welcome to the bring intimacy back show where intimacy is real on the show we believe that intimately connecting with your self your significant other children Family Friends Business Network community and your higher power can elevate your life to work towards a positive future that's we explore intimate topics inspiring life stories spiritually and insightful tips on strengthening relationship this show is hosted by dr. April a Florida licensed mental health counselor relationship and intimacy therapist check out past shows on Apple iTunes Spotify to YouTube or wherever you listen to your podcast now let's get this episode of the bring intimacy back show started because we share with you the secret power to intimacy to create a life you love or love the life you create now here's your host dr. April

welcome to the bring intimacy back show where intimacy is real thank you guys for joining us too much today and if you're listening and you're listening to a podcast please or I'll show please give us feedback cuz we're changing things we'd love to hear from you well today we're going to talk about something that doesn't really get talked about much but I see it so much in my counseling sessions with others that I really thought that you know I really need to have this as a topic on the show and need to address the concerns of people out there with the situation and so the topic today is how infertility has destroyed my intimacy with my partner and that's a topic that I like he said I've heard and I've seen and anyone who's there who's listening who might be feeling well that identify took me or and or if you have friends or sisters or people

share this podcast with them so since I've had this topic out I decided to search and search and find the perfect expert and I mean she is the perfect expert talk about this and this is dr. Sarah Wilson Quest welcome Doctor Sarah

hey there doctor April good to see you. Yes so she talked to Sarah is really a board-certified clinical health psychologist and a fellow of the Academy of clinical Health psychology she is a sex therapist certified by the American Association of sexuality Educators counselors and therapists and improve Consulting certified in the practice of hypnosis by the American Society of clinical hypnosis she's been around she knows a lot and she provides practices so welcome. To Sarah

thank you for having me on the show

so I'm curious. This here first thing how did you even get into this feel

that's a great question I'll tell you I did my dissertation on postpartum depression in couples it seemed to me back and this is a long time ago 1984 when I was doing my research that it couldn't just be all about the hormones in fact it's not it's not about that. Life it's about stress and it's about the quality of your relationship and it's about the pressures and strains that we put on couples as they transition to Parenthood well then later on when I went into private practice I told my OBGYN I was opening a private practice and she said I'll go over here and talk to nurse Owen sewing and take her to lunch and we'll start referring patients to you and I did and I noticed that there's a large overlap

between the kinds of mental health problems do that turn off in the OBGYN office and marital problems and sexual problems has I pursued the certifications in Sex Therapy and have been kind of carving this out as my new dish ever since

so your question was how did I get into the postpartum depression era I picked it as my topic and that might even have sexual issues examples one person in a couple is depressed there's a 50% probability the other person is too and probably a 75% chance that they're having sexual difficulties yes I can yes and now we're in 2020 and for some of us might be listen to send 2021 yes my grade hair right my car but I'd I love the gray curly hair I love it yeah yes I'm curious though how has it changed over time

the sexuality issues that are happening within couples is it getting better because you know how can I say now we're open and we talked about sex and intimacy way to getting worse because there's so much emphasis on it you know so much pressure yeah what do you see well I see both actually I see that it's better in the sense that we are more open and there seems to be less shame and I say that in a qualified way because a lot of people still do, at least in my practice I see a lot of cross-cultural couples I see people from different cultures who had a very traditional cultural background and often times they come in with sexual difficulties early in the relationship

and they might actually stemmed from shame and

excessive modesty and difficulties talking about are experiencing sexuality and talking about it with every partner but I've also seen in the cultural shift towards

it's almost become normative in the dating realm to essentially have sex with strangers

and to have sex with strangers as a part of the getting-to-know-you process instead of getting to know a partner and then having sex with them a sort of flipped in the 30-plus years that I've been doing this work and I see problems arising from that I called with the padlock model that I came up with and I don't know if you have a screen share hear you let me share your screen and do the little white board but it hears my cutesy little drawing of a padlock in the old timey padlocks the metal ones not the digital ones wait for it looks like a purse now it'll look like a padlock inside that casing you had three

plates and you can put in the key and it lines up those plates in order to unlock the lock and in my analogy you see the plates are the head which is kind of where everything happens is the brain that controls everything is okay and I guess we're calling it the junk Outsource the junk I ate I have that evaluated by my

