Why Women Lose Sexual Desire (& How To Reclaim Pleasure Again) w/ Dr. Holly Richmond

[SPEAKER_01]: When women tap into their pleasure, that can feel dangerous to the powers that be for all of the reasons we know now, but when we step into our sexual empowerment, we can come alive. [SPEAKER_00]: How does pleasure regulate the nervous system? [SPEAKER_01]: It's one of our largest dopamine reward systems. [SPEAKER_01]: All of us have different erotic map and the most satisfying erotic maps are the most flexible. [SPEAKER_01]: That's where we want to be in our nervous systems and that's where we want to be in [SPEAKER_00]: How is this harmful, this societal version of what's hot or normal sex? [SPEAKER_01]: It harms us because it becomes a performance. [SPEAKER_01]: We feel inauthentic. [SPEAKER_01]: We have

access to our truth and we end up with some kind of somatic episode. [SPEAKER_01]: What does somatic psychology mean? [SPEAKER_01]: some manic psychology bridges the gap between physical pain and emotional pain. [SPEAKER_01]: You can fix the hormone but you still need to fix the system within which sex function. [SPEAKER_00]: For women who have experienced trauma, how do they start that journey? [SPEAKER_00]: The first is with [SPEAKER_00]: The disruptor podcast is for informational purposes only and does not constitute medical advice. [SPEAKER_00]: Views expressed by guests are their own. [SPEAKER_00]: Consult your healthcare provider before making any medical decisions. [SPEAKER_00]: Dr. Holly Richmond is a world-renowned, somatic psychotherapist in an ASEC certified sex therapist who is revolutionizing

how we treat trauma and reclaim intimacy. [SPEAKER_00]: She is one of the leading voices in the pleasure forward movement, emphasizing that healing is not just about the absence of pain, but the presence of joy. [SPEAKER_00]: With the PhD in Sematic Psychology, Dr. Richmond focuses on the intersection of the mind and body, helping clients navigate the complexities of sexual health, desire, and trauma recovery. [SPEAKER_00]: She is the author of the claimed book, Reclaming Pleasure, a sex positive guide for survivors of sexual assault and trauma, and a frequent contributor to major publications like shape and the New York Times. [SPEAKER_01]: We all know psychology means, but what does the term somatic psychology mean? [SPEAKER_01]: such a good

place to start. [SPEAKER_01]: So somatic psychology bridges the gap between physical pain, expressed through the body, and emotional pain expressed through the psyche. [SPEAKER_01]: And with somatic psychology, I am still a talk therapist, like that is the lane. [SPEAKER_01]: I'm a trained as a clinical psychologist, but the PhD in somatic psychology. [SPEAKER_01]: So some might say, [SPEAKER_01]: You know, so typical psychology is top down. [SPEAKER_01]: We start with the brain and maybe if your practitioner is open to hearing about the body, you might get some of that for a somatic practitioner somatic psychologist. [SPEAKER_01]: We start with the body. [SPEAKER_01]: and incorporate the mind. [SPEAKER_01]: So we are really paying equal attention and I also

want to say in our allopathic or Cartesian model of medicine where the mind and body are separate. [SPEAKER_01]: So Maddox psychology doesn't see it that way. [SPEAKER_01]: So in my dissertation, I studied Maurice Merloup Ponti and he was really one of the first philosophers practitioners to find that non-duality between sex and self. [SPEAKER_01]: So as we get into our sexual conversation here today, it's not me doing sex, it's me having sex, it's me being sex. [SPEAKER_01]: So sex and self are one. [SPEAKER_01]: There's not this dual model anymore. [SPEAKER_01]: And so yeah, combining somatic psychology and sex therapy, it makes sense to me through that lens. [SPEAKER_00]: So why, for someone listening, who's learning about

this? [SPEAKER_00]: And maybe they have tried talk therapy. [SPEAKER_00]: Why, let's go really basic for a second. [SPEAKER_00]: Why is talk therapy sometimes just not enough for people? [SPEAKER_00]: Like why do they not get into the place of healing where they want to? [SPEAKER_01]: because we get stuck in stories. [SPEAKER_01]: And until you can see beyond your story, see deeper to the truth. [SPEAKER_01]: And so I think you and I both agree. [SPEAKER_01]: A lot of truth is expressed through the body. [SPEAKER_01]: You're missing the mark. [SPEAKER_01]: So the process that I work through is awareness, understanding, behavior change. [SPEAKER_01]: And they have to go in that order. [SPEAKER_01]: And that is a psychological process

