Susan Quilliam

Another day, another presentation

2009-11-26T13:54:00.005Z

Yes, another day, or rather another week, and I was off to do another presentation. This time I was attending the annual meeting of the European Society of Sexual Medicine in Lyon.

The task at hand was to present - at a formal dinner - to 100 international opinion formers about the difficulty of addressing sexual issues in medical consultations. As always I was delighted to oblige because - as those of you who read my previous blogs will know - bridging the gap between patients and health professionals is one of my passions. It was all very exciting!

In the event, what excited me most about my four-day presence at the conference was how enthusiastically the other delegates shared my vision. Remember, we are talking here not about a gathering of therapists or counsellors, but of physicians - and frankly, even up to even a few years ago, the issue of empathic communication would have fallen on deaf ears. But this time, not only was my own speech well-received, but the main body of the conference contained a wonderful flurry of other relevant presentations

One of the best was a session led by my colleague John Dean, where two young actors and a willing therapist role-played a worst- and then a best-practice consultation for a couple with sexual difficulties. The actors were convincing, the therapist skilled, and John himself drew some very nice lessons from the demonstration.

In short, the energy for open, sensitive and cooperative patient-professional communication was higher than I have ever seen it; I do believe that there is a real sea change on the way, where both sides can start to understand (and help) the other.

The result, surely, will be better health care and more job satisfaction. The next decade ahead is going to be very exciting!

Yes, there is sex after conception...

2009-11-26T13:47:00.004Z

It all began in early November when I was invited by the British Association of Sex Educators to take part in a seminar on sex in pregnancy and beyond.

I was delighted to have been asked. Because the thing that annoys me is that once conception's actually happened, both lay people and health professionals often assume that sex has done its duty and has become irrelevant.

Pregnancy itself - and the few months after birth - may be a period where stress, strain and raging hormones mean that lovemaking is the last thing on anyone's mind. Plus, he as well as she may be terrified that any form of vigorous exercise - particularly one that involves a penis in a vagina - is going to threaten the pregnancy. End result is all too often that sex goes on hold for at least a year and often more.

Of course, if that's truly a couple's choice, no pressure. But it needn't be that way. Human beings need touch - to reassure, to relax and to bond with each other. Hence I would argue that in that huge challenge that is parenthood, we need such touch more rather than less. So it's essential to help couples to realise that making love after conception is not only Permitted but also a Good Idea.

Hence I put together a 45-minute presentation which offered health professionals a simple guide to helping couples overcome the blocks to having sex, and summarised the best practical advice as to what's possible, what's inadvisable and how to get the most pleasure throughout pregnancy, labour and post partum.

I'm not commenting on my contribution - modesty forbids - but otherwise it was arguably one of the best seminars I've ever attended. The other speakers covered the the myths and the challenges of sexuality and suggested some ways of tackling those. The audience - including not only experienced midwives but also students, was attentive, eager and extremely enthusiastic. The feedback was highly positive. We're going to do it again - hopefully soon, hopefully throughout the country, and hopefully with an attached workshop for skills practice. Watch this space...

Only one thing saddened me. No names, no postmortems, but apparently the NHS hospital first approached as a venue for the training had refused, saying that they didn't feel it appropriate to be covering the practicalities of sexual pleasure during pregnancy. Which brings us, of course, full circle back to the preconceptions I originally railed against...

Well, all I can say is that that wasn't the attitude of the health professionals who attended the course, all of whom were vociferously in favour. So.. please lead me to the nearest wall and let me bang my head against it...

Talking of passion...

2009-10-05T11:30:00.002+01:00

... my past weeks have been full of it. No, not the sexual sort I'm usually writing about - though there are links, as you'll see if you read on.

I'm talking about the passion that people have for a cause - the sort of passion that makes them go the extra mile, give the extra pound, or be willing to spread the word so that others get involved and the passion pool gets bigger and stronger.

The first passion pool I've been involved with of late concerns just that last-mentioned skill: spreading the word - in short, advocacy. The World Association of Sexual Health, having set their millennium aims, are keen to help those in the field to brush up on their advocacy skills to achieve those aims: health for all, an end to sexual abuse, sex education worldwide. I attended a workshop on the subject (brilliantly led by Esther Corona of WAS) earlier this year, and then with Esther's support, led a shorter workshop at the recent International Sex and Relationships Education Conference in Birmingham.

How inspirational was that! Sex educators, sexual health specialists, relationships education teachers, from a variety of countries... all passionate about spreading the word in their own societies. When we came to the exercise where I asked delegates to report on a time they had advocated successfully, we were all moved to tears by the stories that emerged - particularly from two amazing women from Eygpt, Mahaweb and Samira, who had campaigned for decades against female genital mutilation and finally, finally, got it made illegal. The group broke into a spontaneous round of applause and, as the workshop came to an end, we all went forth even more motivated to make a difference.

Three days later, different city (London) and different group (cervical cancer survivors), but just as inspirational a group. I ran two workshops for the charity Jo's Trust which supports women who have had a positive smear or worse. Two groups of women, again with their own stories, this time of unimaginable bravey, both physical and emotional - but once again, despite what they themselves had gone through, with a passion to do their utmost for the cause. Tears flowed even more than they did at Birmingham - but alongside those tears came energy and commitment, that women should be helped in every possible way to cope with the cervical cancer challenge.

In these days of credit crunch and tightened belts, financial wobble and knock-on emotional insecurity, we can lose sight of causes. We can lose sight of the fact that people are still suffering and still need our support.

These two workshops reminded me not only of that fact, but also of the fact that there are still those who feel passionately enough to remember the sufferers, and to give that support. Which - on this cold October morning - gives me, and I hope you, reasons to be cheerful.

Long, hot - slightly depressed - summer...

2009-08-28T09:33:00.005+01:00

So how was your long hot summer? Long and hot, I hope, and full of rest and recuperation - as mine has been.

Back now, I'm downhearted to see that there seems to be very little good news. The economic crisis is still hitting. Politicians are still squabbling. Celebs are still breaking up.

In particular, it hasn't been a particularly good summer for feeling down. According to the newscasts, anxiety and depression rates are soaring. But GPs, apparently, only spot clinical depression in half the patients who have it. And even when the condition is spotted, funding for some forms of treatment - such as exercise - is limited . and there are as yet not enough therapists to go round. No surprises there - but no optimism, either.

But wait! There is a news piece this morning that offers a little light in the darkness. Apparently a study in the Lancet suggests that online therapy increases the chances of recovery from depression twofold when compared to medication only. And as online therapy is likely to be more accessible (handier for client and counsellor, theoretically cheaper when it comes to funding), we can hopefully expect it to be rolled out across the NHS.

I hope it is. For let's not forget - as the long hot summer comes to an end and the darker winter days take hold - that during our lifetime one in four of us will suffer some form of mental illness. This means you - or several of your friends, family and loved ones. So the more that can be done to support the cause (as well as reduce the stigma) the better.

2009-06-25T10:02:00.004+01:00

I do understand, truly I do, exactly why the government has decided not to hand out free smear tests to women in England under the age of 25.

It's absolutely logical. Studies suggest that below that age more women have false positives - which scares them. Subsequent unnecessary treatment may be harmful - and even necessary treatment can occasionally cause damage to the woman and premature birth to her future children. And - though of course this couldn't possibly be a factor in the government's decision - increased smear tests cost money that could be spent on other more urgent causes. You know it makes absolute sense.

And yet, and yet.... If it makes such sense, how come countries like Denmark and Sweden set the test age at 23? How come the advice in many countries is to have the test at 21? And how come the rest of the UK offers smear tests at 20 (why do the words 'postcode' and 'lottery' come inexorably to mind?)

But actually, my main worry here isn't to do with the figures, the statistics or even the logic of the argument (nor am I, as so many press sources are today, citing the Jade argument). No, my main worry is for individual younger women, women who because of their youth are probably less aware of the risks of cervical cancer whilst at the same time being more at risk simply because they are in that life stage of having many partners. The hard fact is that if we lowered the smear test age - lowered it way down to the average age of sexual intercourse at 16, we would save lives. Not many, but a few. And the fact that we aren't doing so horrifies me.

I'm not arguing that cervical smears are a better use of money than other heart-rending health causes - who am I to deny the importance of treatment for leukaemia, infertility, heart disease. and who is anyone to make comparisons and judge who should get the cash?What I'm arguing is that tests would be a better use of money than so many other things that the Government spends on - warfare, thousand-pound-an-hour consultancy, and of course, second homes and dirty videos.

My suggestion? Just cut a fraction back on the expenses and put that money into bringing England into line with the rest of the UK when it comes to the life-saving smear test...

PS: When one writes an academic paper, one need to cite 'vested interests'. This isn't an academic blog, but here is mine. At age 31 I had my own positive smear test, which led to treatment for developing cervical cancer. Yes, even with the age bar held at 25 I would have been spotted and saved. But I still feel a shiver at the thought that any woman, absent the possibility of that test, will have to go through the treatment and the trauma that I suffered.

Let's hear it for the mourners

2009-06-19T13:15:00.007+01:00

I get a lot of letters - I mean a lot - from readers and listeners who have just endured the ending of a relationship.

But here's something that may surprise you. The ones that worry me are not those who outline in heart-rending detail their tears and rages, not those who report a deep loss of self esteem and trust in the world.

Yes, such responses are painful and not to be trivialised - but they are totally normal and healthy. Let emotion flow, get support for the agony, and in the end you will likely recover. Of course there are exceptions, those who are crippled by break-up grief for the rest of their lives; but as with a bereavement, typically nature takes its course and you come through. You may suffer, but you will surive.

No, the readers who terrify me are those that think that they won't - shouldn't - suffer. Those who try to carry on regardless and then wonder why they are finding life difficult. Cf poor, sad Katie Price, downing drinks and hitting the Ibiza dancefloor while shouting defiantly at reporters "I'm over Peter!"

I'm not criticising these readers - their hurt is just as strong as the griefstricken or depressed correspondents, and they need just as much support and pity. But who said that suffering isn't an inevitable part of having loved? Who said that one shouldn't mourn when that love dies?

What sort of world do we live in that persuades people that they should 'bounce back' from the ending of - in Katie's case - a five-year relationship that produced two children? What sort of world do we live in where the default option for coping with such an ending is not to lick our wounds and receive the support and comiseration of friends, but to think we have to carry on regardless drowning our sorrows in drink and yet another relationship. Only last week, in my postbag, I received a long letter from a woman worried there was something wrong because she didn't 'feel better' after her long-term partner had walked out on her... barely a fortnight before.

So let's hear it for the relationship mourners, those who have the courage to feel the pain and grieve the loss, to take their time to come back onto the dating scene, and to learn the lessons of the breakup before they emerge into the world again.

Short term they may seem emotionally weaker than those who don't even break step. Longer-term, however, they will be healthier, happier and far more able to love.

Dying of embarrassment

2009-06-16T10:29:00.003+01:00

Some worrying research results yesterday highlighted the differences in the way men and women react to the suspicion of cancer - that is, whether they hie themselves off to the GP within hours of spotting the lump/bump/lesion, or whether they instead burrow their heads even more firmly into the sand.

No criticism here. Fear, which must surely be the key motivator, is a powerful paralyser. And if men - for yes they are the ones doing the sand-burrowing - are terrified, then that's utterly understandable.

It is, however, also tragic. The abovementioned research, brought out to coincide with Men's Health Week, suggests that there is no biological reason why men are 60% more likely to develop cancer and 70% more likely to die from it - particularly from the gender-specific, sexually-linked types of cancer such as prostate and testicular. Yes, there are major lifestyle causes. but the high mortality rate is also down to an unwillingness to acknowledge symptoms, take them seriously and then report them.

It comes as no surprise that this unwillingness is higher when it comes to the gender-specific cancers - because the emotional discomfort factor is so much higher there. I know this myself - for every 20 letters I receive from women asking me to advise on sexual problems I get perhaps one from a man. A mixture of anxiety, machismo and shame is holding the guys back.
Men are, literally, dying of embarrassment.

The answer? Professor Alan White of the Men's Health Forum puts his finger on it when he appeals for health services to be more male-appropriate. And that doesn't just mean more available outside working hours - but more encouraging, more motivating, and more aware of y chromosome reluctance.

I am inexorably reminded of that classic self-development question: which do you choose to be, the rabbit or the headlights? Let's hope that by next year's Men's Health Week, men are beginning to choose the latter option...

Back again...

2009-06-10T14:15:00.005+01:00

Yes, I confess, it's been a long hiatus. To be precise, six weeks since I last blogged.

I can't claim wild celebrations have kept me from my screen (although admittedly I have had a birthday since I last logged on - don't ask which one but it ended in a '9').

What I can claim is a slew of work. In particular - unusually for me, as my job rarely entails exotic foreign travel - a work-related trip to Istanbul to speak at the DISPAXWorld 09 conference. For those of you not in the know - as I wasn't until the conference organisers contacted me - this is an aviation get-together on the topic of disruptive airline passengers. Some impressive speakers, some fascinating topics, and a wonderful cruise on the Bosphorus, courtesy of our sponsor. In case you're wondering, I was presenting on sexually disruptive behaviour inflight; no, not so much the Mile High Club as sexual attacks, sexual abuse and public indecency. The model I've developed through the work I've done suggests that while there is no excuse for any of these, there are reasons - Air Lust is as induced an altered state as Air Rage and hence needs careful handling.

Other fascinating projects over the past six weeks? Developing a model of why we hate some celebrities and love others... writing about grey sex for the Menopause Matters magazine... preparing a paper on male contraception for the Journal of Family Planning. Also commenting on Posh and Becks's tenth wedding anniversary, giving my views on the importance of 'sharing', and holding forth about the pros and cons of mothers-in-law. It's a fun life.

But perhaps the thing that's most holding my attention right now is my weekly LBC programme. Listener figures are - gratifyingly - up yet again quarter-on-quarter, and Jim Davis and I seem to be building quite a community of supportive fans. The best bits, though, are the calls - about everything, anything, and things you certainly wouldn't mention to an above-mentioned mother-in-law. The caller who was planning to walk out on his family the next morning but hadn't actually broken the news yet. The sobbing girl whose partner had just abandoned her and her two-week-old baby. The gay police officer who was terrified to come out. The thirty-something woman who wanted me to tell her, in detail, on the air, how to masturbate. And these, of course, are the queries it's legal and decent to broadcast... the ones that aren't still get a reply, but by email.

OK, update completed and now I 'm fully back doing my blog, I hope to keep it a little more regular.

And if you need something else to read, check out the musings of Jane Matthews, a friend of mine whose delightful blog charting her self-imposed challenge to be "someone nicer" is something I myself read every day...

Whoopeee!!!!

2009-04-28T13:00:00.005+01:00

Yessss. After a six month review, sex and relationships education in England is to become compulsory for all students of 11 and upwards. At last, at last, the Government has acknowledged what we sex educators have always known - that it's a straight choice between caught and taught.

Thankfully they've come down on the side of the teaching, so contraception, STIs and the supporting raft of relationship advice will be available to all late primary and secondary children from 2011 onwards. And that should mean that more resources are funnelled the SRE way - for student materials, teacher training and course support.

Yes, there are parental and faith school opt-outs, with provision for religious establishments to provide the teaching within the context of their own values. And, actually, though many sexual health providers disagree, I concur with this on the basis that democracy should trump mandatory every time.

But the fact remains that if we can fulfil this promise, in two years' time every adolescent in the country will be receiving regular, targetted, well-delivered SRE education. And with a bit of luck, a few years' after that, we won't be bottom of the European league tables for teen pregnancy and STIs!

PS: following a suggestion from my staff (truly not from me), I am now officially a nominee for the Our Bodies Ourselves Women's Health Heroes Award. If you'd like to vote for me - or even, if you know my work, post a comment in my support, then go to the Women's Health Heroes page and scroll down to find me. Last date for voting is May 8th.

2009-04-07T12:04:00.007+01:00

Well, yet another gap in transmission due to busy-ness at work.

But that doesn't mean to say that nothing's been happening. The past few weeks have been full of sex-relevant media stories. And, happily many of them have carried a hidden upside.

Poor Jade Goody finally lost her battle with cervical cancer - but on the back of that, in some areas of the UK the number of women taking smear tests is up by many per cent. The economic crisis means that men can't afford to keep mistresses any more - and the upside of that is, hopefully, fewer broken marriages and destroyed families. Plus, Jacqui Smith's husband has been caught in flagrante with two porn films - but that in turn has brought the whole issue of porn squarely into the public domain.

It's been that last story that I've been asked to comment most on - including a long interview for The Times - and I have expressed concern. Yes, I was the one who in the recent Family Planning Association Debate on the issue of porn argued that there are no easy answers. And I still think that burying all sexual images and tabooing all sexual information - as was done in Victorian times - is a very bad idea.

Nevertheless, it's becoming clearer and clearer that while the general principle of openness about matters sexual still holds true, it needs to be done well. When linked with inaccurate information (all men have big penises, all women climax immediately upon penetration) and when surrounded by problematic values (a woman is only valid if she is slim and big breasted, a man is only valid if he keeps it up all night) porn is utterly harmful.

And, of course, addictive. I get more and more letters from women in particular who are distressed and disgusted by their partners' use of porn - and the subsequent deceit and betrayal where such partners promise to stop but then secretly. Relate reports a steep increase in marriage breakdown that is fuelled by Internet porn addiction (though whether the breakdown chicken or the addiction egg comes first is still in debate).

No it won't work to ban all erotic images. It won't work to think that our society can magically switch back to pre-sexualisation days.

But what we can do is to encourage a process of emotional maturity in our treatment of sex, so that we don't get stuck at the 'big tits, big cock' stage of adolescent sexuality. What we can do is topoint out that screen portrayals are not real life, and that real life sex is much much better just because it is real.

What we can do, in short, is to constantly remember that good, positive loving sex is much much better than the ersatz porn variety...

Sons and Lovers

2009-03-18T14:21:00.006Z

As we come up to Mothers' Day, I thought I'd point you in the direction of two contrasting stories that have emerged this week - both about mothers' relationship to their sons, both causing a bit of a stir in the press.

Julie Myerson has hit the headlines on the back of her latest book, a reworking of the real life conflicts which resulted in her barring son Jake from the house. Should she have put all this in the public domain? The general concensus is no.

