"Sex and the City"-Shrink Talk

HBO presents

September 27, 2000

Dr. Perelman answers your questions about sex, relationships, and dating in relation to the latest episode of HBO’s “Sex and the City.”

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HBO: Welcome to Shrink Talk! Did this week's episode bring up some familiar issues for you? Dr. Perelman is live, and ready to field your questions about relationships, sex, and dating.

Dr. Perelman: We would like to welcome everyone and remind our audience that this webcast is broadcast for purposes of entertainment only.

Dan: I have a really good friend, and I've started to have feelings for her, and I think she feels the same way, but how can I tell?

Dr. Perelman: I will presume that you are somewhat shy, because of the nature of the question. So how a shy individual may proceed would be somewhat less bold than many people would be inclined. Essentially, I would encourage you to trust your feelings, and suggest asking her out for a date--lunch, if you are truly anxious, or a dinner date, otherwise. How she responds to the request will give you some very specific clues as to her level of interest, which will allow you to proceed accordingly. In that sense, it is really quite simple. Good luck! Let's have another question.

NotMe: Hi. I would like to know if it's normal for a woman after having two children that the sex desire isn't there anymore?

Dr. Perelman: That's actually a very good and important question. There are many reasons why a woman may experience a temporary dip in sexual desire following the birth of a child, especially a second child. These reasons can be both physiological, as well as psychological. If we presume for a moment that you are breast feeding your baby, a hormonal environment is created in your body that not only allows you to successfully let down your milk, but also significantly suppresses your sexual desire in association with the release of the hormone oxytocin. This is a very common phenomenon that usually improves upon termination of breastfeeding after a reasonable period of time. Additionally, a number of women experience both the fatigue and stress associated with the birth of a second child as an immediate cause of diminished sexual desire. This is independent of how you may be feeling about your spouse; however, for some women, anger or resentment at feeling unduly burdened by the responsibilities of motherhood can result in a diminished desire for their husbands. Regardless of which of these causes may be involved, as well as other possible causes, it would be a good idea to discuss this issue with your OB/GYN the next time you have an office visit. Information about these issues will also be available from a variety of self-help groups and professional associations. Again, it is not uncommon, and initially should not be a cause of long term concern.

Helen: Charlotte and Trey's new sex therapist recommended they name their genitalia. Is that an effective way to stimulate openness about sex?

Dr. Perelman: This is an interesting question. I have actually used such a technique in sex education classes for students as a way of encouraging them to be more open in discussing sexually related issues in an undergraduate nursing curriculum. It is humorous, and it reduces anxiety and the sense of social awkwardness. The reason for doing so is the fact that students are frequently interested in learning, but, understandably, do not want to expose any vulnerability about themselves in class discussion. Having said that, the opposite is usually true in sex therapy where such techniques are superfluous and unnecessary. I was actually struck by Trey's question as to whether or not his therapist really did go to Yale, but not for the reasons Trey implied. Rather, I felt that the therapist was colluding with the couple in avoiding a direct discussion of what their problem was. In reality, by the time people with this type of problem arrive in your office, they are more than able, and, indeed, usually eager for one, if not both of them, to get the problem 'off their chest'. By confidently asking for a description of the difficulty they experienced in the last time they attempted a sexual encounter together, one quickly is able to piece together not only an understanding of the sexual problem, but also communicate to the couple the therapist's ability to maturely and responsibly discuss these sexual issues, as well as provide a forum where they will be able to do so, as well. In tonight's episode, the therapist was actually getting in the way of such a dialogue, and, as such, impeded some of the progress they may otherwise have made. Albeit, it made for amusing television.

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