[SPEAKER_00]: So why do you think up until now, and I already have so because then every vertical in women's health, I feel like I'm asking this question, but maybe it's in mental health across no matter how you identify or what gender you identify with. [SPEAKER_00]: But why does the traditional mental health system still ignore [SPEAKER_00]: the body's physical storage of stress and trauma. [SPEAKER_00]: So as a sexual health doctor, I always saw it as vaginism as or chronic pelvic pain. [SPEAKER_00]: You know, when I didn't find anything on ultrasound or insurgery, I often found that it was trauma kind of stored in a woman's body. [SPEAKER_00]: So where do you think we fall in short

with traditional mental health? [SPEAKER_01]: because we've been stuck a lot on the Y and giving interventions that are purely psychological and I know you and I have a lovely relationship where both somaticizers, highly sensitive people and for me, my body was running the show long before my brain would catch up. [SPEAKER_01]: So my body would give me the information and I would be confused. [SPEAKER_01]: until that's why I studied this. [SPEAKER_01]: Partly, you know, know that I sell. [SPEAKER_01]: So there's a part of it that's that's that. [SPEAKER_01]: How can I catch up to what my body is telling me? [SPEAKER_01]: Where for other people, they're very much in their heads and their body are

almost completely offline. [SPEAKER_01]: So we have that piece too. [SPEAKER_01]: And whether you're hypo attuned to your body, so no attunement to your body whatsoever or hyper attunement to your body like UNIR. [SPEAKER_01]: They both have gifts, and they will both fight you in the acid occasionally. [SPEAKER_00]: So, you know, the wildest thing for me is, my body tells me, I just, my brain lets me talk myself out of it or ignore it or just, I keep burning because I'm like trying to get to the finish line, but my executive coach warned me before I had the incident, I was alluding to where I lost the ability to speak. [SPEAKER_00]: multiple times, but acutely it

happened for the first time, and she had warned me beforehand, and she said, if you don't consciously make a decision about your lifestyle, your body's going to do it for you, and she personally had been through a cancer diagnosis, and that's what happened to her. [SPEAKER_00]: She just kept feeling exhausted and kept burning through it, and [SPEAKER_00]: It ended up that she had cancer and so she was coming from a very kind place, like looking out for me and she was right. [SPEAKER_00]: I think not a month after she said that is when I acutely had that incident. [SPEAKER_00]: And I was so scared when that happened because in my mind I knew the words

that I wanted to say and they weren't coming out. [SPEAKER_00]: And in my head I was a neurobile major. [SPEAKER_00]: go figure and I'm a gynecologist and I was like I'm having a stroke like I'm having this whole conversation in my head and I'm watching the audience who know I'm a season speaker and they're like what is going on with her and then like the guy who invited me to speak is like do we need to go to ER I'm like you know I'm like no I just I I actually got on a plane and went home and got the work up at home I was crazy I know but so we that is a

perfect okay you want an example [SPEAKER_01]: that. [SPEAKER_01]: Okay, I'm going to remember that, but I also want to just offer a reframe. [SPEAKER_01]: So this idea that trauma is stored in our body. [SPEAKER_01]: I know a lot of us say that. [SPEAKER_01]: The words I like better as trauma is expressed through our body because stored feels a little bit too permanent. [SPEAKER_01]: I agree. [SPEAKER_01]: I like that so much better. [SPEAKER_01]: Yes. [SPEAKER_01]: So trauma is expressed through our body. [SPEAKER_01]: You're incident. [SPEAKER_01]: I lost the ability to speak. [SPEAKER_01]: A somatic psychologist is going to say, what is the adaptive part of losing the ability to speak? [SPEAKER_01]: What can't you, so part

of it was all brain, right? [SPEAKER_01]: So what do you have? [SPEAKER_01]: Like, throw to like, what can't you swallow? [SPEAKER_01]: What can't you digest? [SPEAKER_01]: So me like, what truth couldn't you process? [SPEAKER_01]: Like, you and I would have many weeks of like, what is, what are you trying to say? [SPEAKER_01]: What is your body trying to say that you can't? [SPEAKER_00]: Uh-huh. [SPEAKER_00]: Oh, yeah. [SPEAKER_00]: There was a, I had, I can say at this point, I had lost complete financial and control over my company. [SPEAKER_00]: It was so far removed from the initial mission and then I was just burning these crazy hours. [SPEAKER_00]: So that's what I actually was being, I

felt like I was being silenced. [SPEAKER_00]: Um, and my voice was no longer ringing true, and then little did I know that it physically would I literally felt like the little mermaid, I was like, I can't speak, I've lost my voice garbled and then gone. [SPEAKER_01]: It was bizarre. [SPEAKER_01]: Um, yes. [SPEAKER_01]: Yeah. [SPEAKER_01]: And so in this process, you have the ability to acquire knowledge without conscious awareness. [SPEAKER_01]: Right, your body is, it's a subconscious process. [SPEAKER_01]: It is running the show in the background or autonomic nervous system, part of that's going on, but it stops you. [SPEAKER_01]: Cause yeah, the body will tap and then it will nudge and then it will push

you over if you stop listening. [SPEAKER_01]: And I'm a card carrying some manicizers. [SPEAKER_01]: So please, no, I've been pushed over too. [SPEAKER_00]: That does, I mean, it doesn't make me feel better that you can empathize with that, but the fact that I'm not alone, yeah. [SPEAKER_00]: And it scared me enough, though, I still believe that for me, unfortunately, I had to experience that to get me to truly change my habits that were built into me as the eldest daughter, as a doctor, as a mother, [SPEAKER_00]: serving everyone and not serving myself. [SPEAKER_00]: So now my voice is back. [SPEAKER_00]: I did do six months of speech therapy in addition to lots of other therapy