Meanwhile, Lucy Baxter is going public with a completely different problem. Her son Otto, 21, has Down's Syndrome, and as a result is finding it difficult to have the normal sexual experiences that a lad of his age wants and expects.

Now, I'm not a mother, so my insights will be limited here - but I'm far more moved, and far less outraged by the the second story than the first. It feels to me absolutely commendable - and very farseeing - that Lucy should be fighting publicly for her son's right to a happy, healthy sex life; his mother is not only doing him a good turn, but doing good for all the other physically and mentally handicapped youngsters (and oldsters) who aren't seen as sexual beings, and who are therefore denied an outlet for their passionate feelings.

The slight nose-twitching that has been going on in response to her speaking out seems to me to be utterly unwarranted. Why should Otto be penalised simply because he has a medical condition? Why should we not support him simply because he does not tally with our view of 'fit'. Why should we not see him as a sexual adult who needs and deserves the pleasure and comfort of an intimate relationship. As Lucy Baxter says, "it's society who has a learning disability" in this respect.

As for Julie Myerson? Yes, her child's drug habit is heartbreaking and everyone sympathises. But perhaps she could learn a lot from Lucy Baxter's support of her son as he tries to make that difficult transition to individuated adulthood.

And perhaps both Julie and her son should thank heaven they don't have the challenges that the Baxter family faces, day in and day out...

Naked as nature intended?

2009-03-02T14:58:00.005Z

I for one will be tuning in to BBC 2's Horizon tomorrow at 9pm for a fascinating glimpse of what we sexologists consider our daily bread: nudity.

The programme will be exploring just why human beings feel embarrassed when they take their clothes off - and, by means of a series of exercises, will be attempting to lower the embarrassment factor for a group of volunteers. Apparently the exercises are so successful that at the end of the filming process, the group walks to their 'take-me-home' taxis stark naked. Gripping stuff.

Of course what interests me most here are the sex-related implications. Apparently we humans are socialised into a wariness of nudity in order to keep sexual temptation to a minimum, avoid infidelity and maintain social stability. Mmm.... I do fail to imagine everyone suddenly jumping into bed with everyone else just because the clothes are off. Nudist camps, by dint of intelligence and respect, manage not to generate daily orgies - and speaking for myself, seeing a naked man who I'm not personally involved with is a turn-off rather than a turn-on. Nevertheless, I get the point.

But I do still have a problem with the backlash that such socialisation creates in society. Because I'd be a rich woman if I had a pound for every advice-seeking letter from a reader who's hung up about their body, hung up about physical intimacy, hung up about getting naked even with the person whom they most love and desire.

Our emphasis on nudity may be keeping us all safe from making love indiscriminately - but it's also keeping us from being at ease with our bodies, and from being unembarrassed and comfortable with other people's bodies. It's also making us wary and inhibited in the very arena and in the very relationships where we should be most open, trusting and uninhibited.

Not to mention the fact that what's forbidden immediately becomes more fascinating. (I'd love to see some studies exploring whether people who are at ease with nudity are less prone to using pornography. I strongly suspect they are.)

So I'm with the Horizon group. No, I won't be walking naked to pick up the next taxi that I hail. But I'd love to live in a world where doing exactly that was entirely possible!

Reclaiming the joy

2009-02-19T15:26:00.007Z

Sorry to revisit a topic I was going on about only a few weeks ago... but if there is one thing that I really "got" when I was rewriting Joy of Sex, it is that while sex may be the same as it was in 1972, the joy certainly isn't. Given the drip feed of horror stories in the press and the continuous warnings about the dangers of sex from all sides, we've somehow lost our optimism, our innocence - somehow, we've flushed the joy baby out with the bathwater.
Don't misunderstand. I'm not advocating condom-free orgies or emotion-free lust-fests. I'm as aware - and as vociferous - as anyone about just what we all need to do is order to make sex safe, sane, concensual and super-enjoyable. But I do feel that we've forgotten that sex is a Good Thing.

Which is why I was delighted to be invited to speak at a ground-breaking new conference in Devon yesterday. Run by the Eddystone Trust (with backing from the thinking person's condom-maker Durex) the training was packed with all sorts of fascinating folk from the world of South West sexual health. We had a great presentation on making older-age sex good, a fascinating interactive workshop on young people and risk taking, and an equally fascinating one on communication. Apparently one of the feedback forms said that it was 'the best workshop' the delegate had ever attended.

My contribution was to set a framework on just why we can get so negative - because of the above mentioned media panic and also, rightly, because of our need to protect ourselves (and particularly our young people) from the very real dangers of sex. I also made the point that sometimes being sex negative comes right from the heart of our own lives. If we love sex, we don't want others to spoil that by being irresponsible... if we've been disappointed in sex, we want to warn others of the dangers. It's all very understandable.

But I stil think it needs a rebalance. I still think we need to recontact the fact that, when safely and lovingly done, sex is one of the most wonderful things in the world. Lose the statistics, let's reclaim the emotion. Lose the cynicism, let's reclaim the joy...

Yet More Joy

2009-02-10T16:03:00.003Z

So just when you thought it was safe to go back in the water... they publish two more books in the Joy of Sex series.

In other words, though I've batting on for months now about the original book, what I didn't stress was that it isn't just a book, it's a whole brand. And this week the next two books in the brand hit the UK shelves (US readers, sadly, have to wait until May to get their hands on them).

The Romantic Lover. The Adventurous Lover. Not to descend into back-cover blurb, but they're both small-and-perfectly-formed hard-backed pocket books, illustrated with more of the great Joy of Sex photos - though the text is entirely new.

Both do what they say on the tin. The Romantic Lover majors on all things pink and loving with sections on massage, foreplay and simultaneous orgasm (yes, it is possible!). The Adventurous Lover ventures into more exotic territory, with sections on anal, bondage and swinging. I can't claim to have tried in full everything I wrote about, but I have talked - in detail - to those who have. :)

So onward and upward. Next stop - later in the year - the Long Weekend Lover. And if anyone out there has any special requests for more titles, we have a long publishing list to go. All ideas gratefully accepted!

Joy coming home to roost...

2009-02-06T10:42:00.004Z

I've spent, in my role as Joy of Sex spokeswoman, the last six months talking about sex - to journalists, TV presenters, radio hosts. And the one thing they always ask me is how things have changed since the book was first published 37 years ago. Typically I list the scientific changes, the rise of the Internet... and eventually come round to the fact that in 1972 there was an atmosphere - how can I put this - of naive optimism.

The orignal book reflected those times, those heady, postpill, sexual-revolution times when (to paraphrase Alex Comfort) a sexually transmitted infection was seen as slightly less problematic than a dose of flue, and infidelity was seen as par for the course.We look back now and wince...

And wincing is very much on the menu this week as reports come through of a sharp rise in sexual cancers in the wake of said revolution. The study, from King's College London, points out that the rate of cancers triggered by the HPV virus have rocketted since the Swinging Sixties and Seventies. And we all know why.

I was there - and contrary to the cliche, I remember it! Thank heaven I was informed and sensible enough to keep my sexual contacts safe and loving - but that wasn't the norm. We genuinely thought that if we were on the pill we were safe from all harm - and that meant we could play without protection. And it is deeply sad that we are now paying the price for our ignorance.

But let's remember that it was ignorance - and let's steer clear of the moralising about those times that is already appearing in the popular press. Please don't blame us. We weren't evil, we weren't immoral, we didnt' set out to have orgies. We were young and hormonally fuelled - and most importantly we just didn't know how dangerous it could be to have sex.

Now society knows, and is much more wary (though interestingly of course, it is this very generation that still doesn't quite realise that they are in danger - the 40+ cohort is currently the one where STI rates are rising highest.) And that in itself is sad.

Because, for all the illness, all the abuse, all the unhappiness that unconsidered sex can cause. we still need to remember that - safely and happily done - sex is wonderful, wonderful, wonderful!

Back from the US

2009-01-30T12:16:00.002Z

Well, I'm back! And the answer to the questions I posed before departure (will I say the right things... will I do the right things... will everyone be able to understand my exotic British accent) is apparently Yes.

To take the last one, I was surprised and delighted at the response to my Britishiness. The exact comment from one TV producer - echoed by many more - was "The word "masturbation" in a Texan accent sounds dirty; in a British accent it sounds decent. We love it!". So there you go...

On a more serious note, I was delighted at the response - the amazing publishers have sold their initial print run of 30,000 copies of the book and are currently ordering in more; it's only been out three weeks.

Just as nice, the interviewers were supportive, the phone-in clients enthusiastic. I had been worried - warned from all directions - that a US audience might be wary. Seems not - lots of phone calls offering congratulations on covering the topic, lots of phone calls asking upfront questions of the kind that you only rarely get this side of the pond.

Only one regret... I was asked to do Oprah (yessss....) but at the last moment got bumped; the amazing "plane-landing-in-the-Hudson" story was just too big.

Back down to earth now and focussing on the British launch of the next two follow-on books - Joy of Sex Romantic Lover and Joy of Sex Adventurous Lover. The Yanks are still ringing me though and there are few things in the pipeline; I may have to swim the Pond again very soon. Can't wait!

Off to the USA...

2009-01-12T15:37:00.002Z

Just a quick postcard as I set off for the next round of publicity for Joy of Sex. This time it's in the States. No, don't get jealous - though it is fun to be flying off to the Big Apple, what will happen when I get there is a relentless circus of appearances and jet lag. All worthwhile, all helpful to the book, but tiring nevertheless.

Justina from Crown, who is publishing my book, has been working hard. As a result, I've been lucky enough to get two slots on the Today programme (The Big Early Morning Show) and a slot on Nightline (The Big Late Night News Show), plus a whole slew of national and regional TV, radio and website interviews and some interesting meetings with production companies and sex toy manufacturers.

I have to admit to a little trepidation; will I say the right things, will I do the right things, and will everyone be able to understand my exotic British accent? But hey, if you don't have the adventures, then you've never lived.

More to come, on my return....

Back to real life... and contraceptive choices

2008-12-10T15:17:00.005Z

There's very little to beat the great feeling when you press "send" on a piece of work - well, very little you can do with your clothes on, anyway. Today I got my high from submitting my latest manuscript - Weekend Lover, you may remember - and winging it off to the publishers. I'm still amazed at how many different activities one can do in the course of an erotic weekend - and all of them legal!

In the meantime, in among the final mansucript checks of a sex book I've been keeping an eye on the 'real life' elements of sex and following today's "pill scare". No, not a horror story of hormonal side-effects, but a panic in some quarters that now women will be able to get the contraceptive pill from their local pharmacist, the country is going to go to rack and ruin.

Stepping aside from that particular argument as being intractable - the sex education lobby and the abstinence lobby come from such totally different moral viewpoints that it often feels like reversing through porridge to even try to reconcile - I'd like to comment instead on whether having easier access to the pill will help the pregnancy rates.

I can't fault the arguments that easier (and just as safe) access to the pill is going to help women take greater charge of their contraception. Of course if something is more widely available it will be more widely used. And all the practicalities affecting contraceptive choice are clear - women use it more if it's easier, less intrusive, more effective, safe, spontaneous, reversible.

But I don't think those are the only elements in play here. What I'm seeing in my postbag are much more subtle influences that affect choice - particularly female choice. In short, I think we underestimate the role of values in creating this problem.

Because it's not just whether a woman can get to the GP surgery that dictates whether she uses contraception or not. It's far more complicated than that. Under the practicalities are a whole slew of emotionally laden reasons why women choose to protect - or not - against conception.

Is contraception feminine ? (if she believes that a woman's main role in life is baby-making, the answer may be no).

Does it negatively influence the way she looks (if the pill makes her put on weight, the answer could be yes)

Does it reflect her friends' choices? (if all her friends are getting pregnant, she'll want to as well)

Does it please her partner? (if he wants condom free, or hates her taking the pill, what is she to do) ?

Does it allow for passion? (the pill and the coil do, the condom and the cap don't)

Does it make her feel good about herself - and make other people feel good about her? (if she believes that having a baby will make her worthwhile, where's her motivation to use contraception?)

All these are amorphous elements... but I believe they are crucial in forming women's choices. Bottom line, the vast majority of sex education today presupposes that women who say they don't want to have children will therefore want to use contraception - and the only issue is making that contraception available.

I disagree - I think many women out there are incongruent about the whole issue. They don't use contraception because it cuts across their core values.

And until we truly take that into account in sex education, in sexual health programmes and in contraceptive consultations, then all the open pharmacies in the world won't dent those pregnancy figures...

Cheap. And cheerful.

2008-12-01T17:33:00.003Z

I was delighted today to read the survey - published on World Aids Day - by the Terence Higgins Trust that suggests that sex is the most popular free activity, and that given the credit crunch people are doing it more and more.

You might think my delight is simply because I write books like the Joy of Sex and want people to buy them. But though yes, the thought did cross my mind that one man's credit crunch might mean my expanded royalty cheque, nevertheless that wasn't my main reason for celebration.

I celebrate because - given safe sex, which of course was the Terence Higgins Trust message - I see little else to beat the activity of getting and giving pleasure. More cholesterol reducing than food, less likely to cause vomiting than alcohol, and much less likely to cause death than smoking. And that's beside the fact that regular sex keeps you trim, boosts your immune system, helps beat depression and raises self esteem. What's not to like?

Maybe I'm naif, but when it comes to having a joyful time, I think sex should be top of everyone's Christmas list.

Back again...

2008-11-26T09:45:00.005Z

... so where was I? Oh yes, in my last blog post I was in full flood about the Joy of Sex post-launch publicity and had just started doing the Jim Davis show regularly, with its accompanying challenges of explaining masturbation live on air.

So, a few weeks later - where does the time go when you're enjoying yourself - life has been incredibly busy and even more enjoyable. Wonderfully, the post-launch publicity for JOY is *still* going - last week I was signing books on the Lovehoney stand at the Erotica Show, and yesterday I did an interview about the book for a German magazine.

My copresenting role alongside Jim Davis - our slot is now called "Sex in the City" - is going from strength to strength. This week we're focussing on World Aids Day, interviewing Justin Gaffney from the UK Network of Sex Work Projects, as well as taking all the many, and increasingly fascinating, calls.

Alongside all that, the first and second books in the follow-up series to Joy of Sex have just arrived back from the printers. Entitled The Romantic Lover and The Adventurous Lover, they are gorgeous - tiny hardbacks, pocket-sized, in elegant shades of cream, bronze and gold with stunning erotic photos slipped in to illustrate my text. Yummy! (In the shops in time for Valentine's Day 2009, in case you're interested.)

And, I'm just finishing up the third follow-up book, which is about dirty weekends. Research, collation, draft and editing in eight weeks; this morning's job is to blend into the edited version all the information I gathered from the Erotica Show. Did you know that you can book an entire S&M suite for a weekend including bed, breakfast and dungeon... variations include a four-poster bondage bed with a cage underneath.

What a strange and fascinating job I do...

Explaining masturbation on worldwide radio...

2008-10-12T14:17:00.006+01:00

The slight gap in communication, folks, has been down to a wonderful amount of work coming out of the launch of Joy of Sex. But today being Sunday, I thought I'd bring things up to date.

There've been more interviews... of course. And more follow-up features. Plus a rather intriguing possible trip to the US in the offing; more detail on that later.

And an appearance at the Cambridge Union, debating "This house calls for a new sexual revolution.". Great fun, and a real feeling of speaking to the next generation of policy makers and governmental leaders; I only hope that when they get into office in a decade or so, they remember my call for more sex education in schools...

I've also, following my 'Joy of Sex special" for LBC a few weeks ago, been invited to appear weekly from now on, doing a double-hander with the wonderful Jim Davis. We really do work well together, fielding such disparate subjects as "I'm Christian and gay", "My new man's ex fell pregnant just before they split", "I come too soon" (a man) and "I've never come" (a woman).

This last involved me giving the listener an on-air step-by-step guide of how to bring herself to climax; one of those wonderful moments when I find myself thinking "I can't believe they pay me for this." On the other hand, most people who have talked to me about that particular programme segment have said that they couldn't do it even if they were paid...

Flippancy apart, I love doing the Jim Davis show and am utterly delighted that they've asked me to do the weekly slot. The phone calls, texts and emails pile up into their hundreds; the calls come from as far away as New York; we are obviously providing a key service - and my only regret is that we can't cover more in the two hours allotted.

If you want to catch the programme, it's every Friday night from 22:00 until midnight, on 97.3FM. And you can find the accompanying blog - written by me this week - here .

Losing my voice...

2008-09-24T11:38:00.003+01:00

...thank heavens, literally not metaphorically. I've done an average of three interviews a day for the past ten days - some of them, for the press, lasting over an hour. Add this to the normal communication of the day - and a touch of chest infection - and it's no wonder I'm suffering from slight loss of volume.

But heavens, no loss of interest in what I'm being asked. The thing that amazes me, every time, is how the same topic, Joy of Sex, elicits such very different responses from different journalists. The nice lady from Men's Health US wanted eight tips for modern male lovers - and a blow by blow account of how those tips might differ from what Alex Comfort would have said in 1972 (answer: radically, because not a lot was known about the clitoris then). The charming woman from the Mumbai Daily News wanted to know what I thought of the Kama Sutra (answer: deep respect). The Kiwi Radio reporter was delightfully informal and did, true to the stereotype, sign off with "no worries mate". Bless.

The Irish are the most surprising. Despite their reputation for inhibition, they unfailingly take the most upfront attitude. At 11am in the morning, they're reading graphic accounts direct from the "Venus Butterfly" section or asking me to explain, in detail, the difference between the vulva and the vagina. (Truly. That was yesterday on the Gerry Ryan show, complete with double entendres...)

So now, I'm just off to do the midnight show on ABC 702 Sydney. I presume that given the timing, they'll be pretty up front too. I just hope that they don't mistake my chest-infection triggered spluttering for shock or inhibition...

Post coital wind-down...

2008-09-12T09:45:00.003+01:00

The launch on Wednesday evening was absolutely fabulous - a canape and drinks do at our local Borders with speeches, flowers and lots of what one attendee described as 'loving energy'. I did my speech (albeit tearfully) and so did publisher David Lamb and Alex Comfort's son Nick.

