Mindfulness might sound simple – just be aware of what you're thinking, right? Mindfulness is more than that, but unfortunately there's no clear definition of "mind" in conventional medicine or western psychology to help us understand what we are trying to keep in our awareness. Brilliant people have tried to describe just exactly what the mind encompasses, but the subject is still up for grabs. What I know is that understanding the mind gives my clients a guide to where their own processes have developed problems and what they can do about it.
The author of Mindsight, Dan Siegel, MD, suggest that the mind "...can be defined as an embodied and relational process that regulates the flow of energy and information." In other words, our minds have a physical reality located in our brains (actually there is no location of mind), but they are something more than just that grey matter upstairs. The mind, according to Dr. Siegel, controls the ins and outs of our energy, our reactions and the vast amount of information that we process daily. One scientist, Richard Davidson, PhD, researched exactly how negative qualities of the mind (fear, anger, shame) can actually change the neural pathways of the brain. He showed clearly that through practice, focus and attention we are capable of changing our brains, a process called neuroplasticity. Fortunately for us, the Dalai Lama suggested that Dr. Davidson turn his attention toward the positive qualities of mindfulness and peaceful inner strength. Just as you can change the biology of your mind (brain) with thought with fear, you can change your neurons with happiness or contentment. In much the same way that a computer and software work together to accomplish goals, your brain and mind work cooperatively to understand, interpret and process the world around you. Computer hardware can work faster or slower depending on the kind of software used and your mind (the software within the hardware of your brain) can change how you understand the universe. Why do software, hardware and mindfulness matter? I use this analogy as a tool to understanding how to work on basic problems with your world. Through study, meditation and mindfulness you can improve your understanding of how the software and hardware of your mind work together. This interaction of the brain and the mind is often the basis for many of the issues we experience. Over time you can use neuroscience research, like that done by Richard Davidson, to update your own software. Mindfully change your processes to reflect the world you would like to inhabit rather than the world of your childhood or your fears. Changing thoughts can impact the pathways in your physical mind and allow you to more readily understand how a problem can be solved. You can improve how you interact with the world around you.
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I've been reflecting a great deal on my upcoming conference, on my work with patients and on how we as health care providers decide how to merge what we learn at these educational events into our practice. The burgeoning field of neuroscience meeting eastern psychology (more specifically Buddhist Psychology) has been a long interest of mine and now there are whole conferences that merge East to West.
Of course my Integrative Medicine Fellowship merged alternative medicine with conventional medicine and that has influenced my practice significantly. To me it seems to be a perfect fit to bridge what is being understood from neuroscience with what we know in human sexuality. As I counsel individuals and couples in sexuality I am certain that this connection brings more to our possibility of growth and experience as whole people. In some of my blogs, I discuss Eastern psychology, mindfulness, neuroscience, and how I see these influences shaping my practice in sexuality counseling and Integrative medicine. As a small introduction, let's evaluate what we call “problems” and how those “problems” affect our sex function and health. In the healthcare world we call this "sexual dysfunction." To understand where these so called problems originate, we turn to the mind. But the question becomes what do we mean by the term "mind?" In Eastern Psychology, the mind is referenced in a broader sense as an integrated being (thoughts, feelings, sensations) verses what we may call our thinking brain in the West. In Western Psychology, there is no firm definition of “mind.” Yet, we commonly use the word in our everyday language. I hear this all the time. “Oh I changed my mind,” “What’s on your mind,” or “I can’t stop my mind from these crazy thoughts." Often, this kind of talk is about the thinking brain. Perhaps this "mind" isn't always the thinking brain we assume it might be. Understanding our problems means it is worth asking a few questions of ourselves to explore how each person defines "mind" for themselves. If we understand how we (as individuals) use the term mind, we can begin to understand how to apply mindfulness to our daily lives. We can begin to learn how to label so-called “problems” from our minds that create distress to our sexual well-being and well-being in general. Today's Exercise: So just take a moment and close your eyes. Take three long breathes – in and out. With continued slow breaths, scan your body from head to toe and contemplate your mind. Keep the inquiry of "where is my mind" active in your thoughts? Ask yourself questions like: "Is it my heart, or my toes, or my belly, or my brain, or my eyes or my skin?" Notice how when you bring attention to each of these areas there is a sense of mind there. This sense that there is a center in each of these areas is commonly know in science as proprioception or “sense of self.” Yet the ability to locate an exact area of this “knowingness” that is occurring with such a questioning thoughtfulness is not fully understood. When we look through the lens of Eastern Psychology we glean a better understanding and where mindfulness is touched. Enjoy this investigative contemplation and look for the upcoming blogs on integrating East and West into Mindful sexuality. Patients often ask, "Is there anything I can do to heal or feel better?" YES! The best tools aren't an exotic new drug or a detailed exercise regime -- its all in your mind. Healing begins with an essential quality of awareness and perceiving called mindfulness.