to understand the why, but also to physically correct the issue that was going on. [SPEAKER_00]: And I also did get on hormone therapy, which is a whole wild ride that a neurologist, you know, people are like, oh, you're in the menopause expert. [SPEAKER_00]: but a neurologist started me on hormone therapy and we learned the exact opposite the people with ate typical migraines or or as should not be on hormone therapy is like no actually he's like it's this the zone of chaos with your hormones that is also you know worsening this so he's like once you go you know fully in the menopause it should get better he's like [SPEAKER_00]: But the combination of the

hormonal fluctuation with the stress and everything you've been through, he's like the stress you work on, the hormones, you know, I'll start you on and then you know how to fix. [SPEAKER_00]: But people were shocked when I shared my story on social. [SPEAKER_00]: They're like, minorologists are telling me the exact opposite. [SPEAKER_00]: I'm like, I'm telling you there's data. [SPEAKER_00]: It's it's pretty fascinating. [SPEAKER_01]: That's, well, what's on me, I hear you now, not in clear. [SPEAKER_01]: I love yours too one voice and yeah, that would be part of the work too. [SPEAKER_01]: It's just what like you really using your voice again and you are. [SPEAKER_01]: I love that you found this path. [SPEAKER_00]:

Yes, it was very important to me. [SPEAKER_00]: And just like it is, I reclaimed my voice. [SPEAKER_00]: So let's talk about doing a deeper dive into reclaiming pleasure and pleasure as medicine. [SPEAKER_00]: Because I think we, and I know I was guilty as a gynecologist, sexual health for me was limited to learning about contraception, fertility, and treating NSTI. [SPEAKER_00]: and medications and how to treat and even to ask those questions with women, I didn't. [SPEAKER_00]: I surgically learned how to treat maybe pain and lubrication a little bit on menopause, but talking about pleasure and orgasm and arousal, all those domains of sexuality that I know like the back of my hand now, never learned. [SPEAKER_00]:

So how does pleasure, number one, [SPEAKER_00]: All sexes deserve it, but how does it actually regulate the nervous system? [SPEAKER_01]: It's one of our largest dopamine-remort systems. [SPEAKER_01]: I mean, the clitoris is the clitoris for a reason, the only organ designed for the sole purpose of female pleasure, more than 10,000 nerve endings. [SPEAKER_01]: The next most is the anus, then after that, the penis. [SPEAKER_00]: Isn't that amazing? [SPEAKER_00]: And yeah, and yet it was just appropriately studied very, very recently. [SPEAKER_00]: Like when I was going through residency in medical school, it was still incomplete that the mapping that you're referring to, the innovation of the clitoris. [SPEAKER_00]: We still didn't know. [SPEAKER_00]: Absolutely. [SPEAKER_01]: It's

just women have been, you know, sidelines. [SPEAKER_01]: We've been sidelines. [SPEAKER_01]: We just haven't been that important to policy, power, culture, religion. [SPEAKER_01]: When women tap into their pleasure, that can feel dangerous to the powers that be for all of the reasons that we know now. [SPEAKER_01]: But for me, I wasn't even studying that 18 years ago. [SPEAKER_01]: I was just trying to figure out, okay, here's sexual trauma. [SPEAKER_01]: I knew so clearly that safety wasn't enough. [SPEAKER_01]: I'm like, what would be on safety? [SPEAKER_01]: Oh, pleasure lives beyond safety. [SPEAKER_01]: Also, [SPEAKER_01]: Control, relinquishing control, connection, eroticism, you know, eros is this this force that animates everything in our lives. [SPEAKER_01]: And I feel

like for women we are just staying so contained, but when we step into our sexual health and our sexual empowerment, then we become alive. [SPEAKER_00]: We come alive when we're not gas lit or ignored or made to feel invisible, right? [SPEAKER_00]: There's so many FDA approved medications for men, you know, they can fill something online and things are shipped to them. [SPEAKER_00]: And I feel like there's no. [SPEAKER_00]: Sigma, taboo, or shame with them, but for women who have experienced trauma or medical gaslighting, how do we get them to a place of, because I feel like they have to be safe, and then they can, like you said, invite the pleasure back. [SPEAKER_00]: Like, at

first you have to be safe, but how do they start that journey? [SPEAKER_00]: How do they, where do they even begin? [SPEAKER_01]: Yes, so the first is with presence, so we're really going to emphasize pleasure over performance because of this cultural lens that we've gotten subjugated to we have been sold that sex and sexuality looks like this you should want this you should want that so the one of the most exciting things I do in my work is helping women discover their sexual template. [SPEAKER_01]: And that asks two primary questions. [SPEAKER_01]: It's looking at desire, which is the psychological process of wanting and arousal the physiological process of wanting. [SPEAKER_01]: in all of us have

a different erotic map. [SPEAKER_01]: And the most satisfying erotic maps are the most flexible. [SPEAKER_01]: Just like we say when we're studying the nervous system, safety is in a place. [SPEAKER_01]: It's not a definition. [SPEAKER_01]: A safe nervous system is a flexible nervous system. [SPEAKER_01]: Because there's no one that goes through life feeling safe all the time. [SPEAKER_01]: You're going to like bump down that nervous system to kind of depressed or sad, despondent, and then plenty of times probably daily, you're going to pop up to anxious, [SPEAKER_01]: So when we come back to that neutral zone, that flexible zone, that's where we want to be in our nervous systems and that's where we want to