I have that agile you waited by the urologist and the gynecologist that I work with Okay okay okay yeah said when you going back I'm just going on on here why didn't think just saying is that the sexual difficulties it's really good to get a physical check-up by a specialist and somebody who actually knows sexual medicine and the the I usually I taken lunch to all of the urologist in Psych OBGYNs in my area are most of them anyway in order to get a feel for who is more comfortable talking about sexuality is that I can work with right and until you want to know that there is a that they actually are comfortable talking about sexuality and have Advanced Training and human sexuality because the

most medical schools don't cover or sexuality and a lot of people are uncomfortable talking with their patients or patients can pick it up right away my tablet, do you see the head that that's that's your attention that your you got to have your head in your body can't be thinking about the laundry list and whether the kids are going to wake up and your heart has to be connected you know if your heart's not connected if you're trying to have sex with a partner in the hopes of growing an attachment

that's going to present problems you're going to end up with in mind experience anyway people end up killing desire long-term and they end up with performance anxiety of various kinds

and it just it just creates a great deal of problems

later on down the road okay yeah well one of the first things that you said and I kind of want to touch on this because this is dealing with infertility and it's dealing with the top part of the head is Shane

yeah yeah yeah I'm many couples are many individuals who are struggling with trying to have a baby yeah yeah sometimes there's and I guess the shame is also headed heart

well I think it's head and heart one of the things that happens in the most frequently in my experience treating sexual and reproductive health issues is that when people start going through infertility first of all the chase after a baby starts to occupy their head right and so their attention is elsewhere and the becomes very focused and emotionally it engaged with having a baby conception sex is like scratch an itch sex only the itch is for baby it's fact is that all of the medical procedures

really cause people to objectify the most intimate in the most delicate part of their vehicle

they're having to objectify sexuality they're feeling objectified as they medicalize this very tender very intimate part of their lives and that wears that we are is on the soul it requires that people compartmentalize and the compartment penalizing of course is the taking of the heart out of that one that I showed you before and that creates problems creates problems for men and for women Etsy about my will statistics hear when a call is undergoing fertility challenges and treatment about 22% of men experience mild to moderate erectile difficulties

and as many as 34% report decreased desire 72% report lubrication problems 81% report decreased sensation and pleasure 23% report difficulties achieving orgasm

that's a lot that's a lot of problems

and I believe it's it's it's coming out of that medicalizing in the way it occupies your head so you taking the the heart out of the lineup and really you're going to take a nap head out of the lineup often times when the first recommendations that I'll give to couples going through infertility is it they have conception sex somewhere else

brighten up the guest room and they keep the sex they have because they like each other and it's fun in the bedroom

okay that's that makes that makes a lot of sense there instead of the bedroom does not become a stressful point and mine to produce a baby yes and so that just like you don't want to have a television in the bedroom for the Sleep hygiene people tell you not to put television in the bedroom because you don't want to create the association's to that that active mental state with the bed the bed should be for two things only and neither of them is watching television

or reading right exactly tips about how to help any people out there who are struggling with infertility thank you are you wanting to feel empowered love secured inspired in these uncertain times if so dr. April a licensed mental health counselor and relationship and sex therapist who specializes in intimacy can help you when are you were in need of inside and skills to work through a struggling relationship through couple counseling or to understand your anxiety or depression and individual counseling or to figure out your life goals and coaching with compassion and expertise can assist you and these areas also she provides services for emotional support animal documentation supervision and

shop in addition dr. April has a group practice called Cape Coral therapist Cape Coral therapist has an awesome team of male and female mental health therapists who specialize in various areas including mental health Christian Counseling trauma addiction immigration and forth counseling and are ready to serve you the Cape Coral therapist team which is rated 5-star on Google reviews is known as the Dream Team because of their energy and passion for therapy and determination to provide you with effective and solution-focused counseling for you and your family in a safe and confidential environment for more information on how you can schedule an appointment in person or virtually with dr. April or any of the therapist at Cape Coral therapist please call 239-565-6921 and you are welcome to visit Doctor April's website ww.w. Dr. April braun.com and WWE

