Episode 73: What does a sexologist do?

Hello, I'm Suzanne Noble, and I'm Zoe Zee, and you are listening to Sex Advice for Seniors. And this week I'm turning it over to Zoe mainly because we are going to talk about something that we probably should have discussed 100 years ago when we first started doing this, which is what it feels like, which is What do you do for a living, Zoe the sexologist? What does that actually mean? I'm, I'm curious to know because I've never been to a sexologist. As you know, I have no formal training other than having slept with thousands of people.

That's the best training you can get.

No, I'm just joking. It's probably not thousands, it's probably a few hundred, but anyway, it doesn't— numbers don't count after a certain amount of time. Yeah, anyway, you know, there's 10 in a room, you don't count them all. So yeah, enough of that.

So as a sexologist, um, I help people have their best sex lives. I mean, essentially, and to understand their bodies and their minds and how they're connected, um, in the realm of sexuality and sexual expression and pleasure in the body. And, um, so that can take a lot of different forms, you know, from writing a book and having a podcast and, uh, answering a lot questions and going into Reddit and doing AMAs and writing articles in magazines and all those sorts of things. And then in addition to that, I have a private practice in which I am a sex and intimacy coach. So that is really the, the sort of bulk of what I do in terms of really getting in there and doing some deep work with individuals and couples together. And so, you know, what does a sex coach do then? A sex coach is, you know, I have a lot of people that come to me with very specific problems, such as I'm having trouble maintaining an erection, or I'm having trouble holding back ejaculation, or I am having trouble, you know, lubricating. I'm a woman with a vulva and I'm having trouble I have no sex desire for sex. I have zero libido or my, you know, my partner and I want a different amount of sex. How do we meet in the middle? I also have a lot of people who are coming back from trauma of some sort. You know, there's a, there's a lot of in the United States anyway. There's a lot of sort of religious shame around or family of origin shame around sex and sexuality. We have a phenomenon in this country called purity culture. Yeah, which is sort of like in the evangelical Christian communities where there's a lot of very, you know, in some of the more you know, um, sort of traditional Christian, uh, churches and sects, there's a little bit of a— not so much an overt explicit shaming of sexuality that exists, but it's much more of a passive thing. But in purity culture, um, there's a lot of very clear articulation about sex and and ideas that really end up causing residual harm, you know. So I do a lot of unwinding that. There are people who are dealing with kinks, or, you know, what, what we call issues with their arousal template. That's a clinical term, you know, for things that turn you on and things that, that people find a little bit problematic. You know, I mentioned on a recent episode, I have a client who needed to have stinky gym shoes near him. And so, which wasn't a problem for him or his partner. So good, good for them. But there are people who have things that they would like to sort of unwind and get past and find a different experience of, you know, so there's a huge range of work that I do with clients to, to cultivate a really healthy, nourishing sex life. And, you know, some of it exists mostly between the ears, some of it exists in the body, and some of it exists in the sort of relationship between those two things.

And is this mainly online, or do you meet them in an office, Or like, what's the setting for these sessions?

It's a great question. I coach people all over the world through technology, through the gift of laptops with Zoom on it. And that actually predates the pandemic.

Really?

Yeah, I have been for a very long time. It used to be Skype. Yeah. When, when I don't know in the UK or Europe if, if people are still using Skype, but here in the States, it's almost exclusively Zoom. That's being used. So yeah, it's totally confidential. You, you know, you just sort of show up for the sessions.

I—

it looks on the outside looking in, it looks very much like, like therapy, like a therapist.

Yeah.

An hour a week with a lot of homework in between.

And I think, you know, I mean, I've never— I The only time I went to— actually twice I went to see, I went to see somebody twice, two different people, when I felt very stuck in my head around certain imagery and fantasies that were preventing me from being intimate with people. Like I just got into a loop in my head and if I couldn't and I couldn't really, you know, achieve an orgasm without being in that little loop. And people started to notice that I wasn't really present, right?

Yeah, yeah.