be in our sexuality. [SPEAKER_00]: So is that why I've read in the data? [SPEAKER_00]: You know, we've talked about women. [SPEAKER_00]: We're learning all about different orgasm patterns. [SPEAKER_00]: They're smart vibrators now. [SPEAKER_00]: It's not all the original masters and Johnson's model that we thought, you know. [SPEAKER_00]: But is that why women who are more open to [SPEAKER_00]: I don't want to say play but maybe that's it. [SPEAKER_00]: Who are curious and just more relaxed in the bedroom or wherever you're having an intimate moment? [SPEAKER_00]: Is that why they're more likely to orgasm or know is it that same thought process? [SPEAKER_01]: It is. [SPEAKER_01]: So play in a imagination or two foundational components of

eroticism. [SPEAKER_01]: and by the way, two foundational components of healthy relationships. [SPEAKER_01]: So when we can put that judgment down, then we can be open literally to orgasm. [SPEAKER_01]: So when I know you've heard me say, my sex positive motto, all sex is good sex as long as it's consensual and pleasurable. [SPEAKER_01]: In 20 or 40 minutes ago, we can't have good sex if it's not safe. [SPEAKER_01]: So that's why consent has to come before pleasure. [SPEAKER_01]: But what all sex is good sex is consensual and pleasurable means. [SPEAKER_01]: As we don't get to judge men on it, we don't get to say that's weird. [SPEAKER_01]: That's perverted. [SPEAKER_01]: She's slutty. [SPEAKER_01]: She's whatever. [SPEAKER_01]:

Like if it's consensual and pleasurable, it is. [SPEAKER_00]: And the story. [SPEAKER_00]: I love that. [SPEAKER_00]: And it's, it's nobody's business, like, other than the people that are involved. [SPEAKER_00]: And like you said, if there's consent. [SPEAKER_00]: Um, so, but I want to go to this O map, um, and, and what you're talking about, because [SPEAKER_00]: I was on a very interesting call today, talking about menopausal and perimenopausal symptoms. [SPEAKER_00]: When the male partners were asked in a heterosexual couple about the most bothersome symptoms to them, it was loss of intimacy and they weren't talking about penetrative [SPEAKER_00]: You know, do hold me, she won't do the things that she used to do. [SPEAKER_00]: Forget

the sex part, like we need to get to that, but I miss the intimacy. [SPEAKER_00]: So can we talk about this work that you're doing as well? [SPEAKER_00]: Yes. [SPEAKER_00]: And the definition of what intimacy is? [SPEAKER_01]: Yeah. [SPEAKER_01]: So we can look kind of the relational intimacy into me seed. [SPEAKER_01]: So what the husbands are saying to their wives? [SPEAKER_01]: is I want to know more about your internal experience of the world. [SPEAKER_01]: I feel like you aren't being vulnerable with me. [SPEAKER_01]: And when we don't touch, which is most men's primary lane to feeling close and connected, he's just at a loss. [SPEAKER_01]: Now, she's in Perry, Menopause, and Menopause. [SPEAKER_01]: So we

don't even know what our symptoms are. [SPEAKER_01]: Like, that's a whole another [SPEAKER_01]: story here. [SPEAKER_01]: But she's also probably come to this phase of feeling like she gave so much of her life in service to others that she needs to have some boundaries and she needs agency and she needs to feel self-directed and reclaiming and she was probably still having sex for her husband [SPEAKER_01]: So that's the question that a sex therapist will ask. [SPEAKER_01]: Yeah, you're having sex, but are you having sex worth wanting? [SPEAKER_01]: And that's, I think it's either Peggy Klein-plats or Jennifer feels, oh my gosh, what is her last name? [SPEAKER_01]: I will find Jennifer Finlinson-Bif. [SPEAKER_01]: Okay. [SPEAKER_01]:

This, are you having sex worth wanting? [SPEAKER_00]: Yeah, sexually satisfying. [SPEAKER_00]: Is it sexually satisfying to you versus checking a box sex or because I love him or her sex or my patients will describe it as just another task they have to perform. [SPEAKER_00]: And we now understand you were talking about dopamine that we're now understanding estrogen receptors in the brain and there is a change in like you said the neurotransmitters [SPEAKER_00]: After we go through the zone of chaos, according to Lisa Musconi's work, God thank God that there is going to be some emotional regulation and empathy centers, but that nurture is kind of going away and it's [SPEAKER_00]: What was perceived as selfishness

before? [SPEAKER_00]: I don't think it's selfish. [SPEAKER_00]: I think it's a beautiful place where women start to discover their self-sexually personally. [SPEAKER_00]: We see entrepreneurs now at 45 to 55 is the fastest growing subset of women entrepreneurs in that phase of life where we stop, I think, [SPEAKER_00]: chasing is the way I want to describe it. [SPEAKER_00]: I don't want to describe it as selfishness, but we don't feel like we have to do that and we can focus on ourselves and our own pleasure. [SPEAKER_00]: I love that. [SPEAKER_00]: Yes. [SPEAKER_01]: Yeah. [SPEAKER_01]: So expectation lives way on the other side of desire. [SPEAKER_01]: So if the woman is feeling an expectation or responsibility, she is