love you. Cape Coral therapist.com you can follow dr. April on LinkedIn at dr. April Brown you can follow Cape Coral therapist on Facebook Cape Coral therapy just remember April and her team of therapists and resources can help you strengthen your intimate connections with yourself your loved ones your community and your higher power

welcome back to the bring empty intimacy show and today we're talking about infertility and how that affect Intimacy in a in a relationship and I have a special guest hair doctor 7 I was Sara Wilson Quest and still talk to Siri you spend talking about some of the different I'm fertility issues that many couples are facing when they have from an Infidel I'm sorry and fertility issues so I'm curious what to pack a couple sexually when they're trying to have a baby in there all these issues are coming up such as 12 tomorrow missing xiety or yeah how does that impact a couple

well one way did it impacts them is that it kind of occupies their mind and their conversation and often times they get out of sync with one another so one partner will be more obsessed if you will and wrapped around the tree

I'm really trying to make this happen and the other partner will be wanting a break and the they'll be kind of out of sync with e with each other that way it's a one of the things that I have people do is protect their conversation and set the site I'm no more than once a week where they can talk about their fertility journey and the next steps and so forth

so that it's not just taking up your whole life and if there's one partner that is coping by distracting themselves or trying to connect emotionally

in another kind of way that sort of sidesteps the fertility challenge that persons not going to feel blindsided and constantly feel sore halfway on guard

because

you know it's going to come up again and then we're going to have all this tension and there's not really anything we can do about it it's really kind of a form of of enlisting somebody else and rumination and what's the difference between useless rumination and useful problem solving action will useful problem solving leads to action and these ruminations don't like the plan is in place the doctor has it and you can't do anything in your kitchen on a Sunday afternoon

all right I love the idea of you say not spending more than one hour week and so I start thinking and there's some couples who are out there listening and they're having issues they're having sex but they're not having a baby what's like the first step how do you know when it's just psychological physical mental

rarely is it just one thing OK the operating the operational definition of infertility is one year of unprotected intercourse so most fertility specialist that I know of anyway will not be get unless you're of advanced stage or you haven't known problems will not really consider evaluating a couple for infertility until and unless they've been trying for a year there's exceptions to that obviously in different doctors are different ways but that's my my understanding

and in that year you don't want to be so focused on conception that you're losing track of your emotional connection with your partner and you're not having fun and being playful

once you begin to see a fertility specialist they've got a very long list of things that they can do to assess and to intervene

and in all of medicine you know they try to start with the least invasive procedures first before they'll graduate to buy panoply a menu of things that they can help people with

it's just that each step of the way you're likely to encounter frustrations and disappointments and then those start adding up emotionally and you've got to keep your heart light and you got to keep your heart open and you got to keep your heart connected to each other and to your higher power is you say and so how do you do that with all the frustrations and sometimes all the decisions of do I try this do I do this do I you know I like it when people will compartmentalize the medical process right that's why I asked people to only set aside structure time that they'll talk about it talk about their feelings talk about the problem-solving do next steps and then in between those conversations really attend to each other into being

people and having fun and delighting in life

I like it when they have sex in a different place so some people will fix up the guest room and I'll have conception red insects in the death in the guest room and fun sex in the bedroom things like that and then sometimes people end up needing couples counseling in order to be able to really productively talk about how their Journey emotionally is different because two people are not going to experience this journey the same way

price of any married couple no matter how good the marriage they're going to have differences in how they cope and what it means to them and how it weighs is on the M can you address the concern that maybe for some men that I may be there are having performance anxiety because how can I put in it so much pressure and sell well it's the best yet because the woman will say okay my temperature spiked we got to do it now and nobody wants to feel like a poodle jumping through hoop in the bedroom light bright and so it you've got to handle that with having a window

right stomach even if you know the moment of ovulation your fertile on a window before and after you might want to use that information to set the stage but you don't want to use it to hold up that you got to jump through okay because if you do then you're going to be objective finding your own body objectifying your partner's body not going to have your heart really in that it will be love making