I was particularly thrilled that so many representatives of organisations managed to make the trip up from London; thank you in particular to Peter Roach from Durex, Cath Allen from Relate, Natalia and David from Greatvine, Jhanne and Debbie from Sense, and Mishelle and Victoria from the Terence Higgins Trust.

And now, continuing the metaphor of my last blog post on Wednesday morning, following the orgasm, my team and I are in full-blown refractory mode - well at least until Monday morning when all sorts of lovely work arising out of Joy of Sex will begin again.

Watch this space...

Today's the day!

2008-09-10T10:17:00.003+01:00

At last, at last... in a flurry of media (Ireland, Scotland, Germany and yes the Australians) the book is launched.

Two years of effort - on my part but just as importantly on the part of my team and the publishers - has at last come to fruition. So... thank you to everyone, absolutely everyone who has been involved in the making, the development and more recently the publicity. I am truly grateful!

It's been occasionally stressful, sometimes frustrating, but largely a pure and increasing pleasure. Bit like sex itself, really...

... therefore I suppose you could say that today is the climax, the peak. The orgasm, so to speak. It certainly feels amazing!

Why Joy of Sex?

2008-09-06T14:41:00.003+01:00

Perhaps the most interesting - and at the same time frustrating - question I'm being asked right now is the "why" question. Why, in short, did I bother writing the book?

Don't get me wrong - everyone is being hugely excited and supportive. (That is, apart from the Alan Titchmarsh Show where he and his two guests just giggled like embarrassed schoolkids for five minutes - which was rather endearing seeing as their combined ages were probably more than the number of pages in the book).

But despite their enthusiasm, at some point absolutely everyone asks the 'why' question. Why does the book need a rewrite? And, why does the world need another sex book?

The answer to the first question is that it's a matter of timing. The Joy of Sex itself hasn't lost its essential appeal - telling people that they can take sex further and more pleasurably than they thought they could. But in the 36 years since publication, the science has developed enormously and the presuppositions have shifted completely. We now know about hormones, pheromones, the importance of the clitoris; we now have internet sex, teen pregnancy and the Venus Butterfly. The original was groundbreaking - but even cultural icons occasionally need a makeover.

The answer to the second question, however, is that it's a matter of common sense. My interviewers may have got sex totally sorted, but the majority of the rest of us haven't. With my agony hat on, I still get letters from thirty-something men who don't know where the clitoris is, and thirty-something women who don't realise that they need one. Plus, we have never been under more pressure to achieve in the bedroom: - to have good sex, to have more sex, to have better sex than the Joneses - despite the fact that the Joneses themselves, due to all the pressure, probably aren't having sex at all.

I passionately believe that there is still a need for a good sex book. There is still a need for a book that doesn't trivialise sex, regard it as junk food, see it in fluffy pink - a book that takes sex seriously, as a powerful and important force in our lives.

There is still a need, above all, for a book that encourages us to relax and take pleasure and show love when we make love.

There is still a need for a book that reinspires us with the joy in sex.

Still bubbling...

2008-09-03T10:37:00.002+01:00

The big news on Joy of sex for today is that the antipodean campaign has kicked off. The nice lady from Hodder in Australia has started lining up interviews already for the October 1st launch: so Sydney Morning Herald yesterday, News.com today and an increasing number of radio interviews lined up for the near future.

Yesterday, I also did an interview for the Times on the latest piece of research suggesting that men might be genetically programmed to be unfaithful. I have no problem with the research - very respectably done by the Karolinska Institute in Stockholm.

What I got a little heated about was the suggestion put forward in some quarters that a genetic tendency equals an excuse. There may be sound reasons for men (and women, let's not forget) to spread their genes around, but actioning that in today's society is dictated far more by upbringing, personality and personal ethics than by a genetic imperative.

Parallel to this, you may have noticed, has been launched a book by one Gary Neuman who claims that if a man strays, it's the woman's fault. Again, excuse me? Yes, women need to work hard to make sure that relationships are healthy and happy - but so do men. And once again, however miserable a partnership, infidelity is an option not an inevitability. You do have a choice here.

As Alex Comfort originally said in Joy of Sex, and I retained in the update, "we have to find our own fidelities."

What a good week...

2008-08-29T19:11:00.004+01:00

I truly don't want to turn this blog into a celebration fest - but this has been such a fun week.

Regular readers will recall that it was The Times last Saturday, then The Sun on Monday. Then I was asked to write a piece for The Express for Wednesday. Then I was on Woman's Hour this morning doing a twohander with Brett Kahr, a lovely therapist from the Tavistock Centre. And that's not counting the Australian interviews and the Indian interviews.

Woman's Hour, unsurprisingly, was eager to look at the issues posed when a woman rewrote JOY. Did I feel that it was necessary to realign the book a female viewpoint (answer: absolutely and according to his son Nick, in 2008 Alex Comfort would have agreed). Did I get irritated at Alex for his lack of feminism (answer: for his time he was actually very pro-feminist).

The Times of India, meanwhile, wanted to know whether I'd included the Kama Sutra in the New Joy of Sex (answer: yes) and whether the western sexual tradition had a manual as old and as explicit as the KS. (answer: no of course not, did you really think we would!).

Next week, the Brazilians are ringing. I wonder what they'll ask about - sex on the beach at Ipanema? Watch this space.

A tale of two features

2008-08-25T10:17:00.003+01:00

Interesting how two very different features can reflect such very different, and yet similar views of the same topic. Or to put it another way, The Times and The Sun both do a good job.

The Times coverage of The New Joy of Sex came out on Saturday morning. It majored hugely on the social significance of the project, delved into my own background, and happily reflected the key point about the whole book: that despite the fact that sex is all around - I would argue *because* of the fact that sex is all around - we need an informed sex manual as much now as we did in 1972 when JOY was first published. (I also hugely liked the big picture of me in a punt!)

The Sun coverage came out this morning and on the surface looked utterly different. Screaming headlines, capitalised key words, lots of sexy pictures, and boxouts comparing what is "in" the new book and "out" of the first one. One might think that the points made were going to be both less subtle and less accurate. Actually no. The same message about the necessity for sexual information and resources came across just as strongly.

Aside from being a potentially useful "compare and contrast" lesson for media students, these two articles made me reflect. It's fashionable to accuse the redtops of scandal-mongering. It's almost as fashionable to sneer at the broadsheets as being merely vehicles for the chattering classes. And either paper, when writing up the material they had to work with - research, the book itself, the interview with me - could have dramatised, patronised or generally let themselves be hi-jacked by the temptation to write The Joy of Sex in an irresponsible way. It's a sex book, after all - and could have easily been fair game.

But neither paper into that trap. At the heart of each - expressed very differently but making their point just as accurately - was an extremely effective treatment of the messages I am trying to get across. So thank you to both journalists involved. You've just made a huge contribution to sex education in Britain today.

Check out Body and Soul tomorrow!

2008-08-21T12:13:00.004+01:00

Just a quick post to tell you about the very first piece of coverage of The New Joy of Sex - by the London Times.

I had great fun doing it - they sent a very accomplished interviewer up from London to spend an afternoon with me. But even more enjoyably than that, they also got a photographer to take some snaps.

Said photographer decided that it would be a great idea to shoot the whole thing on a punt, so imagine me, the photographer and a rather bemused punt chauffeur taking us round and round in circles on the River Cam just in front of King's College Chapel while the tourists floated by gawping.... Embarrassed? You could say that.

The results will be the lead interview in the Times Body and Soul supplement tomorrow Saturday 23rd August; so please do check it out.

Yes!!!! The big day is approaching!

2008-08-19T13:54:00.003+01:00

I admit it. For the past six months I have been a positive tease on this blog.

I have been hinting - more than broadly - that I have been involved in a big sexuality project, which I haven't been at liberty to talk about. Now, I can spill the beans.

You may remember, or have heard of, the seminal book Joy of Sex, written by Dr Alex Comfort in 1972. It's been a huge success, selling 8 million copies worldwide, but sadly Alex died in 2000, though his son Nick did a great job of updating in 2002.

Since then, the publishers have been searching for a female sexologist to "reinvent" the book for the twenty-first century. In 2006 they chose me - and for the past two years I've been working on the project. Now, it's all come to fruition - the UK launch date is September 8th, with a US launch in 2009.

I'm very proud of the New Joy of Sex. All of it has been revised and brought up to date. About half of it has been completely rewritten. There are forty three new sections covering everything from the clitoris through to internet sexuality. And there's a total reorientation of approach - from the mores of 1972 through to the new hedonism (and the new puritanism) of 2008.

As you can imagine, I am getting very excited - not just for myself, but because this is such an important book. What I realised in (re)writing it is that Alex Comfort was one of the first people to emphasise not only the joy but also the power of sex; we tend these days to treat the whole thing as a game, but it's an extremely potent force in life. The New Joy of Sex book, hopefully, makes that statement.

So...for the next few weeks, watch out for regular updates on this blog - of what's happening with Joy of Sex, the launch, and all the interesting work that seems to be coming in on the back of it.

Watch this space...

Shades of Salem?

2008-06-24T15:13:00.010+01:00

I was surprised when I heard - via an American friend - that a rise in teen pregnancy rates in a small East coast US town had hit Time Magazine. Hardly the stuff that front page covers are made of, I would have thought. This story, however, hinged on the claim that there the girls had agreed to get pregnant en masse.

Now that was interesting. I was intrigued when I read the Time feature - and so, apparently, was every news desk in the world. Within hours, Google had several hundred thousand hits on the story and the reader postings on each of those individual stories were numbering in the millions.

The facts are these. Having had a pregnancy rate of about 4 per year up to 2007, over the past year 17 of the female students of Gloucester High fall pregnant. Then, when interviewed by Time magazine, the school principal reports that the girls have a 'pact' with each other to aim for motherhood, and that the repeated queuing for pregnancy tests - and the high-fives on getting positive results - are part of a planned project. All of a sudden it's mayhem. The school officials are unavailable for comment. The town officials call an emergency meeting excluding the Principal. Gloucester's mayor is quoted as denying a "blood-oath bond".

Excuse me? Blood oath bond? Secret pact? I'm not suggesting it's great that 17 girls are currently having to face the challenges of motherhood far too early in their young lives. I'm not claiming we should approve if they did all dare each other to get pregnant. And I'm not saying that we - and all countries with a high teenage pregnancy rate - shouldn't be doing our best to lower that rate (ironically, Gloucester officials recently opposed attempts by local sexual health projects to issue contraceptives to school students).

But it does seem to me - whether or not the story is true - to be a huge overreaction, an overreaction by a society that seems threatened by any hint that young girls might decide to take their lives into their own hands. The principal's original term 'pact', the mayor's term 'blood-oath bond' and more worryingly, the willingness of the press to pick up and run with those loaded terms seem to me to be out of all proportion to the original 17 pregnancies. Shades of Midwich Cuckoos, Villa of the Damned. and the Salem witch trials - which actually happened only 10 miles from Gloucester.

Let's not get threatened by this. Let's not turn natural disapproval into a witchhunt. Let's not see this as any more than it is - a troupe of insecure, immature teens who want to love and be loved and - instinctively knowing that motherhood is a wonderful thing - decide to go for it.

Lust to love - what next?

2008-06-03T16:00:00.002+01:00

We like to think we live in an age where sex can be utterly casual, no strings, no commitment. But sex is a powerful bonding mechanism, and so very often - and this goes for the lads as well as for the girls - something that started as pure pleasure turns into something much more significant and much deeper. If you find yourself falling in love with someone with whom you've agreed to have a 'casual' relationship, what should you do?

Be honest with yourself; don't keep on pretending you don't care when actually you do.
Give it space. Take the time to think things over and find out what you really feel about your partner.
Be honest. Tell your partner what you feel - it's only fair. If they back off, then they were a lost cause anyway.
If your love isn't returned, don't wobble or pressure: there's no law to say that just because you have fallen in love, your partner should too.
You can't make someone else love you - but you can save yourself from heartbreak. Set a time limit of - say - three months, then walk away.
Don't rush into more casual sex - after rejection, you'll just be that much more vulnerable to falling in love again.
If your love is returned, celebrate hugely. Lust that turns into love is a wonderful thing!

When losing weight means losing something else...

2008-05-29T13:10:00.002+01:00

I admit it - I try to keep slim. But I still worry about the relentless emphasis on calorie counting that fills whole column yards in the media.

That's not only because too much emphasis on diet is counterproductive; time and again it's been proven that simply eating when you are hungry and stopping when you are full is the best way to keep weight under control. My worry about the calorie counting brigade is also because I am firmly convinced that most eating problems are underpinned by some sort of emotional element.

Personally, I'm convinced by my own behaviour - quite simply if I'm under stress I mysteriously find myself opening the fridge door... for the seventh time that evening.

Professionally, I'm convinced by the behaviour of my readers - who in letter after letter reveal to me just how closely their weight is linked with their emotional state.

Scenario number one: eating for confidence. Low self-esteem, relationship abuse, under-achievement women in particular fill the low confidence hole in their lives by filling their mouths with food. If they feel good about themselves, the pounds drop off.

Scenario number two: eating for protection. If a woman feels vulnerable around others, particularly around men, she eats to gain weight and make herself feel invisible. If she starts to feel more in control of her relationships and her life, she doesn't need to be weighty.

Scenario number three: eating for anaesthetisation. If a woman is furious - or grief stricken, or afraid - and she doesn't want to show her fury or grief at those she loves, then she may eat to dull the sensations. Resolve the anger or the mourning and she won't need to over-consume.

Lesson here, for all of us. Next time you open the fridge door, ask yourself if it's really food you want. Or is it a confidence boost... an increased sense of control... comfort... a good cry... or permission to protest something bad that is happening in your life. Simply close the fridge door and go for it direct.

Fantasy - good idea or bad girl?

2008-05-22T10:22:00.002+01:00

I was recently asked to write a few hundred words for a very lovely erotica magazine on the topic of sexual fantasy. Of course I obliged - writing not so much about my own mental exploits (yes, I admit it, I do...) but about the fact that my readers often confide anxiously in me about their fantasies. What they angst about, typically, is whether, in the grand scheme of things, fantasy is normal, whether fantasising is bad, and whether one should worry if one fantasises about someone other than one's partner.

To which the answers are, respectively, yes, no and maybe.

Let's take those answers one by one. Yes, fantasy is normal. Almost 100% of men and nearly the same number of women have had a sexual fantasy - so if you're out there and you are dreaming, you are not alone.

And no, fantasy does not mean you are bad - or mad, or sad. Contrary to the myths, it's those with a healthy sexual appetite and repertoire who do it, not the No-Mates. More, those who fantasise are likely to have more orgasms and a much better sex life than those who don't - so, everything to celebrate. Equally, fantasising about something doesn't mean you're going to action it. Typically we dream about things, places and people that are out of our reach, impractical or just plain unwise; we dream instead of doing not as a prelude to it. So, nothing to fret about.

My only caveat - and it's a tiny one - is about whether fantasising when you're partnered means there's something wrong with your partnership. And here, it all depends on exactly who you're dreaming of... the nearer to home the fantasy, the more you ought to be on full alert. So think of your favourite celeb sweeping you off your feet and there's no problem. Find yourself floating away on a dream of your partner's best friend - who, come to think of it, has hinted pretty strongly that they'd be up for some action - and you may want to stop and decide whether you want to go that route.

But otherwise, to my mind, fantasy is a total gift and allowing your mind to wander in a sensuous direction something to be done with eagerness, application - and absolutely no guilt.

Life saving advice....

2008-05-13T14:41:00.002+01:00

Went to (and presented at) a fascinating conference over the weekend courtesy of the Primary Care Sexual Dysfunction Society. In short, medics at the front line of British health care (general practitioners, practice nurses, therapists) often have to deal with sexual issues raised by their patients - PCSDS is an organisation to provide them with information, support and general networking.

Founded by Manchester GP Mike Callender the organisation holds its conference annually in the spring and - more or less annually - calls on me to cover what can only be described as the 'cuddly' side of the business. Perhaps a presentation on how male erectile dysfunction impacts on women partners. Perhaps a few guidelines on how to best support patients who are struggling with emotional issues. Feelings, relationships, counselling... you get the idea.

This year my contribution was twofold. First, a Cook's Tour of the psychological side of women's sexual problems, done as a two-hander with lovely Nottingham-based therapist Angela Gregory. Then - again with Angela - a debate on whether the G spot is important to women's pleasure. In between times, the medics took over, with discussions on cardiac sexology, contraceptive options, and whether one should support - or discourage - patients who want to buy their little blue pill over the Internet.

On one level, of course, all this is deeply strange. Surely everyone can see the slightly weird side of sitting in a Leicestershire business hotel on a sunny Saturday afternoon discussing whether it is advisable to investigate a male patient's sexual problems by sticking a finger up his bum - to check for prostate conditions, I hasten to add.

On the other hand, all this is also deeply important. The passion shown by all present to solving their patient's sexual problems as quickly, efficiently and supportively as possible was wonderful. The commitment displayed to giving the best possible service and generally getting it right was stunning.

Plus, I came away with one literally life-saving nugget - courtesy of Professor Graham Jackson - which I would encourage all readers of this blog to take on board for themselves if they are male (or for their male partners if they are female). It is this. There seems to be a direct link between a man's developing erectile dysfunction and his developing - an average of three years later - the sort of heart condition that results in a quick and fatal heart attack. And - this bit's vital - that link exists whether or not the man has had any worrying cardiac symptoms. Erectile dysfunction is - in the most literal sense of the words - an early warning system.

In other words, if he can't get it up - and that fact isn't linked to a night on the ale or a previously diagnosed medical problem - he should proceed immediately to his GP and get his cardia health checked out. Don't delay. This piece of information, courtesy of the PCSDS, could save a life...

Is my partner going off me?

2008-05-08T12:40:00.002+01:00

I get asked this question so often. A reader spots that something is different at home - perhaps their partner is quieter, more withdrawn, or less sexual. And though these signs are often more indicative of an external problem - worries about work, lack of selfconfidence, depression - it could well be that something's wrong.