almost certainly not going to be able to tap into her desire. [SPEAKER_01]: And at Perry Menopause and Menopause, you're right. [SPEAKER_01]: We go from everything most women are age or taught. [SPEAKER_01]: Love is selfless. [SPEAKER_01]: Two, hold on a minute. [SPEAKER_01]: I can't love unless I love self first. [SPEAKER_01]: It starts with me. [SPEAKER_01]: And by the way, so me, let's just say, it's okay to be a little bit selfish. [SPEAKER_01]: I want all thisness and I want selfishness. [SPEAKER_01]: And when I'm helping women with a sexual template, that's where we go. [SPEAKER_00]: I feel like when I am, now that you've said it, it's okay to be selfish, because to me, it's so hard

to even say the words, but I am so much happier. [SPEAKER_00]: I feel like I am such a better listener, I am a better mother, I'm a better human, I feel more rested, I sleep better when I do the things that fill my bucket or are for me. [SPEAKER_00]: Um, or when there are boundaries, I feel so much better. [SPEAKER_00]: Um, so I know that that is now a requirement that I didn't, uh, use to listen to in my 20s or 30s. [SPEAKER_00]: It has definitely changed after I turned the Big Five, though. [SPEAKER_01]: So many have you seen the meme going around? [SPEAKER_01]: It said to let me get the street. [SPEAKER_01]: I can

either be a bitch or have autoimmune disorder. [SPEAKER_01]: Yes, I have seen that and I have created this is what that's speaking to. [SPEAKER_01]: I can't live in the world without boundaries and without self-agency anymore, or I will end up sick. [SPEAKER_01]: And it's not that directed, but you've experienced something similar, I've experienced something similar. [SPEAKER_01]: So now we don't have to be a bitch, but there has to be a stronger sense of self. [SPEAKER_00]: So how do we then this, this felt sense that you described? [SPEAKER_00]: Um, disrupt a spiral that is happening inside of our nervous system as we're, you know, tugging along and doing, we talked about these big experiences that happened

to us. [SPEAKER_00]: So what, what do we do and how do we disrupt it? [SPEAKER_01]: Yes. [SPEAKER_01]: I love this, this question. [SPEAKER_01]: We first have to figure out where we are because you hear a lot of words like ground come back into your body. [SPEAKER_01]: I don't love that because the [SPEAKER_01]: practitioner hasn't given us a sense of which way are we going. [SPEAKER_01]: So if we go back to that nervous system scale of one to 10, one is hyporerows, very down-regulated, depressed, and hedonic, really just feeling low. [SPEAKER_01]: We get to that four to six phase. [SPEAKER_01]: That's the flexible. [SPEAKER_01]: That's where we can move, up and down. [SPEAKER_01]: We can slide

back and forth. [SPEAKER_01]: We get up to the eight, nine, ten, and then we're in anxiety and panic. [SPEAKER_01]: So to disrupt the process, first we have to name where we are. [SPEAKER_01]: Am I feeling sad or am I feeling anxious? [SPEAKER_01]: Am I feeling grief? [SPEAKER_01]: Am I feeling overwhelmed? [SPEAKER_01]: And once we figure out where we are, then we choose the activity to disrupt. [SPEAKER_01]: So do we need a downregulating activity or do we need an upregulating activity? [SPEAKER_00]: And do you want, can you give us examples of one of each? [SPEAKER_01]: Yeah, downregulating a walk, upregulating a run, downregulating humming. [SPEAKER_01]: up regulating, listening to pop, wrap, whatever you want to listen

to. [SPEAKER_01]: Downregulating, awaited, blanket, upregulating might be self-closure. [SPEAKER_01]: So this is a piece I wanted to make sure to talk to you for a lot of men's sexes down regulating, meaning it calms them down, for a lot of women, it's upregulating. [SPEAKER_01]: So now if my husband approaches me after 10 o'clock at night, I'm like, hell no, because [SPEAKER_01]: and I need to get some sleep because I'm an early riser, right? [SPEAKER_01]: But it's downregulating for him so we're kind of not screwed. [SPEAKER_00]: Oh my gosh, and you know, my husband can kill me for this, but I don't care. [SPEAKER_00]: I, because I adore him and we've been married almost 30 years. [SPEAKER_00]:

And, um, but we joke because his favorite nap in the world is a post-quadal nap. [SPEAKER_00]: He said it's like the best sleep of his life. [SPEAKER_00]: Meanwhile, like, and then he wants me to, you know, lay there so while he's sleeping and I'm like, [SPEAKER_00]: Do do do like what I'm up and we're in to go so for me obviously see I always learn something from you so obviously for me sex is an up-regulating activity because it's the same thing when I'm exhausted it's a hard no I'm like I've spent all day helping other people have sex [SPEAKER_00]: I'm like, I'll see you in the morning, but no, I, I did never thought about

it that way. [SPEAKER_00]: That is so funny because he's so exhausted and he's just like ready to go to sleep. [SPEAKER_00]: So for him, it's downregulating, interesting, almost like, [SPEAKER_00]: with men and women, we also see the difference with, and I don't know if you're a believer in this or not, but spontaneous and responsive desire, a lot of my women, patients think they're broken because they're like, oh, I don't have a ton of spontaneous desire. [SPEAKER_00]: If they did, and now it's gone, you know, we treat. [SPEAKER_00]: But they're like, oh, I can't match his, but I can once, you know, I can respond to him. [SPEAKER_00]: And I'm like, well, that's not a problem.