And so I actually ended up going for hypnotherapy for that, which was, which was quite a traumatic experience, to be really honest, but it did work. But, but it was, I sort of ended up, it wasn't really like a panic attack, but I ended up, my whole nervous system kind of activated and I started shaking from top to bottom and I couldn't stop it. And it was quite scary. Wow. Wow. And quite, yeah, it was like this kind of trauma was trying to get out. Do you use any techniques like that or is it purely just talking therapy?

Um, yeah, the, it's, it is, um, I do a lot of somatic practices, so not necessarily hypnotherapy or EMDR as a trauma treatment.

Yeah.

Yeah.

I did EMDR as well.

Yeah. Um, uh, no, and I've referred out to people, therapists who, um, sort of specialize in that kind of thing, but I am an integrative somatic trauma therapist certified, and I do have a lot of sort of techniques for working, for guiding individuals to work with their own nervous systems. So I will often guide in a session, I will often guide a, you know, a sort of a somatic exercise, which can look like a number of different things. Sometimes it's just closing your eyes and letting me guide you into your body and talking about, you know, what you're experiencing and what the sensations are. And then we, you know, can move energy around. To help to clear the pathways and clear the mind, basically, and ultimately regulate the nervous system. So a lot of people, you know, will come to me and say, I can't, I can't, I can't get out of my head and into my body during sex.

Yeah, exactly. Yeah.

And so then we have a whole— there's a whole sort of set of techniques and tools and skills that I've developed as sort of this package of of, you know, a treatment protocol, sort of, if you will. Cultivate those connections outside of the bedroom and learn to work with your own nervous system and sort of wrangle your thoughts so that you can, once you're in the bedroom, in bed having sex, either solo sex or partnered sex, yeah, you be present with your body and what your body is experiencing without spinning out into anxiety.

Yeah, yeah, yeah.

And then there's a whole other piece of the work that I do that involves couples and working with a couple together. And one of the things that I love most about my work with couples is a, um, a sort of a different format, which are intensives, like in-person intensives. And That's a really special sort of process that we go through together, the three of us. And I structure it with several sort of Zoom sessions that with each individual partner and the couple together, there are worksheets and sort of exercises to do together that all culminate in a 3, 5, or 7-day in-person intensive. Where I either fly to them or they fly out here. I'm in Los Angeles, California. Lovely place to be. Or we meet in the middle, you know, or we meet somewhere lovely. I met a couple one time in Napa Valley and also one in Mexico. And so, you know, like removing yourself from the from the daily grind, from your home, from the environment that is sort of holding the dysfunctionality can be really powerful.

Yeah. And how many— I'm curious to know. So we've— prior to you and I co-hosting this, Peter and I did a few episodes with people from different backgrounds, different cultures, where their cultural imprint in primarily Southeast Asia, for instance, was really detrimental to how they experience sexual pleasure in the same way that we're discussing some of the religious aspects in America around primarily, I would suspect, white people. That are in that purity culture that we've seen and we've heard about? How many of the people that you treat are— have that kind of cultural imprint? Or would you say that primarily the people that come to you are primarily white, fairly middle-class people?

It's an excellent question. I I would say that the vast majority of my clients are— well, that's not true. Okay. I'm right now I'm sitting here going through a rolodex, a mental rolodex of all of my clients, you know. Yeah, I have a— I have an array of people who who come to me. But I will say this, Suzanne Noble, that, um, if I were to have somebody come to me whose culture I wasn't— this happened very recently, actually. Um, a Chinese man, uh, was coming because he's trying to work out, um, his situation with his wife. And they share, um, a very particular— they're both Chinese immigrants, and they share a very, very particular sort of familial and cultural history around sexuality and relationship and intimacy. And I, I suggested that they see a Chinese therapist or someone. I mean, it doesn't matter what they are, but someone who is really intimate with Chinese culture and how those messages— because I'm not the most powerful. I can help them with the somatic stuff, but all that cultural influence, they would be— they would benefit from someone. And so that's what they did. They worked with a Chinese therapist, but then they came to me for sex coaching.

Yeah, yeah, yeah, yeah. Because I think we come— some of us come to these things with an unconscious bias. I know that in the other work that I do that's outside of this, you know, I have to be very aware of how my background, my privilege, all of the stuff that I that I'm brought up with, how that informs how I think about things and how I approach certain topics. And, you know, I know that my background is not everyone's background. So yeah.