Here are five key checks if you suspect failing love:

1: Does your partner still remember your first days and weeks together with joy?
A partner who's falling out of love will 're-remember' the early days as being sad or spoiled. If when you talk about when you met there's regret or disillusionment in his (or her) reaction, then there's a problem. If his face still lights up, it's unlikely that there's real difficulty.

2: Does your partner still welcome affectionate physical contact?
Lacking desire or sexual feeling can be down to stress, tiredness or depression - but even when a partner feels like that, a nonsexual hug can still be welcomed. A partner who can't welcome it is usually feeling bad about the relationship.

3: Does your partner talk positively about you to others?
A disillusioned partner often can't express negative feelings directly - it'd be too threatening. Instead, she ( or he) often complains to friends and family - and if he does it in a joking way, there's often an edge behind the joke. If you spot this happening, then it's time to talk.

4: Does your partner still speak enthusiastically about a future together?
If the two of you can look ahead and make plans together - and genuinely welcome those plans - then however stressed you are right now, there's nothing seriously wrong. If when you try to talk about the future, he slides off the point, start worrying.

5: Does your partner still want to please you and make you happy?
If so, there's unlikely to be real problems. But if she blocks your wishes, fights you at every turn, simply doesn't want to give you what you want, then the goodwill has gone from your relationship and something's wrong.

What to do?
First and foremost, think carefully whether any of these bad signs could be otherwise explained. A partner who's lost his job, is recently bereaved or is worried about the children - could well be withdrawn. But when the problem's resolved itself, they'll come back into balance.

Second, talk about it. Simply asking what's wrong - and listening to the answer - can often sort the problem out.

Third, consider counselling. Even if your partner is unwilling to go, you can get support and guidance by seeing a counsellor. If you are in Britain, log on to www.relate.org.uk. If elsewhere in the world, ask your physician for a list of recommended counsellors.

Turning us on or putting us off?

2008-04-30T11:50:00.003+01:00

Great fun yesterday evening, at the biennial Family Planning Association debate. Two years ago it was on sex education and I bounced up from the floor to make a contribution. This year it was on pornography and I was asked to speak - a really great honour.

The title was "Turning Us On or Putting Us Off". The panel - Mark Limmer the North West Teen Pregnancy Coordinator, Maddy Coy from the Women Abuse Studies Unit and Jamie Maclean of the Erotic Review - was wonderfully facilitated by David Aaronovitch, who seamlessly wove all our statements together then moved it on with substantial audience contributions. I would like to have heard more from "Leanne", a former porn star, and perhaps slightly less from an unamed man in the audience who seemed not to have got the point at all.

Views were wide-ranging - though all agreed on the essential horror of violent porn and the essential wisdom of good sex education. My own approach, though occasionally challenged, hinged on my belief that society is currently in a state of total confusion about many aspects of the porn debate. For a start, what is porn - and what is pleasurable erotica or useful information and knowledge? In my own lifetime I have seen the definition shift - what was reviled thirty years ago is now accepted as natural, normal and helpful.

Above all, though, what I found wonderful was that we were putting issues on the table, talking them through, shining a light on areas that are so often hidden or avoided. Whatever agreements we did or didn't come to, whatever action is or isn't taken, we talked about it sensibly, calmly and usefully.

Hats off - as always - to the Family Planning Association for raising the issue!

Tea with the aunts!

2008-04-21T10:40:00.002+01:00

When people hear that I'm an agony aunt, one of the questions I always get asked is... "and do you and all the other agony aunts meet up then, and swap notes". Normally, I say no. We tend to live at opposite ends of the country - and we tend to live very busy lives. "Tea with the aunts" just isn't on the cards.

But recently, thanks to an invitation from The Tavistock Centre for Couple Relationships, several of us did meet up - and yes, there were tea and cakes served. From the Tavistock's point of view, this was an opportunity to spread the word about the therapy they offer, and - I guess - to debunk a few myths about their being exclusive, traditional and totally out of most people's price bracket. (In fact, much of the work they do is subsidised and you can, theoretically, see one of their highly experienced counsellors completely for free).

There were six of us "aggies" at this meeting and we all listened attentively as the speakers - Susannah Abse and Brett Kahr - outlined the work they do. But then came the surprise. The Tavistock was not just holding an information/publicity session. They were also wanting to swap notes with us as fellow professionals, ask what we did, offer support, identify our daily challenges and compare them with their own.

This was unexpected. I firmly believe that media advisors are just as much trained professionals as anyone else in the field. I would never claim that our job is a counselling job - it's not interactive and it's not longterm. But I would argue that we play just as skilled and demanding a role. We advise not just one but many millions of people. We need to offer wisdom in a few dozen words not over several hundred hours. When we do our job well we disseminate society's best practice. Yes, we are different from counsellors; but we are no less useful or professional.

Some counsellors don't get that. "Agony aunt" can be seen not only as a soft option but as a less skilled one. So it was delightful that the Tavistock were responding to us totally as equals, and initiating a conversation between equals. It turned into an astoundingly useful and insightful occasion, where we discussed mutual problems, offered suggestions and resources, and where both sides learned huge amounts about themselves and about the other.

At the end, it was so successful that we all agreed to meet regularly - for mutual information and support. I am thoroughly looking forward to the next session. And now, if asked whether aggies meet for tea, I can say 'yes'!

Broken hearts are for real

2008-04-04T17:02:00.001+01:00

I commented for LBC Radio this morning on a really moving story from the Cass Business School. Apparently one of their lecturers just analysed over 11,000 life insurance policies to track down just how often, following the death of one partner, the other partner died too.

There's already been research about the stress of bereavement causing heart disease. But apparently losing a spouse can actually mean that in the following twelve months it is twice as likely that a woman will die and an astounding six times more likely that a man will.

So yes, you can die of a broken heart. Or - this is my surmise based on my mailbag, not on science - you can die of grief, of loneliness, of a lower quality of life. You can die because you miss your partner so much and simply can't bear the thought of going on without them. Jim Callaghan tried living without his wife of 67 years for just over a week - tried it, didn't like it, followed her to the grave.

Very moving - but also thought-provoking. So often I get letters which, summarised, say something like "my spouse died a few months ago and my family are telling me to cheer up - I should have got over it by now." To which I usually reply "Rubbish - this is serious stuff, you need to grieve!". I give the same reply, actually, to those whose spouses have left; a relationship breakup is not as final as a death, but it too can have devastating effect.

Advice then. If you are mourning a loss of whatever kind, be gentle on yourself and do all you can to look ahead and regain hope. If you are supporting someone who is mourning a loss, keep close - however much of a brave face they put on, they may well be suffering more deeply than you ever could imagine.

When He Can't Get It Up...

2008-03-26T16:53:00.001Z

I've done a lot of work around sexual problems - in fact, in May I will be speaking at the Primary Care Sexual Dysfunction conference. One of my particular areas of expertise is erectile difficulty, and I find this particularly rewarding work because so often, the problem's easily cured. Here are some guidelines for both sufferer and their partners.

To him:

1: Relax. Often one occurrence of ED scares the life out of a sufferer - and then performance anxiety kicks in and there's no way forward. If ED has happened after a one-off occurrence, then take the pressure off by concentrating on foreplay for a few weeks. Once you aren't under stress, the problem often resolves itself.

2: If it doesn't resolve itself, don't delay getting help. The average man with ED waits years before consulting a doctor, but that's unwise, if only because ED can be a marker of medical problems such as heart disease or diabetes. See your GP right away; he's seen it all before and won't be embarrassed.

3: Be hopeful. Often it takes only a few minutes' consultation to get a diagnosis and effective treatment. Current medications - yes, the little blue pill and its brothers - can be the answer of choice and if not, then more exploration can often come up with alternative solutions.

To her:

1: Don't add more pressure by blaming yourself or the relationship. ED is rarely caused by partnership problems or infidelity that isn't already clear. Sure, if you are rowing daily then his ED may be a sign that you need to sort things out. But ED in a good relationship is almost always a sign that medical intervention's needed.

2: Offer support not challenge. A man who can't get it up is feeling bad about himself to start with. If you wobble, or do him down, this won't help. Instead explain - he may not know - that most ED is down to a physical problem which can be easily sorted.

3: Suggest he get help. You can give your partner permission and encouragement to go to the doctor, when he may be hesitating. You can also suggest he logs on to SortED in 10 for extra guidance.

Adrenalin junkie!

2008-03-20T17:03:00.001Z

I really like giving one-off quotes to national newspapers and magazines. There's something incredibly rewarding about being 'flung' a topic at short notice - anything from the McCartney divorce to the efficacy of antidepressants via the Government's latest policy on teen pregnancy. Picking up the phone and instantly being asked to bring all my expertise into play to give insights at the drop of a hat brings with it a rush of pure adrenalin. Can anything beat that?

Well actually, something can. The adrenalin rush of an extended live radio phone-in is, I must admit, even better. My current drug de jour is a monthly co-presenter appearance on Jim Davis' late night Friday show on LBC. I arrive at 9.30. Jim and I enter the studio and pop our headphones on at 9.55. From then until midnight, anything goes. Responding to Jim's sometimes outrageous though always well-thought through questions is the least of my worries. The emails, texts and live calls from our listeners can mean that any topic is fair game.

Last week we began with 'dumping and being dumped' - and the phone lines swiftly started ringing off the hook. Tears, despair, fury - and that was just Jim and I! As to callers, there was the guy who had dumped his one night stand because she wasn't fit enough - and was now asking me to comment on his taking up with her again now she'd lost weight. There was the woman who was agonising over whether to leave her partner of nineteen years. There was the young man who had lost both his girlfriend and his brother at one stroke when he had arrived home early and found them in bed together. All human life was there.

Of course, it's not just the adrenalin rush that keeps me hooked into this kind of work. It's the incredible feeling when someone signs off with the words 'thanks... that's really helped" - or, as happened on my Heart106 programme earlier this year, when a listener emails to tell me that there's been a happy ending and "we took your advice... and the wedding's in June." That, truly, makes everything worthwhile.

The Ninety Day Plan

2008-03-18T10:38:00.003Z

I love spreading the word about good new ideas in personal development. This one's courtesy of my friend Charley Ferrer, a wonderful American therapist whom I met at the World Conference of Sexology in Montreal in 2005. Charley suggests that, rather than wobbling about whether a new partner is The One for you - and particularly if you find yourself either treading on eggshells for fear you'll lose him (or her) - you simply put together a Ninety Day Plan. which is guaranteed to sort the wheat from the chaff, and the viable relationships from the ones that are never going to work.

Here's how to do it.

1: When you get together a new partner, make a judgment first whether they are obviously a 'no'no' - continuing track record of alcoholism, drug abuse, violence or infidelity. If you know they are - or if at any time you discover that they are - end the relationship immediately.

2: If there are no obvious danger signs, then make a commitment that for Ninety Days, you are going to commit to this person as if the relationship was going to work. Let them know that is what you're doing and that you're not going to back out before that period or over. (Also let them know that this doesn't mean you are assuming you will marry them or have their babies, just that you're theirs for three months.)

3: Now relax. Be kind, generous, loving and caring, without worrying whether it's being returned - give and take may even out over time. Don't worry or wobble - again even if there are slight glitches, love takes a while to bed down. Hang on in there, and give it time to develop.

4: But also, be authentic. Be open, honest, the real you without trying to impress or win your partner over. If you think something, say it. If you want something, say so. If you have an impulse to do something, do it. Within reason (no truly bad behaviour) do what you feel like.The Ninety Day Plan gives you the stability to do this.

5: At the end of the ninety days, take audit. Are you disillusioned with your partner? If so, then walk away - but don't reproach yourself; you have absolutely given it your best shot. Is your partner disillusioned with you? If he is, then best for him to walk away now rather than do it years down the line when you're married or pregnant.

But if you are both happy, then this is good. He has seen the real you and he knows who you really are. That means you have a really solid and hopeful basis to go forward - for the next Ninety Days.

If after four sets of Ninety Days, things are getting better and better, you'll probably find that nice things will happen - like you'll move in together or buy a ring!

Teenage pregnancy - always a disaster?

2008-03-13T10:28:00.002Z

Did you know that teenage birth rates in the UK are no higher than they were in the pre-Pill 1960s? Or that in those Sixties it was seen as normal for women to be married and mothers by the time they were 18?

Both of these stats pop up in a recent Times article covering an upcoming Channel 4 Cutting Edge about teen Mums. Because for all the horror stories about profligate younger Mums, this article, and the documentary, paints a much rosier picture.

Sure, teen pregnancy without the support of a caring partner is hard, much harder than for older and more mature working women. And I'm not saying that all teens step up to the challenge with mature courage and perfect parenting skills.

But I've felt for a while that we catastrophise teen pregnancies unecessarily. Often, having a baby is - in the words of the Channel 4-featured midwives - the 'making' of a girl. They stay with their partners, they grow into fulfilled and supportive parents. And actually, there is not only nothing biologically wrong with a woman giving birth at 14, 15 or 16. We are programmed to produce early; by 30 we are way past our maternity sell by date; the programme even suggests, with reason, that 30-somethings often make more selfish, less dedicated mothers than their younger counterparts.

So no, let's not argue with the Government's 'reduce teen pregnancy' programme. But equally, let's not demonise the teen Mums. On many levels, they do a super job of bearing and bringing up their kids - after which, they go back to education and spent the rest of their lives in productive, fulfilled careers.

Exciting news!

2008-03-11T16:38:00.000Z

I've hinted more than broadly in this blog on several occasions that I've been working on a new and significant publishing project concerning sexuality. Sadly, I still can't spill the beans too publicly - the publisher concerned has issued a total embargo on coverage until the summer, when books will be available and the publicity campaign can begin in earnest.

But that doesn't mean to say I can't tell you about - make that crow about - all the work that I and my team have been doing to prepare for that campaign. Since our first publicity meeting six weeks ago, we've actually been working flat out.

Laura has been putting together list after list of names that the publishers can approach for coverage, comment and endorsement. Not just contacts in print, radio and television. Not just other agony aunts, media medics and columnists. But academics who might want to put it on their reading lists, academic journals who might want to review it, and counselling organisations who might want to invite me to speak at their conferences. (I"m already speaking about the project in Rome in a few weeks' time, but more about that later.)

In the meantime, Joy has been doing 'projects'. Commissioning a special postcard to be handed out to all and sundry... talking to bookshops and venues to arrange a Cambridge launch... liaising with certain Universities to organise debates on the topic... briefing the publisher's Special Sales department on whom they could approach to get tie ins or merchandising.

My role - along with working on the next stage of the project - has been quite simply to gather as many contacts as I can. If I speak to a journalist, I ask them if they want to be including on the mailing list. If I do a show, I ask the presenter if I can let him know nearer the time. When I talk to anybody and everybody who might have a professional interest, I tell them the bare bones and ask if they want to be kept informed. They all do.

If you're reading this as a journalist, academic or columnist who might be interested in covering the story - without yet, of course, knowing exactly what the story is :) - let me know. I shall put you on the mailing list and, nearer the time, the publishers will send you a press release and, if relevant, a review copy.

Marriage on the rocks?

2008-01-18T11:03:00.000Z

I am an optimist at the worst of times. But even I was slightly wobbled today by a report published today - albeit by a firm of divorce solicitors - reporting that of the 2000 adults they surveyed, nearly 60% were unhappy in their marriage.

Half of husbands thought their partnership was loveless. 59% of wives would leave tomorrow if they didn't have to worry about the money. Many were holding back from divorce for fear of losing contact with their children. Others were holding back from fear of losing the roof over their heads.

I pay tribute to those who are hanging in there, trying to make it all work. But I do think it is tragic that - for whatever complex reasons - the love that we all see as central to our lives so rarely succeeds in working.

Which is one reason why I liaise so closely with - and support so enthusiastically - the work of Relate, the couples counselling service. If only those 59% of spouses who reported being so unhappy had thought of trying marriage guidance, I bet that statistic would be much lower. If you're among the unhappy majority, log on to www.relate.org.uk.

Hats off to the hypnotherapist

2008-01-16T14:05:00.000Z

I dont' usually do endorsements, but today's news that Paul McKenna has just become Britain's highest paid TV personality has stirred me to one. Because actually I think McKenna is on the right lines when he advises about eating habits.

The ideas he puts forward are by no means new. Back in the Eighties, a book called Diets Don't Work put forward the same, then revolutionary concepts. The theories were then recycled with a feminist slant by Suzie Orbach of Fat is a Feminist Issue fame, under the title On Eating. McKenna has now espoused them in his book I Can Make You Thin - and probably made ten times more money in the first month's publication of that one book than the other two tomes have in their entire history.

But I don't begrudge him, because as I said, the concepts work. They're very simple. Eat only when you are hungry. Eat only what your body wants to eat. Stop eating when you are full. Sounds obvious? It is - naturally slim people do just that - but the advice none the less valuable, particularly when you look at all the other diet guidelines.

Because much of the rest of the slimming industry is based on the presupposition that people need to be told what to eat and how much to eat - and that unless they are, they will not lose weight.

Now, calorie (or carb, or unit) counting can be effective short-term, no doubt. It's the long term I query - the fact that most diets, as the original book suggested, don't work longterm, because they alienate people from their bodies, and train them to override signals both of hunger but also of the kinds of food one needs and doesn't need, and the signals of satiation. The result is that, in the end - given body fascism, media hype and endless amounts of peer pressure - most of us end up eating what we think we should, not what our bodies need. We end up eating foods that we are told are 'good for us' even if we then have bad reactions to them, and avoid foods that are 'bad for us' even if we end up malnourished as a result. Most importantly, we learn to mistrust our bodies, eat through emotion rather than true hunger, and overeat in order to cope with the stress of doing both of those things.

So, unusually for me, an endorsement - not specifically of McKenna, but of the approach he takes. If you want to lose weight, bin the counting charts. Instead, learn to listen to your body signals, eat exactly what you need, in the amounts you need, and simply stop eating when you are full.

Cause and effect... or is it?

2008-01-03T12:16:00.001Z

Rather hysterical coverage in the press this morning on teenage pregnancy. David Paton of Nottingham University Business School has just analysed Department of Health figures and come up with the statistic that more than 20 girls between 13 and 15 become pregnant every day.