[SPEAKER_00]: That's sometimes a gender difference that we see. [SPEAKER_00]: And it's just the way that we're built. [SPEAKER_00]: So do you see that with your patients as well? [SPEAKER_00]: I absolutely do. [SPEAKER_01]: And just normalizing that. [SPEAKER_01]: And I will self disclose. [SPEAKER_01]: So everything happened later in life for me because I had my kids so late. [SPEAKER_01]: So I started Perry Menopause around 52, 53. [SPEAKER_01]: and was just so flat, low energy, zero, access to my libido. [SPEAKER_01]: And I know everything I should be doing. [SPEAKER_01]: And I just couldn't wrap my heads around it. [SPEAKER_01]: So I had my blood work done. [SPEAKER_01]: My testosterone was nine. [SPEAKER_01]: And my husband was 790.

[SPEAKER_01]: I mean, we're not even close to being on the same plane field. [SPEAKER_01]: But that was just normalized it for me, invalidated. [SPEAKER_01]: And then I started hormone replacement therapy and the world changed. [SPEAKER_01]: And I'm not saying like it's a quick fix for all. [SPEAKER_01]: I have the sexual tool kit. [SPEAKER_01]: So for a lot of couples, you can fix the hormone, but you still need to fix the system within which sex functions. [SPEAKER_01]: So it's both, again, somatic psychology. [SPEAKER_00]: Oh, yeah, bios, yeah. [SPEAKER_00]: The biosycho social, that is why I think even with Adi, which I took. [SPEAKER_00]: And I take testosterone, the first female sexual health care drug, you just

can't give it to someone the way that the package insert said, [SPEAKER_00]: And the FDA said, and then if there's no response in eight weeks, have you addressed does she have pain? [SPEAKER_00]: Is there a problem in the relationship, is she, all of a sudden, a caretaker to older parents? [SPEAKER_00]: What is her testosterone level? [SPEAKER_00]: Is she in parry menopause of what is going on? [SPEAKER_00]: You can't just, there's no, no, no, no, no. [SPEAKER_00]: one solution for everybody to foster and fix is a lot of the domains of sexuality. [SPEAKER_00]: And we're learning so much more benefit for women, muscle, cognition, mood. [SPEAKER_00]: A paper just came out very recently about mood. [SPEAKER_00]:

It's so beneficial, but you're right. [SPEAKER_00]: I don't want people to think who are listening that are on testosterone that all their problems aren't fixed are like, wait, because they might [SPEAKER_00]: to their sexual health care box. [SPEAKER_00]: But for me, it happened during COVID. [SPEAKER_00]: I found three children at home all of a sudden. [SPEAKER_00]: This was pre-me raising any venture capital funds. [SPEAKER_00]: I had not one, but two locations, probably a staff of about 20, that I kept employed because how can you not? [SPEAKER_00]: And all these women are coming to work with just masks and no vaccine, think about it, and taking care of patients. [SPEAKER_00]: and I had no MBA and

had to keep us profitable and everyone employed with restrictions on appointment types. [SPEAKER_00]: So you can imagine six months into this madness and my husband, who's double-boarded is an oncologist and internist, is called to the front lines. [SPEAKER_00]: And so the whole, you know, the thing you see in the movies. [SPEAKER_00]: So I was like, okay, yeah, stress response. [SPEAKER_00]: No, [SPEAKER_00]: When I could care less I was like some things wrong like something is wrong. [SPEAKER_00]: Like I now have had time to adapt to the new state I don't even want to call it normal. [SPEAKER_00]: You know the state of the world the way that it was and there was no spontaneous thoughts

of sexuality There were the sex streams were gone And so I was like okay, so that's when I started myself on the medication. [SPEAKER_00]: I was like yep need need to do that and a little bit of testosterone and [SPEAKER_00]: took a couple of weeks. [SPEAKER_00]: And then I just felt like myself again. [SPEAKER_00]: And it was great. [SPEAKER_00]: It was like, okay, this is this is good. [SPEAKER_00]: It's not dead. [SPEAKER_00]: But for a minute, I was like, is it ever going to come back? [SPEAKER_00]: So let's talk about this, [SPEAKER_00]: You know, what society, a lot of my patients learned about sex from porn or from watching TV. [SPEAKER_00]: And they come to

me and they say, hey, Dr. [SPEAKER_00]: Unbroken. [SPEAKER_00]: Because so-and-so had orgasm in, you know, two minutes. [SPEAKER_00]: She's ripping off her clothes. [SPEAKER_00]: She's climaxing. [SPEAKER_00]: What do they call it? [SPEAKER_00]: Bridgerton Pinnacles, which I thought was adorable. [SPEAKER_00]: That was a new slang term I learned. [SPEAKER_00]: And that's slang, but no one clays to I learned for orgasm. [SPEAKER_00]: How does this actually harmful to us and to our nervous systems? [SPEAKER_00]: This societal version of what's hot or normal sex? [SPEAKER_01]: It harms us because it becomes a performance. [SPEAKER_01]: First of all, it's a lot of times unattainable. [SPEAKER_01]: And by the way, we've got men learning that that's what sex is through