Yeah, I think that's true. You bring up such a good point. And I think that's kind of true with any work in any society, any system, right? You want to always be aware and conscious of your limitations. I wrote a whole author's statement in the beginning of my book about who I am, what demographic I am, what experience I have, what education I have, and so that you understand what lens it is that I'm speaking about these things through, what lens. And being aware, just as human beings, we have a responsibility to be aware of our biases and our blind spots.

Yeah, so when going back to working with couples and you go off to lovely Cabo or wherever and you hang out with them, how, how familiar is this? Are these sessions like, are these people actually having sexual in front of you, or are they going away and you're giving them instructions and then report back to me how it went? Like how that's pretty— you have to be prepared to be pretty vulnerable and exposed to discuss these topics, right, with somebody who's not your partner.

Yeah. Namely me.

Yeah.

Yeah.

Yeah.

Yeah. I mean, the biggest question that people ask me when I tell them what I am, what I do for a living, But inevitably, do you watch people have sex?

Yeah.

The answer is no, I do not. I have done hands-on work and I am willing to do hands-on work, but it's, it brings the work and the sessions into a completely different category. Yeah. And it's, and it's, it's not my preference. I do it when I feel, when I feel safe enough. To be involved on that level. And we have a deep understanding and there's a deep level of safety already in the sort of clinical relationship. What are— what my— what my sessions look like, particularly like an intensive, is depending on the couple and depending on what they're dealing with, it's usually It's— I'm again, I'm like, this work can be so sort of enormous and, and sort of traverse lots of different areas. So there's a lot of relational work that involved that looks a lot like if you were going to a deep, deep, you know, sort of couples counselor session and really getting down to the nitty-gritty of you know, what's actually happening between the two people. It's very much like that. It's just that I include sexuality, whereas most therapists don't. They're not trained to, and it's siloed into this sort of separate area. So when I come to a couple, and I work with a lot of couples that are like at the edge of divorce, you know, they just can't, like, they can't get, they can't, they're not meeting each other's needs. They can't understand how they can meet each other's needs. They don't even understand exactly the nature of the needs. So we sort of break it all down to the core level of like, you know, and undoubtedly like family of origin, family constellation work, childhood trauma, core wounds, you know, attachment, attachment wounds, all those kinds of things all come in to play. But what the beauty of having an intensive does is that you're not— you can let— you can dive into this work without having to close a Zoom window after 50 minutes.

Yeah.

And then go about your day and show up to your 3:00 meeting at work. Right, right, right. Like, we can just go all the way and then, you know, take breaks and recover and fill up and nourish. And I can sort of guide and curate their exposure to each other throughout this process. And, and so, yes, often I will send them back, you know, if it's a particular, like, sexual issue, I'll send them back to do an exercise, you know, and come back, you know, come back for our afternoon session and we'll sort of debrief and see what happened in there.

Yeah. I mean, it sounds hardcore, to be honest.

It is. And it is.

And kind of scary in a way. And I suspect that, you know, you really have to be committed to your relationship to want to go into this because, you know, as we know, and I know personally, it's if you've never spoken about sex with your partner before and you're like, look, we just have to deal with this and let's just go and see somebody and deal with this. And then go into it. Can you know, it's, it's like you said, it's, it's deep work. It's often, I suspect, really can be quite revealing. I know some of the conversations I've had when I've been in long-term relationships and haven't asked the questions at the onset and then ask them later. I was like, oh shit. So that's who you are. Oh, right. Okay. Those past 4 years that we've been together, or 10 or whatever, it can be a real shock to find these things out, right? About the other person.

Yeah. You know, Suzanne, I think the best thing that I do, the most, that my favorite part of what I get to do with people is, particularly couples, but in general, like, is validate their experience. And to, and to create a safe space to have these conversations and to talk about the things that you were conditioned to believe that you should never talk about.

Yeah, exactly.

That are now causing pain and suffering in your life on some level, either very overtly or that sort of, you know, that sort of persistent underlying ennui and malaise, you know?

Yeah.

