LiveWorld Transcripts

HBO presents

Dr. Adam Cotsen
"Sex and the City"-Shrink Talk

October 11, 2000

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Milka: Hello, Dr. Recently, my live-in boyfriend has tried to do what I consider rather 'kinky' sex. What are the possibilities that he has a new girl friend that he's learning this from?

Dr. Cotsen: Hahahahaha! I suppose it's possible, but it's really more likely that he is becoming more comfortable with you and more secure in his relationship with you. Soooooo, he now feels like he can come forward with many of the kinky requests that he might have felt too embarrassed or insecure to make of you earlier in the relationship. I suppose he could have gotten these ideas from a new woman in his life, however, most of the time "kinky" ideas are generated by men and humored by women.

Cotsen Fan: I have S&M fantasies. Is this normal, or do I need help?

Dr. Cotsen: Geez, sado-masochistical fantasies in my very own Cotsen fan. You're making me blush! Most of the time, this is normal, or at least, eccentric and creative. Only rarely do such fantasies turn out to be pathological. Many people have S&M fantasies, and they can be quite erotic and perfectly OK as fantasies. They can even be very thrilling to act out, The only problem is if, in the role-playing or acting out of these fantasies, you would be tempted to force yourself on one against their consent, or cause true harm to either you or them. These extremes are rarely the case, and most of the time, what people with S&M fantasies need is to get more comfortable with, and allow themselves to enjoy, the full flowering creativity of their utmost fantasies and sexual wishes, even if these wishes are rather taboo.

Sternchen: Young men in their 20s are using Viagra to heighten their sexuality. Is this a bad thing and can it cause problems later in life?

Dr. Cotsen: We don't really know about later in life, because Viagra has not been either in testing or out on the market for much more than the last five to ten years. Viagra certainly can cause problems, and in fact, can cause death if it's combined with a street drug known as toppers (or amyl nitrate). So young men in their twenties should be very aware of that risk. Older men need to be careful not to combine poppers with a similar substance, the cardiac medication nitroglycerine. This can also lead to sudden death. But now that I've scared you all, I must say that Viagra is essentially an otherwise fairly mild medication with mild side effects, and worth trying for people who really need it.

Coffee: There is such the theme to tonight's episode, the whole cosmic things in a relationship. Can you go back and fix something that you did wrong in a past relationship and make it good for your next relationship?

Dr. Cotsen: That is really much more of a question for a psychic, or perhaps a Buddhist, than for myself. However, I will say that it can be very important when you realize that you have had a pattern of bad behavior in relationships, such as relationships that have been marred by the abuse of alcohol or drugs, then you may find it very helpful to do the Twelve Steps, which involve taking a moral inventory of how you have behaved, and making amends to the various people that you have hurt. After making amends in such a way, you will be very unlikely to repeat the same mistakes in future relationships. This is not exactly what Carrie was trying to do tonight, but I think it's something important to chew on, at least until next week.

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