Of course this is sad news. And I totally agree with Professor Paton's analysis that social deprivation and family breakdown are key factors influencing these figures. Where I disagree with Professor Paton is where he claims that because deprivation and breakdown are key causes of teen pregnancy, sex education doesn't figure in the equation - more, that knowing about contraception (here I quote) "leads to an increase in risky sexual behaviour."

I do understand that you've reviewed the figures, Prof Paton. And I do understand that you've drawn conclusions that appeal to the moral majority. But they just don't tie in with what I'm seeing in my postbag from real teenagers who open up to me. Not a single one of these young people reports that knowing about condoms makes it more likely that they will have risky sex. Not a single one says that having available family planning services normalises sexual activity. Why? For the blindingly obvious reason that those who use these services are those who take precautions and don't appear in the statistics you're quoting.

What I read in my postbag are cries from the heart. Yes, these are very often linked with family breakdown and social deprivation; if a young girl feels unloved and insecure - and if her family members are also thus struggling - then it makes every sense in the world that she will cling to whoever will give her love, even if the price of that love is sex, ignorant of protection and contraception.

What everyone seems to miss here is that 14 year olds - like their adult counterparts - don't have sex in order to be irresponsible, rebellious and pregnant. They have sex in order to be accepted, valued and loved. Unless we take that on board then all the statistical analyses and horrified press coverage in the world will never get the teenage pregnancy rate down.

PS: going to Argentina to dance tango for twelve days. I'll be back writing after that.

Happy New Year!

2008-01-02T11:42:00.000Z

As regular readers of this blog will have noticed, the last few weeks have been marked by a singular absence of entries. Not because of Christmas festivities but because I have been working up to the final deadline for the Classic Sex Book, which I have now - whoopee!!! - handed to the publisher.

Can't be too free with the details yet, as it's still slightly under wraps, but it's due out in September... watch this space.

As for 2008, I thought that for the first column this year, I'd turn my attention to New Year's Resolutions. No, not mine - though I do have a list of about ten which I'm beginning to action - but resolutions for others, resolutions which, if adopted, would make the world a much happier place.

So here goes. For 2008, I wish that..

1: ... "your condom or mine" was as normal a chat up line as "do you come here often?"

2: ... twenty somethings realised that the first few months of a relationship are hormonally fuelled, and therefore not necessarily a sufficient foundation on which to get pregnant.

3: ... fifty-somethings became aware that in terms of sexually transmitted infections, their longer history makes them even more at risk than twenty-somethings

4: ... every engaged couple believed that having pre-marriage preparation isn't unromantic nor a lack of faith but instead a great start to a successful married life. (If you're interested, log on to Relate's website on www.relate.org.uk and search for 'Couples Course')

5: ... every man knew what to do with the clitoris and every woman knew what to do with the frenulum.

6 ... every couple struggling to stay together could realise that counselling really does help and that it's not a sign of weakness to get outside support. (www.relate.org.uk)

7: ... everyone recovering from a relationship loss could accept that it takes time to recover - and that rebound relationships may dull the pain short term but long-term are likely to be either a bad choice or doomed to end.

8: ...every parent started taking responsibility for resourcing their children around making confident sexual decisions - information, emotional support and positive role models.

9: ... Ed Balls (British Secretary of State for Education) can carry through on his just-announced promise to drag Britain's sex education teaching into the 21st century (no, that wasn't how he expressed it but you know what I mean.)

10: everyone would back a new campaign just launched that hopes to bring an end to cervical cancer. If you want to add your signature, log on to http://www.cervicalcancerpetition.eu/)

Happy New Year!

Happy Christmas...

2007-12-24T18:45:00.000Z

Christmas Eve... may I wish everyone a really happy Christmas festivities and a wonderful New Year in 2008. I shall be back blog-writing very shortly...

Susan
x

Permission to cry, please!

2007-12-03T11:43:00.000Z

I've never been one - both in my columns and with my friends - to dismiss the helpfulness of medical support for emotional issues. Sometimes, you just need to take the tablets.

On the other hand, I've always maintained that tablets should take second place to the emotions themselves. Most times, it's much more helpful to cry, to sob, to grieve or to rage.

So I was delighted to see the publication of a new book, The Loss of Sorrow: How Psychiatry Transformed Normal Sorrow into Depressive Disorder (Allan V. Horwitz and Jerome C Wakefield, Oxford University Press). It does exactly what it says on the cover - makes the point that society has pathologised normal sadness until experiencing it has become a cause for embarrassment, then shame, then treatment. Wrong, wrong, wrong.

To say - as some medical diagnostic tomes do - that a person who is still suffering more than two months after a bereavement are therefore clinically depressed is not only misguided, it is actually harmful. The same goes for smaller traumas - relationship breakup, job loss, illness. If one has a loss, one is meant to grieve. It is what nature intended us to do - not only to physically relieve stress, but also to enrol others in supporting you through that stress. Failing to do so means one gets stuck at the grieving stage, unable to move on, unable to start recovering.

Not realising this point underpins so many of the problems with which my readers write to me, readers who - six months after an unexpected breakup worry that they still miss their partner of twenty years, or twelve months after a vicious divorce feel guilty that they are still finding it difficult to form a relationship. Of course they are. Of course we all would be. This is Nature's way of helping one recover, lick wounds. One wouldn't deny a person with a broken leg a crutch to walk on until the leg was healed; emotions are the heart's crutch and should be fully felt until they are no longer needed.

Yes, some people get stuck in emotions - mostly because they are not getting support from those around, or because they are truly mentally ill; and then, of course, professional help may include medication. But most folk, given space and time and permission, will do what any normal two year old does - scream their heads off for a while, accept a cuddle from a nearby grown-up - and then toddle off again, mind and heart clear.

Instead of telling people to pull themselves together, therefore, I recommend that we actually allow them to completely to fall apart. If we did, then people might be a lot happier - and human beings would be a lot healthier - than they are now.

There but for the grace of God...

2007-11-26T11:18:00.001Z

As a very innocent 19 year old, coming back from an evening with friends, I was once mauled by a stranger on a train. Nearly forty years later I can still remember the feeling as he leant over me and put his hand on my breast. I screamed and ran out of the compartment into the next carriage, asking for help.

Hardly anyone even looked up - those who did sniffed disapprovingly. When I pleaded for someone to go back into the compartment and fetch my bag and coat, one man - old enough to be my father - obliged, but grumbled as he did so. I slowly realised from the mutters around me that my fellow passengers thought that I was to blame for what had happened - though in my innocence, I actually couldn't understand why. I left the train weeping.

I tell this story not for sympathy, but to illustrate the fact that society forty years ago made completely unwarranted assumptions about sexual attack. I had not been drinking heavily (one glass of wine), nor was I outrageously dressed (perfectly decent shorts, in an age where everyone wore them). Yet the assumption of my fellow travellers was that I had 'asked' to have a total stranger come across and put his hand on my breast.

I also tell this story to point up the fact that forty years on, sadly not much has changed. The announcement this week that juries are to be given information packs to counter 'rape myths' highlights the fact that we still as a society believe those myths. The stories of female binge drinking, the media hype on promiscuous sex - all of these mean that as a society we think that women (and men, for the victims of sexual assault are not unilaterally female) are living wild irresponsible lives and that therefore they are to blame for anything that happens to them.

My own experience forty years ago - and my current knowledge of the young people I regularly mix with, and hear from through my columns - is the opposite. Yes, there are exceptions, yes youth is a time for pushing the boundaries. It was ever so. But in many ways, young people are more aware nowadays, if anything more responsible.

And in any case, that isn't the point. It was the man who crossed the train compartment and put his hand on my breast who was at fault, not the 19-year old me travelling home on the train. It is the predator, male or female who is at fault, not their prey. Attackers have a choice to do right or wrong, however vulnerable their victims are. By claiming that the victims 'invite' the attack we muddy the waters, offer excuses, let wrong-doers off the hook. We also insult the vast majority of normal, decent men by suggesting that any male who sees a short skirt is automatically and excusably inflamed to rape, that any male who sees an inebriated woman is inevitably and forgivably driven to abuse. The result? The conviction rate for rape in the UK is currently 6% and 40% of adults who are raped tell no one.

Which is why I am delighted that the legal system is in the process of pointing out all the above to those who make crucial decisions in court cases.

Now all we need to do is to convince the rest of society, and we will at last - forty years after my 'little scare' - be getting somewhere.

Sorry, talking about sex again...

2007-11-22T12:42:00.000Z

As regular readers of this blog will know, I'm currently working hard down the salt mines rewriting a Classic Sex Book. My friends, tolerant as they are, have for the past few months accepted my heavy workload - but have never been able to resist responding to my alibi for not coming out to play with comments like "working on the sex book - is that theory, or practice???".

I know such comments are always underpinned by great good humour - but I'm also aware that even in our current society, it's a source of such humour to suggest that anyone over the age of 25 is actually doing more than just dreaming of sex. Passion, the media tells and shows us, is reserved for the young and beautiful. Which is why, a few weeks ago, one of my blog posts highlighted recent research showing that a high proportion of over 70s are still swinging from the chandeliers.

I'm delighted today to report some qualitative anecdotes to add to that quantitative evidence. A new book - Over the Hill and Betwen the Sheets: Sex, Love and Lust in Middle Age - is a collection of personal stories edited by Gail Belsky. And the book is a gem of tales both passionate and moving, not only of how lust was rediscovered through new relationships in midlife, but how it was regained in established couples for whom time, children and the daily grind had all but extinguished desire.

I deeply believe - through personal experience as well as professional expertise - that sex can both last and improve over time; but it's nice to see other accounts confirm thatin print. All the more ammunition for when my rewrite of The Sex Book is published and I find myself defending the right not only of twenty-somethings but also ninety-somethings to have a fulfilling and adventurous love life.

Shopping better than sex? I don't think so...

2007-11-20T09:45:00.000Z

No, it's a long way from academic research. But the latest 'reader survey' from a woman's magazine - in this case, First - still interests me.

Because it blows out of the water many of the more doom-laden ideas we currently have about relationships, and presents a much more optimistic view. Ninety-four per cent of wives said they were happily married, 72% of all women still fancied their partners, and only half said that their love lives had diminished after having children. For a Pollyanna like me, that's a nice result.

Where the survey wasn't so encouraging, however, was when it came to sex. Four in ten would rather go shopping than make love, and over a third said they would be happy in a sexless marriage. Which - while it gives the lie to the proposition that we are all sex-mad, and also supports the idea that love rather than passion is the key to a happy life - also seems rather sad to me. Sex is so wonderful that surely we should want it - and be putting energy into having it - throughout our lives.

No, sex is not compulsory and if a relationship doesn't include it, that doesn't mean that love is on the rocks. But sex is very wonderful - and absent it, we may well be missing out on a host of other benefits: affection, cuddles, physical proximity, eye contact and simply shared pleasure. If partners don't make love and don't want to, no problem; if they don't make love and want to, there is plenty of help available and actually, it works.

I don't usually include an advertising slot in this blog - but if you're reading this and your sex life is not what it could be, contact Relate right now... www.relate.org.uk.

Birth, contraception, bastardy...

2007-11-18T11:45:00.000Z

Most of the end of last week was taken up with preparation for - and presentation at - a very nicely-put together conference run by the Journal of Hospital Medicine, who had decided they needed to inform their readers about family planning. High profile speakers like Profs James Trussell of Princeton and Kaye Wellings of the London School of Tropical Medicine sat alongside coalface presenters working at family planning organisations such as Brook.

The whole thing was utterly fascinating - hearing the latest updates on how women (and men) are making their choices, or failing to, as regards contraception, termination and sexual health. And I enjoyed making my own contribution - on the emotional underpinnings of contraceptive decisions and how these influence what people do. But what came across to me most, among all the medical-speak and pharma-slang, was just how concerned all the speakers and delegates were with the patients in their care. Throughout the whole conference there ran a real thread of warmth and compassion on every family planning issue; moving and heartwarming in the extreme.

There was also, for me, a curious juxtaposition. Only the previous evening I had gone to see the latest Royal Shakespeare King Lear, starring (and I do mean starring - despite the critical reviews it was a total tour de force) Ian McKellen. As I settled into my seat, my conference preparation at the forefront of my mind, one of the themes of the play totally hit the mark. Family love... parents... children... and yes, the issue of unwanted offspring that runs as a subplot to the whole play.

I loved Lear, and everything about it. But I became aware during the performance that I am very, very glad that I live in the present day and not the Shakespearean era. For nowadays we do have the choice of preventing unwanted conception. We do give women the right to choose. And if their choice is to give birth, then however much we may disagree with their decision or criticise the original conception, we do not now judge the offspring of non-wedlock birth as more - well, illegitimate - than those of in-wedlock birth. The care, support and compassion I experienced at the Family Planning Conference is the benchmark nowadays for health care - but it also reflects the lack of stigma in society around this whole issue.

In short, right thinking people nowadays do not call others 'bastards' because of the circumstances of their birth. Correctly and ethically, we judge them entirely on their merits.

Sad, but true

2007-11-14T13:25:00.000Z

Oh dear. My last blog post, about chlamydia, brought a sad and angry letter from a man who has had it. He seemed to think that I was being "sexist and ignorant" when I reported that one in ten men think that the condition is a flower.

But sorry, not my thoughts.

Instead the results of a study run by the British National Chlamydia Screening Programme; the research was published last week in a number of British national newspapers. I quoted this research not to attack men, but to highlight the whole issue and urge action.

And in this, I and my critic and I are utterly in agreement. What his post proves is absolutely true - that chlamydia is devastating on every level. We must all do all we can to improve the situation.

I'm sorry you are upset, sir, and I extend my sympathies for your illness.

Roses are red, violets are blue...

2007-11-09T10:38:00.000Z

... but apparently 10% of men think that the sexually transmitted disease chlamydia is a flower. Oh dear. And this despite the fact that it can cause infertility in both genders.

Which is why I bounced with glee today on learning that a new initiative is to be launched to encourage chlamydia screening not only for women but also for men.

If you're a man reading this, check it out. If you're a woman, check it out and then tell your man.

Appearances can be deceptive...

2007-11-07T14:39:00.000Z

I so love it when society's prejudices are undermined. As they surely were with today's report that a campaign to support licensed brothels has been launched by - wait for it - the Women's Institute.

We used to think that the WI was the breeding ground for traditional family values and conservative opinions. But actually, that organisation has always been at the forefront of supporting women - their website specifically mentions their mission as including "campaigning". And surely, surely, prostititutes need campaigning support from women worldwide and from all walks of life.

Well done the WI.

A very positive take on positive smears

2007-11-06T09:13:00.000Z

As regular readers of my work will know, I'm a great supporter of cervical cancer issues. So at the end of last week I unhesitatingly trotted along to a charity gala run by Jo's Trust, the cervical cancer charity.

Now, in general, gala dinners per se can leave me cold; the business versions in particular can be stuffed full of cold fish of all kinds. Charity galas are always much better - full of good people willing to put their money where their mouths are.

But I have to say that the Jo's Trust gala took the biscuit for most fun event of the year if not the millenium-so-far. For a start, the guests were sparky - I sat next to (and tangoed with) one of the male contestants in this year's Strictly Come Dancing, while on my other side was a fascinating up and coming fashion designer. (I don't usually get overwhelmed by celeb-ness, but these people were genuinely nice.)

The entertainment too was sparky - some acrobats doing their stuff suspended from the ceiling, a troope of smiley carnival dancers, and a belting rock and roll singer. Touching too, especially consdering the gala focus, was the stunningly talented Capital Girls Choir - for we all realised that these were the women of the future, for whose cervical health we were raising money.

Most moving, however, was the after-dinner speech. Yes, I did say the after-dinner speech. Given by Jo's Trust organiser Pamela Morton, it literally brought tears to most people's eyes - including her own - as she talked about Jo's Trust women who were struggling with the disease, those who had won and those who, in the past year, had lost their fight.

Best of all, though, was the final point of Pamela's speech - where she described how only this week, the government has licensed for use with teenage girls the wonderful "cervical cancer vaccine" which protects against the HPV virus that triggers the cancer.

By attending and donating at the dinner we were, as Pamela pointed out, not only actively fighting fight for cervical health. Just as importantly, we were celebrating the most important breakthrough ever in that very fight.

Arranged or rearranged

2007-10-30T15:40:00.000Z

I was fascinated to see a report in the Times on Monday that Arrange Me a Marriage, a new primetime show for BBC Two, aims to discover whether arranged marriages would work for British singletons. The presenter, a Glasgow matchmaker called Anella Rahman, aims to explore whether the principles of Asian marriage (match couples through background and life goals, provide prior vetting by family, tally expectations of marriage) will work better than the love criteria that most young Brits work to when choosing a mate.

I'm fascinated by the report for two reasons. First, this programme began conceptual life aiming to use a team of experts - and I was one of the people initially approached. I'm glad to say the producers changed their vision - glad because I genuinely believe that fielding use of just one Asian matchmaker creates a stronger and more interesting focus than the original scenario. So go, Aneela Rahman, go!

I'm fascinated secondly because I agree with the programme's premise. Of course I recognise the dangers of people marrying sight unseen, and of course everyone - including the most fervid supporters of arranged unions - would condemn forced or unwilling marriages.

But I also know, from the sharp end, that the traditional Western route to marriage has major drawbacks. For a start, it allows lust to massively dictate partner choice - and we know from research that the lust component of a union lasts a few years at most. But more, research also shows that the criteria that make for a long lasting and happy marriage are not the ones that many Western couples use to make their choice - but are the ones that inform the best arranged marriages. Common values, common opinions, common relationship expectations, common life aims - these are the things that recent studies show matter in love, not looks, or being 'cool', and certainly not the emotional neediness and dependency that motivate so many unions today.

I shall be watching Arrange Me a Marriage avidly, not only through enjoyment but also in the hope that it will hold love lessons for us all - and particularly for those of my readers who are currently in the process of choosing their life partners.

Babyshock...

2007-10-25T11:20:00.000+01:00

For various reasons too complex (and medical) to explain, I am not a mother myself. But I do get thousands of letters every year from mothers who are struggling with some aspect of parenthood. I have no doubt that while it's the most rewarding role in life, it's also the hardest job in the world.

So I was unsurprised last week to read that a recent poll by Mother and Baby magazine suggests that the first 'baby year' in any new mother's life is the worst. Women approach motherhood - much as they often approach marriage - in a romantic haze, believing that while giving birth might be painful, what follows will be demanding but joyful. The reality can be very different.