porn and movies and shows as well. [SPEAKER_01]: I mean, it is just it's a mess. [SPEAKER_01]: You know, one of the sentences that a lot of sex therapists will say learning to have sex by watching porn is like learning to drive watching the fast and the furious. [SPEAKER_01]: That, oh my, can I use that? [SPEAKER_00]: That's not my thing analogy. [SPEAKER_01]: Yes. [SPEAKER_01]: It's not mine. [SPEAKER_01]: I can't tell you who said that, but it's exactly that. [SPEAKER_01]: But when we become a performance, then we feel inauthentic, then we don't have access to our [SPEAKER_01]: And then we end up where you were, so me, we end up with some kind of somatic episode with

our body saying, hey lady, listen, listen to me. [SPEAKER_01]: I am not going to perform for you. [SPEAKER_01]: This doesn't feel authentic to me. [SPEAKER_01]: But then at that place, you've really got to be willing to do a deep dive into what kind of sex you like. [SPEAKER_01]: And so me, what you like is going to be different from what I like, different what she likes. [SPEAKER_01]: And it's all beautiful if we can come at it from this place of non-judgment and presence. [SPEAKER_01]: Yeah, I'll leave it there. [SPEAKER_00]: So do you think then you alluded to self pleasure, which a lot of people get very uncomfortable. [SPEAKER_00]: I was on a stage just a

couple of days ago and you can see the audience kind of giggling and talking about it and we were like, no, if you don't know what feels good or feels right or understand your own anatomy and you plan on being with someone. [SPEAKER_00]: You won't have the right tools or vocabularity or a communication whatever you want to say to be able to communicate to that person. [SPEAKER_00]: This feels good. [SPEAKER_00]: This doesn't feel good. [SPEAKER_00]: This is what I like. [SPEAKER_00]: So as you are teaching someone about desire and about, you know, they're sexual, you called it math. [SPEAKER_01]: Sexual template. [SPEAKER_01]: Yeah, so desire or arousal and sexual template. [SPEAKER_00]: Is that one of

the ways that you teach people that that's how they can figure out what they actually want and like rather than what you've been told or watched? [SPEAKER_00]: Exactly. [SPEAKER_01]: Yes, so I create a self pleasure protocol for them and depending where they are, we are going to start very very slow and it's not even going to include genital touch. [SPEAKER_01]: It's just going to include somatic practices with their body. [SPEAKER_01]: If they absolutely just can't do that, I almost never encountered this. [SPEAKER_01]: Then I could say, then I'll create a protocol with their partner. [SPEAKER_01]: But yes, you've got to know what you like, because some women, they just want literal stimulation. [SPEAKER_01]: Some women

are like, oh my gosh, my G spots where it's at. [SPEAKER_01]: And others are like, I just feel like I want to pee. [SPEAKER_01]: Don't touch me there. [SPEAKER_01]: Oh, good. [SPEAKER_01]: Great. [SPEAKER_01]: Like, so much wonderful information to have. [SPEAKER_00]: So that's my other question that I'm going to throw at you, that I'm genuinely curious about your opinion. [SPEAKER_00]: So as people always ask me when I refer them to therapy, for sexual health, they're like, well, am I supposed to, that's how the question always goes. [SPEAKER_00]: Am I supposed to, like asking for permission? [SPEAKER_00]: Go by myself or with my partner. [SPEAKER_00]: So, and you probably are going to say it's curated and

it's nuanced. [SPEAKER_00]: but do you find that one is better than the other to start with if both partners are willing and willing to go? [SPEAKER_01]: Yeah, what I my favorite to do at this point, as I'm doing more sexual wellness coaching instead of therapy, [SPEAKER_01]: is to have the couple come in and I'll get grounded with them and then I'll do several individual sessions with her, several individual sessions with him, then the three of us will come back together and then she'll pop in three months later, he'll pop back in as necessary, and therapy this is not encouraged. [SPEAKER_01]: I absolutely love it as a coach because I have all the information and I

can give all the tools. [SPEAKER_01]: So the answer is both. [SPEAKER_00]: Yeah, because it's always interesting to me, I get to hear things when I practice for two decades in the gynecology office when the partner wasn't there. [SPEAKER_00]: Things that they were comfortable saying to me that they felt like would hurt their partner and then they needed the correct tools, to be able to even start that conversation, like, I'm bored or I can't orgas. [SPEAKER_00]: Whatever it is, [SPEAKER_00]: Um, and uh, so sometimes they wanted that alone time with their therapist, other times, they were like, I can't, no, we need to go together. [SPEAKER_00]: Like, I can't explain anything to him and I just

want to go together. [SPEAKER_00]: So, it's really interesting, but I always wonder what the other partner would be telling me, you know, as I was treating the patient, I'm like, I wonder what their take is on this. [SPEAKER_00]: And if they're just thinking that everything is okay. [SPEAKER_00]: So I love the way that you address the situation, particularly for those people that are in a couple or identify with a partner. [SPEAKER_00]: So how do you see, because for me, [SPEAKER_00]: two decades ago, I felt like I was alone on an island and people thought I was crazy to start a sexual healthcare practice in Cincinnati, Ohio. [SPEAKER_00]: And so for me, I'm seeing it now