I, I, uh, you know, I think that it is deep work and it doesn't— you can take it as far as you want to take it. You know, you can come to me and have like, look, we have different desire levels. You know, my wife wants to have sex all the time and I'm just not that into it. And how do we meet in the middle? That's not that deep. Yeah, you know, I mean, I mean, we could take it down to the core level, but we don't have to, you know. We can, we can sort of coach it from, from the behavioral aspect. If that isn't solving the problem, and it often, it does solve the problem, it's like, okay, you're thinking about this the wrong way. Let's break this down into the 3 kinds of intimacy, the 3 levels of intimacy, and let's make a tactical plan for managing your sex life in the context of your busy lives in other areas. Easy, right? Um, the, the, um, you know, I think that when, when we talk about, um, sort of what, how, how to use a sex coach, how to, how to improve our sex lives because we've never paid attention to this, um, there's a huge range. And, um, And some of it gets very much like therapy and sometimes it's just really like better planning, better planning, better communication. Everybody, everybody needs better communication about anything in their lives. Yeah. Yeah.

Yeah, for sure. I mean, I've just had my friend stay with me for 3 weeks in the Grand Canaries who was my partner for a number of years and now he's my best friend and I am more open and honest with him now when there's no risk attached. Well, I don't, I don't see any risk attached to being totally transparent about all the things I get up to or want to get up to. And, you know, just all the stuff that I, that I enjoy, right? And he doesn't. And we're, as in our earlier part of our relationship, he— I found him to be very judgmental about some of the earlier choices that I'd made about my sex life. Now he's not judgmental at all. He's like, yeah, whatever you want to do, you go off and do. Like, doesn't affect me. We're just mates now, you know. So, and I would have liked to have gotten to that point in our relationship when we were intimate, but I just found that the reaction that I got was so overwhelmingly like, you're a bat, you know, kind of quite negative that I didn't. I just kind of took it out, and I've done— and I've done that in multiple relationships when my previous behavior or something that I want to do just doesn't doesn't gel very well.

Yeah. Oh, okay.

I'll just, I'll just remove this from our relationship. I— that's just a side note. What I— one thing I did want to ask, because I know that you've spoken about it a couple of times and just in passing, was the fact that you've dealt quite often with people who have had serious porn addiction. And we get loads of inquiry— I get loads of inquiries on TikTok and really sad messages from people whose partners, who are primarily men with penises, um, are addicted to porn. And so when you're dealing— when you're working with these people, is it typically because they're in a relationship and it's, it's come up and they've decided they're going to do something about it, or because it's starting to— like, are— do you see any patterns of the people that, that struggle with this and, and when and why they come to you?

Yeah, there are two. In, in specifically to porn addiction? Yeah, yeah. Um, there are— yes, there are two scenarios, generally two buckets that, that people who are dealing with that fall into. One is that Um, I get a lot of people who come to me with erectile dysfunction or intimacy issues or not being able— it, like, like, it's their, their partnered sex is, is not working, right? And it's enough, like, I can, I can often sort of spidey sense it out that there's something going on there in terms of pornography, porn use.

Yeah.

And so Sometimes I help people understand that they actually do have a porn addiction. I am not qualified to diagnose addiction, right? But I, you know, certainly compulsive behavior I can name and point to and, and help somebody, you know, get properly resourced in understanding and owning and, and making changes, healing from that. Um, so yeah, so like the function, sometimes it's they come in with like dysfunction in the relationship or in themselves.

Yeah.

And, uh, and then sometimes, and I sort of drill it down and recognize, uh, compulsive porn use as a, as a contributing factor. Um, but there are a number of people who come to me. I had a discovery session yesterday with someone who is very well aware of his porn addiction and really struggling to stay sober and struggling to replace his very troubling fantasies and what will, you know, allow him to have an orgasm and sort of have a sexual experience. He really wants to change that. He's really troubled by that. And it's really, I mean, it's very at my heart. Goes out, you know, to people who are dealing with that and can't seem to sort of resist or turn the tide. So, you know, there's that. People who come to me and say, I want to stop watching porn and I'm having a very hard time doing it. I got you.