you get performance anxiety in men and women just looks different and your right arm and sometimes in with women on sometimes they get so into like oh my gosh I really need this to happen but they're not present exactly they're not present yes right and your partner can always tell when you're not present and it's going to feel you said yes and so I love the diagram you put up earlier but haven't they had the heart and the junk connector Parts open to your partner and your child's working Mac

normal nothing spectacular but for couples in and out with nothing spectacular but for some individuals who may be listening

what if they're struggling in and having their head in the game

the number to work to try to fake out that I want to get them in I want to get their head in their body and that might involve it might involve meditation it might involve learning to mindfulness meditation keeping your head in your body there's an exercise that I love to do with couples and it I called skin-to-skin Primetime and it's some of my patients renamed at the naked hug and that is where they spent 15 minutes a day in a full frontal Embrace holding each other but the catch is that no matter what comes up they're not going to have sex at that time the close on go back in the kitchen and cook dinner

can I catch it gives them the touched it gives them it gives the unconscious mind that sense of safety of being held and there's no demand cuz you know you have an agreement you're not going to have sex no matter how or else you get so you get the experience of being connected emotionally being naked and not ashamed being a little bit aroused in a little bit relaxed but there's no demand it's not going to happen on velcros that whole thing and it and it and it and it works beautifully yes so we just now but was talking about the head have you also seen couples who maybe have gone through this infertility for a year

2 years I'd attempt time and the heart is not in it but they want a baby you know what I mean yeah yeah I do is I tell you that the hardest is where they had several pregnancies and they've lost in the heart is wanting to protect itself and the head is forging ahead in the wind as an act of the will answer forcing the wheel on heart and that is so very hard so very hard that's a that's a more complicated treatment have any simple and easy recommendations for that skin-to-skin prime time is going to be one of them because I want to restore that sense of sanctuary of safety of

of the Return to Eden in the bedroom

it should be a safe place safe from demands and and if we've compartmentalised out the conception sex that's easier to do

okay okay and that that helps with the heart Andrea it help to open up the heart and it helps them and they're going to have to they may need help with a couples therapist in grieving together the washers and in making a decision about when to stop oftentimes couples are not on the same page with that one will decide that I can't take this anymore can't take another loss and the other will go just one more time just one more time

you know it's very hard to risk your heart once it's been shattered so many times. It's been devastating so but we're going to take a short break and when we come back we'll talk more cuz we do have some questions that people have Skynet yes but in this break here dr. Sarah I would love for you to share without audience what you do are they can reach you and other things that you provide couples out there and individuals and your clinical practice okay you want me to do that now or acid right now, that's Dr s a r a. Com

and I'm in North Carolina currently I'm licensed in North Carolina and Virginia and in Washington DC and I am a member of the Colts I packed when we pull it up here hold on just second

so beginning in January I can also teach see people in Arizona Colorado Delaware Georgia Illinois Missouri Nebraska Nevada New Hampshire Oklahoma Pennsylvania Texas Utah

in January not in children children I'm licensed in DC North Carolina and Virginia okay awesome and be like now we're talking about infertility Doctor Sarah also works with a wide range of sexual issues yeah what did the other issues that you work with

well the sexual dysfunctions and I like I said I got into this through the postpartum depression I'm I'm board certified as a clinical health psychologist so I see people who have sexual issues around cancer around diabetes around normal aging around a variety of health problems I see people for health problems I see people for garden-variety depression and anxiety in

problems in living well okay yes well thank you so much for letting us know what you doing with your five. So what have I first questions we have it's from a young lady and Arizona and she since my husband and I are having fertility issues

and I get mad when people ask me when is the baby coming you know all my friends are having babies and when I see them on social media get upset sometimes why is that

does your heart hurts your aching for a baby and you can't get it and you haven't been able to get it and you can't have it right yet it's not under your control is one of the most common problems that I see you know it's becomes hard to go to those baby showers and becomes hard to seal those kinds of questions and my advice to you would be to prepare your script so that when people

when people ask you've got you know five or six different drop down menu items you can pick from in there well-rehearsed and you can just say well the store must be on strike this year at our house or whatever to find out a private journey and it's a painful right now I don't care to share depending on what your comfort level is in terms of how much you want to share with people but you know the questions are coming so you may as well prepare a scripted answer