New mothers, says the survey, are incredibly lonely. Once loving partner is back at work and supportive grandparents have gone back home, what remains is simply you and baby. Cut off from family, friend, work colleagues - trapped in a shiny house on a shiny and deserted estate - new mums can go stir crazy.

It didn't used to be like this, and to be frank, I don't think it should be like this. New Mums need regular, and nearby support - of the sort that was there when, 100 years ago, we lived next door to our own mothers and just across the road from our peer group who, like us, were busy giving birth. Now we mainly live hundreds of miles from our families, and are surrounded by neighbours who are gone for most of the week Overall, the average new mother spends only 90 minutes a day with other adults.

Yes, this too will pass. Babies grow and go to playschool. Children grow and go to big school. Mums go back to work and pretty soon are usually once more a happy part of society again. But during that first crucial year - when they deserve all the support society can offer - far too many women feel lonely and abandoned.

Two glimmers of hope here. First, Tesco supermarkets' latest scheme to get mothers and toddlers meeting up in their stores. Second, the Meet-a-Mum organisation Mama, which provides a befriending service for new, particularly postnatally depressed, mothers.

Great ideas both. But according to the Mother and Baby figures, just a drop in the ocean...

Call me Pollyanna...

2007-10-15T17:12:00.000+01:00

I often get poo-pooed by both colleagues and peers for my optimistic attitude to life. I'm the one who thinks that, actually, yoof today is a darn sight more aware than I ever was as a teenager. I'm the one who believes that couples have much more successful relationships than they used to because people are now much more emotionally literate. I'm the one who holds that society is not actually going to the dogs but is slowly but surely becoming more evolved, intelligent and compassionate. A hundred years ago I and many other women like me would have been imprisoned in the home - that is if we weren't dead in childbirth. I count my blessings on a daily basis.

But when, over the weekend, I found that my bag had been stolen - complete with mobile phone,driving licence and credit card - my optimism was sorely tested. I was in Barcelona. I don't speak Spanish. And though I had followed all the advice about hanging on to my bag and keeping it in sight, it took just one distraction and it was gone from underneath the restaurant chair. Silly me.

But once again human nature, seemingly proven by the theft to be dishonest and nasty, stepped up positively to the plate. The Spaniards at the next table, who spoke no English, nevertheless saw my distress; then summoned the waiter and on my behalf demanded assistance. He sympathised, instigated a search, then when it proved fruitless, talked me through directions to the police station.

The police, who would have been totally justified in casting their eyes up to heaven and blaming the stupid foreign tourist, were patience itself - they had even installed a freephone directly connecting me to my credit card provider so that I could - even before filling in the police forms - cancel my card. The provider, in turn, calmly and coolly took action, offered to send me replacement card and cash, and equally uttered not a word of reproach.

Then there were the folk in the waiting room. We all huddled together sympathising, and when they heard that my companion and I had come to Barcelona to dance tango, they insisted on a demonstration. Applause all round, including from the police, who quickly and speedily processed my denuncio and sent me on my way.

Yes, it was horrid to be the target of pickpockets. Yes I could kick myself for falling for it. (And yes, I do know that much worse things happen to folk every day of the year, many times over - and that as a solvent, educated assertive woman I am wellplaced to cope with what was actually, something very trivial.)

But once again, what I am mainly left with is optimism - triggered by the little things done by ordinary people, who responded positively and supportively where they could have turned a blind eye, shrugged their shoulders, and roundly blamed...

Life is about Mobiles...

2007-10-12T13:19:00.001+01:00

Worked on yet another ad campaign yesterday - this time talking about the place of mobile phones in our lives. The day started slightly comatose, as the car came at 4am to take me down to CNN for a 06:15 interview... but then we proceeded happily through BBC Asian network, BBC Technology and numerous other radio stations until well into the afternoon. Great fun!

The whole event was centred round a new study by the LSE in conjunction with The Carphone Warehouse - 5000 people interviewed in 5 European countries. The results made interesting reading for we Brits. We are (surprisingly) more likely to send erotic mateial by phone than any nationality other than the Swedes. We are (unsurprisingly) more likely to feel rejected if our phone doesn't ring than any other nationality than the Spanish. We also lie a lot by phone (though not as much as the French, mon Dieu) ...

The radios gobbled it up. They were particularly interested in the flirting, cheating and dumping that goes on by virtue of the new technology - which was excellent, because that's my area of expertise. I variously quoted, commented - and flirted - with presenters all round the country on the topic. It was a great campaign to do, sensible, well researched and adding to our understanding. What's not to like...

And, of course, life imitates advertising. In between the interviews, like a series of illustrative cameos to my voiceover, I kept seeing... the early morning taxi driver... the BBC technician... the nice lady from the recording studios... the ops room operator...and of course, all four of the clients I was working for... tapping, talking, listening and smiling - into their mobiles...

It's good to talk - and it saves the nation money!

2007-10-10T20:21:00.000+01:00

Just a quick blog entry today, to celebrate the announcement that £170m a year is to be set aside for 'talking treatments' on the NHS. The aim is to reduce the wait for counselling from 18 months to two weeks, and make sure that everyone who needs support gets it. The justification, says Health Secretary Alan Johnson, is that the country will save billions because mental health currently loses us 91 million working days a year.

Yes, yes, yes... thank heavens they've realised that providing support for emotional difficulties is not just liberal drivel - it works, and often better than throwing a pill at the problem. Well done Alan Johnson!

Real, please, not reality

2007-10-08T17:34:00.000+01:00

At the start, I used to really like the Pop Idol/X Factor phenomenon. Yes, I was one of those who voted for Will Young, believing - rightly as it turned out - that Gareth Gates was too young to profit from the opportunity. Even last year, I was spellbound at Leona Lewis - surely the best voice ever to appear, let alone win, such a series.

But over the years, though, I've had my doubts. What started out as a simple talent contest was becoming far too scripted for my liking. And now, reports have it, my doubts have been confirmed; much of the seemingly spontaneous interactions may well have been plotted out beforehand or even re-run for the cameras.

From a psychologist's viewpoint, what particularly irks me is the way bad and good news is broken. Of course good television should build suspense. Of course it should show, and stir, emotion. But I object to the way the panel seemingly (for this may all, of course, be simply acting) plays with contestants when they are sending them home or putting them through to the next round.

"I hate to do this to you.... but you're through!"... "We have serious doubts about you... and you're going to the final"... "You've done so, so well... but now you're dumped." It's not just cruel, it's prime time cruel; the results are plain to see as the contestants sob their way through the ordeal. (Interestingly, I largely exonerate the infamous Simon Cowell from this - of all the judges he seems to tread the line of honest and clear feedback most ethically. If you're listening, Simon, try to persuade the producers to run the whole show to those standards...)

Actually, it's not the just the torture of contestants - some of them, this year, as young as 14 - that annoys me. It's the permission and approval that is given to such torture. In an age where school and workplace bullying is rife, this leading on and then pulling back is the worst kind of manipulation.

More, the contestants are expected to accept this, not to object to being manipulated, even to laugh at the joke (and at themselves`). And all this is horribly parallel to the way bullying victims are further tortured by their tormentors; the pain not only happens, one is told that it is not pain, and that one should simply bear it; "can't take a joke... sissy... what a wimp". If only one of the contestants, having been thus wound up, had the gall to object, to protest their treatment, to get angry instead of bursting into tears or hugging their oppressors.

If only, too, the producers had the courage to trust both judges and contestants to deliver compelling television without such manipulation. Real emotions - of the sort that human beings feel when something matters as much as X Factor success matters - would make good television on its own.

Genuine desire for success, genuine disappointment at failure, genuine commitment to their art and their own development - all of these unhyped - would surely make good television, as well as being a better role model for viewers.

More importantly, encouraging these genuine feelings in contestants would surely turn the winners into more mature and hence more successful stars.

Yes, boys too please!

2007-10-04T15:45:00.000+01:00

You've probably gathered if you read this blog regularly that I'm a staunch supporter not only of treatments for cervical cancer, but also of prevention - that is, the new cervical cancer vaccine for preventing the HPV virus. And debate has been raging about whether, how and at what age this vaccine should be given out. To adults only? To teenagers? To pre-pubescents? Those newspapers that rant rather than write have been having a field day.

One thing that has been taken for granted by all the media, however, is that vaccinations should be given to girls. After all, it's girls wot get this cancer isn't it, so it's girls wot ought to be vaccinated! :)

So I was delighted to see my colleague Anne Szarewski speaking out in GP magazine this week in favour of vaccinating the boys. And - despite the commentators who worry that this would take the funding away from the female market, I agree with Anne.

It's not just that vaccinating boys will make it less likely that they will infect their partners. It's that by vaccinating boys too we send a clear message that it takes two to tango and that the lads as well as the girls who should be taking responsibility.

So yes, of course don't cut back on the female vaccination programme. Of course don't fail to get the message across to girls.

But when we're arguing about vaccinating boys as opposed to not vaccinating them, it seems like a nobrainer to me.

Reasons to be cheerless... one... two.. three

2007-10-02T10:14:00.000+01:00

What makes you happy is, apparently... what makes you unhappy. This very Zen thought comes, not inappropriately, from Japanese psychologist Shigehiro Oishi, who in the new issue of the Journal of Personality and Social Psychology, suggests that people who have good things happen to them are, in the end, more miserable.

Say that again? The reason, apparently, is that if we have a good life, we end up taking 'good' for granted and are poleaxed if something bad happens. If we are used to - and even expect - the worst, then a cheerful event cheers us up enormously.

My gut reaction (and the fact that I once authored a book on Postive Thinking) is to balk at this. Surely pessimism is by definition a bad idea, meaning that we think depressed and depressing thoughts more and more often?

But logically, I have to admit that there is a grain of truth here. Letter after letter I receive from my readers show that we now expect so much out of life that - as my mother used to say when I had thrown a particular annoying temper tantrum "there's no pleasing you!". We expect the earth - from our jobs, our families, our relationships - and if we don't get it we not only feel bad about all those things but also about ourselves and our own validity.

No, we shouldn't settle for the worst and we shouldn't accept it as our lot. We particularly shouldn't accept it as someone else's lot, shouldn't simply put up with oppression, cruelty, poverty and war. But the relentless pursuit of happiness doesn't work either; philosophers have been telling us that for thousands of years and they are right.

Let's just hope that, now a psychologist is telling us, we will finally listen.

Partying Direct Dot Com

2007-09-27T10:38:00.000+01:00

I am not a party animal, never have been. And usually, when I get an invitation to a press launch, or whatever, I mysteriously find I have to wash my hair, again.

But last night was different. Dating Direct, the website for which I'm a consultant psychologist - held its annual fest to celebrate National Dating Day. Of course, it involved a swish London club, lots of Very Beautiful People, acres of canapes and gallons of cocktails (thrown together by the Bar Wizards, who did an incredibly impressive choreography right there on the floor in front of us.)

But so far, so standard. What made this party unusual - and for me, truly enjoyable - was what underpinned the hype. Because I've worked with these people, know the focus and commitment they put into the DatingDirect site, know how good the product is, know how we've all worked and worked - particularly over the past six months - to add extra features, put in extra quality controls and relaunch the product in the service of all those single people out there who deserve love.

I don't mean to sound like an endorsement, but for once the champagne seemed absolutely appropriate. We deserved to party.

Having it all

2007-09-25T14:22:00.000+01:00

Two studies hit the headlines today - and most papers have bundled them into one article. They both ring very true to me.

The first study, from Princeton University, suggests that compared to the Sixties women still do just as many jobs that they rate 'unpleasant' while men have cut back on such tasks - the gap between the genders' commitment to teeth-gritting has widened.

The second study, from the University of Pennsylvania, suggests that compared to the Seventies, men are happier while women's satisfaction has remained the same. Again the gap between the genders - this time when it comes to life fulfilment - has widened.

I'm not going to go off on a women's lib rant here - and I do think it's great that men are in general more contented. But it does make me sad that women are not. Compared to my mother, I have more opportunities, a better standard of living, a better chance to work at a job that fulfils me, the choice of whether to have children or not. Yet still my gender is no happier.

The 'why' could well, of course, be precisely because we have so many more opportunities in life. I'm absolutely not saying that women shouldn't work... or shouldn't have children... or shouldn't travel - quite the opposite. But while the above-quoted studies show that men have kicked back a little in life and are not demanding quite so much of themselves, we women are working just as hard if not harder in order to have it all and do it all.

I wouldn't swap my life - or the benefits I have compared to previous generations of women. But I long for the time when we can have it all without having to do it all - career development, childrearing, housework, eldercare - 24/7 and with a smile.

Seven year folly...

2007-09-21T11:13:00.000+01:00

Just looking at the story today from Berlin, where controversial German politician Gabriele Pauli is suggesting a seven year limit on civil marriages to allow couples to renew their commitment round about the time of the fabled seven year itch.

Ms Pauli seems to present a coherent argument for allowing couples a natural break where they could choose to stay together or part amicably. And certainly from the biological viewpoint, it makes every sense. We humans are programmed to fall in love - ie, to make babies - in the initial stages of a relationship; but thereafter our hormones shift to create a more stable, less exciting, set of emotional connections. Seven years into an affair is one of the times where we might be tempted to break away, to seek excitement once more and wander off to pastures new.

Which is exactly why, of all the bad ideas I have ever heard politicians make, this leads the field! Tying in a renewal of commitment to the very point in a marriage where the bonds are most frail and partners are feeling most disillusioned seems to me the height of folly. Divorce is always traumatic, always a crisis life event that changes lives - for the partners involved, and for their innocent children. What we ought to be promoting at that point is not breakup but extra resources - increased support as partnerships struggle to survive, society's backing for partners to help them stay together and make it work.

For actually, couples can make it work. My work as an agony aunt in general - and my work with Relate in particular - tells me that time and again, if partners hunker down and get through that seven year watershed, they have a great chance of weathering the storm and ending up with a solid, loving and lifelong commitment.

By encouraging them not to hunker down, but to cut and run, Ms Pauli does her constitutents - and their families - no favours at all.

Birds, Bees and embarrassed Dads...

2007-09-18T13:19:00.001+01:00

First, major apologies... a whole slew of deadline work has kept me away from my blog this week. But I just had to come back to it when I read the headlines yesterday about the new research from Parentline Plus about why Dads don't talk to their children about sex.

Yes, I totally understand that the fathers deeply believe that the reason they don't is because it would ruin the time they spend with their kids. Particularly if parents are separated and visits to children are limited, it makes perfect sense that Dads don't want to start talking about the birds and the bees on Saturday afternoon access visits. Besides, sex talk - Dads apparently feel - deals with tricky subjects, ones that could lead to defensiveness or argument.

Oh dear. Here's a chance for fathers not only to be of use to children - children who talk to their parents about sex are significantly more likely to have sex later and less likely to get pregant. It's also a chance to strengthen the bond, to talk about real stuff, not just whether Liverpool should have slaughtered Portsmouth or whether Kylie is going to be any good on the Christmas Dr Who special.

How to handle emotions, how to build relationships, how to have enjoyable and responsible sex lives - these are the things that Dads should be talking to their kids about. The fact that they are scared of doing so - for I do believe that's what underpins these fathers' views, whether they realise it or not - is deeply, deeply sad.

Sex and the pill (no, not the one you think I mean)

2007-09-12T15:35:00.000+01:00

Yesterday I took part in Radio 4's Case Notes, a half-hour's digest presented by the thinking girl's doc, Mark Porter. This week's programme was all about sex problems (part of the Radio 4 The Sex Lives of Us season) and Mark, sexual physician John Dean and I batted about several topics including erectile dysfunction (for him), anorgasmia (for her) and loss of desire (for both).

Despite the fact that I was the only non-medic present, Mark gave me a deal of leeway to argue against medication for sexual problems - and he and John happily agreed with my stance. Yes, medication is a wonderful way forward for some problems; you only have to look at the eye-watering alternative treatments for ED (pumps, injections, surgery) to acknowledge that sometimes medication is by far the best option. But I am still wary.

For a start, pill-popping may hide an underlying physical issue. During a recent pilot scheme to dole out the little blue pill through Boots the Chemist, 9 out of every ten men who turned up tested positive for diabetes or heart disease and needed to be referred to a consultant rather than simply prescribed the pill.

Secondly, however, many sexual problems are not physically caused. The woman with low sexual desire may be tempted by the upcoming range of testosterone patches - whilst ignoring the fact that she's exhausted, depressed, in an abusive relationship, and with two under-fives to look after. Sort that lot out and she not only would be less likely to need the patches, but more likely to live a fulfilled and happy life.

John Bancroft, head of the famed Kinsey Institute, once famously said that the traditional role of the penis has been to tell its owner the truth... whether or not he wants to hear it. And whilst I don't wish to underplay the role of physical issues, I suspect many sexual problems serve the same function for both men and women.

So let's not medicalise or medicate where inappropriate. Instead, let's regard any sexual disorder as carrying a message that both its sufferer and their physician needs to hear...

And now for something completely different...

2007-09-09T18:21:00.000+01:00

On Thursday and Friday of this week, yet another of those projects that make me feel that I have the best job in the world. A whole two days spent explaining to interested journalists the real truth behind the little known disease of rheumatoid arthritis.

Fact: it's an autoimmune disease in which the body attacks itself, destroying and deforming the joints. Fact: it's not just a disease of the elderly but can strike three month old babies - the classic RA sufferer is a woman in her mid-thirties. Fact: it's an irreversible and lifelong condition that can render the sufferer disabled and in constant pain. Fact: it can shatter self esteem, end careers, destroy marriages, tear apart family life. Fact: There are 400,000 sufferers in the UK alone.

So, you may ask, what's the joy there? Where's the fun in talking about that?

The fun is in giving those facts - plus the additional fact that new treatments, practical aids and emotional support can now give an RA sufferer back their life - to dozen of journalists who, at first neutral, then became fascinated, then actively fired-up to cover the condition in health features across a wide range of magazines.

Result - not only a good job well done (by myself, by Sue Oliver the arthritis nurse consultant with whom I was working and by the PR company who hired us). But also a result for the issue of arthritis care.