in continuing medical education. [SPEAKER_00]: I'm seeing it finally on main stage. [SPEAKER_00]: I'm seeing it in shows that we were actually talking about, you know, female sexuality. [SPEAKER_00]: There's a documentary about women's sexual health care. [SPEAKER_00]: female sexuality, so I'm really excited, we still have a lot of work, but what does the future of sexual wellness look like for you? [SPEAKER_01]: Well, first I want to give a little plug and shout out to modern sex therapy institutes where I'm the associate director there and we train therapist to be sex therapist so that more therapists in the world are having these important conversations and they're not this this duality between sex and self. [SPEAKER_01]: So I

loved that. [SPEAKER_01]: Yeah, more education in general and people thinking through the sex positive lens. [SPEAKER_01]: The future of sexuality for me, I know you probably want one word, but I had to go with two. [SPEAKER_01]: So the first is shameless. [SPEAKER_01]: Love it. [SPEAKER_01]: I want a shameless world. [SPEAKER_01]: When we can own what we want that to your question earlier, not based it on the movies, not based it on porn. [SPEAKER_01]: not based on the culturally prescribed expectations of perfection, it's shameless, it's the opposite of shame. [SPEAKER_01]: Obviously, my next word is integrated, and by integrated, I mean again, this idea of non-dual, there's not myself over here and me having sex here,

it's one and the same. [SPEAKER_01]: So we have this cohesive model of I am a sexual being and from that place of truth, [SPEAKER_00]: I love that. [SPEAKER_00]: And yes, of course, you can have two words. [SPEAKER_00]: So what is your best piece of advice for someone listening at home who is feeling completely disconnected from their body? [SPEAKER_01]: So first, I would love for her to slow down if she can. [SPEAKER_01]: She really needs to come back into relationship with her body that is going to look different for all of us. [SPEAKER_01]: I have rarely seen a woman being relationship with her body where there is not movement involved so some form of movement practice,

whether it's hiking, whether it's dancing, whether it's running, whether it's swimming, whether it's rope, yoga, like some form of being present in my body, again without a ton of expectations. [SPEAKER_01]: The other piece I wanted to add to that, I love women getting in touch with their bodies where it's something that they wouldn't normally do. [SPEAKER_01]: When we can remember the humility of the body, like the kind of the humor and being in a human body, [SPEAKER_01]: There's nothing I love more than laughing at myself. [SPEAKER_01]: So I've recently taken up pole dancing. [SPEAKER_01]: I am so bad at it, but it checks the box of doing something with my body, something sexy, and something

a little bit naughty. [SPEAKER_01]: Like I am built completely wrong to be a pole dancer, I'm built like a spider monkey, and it's quite an entertaining experience. [SPEAKER_00]: So I'm laughing with you because in the green room at a medical educational event for women. [SPEAKER_00]: There were a bunch of speakers back stage talking about holding and saying and how empowering it was. [SPEAKER_00]: And some of them, I love them, they're so fun, but I would have never guessed. [SPEAKER_00]: And it's not a judgment by any means, I think that's super cool, but they were all talking about their heel sizes and, um, but people in the audience would have never guessed that these esteemed women

were pole dancing, and I think it's great that they can have fun with their sexuality, they can express themselves, and they get to know their body, and I think it's super sexy. [SPEAKER_01]: Yeah, I can't even choose that would be a disaster for me. [SPEAKER_01]: So really, it's not stripping. [SPEAKER_01]: So for your listeners, it's not stripping. [SPEAKER_01]: It's literally the art of poll and just feeling strong and capable and a little bit sexy sometimes. [SPEAKER_00]: Yeah, um, absolutely, uh, and a great form of exercises as well. [SPEAKER_00]: Yes. [SPEAKER_00]: You're essentially lifting your own body weight. [SPEAKER_00]: Yeah. [SPEAKER_00]: Yeah. [SPEAKER_00]: So good for your bones, too. [SPEAKER_00]: Um, I want the audience to

know where they can find you, where they can keep up with you and what you're up to next. [SPEAKER_01]: Oh, my gosh. [SPEAKER_01]: So finding me, um, my website, Dr. Holly Richmond.com. [SPEAKER_01]: And social media, Dr. Holly Richmond, DR, H-O-L-O-Y, R-I-C-H-M-O-N-D. My website is being updated, but you'll get there and offering intensive, retreats, individual therapy, lots of different experiences, and the education through modern sex therapy institutes. [SPEAKER_01]: So I would love to hear from you all any questions, any way that I can help and support. [SPEAKER_00]: Thank you from being such a bad ass disruptor and for taking the time to be with me today. [SPEAKER_00]: I appreciate it so much. [SPEAKER_00]: Thank you so

much. [SPEAKER_00]: Thank you everyone. [SPEAKER_00]: Your body is not the enemy. [SPEAKER_00]: It is the vessel for your power. [SPEAKER_00]: I want you to remember that and I want you to tag and send this episode to a disruptor in your light. [SPEAKER_00]: This is more than a conversation, it's a call, a call to build something better. [SPEAKER_00]: Subscribe, share, and bring more disruptors into this room. [SPEAKER_00]: For unfiltered insights and bold ideas, go to drsomeet.com to sign up for the monthly disruptor newsletter and follow us on social at drsomeet. [SPEAKER_00]: We're not waiting for a seat at the table, we're building our own table.