they start to feel the fear and loss that comes with aging. To run from the terror that they are not so young and invulnerable anymore, they have an affair to deny the aging, and all that aging means. They find something or someone “young and new”.

Are You Lonely In Your Marriage?

Mon, 03 Mar 2008 13:46:09 -0500

Most women I see tell me they are happy that they found someone special and are married because they would not want to be alone. What’s more curious, however, is how many women tell me that they really feel lonely IN their marriage. As hard as it is to feel lonely when you have no significant other, it is even more emotionally difficult when you do have a partner and you feel lonely anyway. When you are single, you at least have the fantasy that one day you’ll meet someone and not be lonely. But when you are married, your loneliness feels infinite and hopeless. You wonder, is it me, is it him or is it us?

What is loneliness?

Married or not, everyone has some time they spend alone. But not everyone enjoys it. The fact is to some degree we are all alone, in that no one can ever be at one with us “really”. On the other hand, metaphorically, we can feel at one with someone for periods of very intimate time. This happens in great friendships and great marriages. Still, even with your soul mate, there are times you will be alone. Alone simply means no other human being is with you. Alone time can even be intensely enjoyable if it is experienced as a freedom to do what you want and if you have the self confidence to think that your own company is pretty darn good. Loneliness is a feeling of emptiness, abandonment and rejection. You do not need to be alone to feel lonely and lonely is not a good feeling.

Watch the segment from TODAY

Marriage: It's only going to get worse

Tue, 12 Feb 2008 15:21:01 -0500

Researchers analyzed data collected from 1992 through 2005, as part of the Social Relations and Health Over the Life Course Study and particularly at the ratings to these two statements.

My (spouse/partner, child, friend) gets on my nerves.
My (spouse/partner, child, friend) makes too many demands on me.

In all age groups people reported viewing their spouse as more negatively than children or friends. This negative view of spouses tends to increase over time. Previous research has shown that the older people get the more stable their emotions and the less negative their experiences in a relationship, but marriages don't follow this rule.

Likely explanations are that children grow up and spend less time with you and you can pick, switch up and get rid of friends. But spouses stay with you and live with you, and over time, it seems, all this togetherness allows irritations at habits and differences to grow and fester. Demands that once were a little annoying seem a lot more annoying over time.

Most importantly is for people to know that some of these feelings are really normal and do not mean that you don't love each other anymore or should split up. It does mean finding better ways to communicate what is really a problem and tolerate what isn't such a big deal. It also means reorienting expectations so that you stop pining for perfection when "pretty happy" is much more reasonable.

Watch the segment from TODAY

Please remember that when you post a comment to this blog, your comment and the name under which you submit it may be viewed by the public.

Compulsive Shopping

Tue, 05 Feb 2008 16:05:44 -0500

Do you repetitively shop for unneeded items? Do you shop impulsively and ring up huge credit card bills that you can’t afford? Do you get an incredible rush from shopping that you find yourself craving? Then you may be a sufferer of compulsive shopping disorder. While many people joke about “shopping till you drop” and “I can’t resist a sale,” the compulsive shopper really does have an addiction. This a true disorder thought to effect as much as 8% of the U.S. population. 90% of those affected are women.

Watch the segment from TODAY:

CSD (Compulsive Shopping Disorder) is one of the obsessive-compulsive disorders much like compulsive gambling and binge eating. In fact, people with other addictive behaviors may also suffer with CSD. People with CSD may also suffer from anxiety and depression. They often shop in hopes it will reduce their tension or low mood, and not only does this fail to work, but they tend to feel worse due to the consequences of over shopping.

Many of these people have credit card debts they cannot possibly handle, legal problems including bankruptcy, destroyed marriages and ruined friendships as a result of lying about their compulsive spending. They often shop for the same object over and over again; objects that they do not even use. They may even have emotional “blackouts” where they cannot remember buying the things they did buy.

In July 2005, of The Journal of Clinical Psychiatry published a study from Stanford by Dr. Lorrin Koran. It looked at the use of Celexa (a serotonin reuptake inhibitor) for compulsive-shopping disorder. In this initial study it appeared that celexa was effective in reducing the symptoms of CSD. The celexa also reduced the patients anxiety and depression.