If you want to know more about rheumatoid arthritis, click here.

What is a saint?

2007-09-04T22:49:00.000+01:00

As you may have gathered, I've been up to my eyes in work over the past five days - so the blog has suffered. But I'm back now, the big piece of work for Dating Direct done and dusted.

In between the work, however, I had time to notice the coverage in today's Daily Mail of new 'discoveries' about nursing heroine Florence Nightingale. Seems that rather than silently ministering to the sick with a weak smile, she was much more likely to be demanding extra resources, stroppily complaining about conditions and generally making a nuisance of herself.

The thing that fascinated me about all this was the constant implication - in the Mail and in other papers - that because she demonstrated this behaviour, Nightingale was therefore, by definition, not as saintly as she has been painted by history. Excuse me? Does being assertive and demanding in the cause of good - for noone is suggesting that she saved any fewer lives or achieved any less in her lifetime because of her manner - render one less deserving of sainthood?

In my opinion, saints are not necessarily quiet mice. They're robustly human, with human energy for getting things done - be that by nursing, praying, or by assertively throwing money lenders out of temples.

Or as George Bernard Shaw wrote. "“The reasonable man adapts himself to the world; the unreasonable man persists in trying to adapt the world to himself. Therefore, all progress depends on the unreasonable man"

Let's hear it for unreasonable men and women....

2007-08-31T15:52:00.000+01:00

Yes, still working happily away on the Dating Direct job - so fascinating! But I broke out of my purdah yesterday to do a piece for BBC News 24. The news broke yesterday that the divorce rate is down - lowest since 1984 - and so of course everyone is clamouring to know why.

My own take on it is that in some ways this is significant and in some ways it simply isn't. The insignificant bit is that the divorce rate is down because the marriage rate is down: less marriage mean less marriage-breakups.

But the significant bit - which all the experts seem to be supporting - is that I do believe there is a sea change on the way. People are thinking more carefully before they marry. They are making better choices. They are marrying later in life and further down the road in their relationship. They have more realistic expectations and they are more knowledgeable about what to do when those expectations aren't met. I do believe that counselling - as well as other support mechanisms such as self-help books and agony aunt columns - are making us more emotionally literate.

Let's hope the trend continues. I for one would be thrilled to bits to have nothing to do because everyone in the world was happy, fulfilled and content in their relationships!

Dating Developed...

2007-08-28T09:19:00.000+01:00

Not trying to get the sympathy vote here, but while the rest of you were enjoying the sunshine over the weekend, I was working. Not my usual round of agony and broadcasting, but a rush job with online relationships site Dating Direct, for whom I'm the Relationships Spokesperson.

Which led me on to thinking about the whole issue of internet dating and the way it's matured over the past decade. At the start, when it was all very new, it was seen as sad - and if people did it, they certainly didn't 'fess up. Then a few years ago, around the time I got involved with Dating Direct, there was a flurry of press coverage: a few reporting with amusement stories of Sarah from Chelmsford marrying Simon from Chicago because they had - gasp - met on the web, plus many more stories pointing the finger with horror at all those Sarahs or Simons whose Internet loves had proved to be someone completely other than they had claimed to be online, or to be after something completely other than marriage...

Fast forward to today and spot the shift. Yes,there are still horror stories in the press - and of course I am in no way condoning Internet exploitation. But contacting potential partners over the web is now so normal that it doesn't merit even the middle pages of the Daily Whatever, and the amount of outrage over Internet dating scandals is noticeably down too.

What's happened? I venture to suggest that we're learning. We've realised, as we use the Internet more and more, that - like real life dating - it has its customs, its rules, its ups and its downs, but what we need to do is to work that. Outraged of Worthing is no longer throwing a wobblie because the man she chatted to online doesn't propose to her the minute they meet up, because she's realised that it's unrealistic to expect him to do so. Broken-hearted of Wallasey is no longer writing devastated letters to me because the woman he chatted up online has suddenly decided that he's not the one for her, because he now knows that, well, these things happen.

We - or almost all of us bar the very young and the very inexperienced - now understand that the Internet creates an atmosphere of excitement and anticipation that can undermine our realism. We now understand that going to meet someone we have met online may feel like getting together with an old friend but that - as with any sight-unseen blind date - it is in reality getting to know a stranger. We aregrowing up, learning the ropes, exploring the boundaries - and as we get the hang of the system, we are making fewer and fewer mistakes and gaining more and more appreciation of what Internet dating has to offer; a huge range of possibilities; the chance to get to know someone much more deeply than normal pubbing or clubbing would allow; a clear statement on both sides of what the agenda is. In our fragmented society, where all the traditional methods of meeting, falling for and pairing up with partners are increasingly impossible, the Internet is a wonderful solution. Despite the early press coverage, Simon from Chicago and Sarah from Chelmsford were not an aberration - but the way forward.

In short, considering how very recently Internet dating was born and has grown up, I am delighted to see how quickly and how rewardingly it's come of age. And no, I'm not just saying that because I work for them...

Age shall not wither....

2007-08-23T12:24:00.000+01:00

At last statistics have proved what I've known professionally for decades and am increasingly coming to know on a personal level... sexual desire does not fade with age. The myth that sex stops at 40, or with the twentieth wrinkle, whichever comes sooner, is just that - a myth.

A survey published in the New England Journal of Medicine, and covered in almost all the national newspapers today with varying degrees of seriousness, shows that older people still want, need and love sex - and most of them, despite the occasional erectile or lubricative glitch, are still getting it. The majority of those under 74 are making love regularly and happily.

The flipside - for sadly, there is a flipside - is that they may well be making love unsafely. For after all, these nasty STDs don't affect anyone but the young, do they? (Of course they do, one of the biggest rises in infection occurs among the older cohort, who think that anyone they sleep with has been celibate or at least faithful for the past several decades. Dream on.)

But safe sex warnings apart, I'm delighted that at last those of us in our middle years are finally being appreciated for who we are. We are not ony warm blooded and passionate, - but also knowledgeable about our own bodies, about how to turn a partner on, about how to make sex not only loving but also lustful. What's not to like?

Good to talk...

2007-08-22T15:49:00.000+01:00

I was asked to do a nice piece for Radio Cambridge today on the Antonia Brickell Show. Apparently writer and philosopher Theodore Zeldin, coming up to his 74th birthday, has decided to celebrate not by asking to a party all his friends but... a group of strangers.

His point, apparently, is that in today's world we get isolated... never talk at any deep level... let friendships lapse (indeed, lose friends at the rate of just over one a year)... and that we need to redress the balance. Talking to strangers, he reckons, is a way to do this, to break down our differences, and get us Connected.

I'm all for it. I totally agree that we should widen our social contacts - if only because we as a society are so wary of strangers, so paranoid that we fear simply chatting to someone we don't know will put us in danger of being mugged, literally or emotionally.

My own personal celebration of Professor Zeldin's birthday will, therefore, be to talk to at least one stranger in the next few days - at a bus-stop, on a rail station, in a shop.... I'll let you know how I get on.

And, if Professor Zeldin reads this and hasn't yet had his birthday party... can I have an invitation please?

Regretting the regrets

2007-08-20T14:07:00.000+01:00

At age 26, a few months after my mother died of cancer, I found a lump in my breast. And in the three days between that and my GP's reassurance that the lump was benign, I did a lot of thinking. The result was that I made up my mind to do three things - and no, I'm not going to tell you what they were, but the most innocent was to move to London, which I did a short while later.

The lesson I learned in those three thoughtful days was that I rarely regret what I have done, but I often regret what I haven't done. And it seems I'm not alone. A recent survey, albeit not a scientifically researched one, suggests that we all have something we regret - and many of those regrets are about not doing things. We wish we'd saved more, we wish we'd travelled more, we wish we'd gone into a different career...

No, of course sometimes we simply don't have the strength or the skill; I will never climb Everest or play solo piano with the London Philharmonic. (Though I have three times fulfilled my dream of dancing on the West End Stage - through sweat and tears, not through talent.)

But sometimes we say no to things not because we can't, but because we believe we can't, or shouldn't, or mustn't. My postbag is littered with such beliefs, with readers telling me that they are "too old" for A, "too fat" for B, or that C would disapprove if they dared to do D.

So while I don't wish to go all happy-clappy in this blog, I do want to reaffirm my own resolution - and call on you to reaffirm yours - to take note when you want something and to do it if you possibly can.

In short I wouldn't want to be either Edith Piaf or Frank Sinatra. But if I had to choose between their respective anthems, I'd rather bypass "Regrets, I've had a few..." and sign up to "Je ne regrette rien".

Depression - reality not myth

2007-08-17T09:57:00.000+01:00

After yesterday's rather light and lively entry, I was brought back to earth with a bump this morning by reading the latest media reports of comments from Professor Gordon Parker of the University of South Wales.

In short, Professor Parker - with every good intention - has been quoted as saying that depression is overdiagnosed in the world today and that it is normal to feel down in the dumps from time to time. He also adds a warning about overmedicalisation.

On the one hand, I agree with what he says - we can be told to pop a pill when what we need is support to face our problems.

But notice I say "support". For what worries me about Professor Parker's statement is that, as reported in the media, it can seem to play down depression in a way that will deny sufferers support. Headlines such as "The myth of depression" just add to an already existing attitude that views depressive illness as trivial, all in the mind and something that you can simply 'get over' - and deprioritises mental health charities as a result.

Clinical depression is to a down mood as a raging migraine is to a slight headache. It is a real, painful, mind-altering condition that can drive its sufferers to the point of suicide - and beyond.

So yes, by all means let's ride with - and learn from - a dip in happiness that lasts a day or so in the wake of a real-life disappointment or setback.

But let's not demean the condition of depression - or its sufferers - by labelling it a myth.

For help with depression, see your GP or contact Depression Alliance.

The wall

2007-08-16T11:39:00.000+01:00

On the opposite side of the road that lies below my office window there is a wall, grey stone,and about three feet high.

Small children run towards it screaming with joy and demand that their grandfathers lift them up so they can walk along it.

Students just arrived at the University, freed of parental inhibition stagger along beside the wall, lean on it, and then slowly fall backwards and disappear behind it.

Groups of young people hang out at the wall, chatting, flirting, mock-fighting and generally eyeing each other up and down.

Students about to leave the University and head off to adult life, perch on the wall in academic gowns with bottles of postgraduation champagne.

Young lovers snuggle up on the wall together, gaze into each other's eyes and steer a fine line between passion and public indecency.

Lunchtime office workers sit on the wall and eat their sandwiches or smoke that forbidden cigarette, staring into space and - presumably - mulling over their lives.

Proud parents pushing prams pause at the wall, take a moment to lean in and gaze at their new offspring, smile at each other and then walk on.

And... yes... small children run towards it screaming with joy and demand that their grandfathers lift them up so they can walk along it...

I sit and watch from my window and love what I see.

Much better than television.

Intimations of mortality...

2007-08-14T17:04:00.000+01:00

I was sad to see reported in the weekend's news that comedienne Dawn French, 49, is convinced that she will die when she is 50, and has retired to the country to prepare for death.

But my guess is that Dawn herself is not sad at all. On the contrary, she seems calm, collected and at peace with her own mortality. All round her, I guess, family, friends and fans are weeping and wailing, trying to convince her that what she believes is misguided, morbid, or a little mad. She, however, has believed since she was a child that she will die young and so has come to terms with it.

I very much hope, for everyone's sake - not least her husband and daughter's - that Dawn is just plain wrong about this one. But if I had to make my choice between her accepting and positive approach to dying and the terror that the rest of us feel when faced with our inevitable mortality, I know exactly which I would choose.

Making the world a happy bunny

2007-08-14T16:46:00.000+01:00

No, I admit it, not my headline but the current hook for the latest in neat campaigns to sell sex toys.

As you probably know, new recycling regs mean that all electrical equipment must be disposed of at a "designated electrical waste collection centre". Which is fine if your throw-out is a toaster, a cooker or a hairdryer. But not so good if what you're taking to the tip is a collection of vibrators.

Bad enough to see the smirk on the face of the Customs official as they rifle through your carry on-luggage and find a rampant rabbit (who, me, talking from personal experience... nooooo!) But to have to produce and then dispose of said sex toys at your local disposal centre? Not a good idea.

Now sex toy website Love Honey has launched an "amnesty" campaign to make the whole thing easier. You send them your vibrator. They recycle it. They donate £1 to charity. They send you a new vibrator for half price.

I'm not on Love Honey's payroll, but I do approve. Good idea, well marketed, subtly pushes the safe sex message and very green. What's not to like?

The demanding art of agony aunting

2007-08-10T18:47:00.000+01:00

In this morning's email, a note from Lianne, a sixth form student who as part of her A Level dissertation, is researching the role of the agony aunt in modern society. Nicely done - the questionnaire I was asked to fill in was thoughtful and well written, and I was glad she'd asked...

... I was particularly glad she'd asked because her survey led me to think through and write down in black and white just what I do as an agony aunt. Many people presuppose that we advice columists simply, well, give advice to the person who writes to us. But I find our job is actually far more mentally demanding and emotionally draining than that.

To begin with, an agony aunt's role, remember, is not simply to respond to the letter that is written. When I answer the heartfelt problem from Desperate of Dorking, I am also answering the similar current problem of Desperate of Dungeness, the similar future problem of Desperate of Dublin - and increasingly, given the worldwide web, the similar but culturally disparate problem of Desperate of Dallas, Dubai or Dharamsala. None of these people will ever write to me, but all them, along with my million other interested readers, will read and benefit from my column every single week.

Remember too that the best agony aunts do far more than simply give advice. We not only try to write an answer which offers emotional normalisation, which suggests that the presented problem is not insurmountable, which reassures that a person who suffers from that problem is not a monster. We also try to write an answer that helps readers see things differently, find different solutions, find better strategies for dealing. Plus, perhaps most importantly, we attempt to write an answer that gives more generalised and transferrable guidance, that reflects society's best practice in order to help readers to manifest their own best behaviour.

And we do all this in - on average - 150 words, on a one-shot-try, with no interaction with our 'clients'. We feel with our readers, we reach out to our readers, we respond to them from the heart - and then, every day, we worry about not being able to do more for them.

No wonder, sometimes, that the adjective "agony" in our job title can be applied almost as much to what we experience as to what our readers endure...

In praise of the non-babe

2007-08-08T20:28:00.000+01:00

All over Britain, sensitive caring men are currently breathing a sigh of relief. Dr Lynda Bothroyd of St Andrews' and Durham universities has determined that when asked to choose between 'carers' and hunks, women choose the former. David Hasselhof eat your heart out - Johnny Depp's the one for me.

Jokes aside, though, there's an interesting point to be made here for both genders. Because the myth is that only the drop-dead gorgeous men and women get partners and the rest of us might as well cash in our chips. Sadly, a lot of the research also seems to suggest that women will go for muscles and men will go for boobs and bums. Which has surely contributed to the current fascination with appearance, this belief that if we aren't fit, we'll never get a partner - and hence that we need to have cosmetic surgery on all points south.

The reality is that attraction is a lot more complex than that. The research that suggests people only go for hunks and babes may be accurate in its own terms. But these studies are always about initial attraction - to be blunt, they test only who we want to make babies with, not who we want to form a loving relationship with.

In fact, we are far more sensible than that. For a long term relationship, as Bothroyd's study shows, and other research supports, what we want in a partner is not looks but character. Being drop dead gorgeous is no guarantee of finding love nor of making a happy relationship. The key to success is much more around the personality and experience we bring to a relationship.

So let's hear it for those of us who don't look like Catherine Zeta Jones or Orlando Bloom...

The ugh factor

2007-08-05T20:12:00.000+01:00

I spent Friday consulting to a pharma company that is trying to gain more acceptance for its vaginal atrophy product.

Its what? Let me explain. The pharma has produced a pessary to help women who, usually because they're postmenopausal, suffer difficulty with... how shall I put this... thinning of the skin... loss of lubrication... discomfort while...

I can almost hear you wincing.

Actually, that was the whole point of the consultancy - to find a way to present the topic in a way that anyone will listen to. Because say the words "vaginal atrophy" and people's first response is incomprehension and their second response is a wrinkled nose and an "ugh" noise. Even women don't want to talk about it, while men simply turn white and start talking football.

But it's a real problem - I know because I get letters about it from my readers. After a certain age, with the shift in hormone levels, many women start to suffer. Itching, dryness, urinary incontinence and yes, pain and in particular pain during intercourse. It's not a trivial issue. "It hurts" say my readers - and they don't just mean the physical discomfort. They mean the horror of having one's most pleasurable and intimate part start to let you down... the strain and stress that puts on your relationship... and the intimation if not of mortality then at least of ageing.

This is not a plug for the pharma product. But help of various kinds is available - and many women don't seek it both because they don't know about it and because if they do, they're embarrassed to even admit they need it.

So it would be great if we started to take this one seriously. If the media gritted their teeth and covered it. If the health profession started asking pertinent and sympathetic questions of menopausal patients. And if ordinary men and women worldwide stopped wincing and started talking...

Ooops....

2007-08-01T12:41:00.000+01:00

Regular readers may remember my piece of a last week roundly endorsing the showing of a death on prime time television. It now turns out that the programme doesn't show Malcolm Pointon's moment of death, but the moment of his passing into unconsciousness three days earlier.

I'm not criticising his wife - she didn't issue the press releases giving the impression that death was what was being filmed, though at the same time she didn't deny them. I do blame the production company for allowing the story to run in the press and for capitalising on the ensuing debate to raise interest in the documentary.

But most of all, I'm sad that everyone bottled. I totally understand that Barbara Pointon might not want this private moment filmed - but the point I made in my earlier post still stands. This very privacy around death means that we as a society do not know the reality of it. If we did, we would both take death more seriously and live life more fully.

Just going down the (computer) garden, dear

2007-07-30T15:45:00.000+01:00

One of the biggest topics in my postbag right now - and for the past three or four years - is from women complaining that they have lost their partners to the Internet. I'm not talking about online cheating here, but the simple fact that many men are retreating to their computer screens more or less 24/7,leaving their women lonely and resentful.

On the surface it's a no-brainer. Anyone, male or female, who withdraws from relationship contact so decisively is surely making a statement about their commitment - and so the pages of outraged protest from abandoned partners has always left me sympathetic and supportive.