Yeah, I can appreciate that. And I think, you know, it's, um, from the messages that I get, it's clearly impacting a lot of people's relationships and also there seems to be a degree of defensiveness around, oh, that's not it. You know, when couples talk about it in the messages, it's like, he doesn't want to acknowledge it. I've confronted him about it. He says it's nothing to do with that. And, you know, and so it goes. So There's a lot of—

I mean, look, Suzanne Noble, there's a lot of shame around, um, around pornography. There's a lot of shame around sex of all kinds, and there's a lot of shame around pornography. And also, as we live in a culture and a system that basically excuses— boys will be boys, men will be men, men have penises, you know, we're gonna watch porn. And there are a lot of men who don't watch porn. And I'm not vilifying— I'm a huge champion of exhibitionism and voyeurism, and, and all of that is very— can be extremely healthy if it's not compulsive. Yeah, it's all consensual. It's a— it's an enormous healthy part of sexual expression. Yeah, but there are issues with porn, and maybe we need to talk a little bit more about that separately.

Yeah, I mean, look, all of this boils down to, as you said before, we've— and we've said it often enough— you can do whatever you want provided people don't get hurt and provided it doesn't stop you from being— from living a fulfilling life and being happy, right? I mean, Once it becomes something that becomes absolutely necessary for you to, you know, have an orgasm or, or just do, do just have some degree of sexual pleasure and you can't get along without it, then it becomes problematic. And I've engaged with numerous people whose fantasies were so obscure and weird and bizarre. I thought, who is, how are you ever going to find somebody that is going to do this for you? And when that happens, you know, I think it is important to try and recognize that it's not healthy and to seek help. I mean, unfortunately, the bottom line is that people like yourself are, you know, operate outside of public health systems. So, so they— we can't just choose when we're, when we're experiencing these problems to just go to the National Health Service, I suspect, and just say, hey, can you like put me in touch with a sexologist because I need some support around this, right? Yeah, it's, um, there's a lot of shit that gets told to menopausal women about lack of desire just being perfectly normal for women of our age and therefore just deal with it, right? So there's a lot of challenges around that and there's not enough just general information that people like yourself exist do this work and, you know, are accessible to, I suppose, people that can afford it, which is, which is the bottom line, really.

It's like, yeah, yeah. I mean, mental health of all, I mean, mental health and wellness and all of that is, you know, we don't, as culturally, as a system, we don't really value that and provide resources for that in the way that we do if you have a, you know, tonsillitis. Yeah. You know, I think that what you're saying is, yes, it's so true. And it's— I am often saying, look, we are— we are— we put money into and allocate resources for physical fitness, for for dental health, for, um, financial stability and growth and wealth, for— like, we cultivate all of these things in our lives for travel, you know.

Yeah.

But nobody ever tells us that we need to, to sort of invest in and allocate resources to our sexual well-being. And, and, and actually, what we're sort of conditioned to believe is that sex just takes care of itself. You don't need to talk about it. You don't need to deal with it, whatever, it's just that other thing, let it lie. And that's exactly not right.

No, I mean, I'm assuming you're— because you're in America, you're not in plan of any insurance company.

I am not in plan of any insurance company. And not only that, Suzanne, but I can't advertise on social media because it's banned, because anything sexual wellness and sexual health Yes, yeah, is, is not— it's, it's, it's on— it's in the same category as pornography. So that's— so there you go.

It's ridiculous. The whole thing is just insanely insane. Yeah, it's nuts. It's not— but you know, it's, we— it's the same with any— and it's the same with sex tech, it's the same with anything primarily to do— primarily but not exclusively to do with female sexual health. But male sexual— but when it comes to your job, it also includes male sexual health. So the whole thing is crazy, but there you go. Anyway, now we know what you do. I'm so grateful because I, you know, I've been talking to you for months and I don't— I didn't know what you did.

Well, thank you.

If you want to— if you are listening to this and thinking, I could use some of that magic stuff that Zoe, um, that Zoe prescribes, then go and check her out, and the link is in the bio. And yeah, we're gonna— and coming up this year, we've got some big plans to do some better— some stuff together around um, some activities and things that are specifically aimed at couples and creating better intimacy in couples? I think that's one of the things that we've talked about so yeah stay in touch! Have a lovely day Zoe—

yes thank you Suzanne noble... You too! Thank you for watching this video. Please subscribe to our channel if it was informative or inspiring.