Mindfulness is a term borrowed by psychology from the spiritual path of the Buddhas, but the science supports mindfulness as a helpful piece of our own healing from many traumas. We use the term mindfulness to describe that moment-to-moment focus where you have your complete attention on the experience before you. This is easiest to think about when the experience is happy like marrying the love of your life, holding your child for the first time or an incredible vacation sunset. Difficult situations like hearing that you have cancer or that your job is going away are harder for us to manage mindfulness. Often our feelings of judgment, opinion and fear rush in to fill that space and defend us from the experience. We're trying to fight against the bad or threatening experience, which is a pretty natural desire. Unfortunately, that desire to fight the situation immediately means we become tense. We take a stance and then begin focusing on that divide between us and "it." Mindfulness sounds pretty simple -- be aware of right now. Okay, you've got that, you're reading a blog entry on it. But truly being in a mindful state requires a non-judgmental observation of your thoughts, and feelings and then accepting those things without attaching any importance to them. This kind of observation and acceptance without injecting our negative self-talk, societal training or other input takes time and practice. Afterall, we've spent a lifetime learning what is "good" or "bad" and having opinions about everything from food to careers to pets. Being in the moment, finding your place with mindfulness, brings about a wealth of tools for you to use in healing sexual wounds, personal growth, health and emotional well -being. Not to mention stress relief! Sexuality counseling is a key tool in assisting individuals and couples to handle erectile dysfunction. There is more to sex than an erect penis! Blood flow, medications and other medical impediments can impact erections, but the body is more than just systems. As a person your thoughts, worries, connections and interactions also affect the body's ability to get and maintain an erection.
You should seek medical treatment and then sexuality counseling for erectile dysfunction as soon as you notice the symptoms. Most people notice an inability to get an erection, lessening rigidity, loss of erection during intercourse or fewer morning erections. Many medications and medical conditions like diabetes, blood pressure issues or injury can change your ability to achieve satisfactory erections. Treating medical causes is only the first step in recovery from erectile dysfunction. I often recommend lifestyle changes including diet, stretching, meditation or exercise to address physical causes of erectile dysfunction. I find that shifting the individual's thoughts away from penis centered sex to a sensual whole body idea of sex works well. Focusing on connection and satisfaction without pressure to perform a very narrow action can relieve stress while building a positive new outlook on what sex offers to you. Couples who embrace a broader definition of sensuality often redefine their own needs sexually and learn to meet those needs in exciting new ways. Developing a new sexual style can encourage a deepening of connection in body-heart-spirit. What is Sherri’s approach to FSD?
FSD may include a list of common physical (sensations) symptoms, yet a more comprehensive evaluation needs to include what is happening emotionally (passion), mentally (beliefs), and spiritually (meaning). Because we are a dynamically integrated system of energy, it is essential to include each aspect of being human and how that impacts sexuality. I may begin working with someone who has just had a typical yearly exam, but my questions are more likely to probe the heart and mind aspects left unattended by a medical-only approach. (Don’t worry, I’ll discuss specific treatments for FSD later in this blog series.) Stress and personal life experiences can become a trigger for FSD or it can work in the other direction. FSD contributes to a woman’s mental, emotional and spiritual stress in a very real and life altering way. Without emotional connection and reassurances that she may not be getting from her sexual partner, a woman’s anxiety may also increase from multiple responsibilities such as work, finances, children, etc. Gina Ogden, author and distinguished sex therapist, developed the ISIS Wheel of Sexual Experience as a tool for examining the aspects of a woman’s sexual understanding. The wheel divides the idea of a woman’s sexuality into four domains: physical, emotional, mental and spritual with the center being the integrative experience. This tool has proven invaluable in working with my patients. By encompassing and gently examining all aspects of the woman, we are able to look at a broader picture of desire and intimacy. Female Sexual Dysfunction (or FSD as it is commonly known) is often an umbrella term for what modern medicine calls sexual dysfunctions such as, low libido, low desire, painful intercourse, aversions to sex and difficulty with or absent orgasms. FSD can even be divided into several disorders including low sexual desire or sexual arousal disorder (desire is there, no arousal); orgasmic disorder; and sexual pain disorder.
What we do as clinicians is determine if the dysfunction is persistent or episodic, how much distress it's causing, and if other medical issues (disease, medications, substance use/abuse) are the problems. The DSM-IV (published by The American Psychiatric Association) provides a framework for diagnosis of Female Sexual Dysfunction, however, the labeling of sexuality as a dysfunction is part of the problem. This labeling may engender a harmful sort of shaming around sex and an idea that women need to be “fixed” because they are broken, when the patient lacks only understanding and healing of the heart, mind and body together. The truth is that women can and do have active, healthy and satisfying sexual lives, but sometimes our bodies, minds and hearts need a little help to overcome bumps in the road. Let’s discover the myths and truths about Female Sexual Dysfunction.
If you are concerned about your sexual functioning, consult your physician for a complete physical. This will give you a basic understanding of at least one aspect of the interwoven puzzle that is Female Sexual Dysfunction. In this four-part blog series, I invite you to explore the realities of Female Sexual Dysfunction and develop a little bit of pro-activeness on behalf of your sexual self. We’ll learn about the myths of desire, understand where medical interventions can help and when the power to heal really starts with the woman in charge – you.