But I've suspected for a while that it's not quite as simple as that. Relationships are systems - what one partner does not only affects the other, but is a direct result of the other's actions. The outraged women who write to me are not simply victims; the situation almost always has two sides.

Plus, while - as I've commented on this blog before - women tend to react to stress by talking it through, men react by withdrawing. If a relationship is under strain, a man seeks solace on his keyboard - just at the very time when a woman needs the reassurance of interaction.

So I was pleased to see, in Saturday's Times, a piece making just this point. Such dynamics, writer Naomi Shragai quite rightly suggests, are not the cause of relationship problems, but the result of both partners' solutions-of-choice.

The piece not only posits a fresh - and in my mind entirely accurate - view of the Internet problem, but also offers some helpful hints. If you're suffering at either edge of this particular sword, I'd advise you to read it.

Morbid - no, necessary

2007-07-27T11:44:00.000+01:00

Nice piece by Bel Mooney in the Mail this morning on the upcoming ITV documentary which shows, on primetime television, the last moments of a life. There's been a lot of controversy about this programme - as there was a decade ago when the BBC showed a death on The Human Body. Like Bel, however, I'm absolutely in favour.

Of course if a 'real death' is shown disrespectfully, humorously or violently, we should condemn it. But actually, we see 'pretend death'shown in all these ways, many times a week on the media, and barely an eyebrow is raised. This showing of real death in a serious, reverent - and above all, honest - way is to me a huge step forward.

I saw my father die. He was 78 years old, and he died of terminal lung cancer in a hospital bed with me and my uncle at his side. It was an unbearably upsetting moment - but nevetheless I am glad I was there. I had not been there when my mother died and I had always felt somehow cheated at that. We need to witness the moment of death.

But surely we only need to witness when the dying person is close to us? Surely when they are a stranger, as is the case on the upcoming documentary, our interest is morbid and voyeuristic. Not at all. Death, like sex, is something we rarely see in person - yet it is one of the defining elements that makes us human. We will all die, will all lose loved ones to death. We all want to know - and arguably deserve to know - what it looks like.

Seeing my father die has not removed my fear of being dead, because I don't know what follows. But it has removed my fear of dying - and thus made me far more able to live fully. If the upcoming documentary does that for even a handful of its viewers, then it will be worthwhile.

Be Prepared - take a condom!

2007-07-25T16:05:00.000+01:00

Where did you learn about sex? If you're of a certain age, probably from an embarrassed parent... a giggling friend... or round the back of the bike sheds. Today's youngsters, on the other hand, are much more likely to get their facts about the birds and the bees attending a Girl Guide Jamboree.

Today's report that Girl Guides (as they used to be called) are scrapping their goody-goody image and demanding lessons on safe sex comes hot on the heels of July's survey from the British Youth Parliament suggesting that young people are campaigning for better sex education.

Now tthis is probably raising hackles in middle England, with worried parents seeing this as proof that the yoof of today is more debauched than ever before. I beg to differ.

I grew up in the Sixties, when we believed, to paraphrase Philip Larkin, that sex had just been invented. We acted accordingly. But we acted with very little responsibility, no awareness whatsoever of sexually transmitted infection, and a total presupposition that if you didn't want sex you were weird. The pressure from the lads to make a girl 'put out' would horrify today's confident young women. The irresponsibility of the girls to put out without contraception would horrify today's young men.

Yes, of course we live in a more sexualised society today than in the past. That's not down to teens however, who take their lead from the adults around them and the media which is controlled by said adults.

No, in my opinion, teens today are far more aware, sensible and responible than we ever were - and the proof of that pudding is in their asking for more sex education, to help them cope with a more sexualised society. Good on the Guides, I say, for following up on their motto...

You're not fat!

2007-07-24T12:50:00.000+01:00

Coincidence is a funny thing. On the train this morning I sat opposite two boys and a girl, delightful teenagers of about 14 or 15. No, really, they were lovely - chatting among themselves about school, homework, friends, and what they'd done over the weekend.

But trains being what they are, I caught most of what they were saying, and when the girl started talking about a classmate, whom she eulogised for her face and figure, my attention homed in on the phrase "She's so skinny... whereas I'm fat."

I glanced across to see a sylphlike creature, with a waist you could have circled in both hands. And I winced. But I wasn't the only one - her male friends immediately took up the challenge. "You're not fat... come on... you look great."

The Sylph was having none of it. She protested, argued, pushed back. But worryingly, this wasn't out of false modesty; there were no flirty giggles as she asserted that she really ought to lose the fat on her stomach (what stomach?). She was deadly serious in her belief that she was overweight and needed to lose half a stone. I winced again.

As we reached London and all got up to leave the train, my wincing turned into an active discomfort - and suddenly I abandoned that English rule about never talking to strangers. I tapped the Sylph on the shoulder and gently made my point... that she wasn't fat but slim, slim, slim... that I received countless letters from women with eating disorders... and that she desperately needed to rethink her body image.

The Sylph was shyly polite. Her male friends were fabulous "we keep telling her that... maybe now she'll listen...". We parted with mutual smiles.

But I did wonder, as I walked away, whether if she didn't listen to her mates she would listen to that strange woman who had accosted her on a train. And I also wondered whether, if she didn't listen, how she would end up.

I began this blog entry with the words "Coincidence is a funny thing." - and you're probably wondering where the coincidence in this tale lies. Well here we go. This morning's press covered a study by the Schools Health Education Unit which revealed that over half the teenage girls in Britain believe they need to lose weight, while 40% typically miss breakfast - and sometimes lunch - in an attempt to emulate the sticklike status of their celebrity idols.

I strongly suspect that one of that 40% travelled opposite me on the London train this morning....

Money can't buy you love

2007-07-19T17:12:00.000+01:00

Today's reports that Sir Paul McArtney has offered Heather Mills £70 million as a divorce settlement will doubtless spark a flurry of editorial or feature comment on greed and avarice in general and the financial battlegrounds of divorce payoffs in particular.

As a psychologist, I see it differently. Post-divorce fights about money (like all relationship fights about money) are never only about the finances. They're about a whole host of much more emotional issues - power, control, self-esteem, jealousy, revenge, guilt. It is no coincidence that a Relate survey identified money as the top issue in marital conflict. And when marital conlict peaks in divorce, and the currency of love has disappeared, what can ever replace it? The answer is all too often hard cash.

We fight over the money side of a breakup because that is the only power we still have left over our beloved, or because we want to punish them for the end of the relationship. We shrink from fighting over the money side of a breakup because it is the only way we know how to make amends for having stopped loving them, or because we still treasure hopes of their loving us again.

So what I as a psychologist see behind Paul's offer and Heather's counteroffer is not avarice or greed. At bottom, I see the deep pain of two people who thought they were loved and realise that they are not.

Tell us more...

2007-07-19T10:56:00.000+01:00

It feels so good when what you've written hits a chord with your readers.

It feels even better when what you've written hits such a big chord that a national newspaper asks you to write a much longer think-piece on it. So nice to be wanted.

My blog of earlier this week about co-rumination entranced the Daily Mail so much that they asked me to tell them more. The expanded piece can be found on p65 of this morning's Mail - or click on this link.

You are what they say you are!

2007-07-18T13:27:00.000+01:00

I've always thought that the recent smoking ban is good news - what's not to like unless you're addicted? But I didn't predict that it would also give me a wonderful real life example of what I've always held to be true; people live up (or down) to the expectations that others have of them. So punish somebody for something they haven't done, and they'll more than likely go ahead and do it.

Here's the psychology. If you tell someone that they are a certain type of person, they automatically shift their behaviour somewhat towards being that kind of person. So tell a child they are naughty and their behaviour deteriorates; tell them they are good and their behaviour improves. It's not an overnight shift, but a refocussing of the child's attention onto certain elements of their personality, plus a reinforcing and rewarding of those elements. Result - the behaviour you prophecied, whether bad or good, becomes self-fulfilling.

Here's the linked smoking ban anecdote, reported in The Sun last week. Council warden hands out a £50 fine to a couple who looked as if they were about to drop their cigarette butts but hadn't yet done so. Couple immediately drop cigarettes. Couples' later comment "We thought if we were going to get fined, we might as well get our money's worth." Living up to expectations - you bet!

Sure, some people's behaviour needs a short sharp shock. But punishing someone - child, lover, team, or an entire society - for something they're not actually doing, and you're inviting them to do it anyway.

Call me Polyanna. But I reckon that council warden would get more results if he actively thanked people who are good in binning their butts, rather than fining people who he suspects might possibly be considering naughtiness...

Talk to me

2007-07-16T14:46:00.000+01:00

Personally, I've always relied on friends to help me through the bad times. Professionally, I've always advocated the support of friendship as a way of getting through the bad times. But a recent study in the Journal of Developmental Psychology, suggests that friendship may not be the solution of choice when one has problems - at least, if one is a girl.

The study, which involved 813 American girls and boys aged 9 to 15, got them revealing how much - and how effectively - they discussed their problems with friends. As expected, girls did it more. As expected, both boys and girls felt closer to friends after doing it. But, not as expected, girls felt more anxious and depressed as a result. Boys simply chatted things through and then let them go, but female teens ended up reinforcing each other's negative thoughts, feeling worse and worse about themselves - and then talking about it all even more as proof of friendship!

This study was done on adolescents but I strongly suspect this theory holds true across the board. Women like to talk things through and we tend to think that in and of itself is the solution. But actually, we may have a lot to learn from the boys. They don't get bogged down in the negatives. Their strategy - define the problem, find a solution, but avoid overthinking and overtalking - leaves them feeling more positive and more resourced. Perhaps, just perhaps, we should take a leaf out of their book and use some of the Mars approach rather than being unilaterally Venus.

Let me be clear. I'm not arguing against talking. Properly done, it supports, clarifies, and inspires. The problem is what the Developmental Psychology study calls "co-rumination" - going over and over negative issues, and so spiralling into ever more negative states.

And, let me be even clearer, I'm not arguing either against talking therapies. Well-done, counselling isn't co-rumination - any therapist worth their salt will slash straight through a client's descent into that kind of unhelpful thinking, and encourage them to find solutions to their problems.

No, the message of this study for me is not to drop our friends - or flee the counselling room. It's to learn just when, where and above all *how* it's good to talk - and when you need to simply take action and move on.

Friday snippets

2007-07-13T12:19:00.001+01:00

Three pre-weekend stories.

Firstly, Radio Cambridge called me in to do a comment piece for their Drivetime Programme. Apparently a new text flirting service has just been launched, specifically aimed at people stuck in traffic jams who want to chat each other up! Light and lively little piece, but it turned serious when the presenter, Antonia Brickell, asked whether I approved of all this new technology; surely texting, chat rooms and internet dating sites were dangerous?

Lovely contentious question, Antonia - and great radio. Because I was then able to counter that actually I'm the Internet's biggest fan. It's not just the increased communication that I love. It's not just that research suggests people are *more* honest on the web because they're wary of being found out because they have to put things down in black white. I also love the Internet because folk who have formerly been marginalised in society now have a much bigger chance of getting involved and accepted. Example? My quadraplegic reader who ten years ago had no mates, and now has hundreds of friends who adore his lovely mind and personality as revealed in his emails - and don't care in the least that he can't move.

Secondly, though I try never to stray into the political arena, this week Gordon Brown has delighted me by coming down heavily against the supercasino plans. Yes, I do understand the regeneration argument. But if the casino-supporters were at the receiving end of the agony mailbag that I get from desperate wives and husbands who see their lives trashed by a gambling-addicted spouse, they would think twice about doing anything at all that supported the 'sport'. (Breaking news: Nokia has now banned gambling ads from its mobile ad network... considering how much revenue that will lose them, I think that's an incredibly brave move!)

Finally, on a more personal note, I've spent a good deal of time over the past few days being gobsmacked (as they say oop North where I come from) by the positive response to this website and this blog. Big thanks to all those people who have written to tell me they love it.

But what do you actually dooooo?

2007-07-12T09:51:00.000+01:00

As I've mentioned earlier, my working life has no clear pattern - any two days are usually utterly different. But Mondays and Thursdays have something in common - on both I write and submit agony columns. Today, it's my column for That's Life, a woman's weekly for whom I've written for over a decade now.

My postbag always moves me. A few sentences on lined paper torn from a notebook and hand-scribbled in a guy's coffee break. Several paragraphs inside a pink card with kittens on the front carefully printed by a fourteen-year-old, probably during a maths lesson. Fourteen pages of stream of consciousness, almost certainly written at the dead of night and downstairs, while the hated and feared spouse sleeps on upstairs.

How do I respond? Always from the gut. Yes of course I research around the problems presented, of course I refer on to an appropriate organisation. But the core of my answer is always instinctive, a reaching out to the letter writer, to make them feel understood and to give them a way forward.

I haven't got the answers. But what I can do - what my expertise and experience enables me to do - is to help my readers see their problems differently. The guy writing in his coffee break needs to realise that ending his affair will be hard but not impossible. The schoolgirl writing at her desk needs to realise that she doesn't need to sleep with the boy in order to get the love she craves. The spouse writing in the dead of night needs to realise that leaving the violent partner is the best thing for everyone.

Of course, I'm not just addressing those people. Yes, I originally write person-to-peson, but I'm published to an audience of millions, who buy the magazines and websites that run my columns. What I say needs to help them too see their problems differently - needs to give them permission to stay, to leave, to say yes, to say no.

Above all, my agony aunt columns need to give people the message that when times get tough, they're not alone - and that they deserve not to be alone. If not from friends and family, then from advisors, counsellors, therapists - and from agony aunts - people should feel able to reach out and get the help and support they need.

Eat your heart out, Corrie!

2007-07-11T10:10:00.000+01:00

As well as covering "drugs, sex and rock and roll" for the mass media, I'm also heavily involved in the more academic side of things - most particularly sexual health. Yesterday, for example, I attended the quarterly meeting of the Editorial Board of the Journal of Family Planning and Reproductive Health, a cute little mag that belies its rather ponderous name to give coverage of a range of topics from menstruation to the menopause by way of contraception, sexually transmitted diseases and cervical cancer - anything to do with women's and men's bits, basically.

Of course it's a serious journal - the list of contributors always reads like a Who's Who of key world figures in sexual health. But what always amazes me during our meetings is the fact that in addition it's so much about real life, real stories of patients who have had to make difficult choices, real concerns of health professionals who have had to face difficult challenges. Granted, unless you have a medical interest in the topic, you won't keep a copy on your bedside table; but beneath the long Latin words and the carefully correlated statistics, there lie so many human stories - stories that frankly, I find much more interesting and inspiring than any TV soap.

I can't believe I just did that!

2007-07-07T11:43:00.000+01:00

Psychologists at Exeter University have made a neat discovery. Apparently they've tracked down a brain mechanism that alerts us, in the present, to mistakes we've made in the past. So volunteers who messed up on a set task experienced a sort of instinctive mental flinch when they were about to repeat that mess-up. Useful, say the psychologists, because it provides us with an early warning system in skills such as driving.

My thought was this. If we have such a mine detector for physical competencies, what about emotional competencies? Wouldn't it be great if we could learn not to date the partners who make us miserable, or not to run the addictive behaviours that cause us heartbreak? Wouldn't it be great if we could learn to avoid mistakes in our relationships?

Well actually, we do learn. We develop emotional mine detectors from the day we are born - and many of them stand us in very good stead. Problem is, we also overlearn. We learn, too quickly for our own good sometimes, that we need to flinch and run away from certain situations. And then, because of our past mistakes we can end up emotionally paralysed, scared of ourselves, scared of other people, scared of living our lives.

The vast majority of my agony aunt correspondents - and the vast majority of people worldwide who turn up in therapy - are folks who have a wired-in early warning system that leaves them believing that they can do nothing, be nothing, love no-one - for fear of making the same mistakes again.

Note to Exeter, then. Once you've tracked down not only our physical but also our emotional early warning system, can you please work out a way that - when we need and want to - we can also put that system on hold for a moment, relax, and start trusting the world and trusting ourselves

Equality equals happiness - proof at last

2007-07-03T11:21:00.000+01:00

Yessssss.... finally, some backing for what has always seemed to me to be a no-brainer. The Pew Research Center in Washington has surveyed 2000 couples about marital satisfaction and has concluded that sharing household chores is one of the most important factors.

This isn't a trivial issue. Not equalising housework was all very well when housework was what women did and out-of-housework was what men did. But all change - now everyone has a job and yet women still do the bulk of the childrearing and home-cleaning. For a partner to help isn't just easier all round - it's a sign of respect, concern and love.

Lads, I totally understand that you don't want to do the ironing because you find it boring and unfulfiling. But the hidden message in opting out of that stuff that you think it's OK for us to be bored and unfulfilled.

Sex, drugs and rock n' roll!

2007-07-02T11:19:00.000+01:00

I spent the weekend catching up on a backlog of work. It's never the same day twice. Yes there are regular commitments - Monday column for AOL, Tuesday phone-in for Heart Radio, Thursday page for That's Life. But otherwise... what do I do, what have you got?

This weekend it was a mixture of sex, drugs and rock and roll.

Sex? I've been working for a while on a rewrite of a (rather famous) sex book, and we've just reached a new phase of firming up on what needs to be done: working through tens of thousands of words of research on such disparate topics as vibrators... orgasms... oral sex and pompoir (don't ask), I caught myself wondering happily how on earth I had, by some miracle, ended up doing as an enjoyable career what most people do just for enjoyment.

Drugs? I'm deeply involved - for personal as well as professional reasons - in cervical cancer campaigning; so on Saturday I spent some time looking over the news clips covering the latest vaccine. Lots of debate about whether 12-year-old girls should be injected, or whether the very act of vaccinating would make them more likely to have early sex. For me it's a no-brainer. If a 12-year-old girl is aware enough to be having the vaccine, then she's probably aware enough to know not to have sex for a while. It's the kids who don't have the vaccine that I worry about - they're much more likely to get caught not taught.

Rock and roll? Well, no, not really... but I did write a comment for a weekly glossy on the Spice Girls Reunion. I love serving up serious psychology that can teach people how to best live their lives... in the guise of a celeb news story. Sneaky, I know, but... such fun!