If you think you have a problem with shopping, there are ways to curb your “addiction” and it's important for both you and your family that you do so.

Shop only in a store. Shopping by catalogue, internet and TV shopping channels are ways to shop huge volumes in a short time. It is far too tempting for a shopaholic. Make these other methods completely off limits.
Stick to a list. Before you go shopping, at all make a list of what you need and buy ONLY what is on the list.
Use only cash or a check. Credit cards lead to less control and lots of debt. Only keep a credit card for true emergencies. For all purchases, only allow yourself to use cash or checks.
Group therapy. Just like for other addictions there are groups for people who share this problem and often being with others and hearing their harrowing stories is a help.
Medication and psychotherapy. If you truly have compulsive-shopping disorder you will likely not be able to control it on your own. Get a professional evaluation and consider treatment with therapy (to look at the underlying mood problem which may be fueling the addiction) and with medication which appears in this latest research to be effective.

"Are You a Compulsive Shopper?"
People on the Street Weight In:

More from Gail:

Are You a Compulsive Liar?

Keeping New Year's Resolutions Throughout 2008

Fri, 01 Feb 2008 16:57:52 -0500

Did you miss Gail's segment on TODAY? Have a question or comment?

Watch her segment with Ariane de Bonvoisin from TODAY:

Dr. Gail Saltz discusses how you can stay on top of your resolutions in 2008 beyond January.

Depression and Antidepressants

Wed, 30 Jan 2008 11:46:06 -0500

True Major Depression has a specific set of symptoms.

Depression means that you have shown the following symptoms for more than 2 weeks:

Feeling hopeless, helpless or worthless much of the day every day
change in sleep (too little or too much)
change in appetite (too little or too much)
loss of concentration and libido
anhedonia which means inability to take pleasure in anything
possibly suicidal thoughts or feelings.

If you have several symptoms you should have an evaluation by a psychiatrist. If any of these symptoms are affecting your ability to function, affecting your relationships or if you have any suicidal thoughts you should have an evaluation by a psychiatrist. Not all depression should be treated with an antidepressant, it depends on the severity.

Antidepressants affect different neurotransmitters in the brain. These are the chemicals that send messages between nerves and how our brain "talks to itself and the rest of the body". Some antidepressants affect the amount of serotonin, others norepinephren, and some also effect dopamine. Some newer antidepressants effect a combination of serotonin and norepinephren. The relative deficit of these neurotransmitters is believed to play a role in depression.

Some people will respond to one antidepressant and not another. Some will respond to none. We don't really know why. but a recent study found that a gene responsible for producing a protein which blocks the entrance of certain medications into the brain could be one explanation for why a person could respond to one drug and not another (that gets blocked before even crossing into the brain).

Mild to moderate depression may be treatable with psychotherapy, support and exercise alone. Moderate to severe depression is likely to require medication plus psychotherapy. The combination is proven to be more effective than psychotherapy alone. In order to benefit from psychotherapy one must possess a certain degree of ability to think through the process and have reasonable judgment. Sometimes medication is required to improve functioning enough to have psychotherapy help. In addition, if a patient is in danger due to diminished functioning or suicidal ideation, they need meds. Depression has a 15% suicide rate; it can be a deadly disease.

A recent report stated that some clinical trails of negative findings on antidepressants may have been withheld from publication. Any withholding of study results skew how professionals and people view the efficacy of a medication. Antidepressants do not always work, as much as 30% of people will not respond to any antidepressant. This does not mean they should not be tried with a person who is seriously depressed; we don't know who those 70% are going to be.

But many people are taking antidepressants for sadness and not for true depression; this is an overuse and an inappropriate use. On the other hand over 50% of people with true major depression are not getting any treatment at all. There are people who need treatment, both medication and psychotherapy, who either don't know that they have depression or feel they should be able to help themselves and are too ashamed to get the help they need.

More from Gail:

Please remember that when you post a comment to this blog, your comment and the name under which you submit it may be viewed by the public.