I like how you put depending on who's asking because you're right you can let people know that it's a private journey I don't have to discuss my my business with you or the other thing you said about the store he can make a joke out of it you know what I'm saying yeah yeah I think I think how much humor you're going to use and and and how point is you're going to be is going to depend on how intrusive they are or whatever I've known people that had to resort to what I call clicker training

and I'm fate had a parent that was particularly intrusive and they really were tired of explaining it because every time is this this French pear relative whatever starts to give them their their medical advice even though they don't have any medical credentials you may have to just change the subject you may have to drop the call and call them back later you may have to figure out how to do something behavioral that doesn't involve words in order to let that person know that you can't talk about this you won't talk about this with them on the context in the person in the relationship that you have right okay good another question we have Ritz young lady out in California and her question is how I feel

is it because I'm taking a lot of medication and hormones and I'm crying sometimes that all these things are happening but it doesn't seem like my husband understand sometimes I don't even understand myself what can I do when I just feel just like a crazy person on other stuff but whenever your your body is going through a lot of different changes whenever you're whether it's the hormones or it's a treatment of some sort or there's pain there's bloating there's all kinds of side effects with any medications that you're on you're not going to have the bandwidth that you usually have bandwidth is what we use for emotion regulation right for that we deal with stress and now has any band with everybody's got like 3 millimeters of bandwidth because of the covid-19 and and we just had a horrific election season

so you don't have any bandwidth

your husband's not going to understand he didn't live in a woman's body

he was in his own body right okay so there are there are things that he's not going to be able to understand and you're just going to have to ask him to respect your process and you're going to have to have funny ways to cope with that and how and ways to protect your bandwidth given that it's really skinny

what you suggested and that situation or do you know of any like online groups or books

some people have benefited from a group called resolve resolve resolve which is Nationwide fertility support network that educates people it's a not-for-profit and whatever their offerings are there free

awesome another question it's coming from women here in Florida she's his my husband was so excited in the beginning about infertility about a mess going to this infertility process but now he's not

yeah well I need to know how long it's been thinking that there's been lots of disappointments you know when people's first start down the turn they first go to the doctor they just know is that the solution is going to be easy and quick and they'll be pregnant next month and that kind of optimism last for varying lengths of time some people it lasts a long time and some people

start to feel pessimistic and to protect their heart after just a few disappointments

but one of the frustrations is that it's clearly not under your control and we're used to thinking that this of course it's under my control I have to do is have sex and I'm going to get pregnant this is why we've been avoiding this for so long

stop running in and it'll catch me and it turns out to be harder than that for a lot of people

and then there's the holy feel so unfair but who promised fairness life is not fair by Rich is very hard sometimes yes and yes and I next question has a little bit to do with that and it's full of young women in South Carolina and she says they've been married for 5 years and they have not had a baby and when she talks with her family and friends they all say to just pray

and that's and that's what her husband is saying but she's she's wanting to look at other options but she doesn't know

because you'd be like Shih Tzus support

and you might not have a support I don't you have your own family context in your own subculture like that it it it finds itself in but given that it's been 5 years

it's probably not a bad idea probably be a good idea to at least go visit a fertility specialist and get some initial testing like I said it's a wide range of things that they do they have to go through a lot of chest before they'll give you a treatment plan and say of this is why we can't make assumptions about what might be

the block right but neither can you expect

God to intervene divinely without some effort on your part to Avail yourself of medical

wisdom right right cuz it's just like if you had anything else going wrong with you you would go to the doctor and get it checked out anyway. To Sarah this next question is heartbreaking the question is I'm struggling and having a baby is something wrong with me cuz everybody else can have it really quick and fast but it might is something wrong with me as a woman since I'm struggling and having a baby