Possibly one of the most troubling issues with the group of symptoms called “Female Sexual Dysfunction” is that you might be willing to brush them off as “simply getting older” or “losing your interest.” Your friends might say that it is just what is happening through menopause or perimenopause and there is nothing to be done. This might be one place where knowing yourself and having someone like me on your side could really change things. Many factors go into a healthy sexuality including the body’s health, side effects from trauma or medicines, emotional stress or change, as well as the heart’s desires. Sexuality and physical health can be closely related through menopause and perimenopause, but there are a lot of different factors that go into a healthy sexuality. Modern medicine can be combined with yoga, acupuncture and herbal treatments to rebuild your overall health. Remember that your sexual health is important to your satisfaction and happiness as a whole person and not everyone functions exactly the same. Next we’ll discover the myths and truths about what FSD really looks like! During my training in Integrative Medicine, we had a full day of mindfulness activities — eating, walking, touching, listening, smelling — an experiential cultivation of the five senses. I had a meditation practice at the time, yet it never occurred to me that I might apply mindfulness to my senses. The experience of being mindful about how I perceive the world changed how I approached eating, walking, touching, listening and smelling. So when I think about the usefulness of slowing down, dropping into the senses and being present to sexual experiences, it only makes sense that teaching patients how to bring awareness to their senses is vital to cultivating sexual well-being.
Patients often complain about being in thinking mode during sex (i.e., the kids, house chores, work, etc). The person misses a lot of the pleasure and desire available to them by being present and aware of their body. Their thoughts and worries thwart healing sexual enjoyment. Learning new skills works best if you start small, so I like to use the following eating exercise as a way to begin learning how to be aware and mindful of your body's sensations. Next time you sit down to eat, try the following exercise. (We will work into the sexual experience in a later blog but you can certainly try this out with the next touch you receive from your partner!) First make sure you are sitting in front of your food and it is completely prepared. This is where you will prepare your mind to be still. Sitting up straight with your hands resting lightly in your lap, take a deep breath down to your belly and count to six. Slightly hold and exhale through your pursed lips to a count of six and then hold again at end of exhalation before grabbing onto the next breathe. Do this about five times. With a mind of appreciation, place a bit of food in your mouth and very slowly taste into your food, very slowly chewing and being aware of the taste. Continue to bring conscious breath to the experience. If you catch your thinking going to work issues or other things, bring your attention back to the flavors, textures, and chewing experience of the food. If you are able to get through your entire meal with this level of awareness – congrats you’re on your way to cultivating a mindful life of well-being! If you struggle with this, which is most of us, just keep up the work and bringing your mind back to the sensations you have with each bite. Over time, you will have a whole new appreciate for this incredible ability to eat food and a building skill for using your mindfulness to enjoy your body's amazing sensations. Would you like to join me for a little story and some sexual healing?
My story is this: I am opening this space (in my first-ever blog) between the worlds of medicine, healing and sexuality to build knowledge and a place of hopeful growth. I blend techniques for the body, mind and heart to reach a true place of healing in my practice as a Nurse Practitioner and Sexual Therapist. As a Family Nurse Practitioner for many years, I’ve watched as current treatments for diseases, disorders, and dysfunction failed to help my patients. Each patient I see isn’t simply a set of symptoms, but a whole person with a story to tell. It seemed to me that the medical approach I worked within didn’t help patients to get “better.” So after years of professional frustration, I went back to school to find a way to cultivate a sense of well-being for my clients physically, emotionally, mentally, and spiritually in the areas of health and sexuality. My education as a Nurse Practitioner, then becoming a Fellow of Integrative Medicine and finally in Sex Therapy guides my practice to evolving a treatment plan encompassing the complete person; body, mind and spirit. One of the most attractive aspects of Integrative Medicine is the perspective of each patient as a dynamic energy body that needs support rather than being “fixed” or that something is “wrong.” Therefore, approaching the aging process from the view of a dynamic energy system, healing and well-being emerge. As I began utilizing an Integrative approach with patients, I’ve witnessed transformations in their health and sexuality at much greater levels. Patients truly appreciated alternative treatments and even request it! Focusing on Integrative health and sexuality is a passion and calling that has brought me to a leading-edge practice and this new space for sharing! |
Sherri AikinSherri Aikin is a Fellow of Integrative Medicine, Nurse Practitioner, Sex Counselor, Mindfulness Facilitator, and Life Coach. Categories
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Effective February, 2024, I will have some limited availability for in-person visits on Wednesdays only. Office location: 6630 South McCarran Blvd., B-18, Reno, Nevada 89509. In-person visits are scheduled through ChARM. Testimonials"Throughout my 40s, I sought help from different professionals for perimenopausal and relationship issues. In Sherri, I found a trusted guide to help me navigate the turbulent waters...." |