I don't exactly know what you mean is there a medical problem there might be I don't know but are you defective as a woman I'd say that's stinkin Thinkin and you don't want to let your mind go there because if you do you'll turn up a good ol head of depression if not anxiety and that's not going to be any good you may have a medical problem. That is often solvable sometimes not

but

defective it's not a moral failing right exactly and

we don't know

that you're the problem right one third of the time the issue is a male factor in infertility 1/3 of the time it's a female Factor infertility and 1/3 of the time it's a combination or it remains a mystery never to be down okay I'm so glad she mention that because

and if it's the females for many females in a blaming themselves

yeah

so I third is maybe issues with the female body of some sort and 1/3 maybe issues with the man's body and then you said it third maybe the couple together or some of the things that they just sometimes never know or sometimes never know remains a mystery Medical Science we think that you know it's it's so Advanced compared to our grandparents and great-grandparents that surely to goodness there must be an answer sometimes there is it and I find in my practice not just with reproductive Health but with other health issues that it's when things are a mystery and oftentimes they are is that people are in the greatest amount of Torment for the longest time because we would like answers we like certain TM

not knowing ambiguity is hard-wired in the brain to create anxiety in the blanks oftentimes fill in the blanks with self-blame right and for a lot of people if it's a really well established and really hard to change and hard to shake and oftentimes we filled in the blanks with a lot of subjective

certainty weeks feel this must be absolutely sure I know what it is my Spidey senses are telling me but

is unknown it really is not known that's the problem yeah and I tell my clients all the time they have to learn how to love himself because they're going to be with themselves for the rest of their lives and they you know and you can and you should really talk trash about yourself you know so do we have time for one last question and it says

how can I make the ovulation time. More sexy and desirable because it seems so routine every month that we're trying around ovulation that's when you're having your conception stop sex will one of the things you could do is you could fix up that guest room as you know your little Boudoir you could have candles you could you could make it fun and playful you could save that for your time to experiment or have a game going with your partner

I don't know people spice it up different ways you may have to figure out how to make it more playful between the two of you so that you're sort of taking yourselves out a little bit and you're not so focused on the conception that it takes all the fun out of it I like how you said last time about different location of different bedroom and if it could be different location sometime you know you can go on a travel yeah and I know of people who have sometimes even a small plane you know you said yeah so it's not the same same old thing over and over again with just can be kind of you know hard on on a couple

and you've got to figure out how to get your mind in your body and a really Pleasant present to all Five Senses Into the emotional connection with your husband you have to be able to tolerate the not knowing we're making a baby this time and I kind of talked a little bit about but couples counseling as you do as you do it deals with The Head and the Heart Is that you put this three parts to it right right right yes it's so hard and junk and if you doing the physical part but it's still not working when should a couple think about going into couples counseling to work on The Head and the Heart

I think when you feel like you're drifting apart and this is driving a wedge between the two of you and if you are not able to protect your conversation and limit your conversation your problem solving your morning about this process to just once a week doesn't have to be for a full hour for some people in 15 minutes is not not going to set a time on it but just to your set aside time if you're not able to get your mind off of it and really be present to one another and remember that the reason you make love is because you like each other you love each other that's fun

good gay cast yes so Doctor Sarah tell us again how they can reach you

dr. Sarah. Com DRS ara.com doctor sara.com I've got an 800 number it goes to an answering service Somewhere in Arizona scores right now yes yes and that number is quickly get me an email and as long as you live in one of the states where I'm license switches North Carolina Washington DC or Virginia

I can attend you through the virtual medium and those other 14 States that's coming in January okay I'll some and you haven't the 800 number I believe correct is 866-337-4911 is it for 911

yeah I think that's what I

I don't call myself so I do okay okay yes I think that's the number

yeah yes yeah 66337 4911 that's how I remember 9-11 but doctor sara.com email is easiest okay and okay they can find you on Facebook also dr. Sara rosenquist on Facebook Dr s a r a r o s e n q u i s t i thank you so much for being on the show we really do appreciate it you're always welcome back and all those people who are out there listening on check out and if my counseling services at w w dr. April braun.com if you enjoy the show and you would like to see more of bringing intimacy back show check it out website at ww.w and intimacy back or follow us on YouTube Facebook iTunes or Spotify thank you very much all right great thanks for having me