Melanie Cole: Welcome to conversations with MIT Health, I'm Melanie Cole. Joining me today is Joanna Goldsmith. She's a licensed independent clinical social worker at MIT Student Mental Health and Counseling Services. She's here today and anxiety and share resources for understanding and coping with one's own anxieties around sex. Joanna, thank you so much for being with us today. Let's define this. People may think it's pretty straightforward, but I don't really necessarily agree. What do we mean when we say sex? Does it have different definitions?

Joanna Goldsmith: yes, absolutely. And thank you so much for having me. I will say that there's so much to talk about when it comes to sex and sexuality, and today I'm really going to be focusing mostly on anxiety as related to this. And here at student mental health and counseling, we frequently work with students who are experiencing anxiety. This can be related to relationships, academic work, family issues and certainly sex. So before we start, I do think it's really important to define what we mean by.

There's such a range of sexual activity that people engage in either alone or with a partner or partners. And maybe you were someone who was fortunate to grow up with really progressive and sex, positive education when it comes to sex. But if you're like many people you may have only learned about. In terms of pregnancy prevention. Pregnancy prevention is super important. But pregnancy only happens from one way of having sex. So this leaves out many, many people.

I'm gonna offer some really general ways I'm considering sex. And I really encourage people to think about it on their own terms. So certainly sex can involve intercourse and that can be oral, digital, anal, vaginal, masturbating can be sex with oneself and it can also be a partnered activity. And sex really involves the entire body. So think about the skin as a sex organ. What people desire and find erotic really is so individual. And so are the ways in which people have sex.

Melanie Cole: Well, that was a very comprehensive answer. And thank you. So let's talk about some of the common anxieties that people experience when. Relates to sex because I know there's a lot of, you know, there's been talk in the last 20 years and we've heard about sex therapists and all of these things. There are so many different anxieties now, speak about some of those.

Joanna Goldsmith: Right. So I think it's really important to also acknowledge what informs our views and attitudes towards sex. A lot of this has to do with culture, religion, and family. So sometimes having an understanding of one's sexuality and having experiences of can come into conflict with how we were brought up. And this can understandably create a lot of anxiety. In the mental health field, we want to support people in understanding themselves better and also honoring where people come from.

We know this is especially true for folks who are part of the LGBTQIA community, or who are wondering if they might be and have real concerns that they will not be supported by their family or community. And this is of course, further complicated for people who hold intersecting identities. So we have to think about how does having a marginalized identity impact someone's sex life. I think anxiety also stems from cultural pressure in having had certain sexual experiences. So, someone feeling like they have to know exactly what to do when it comes to having sex.

And that can come with shame when you believe that you are not meeting an expectation and we can think of lots of reasons why this is the case. Ideas about what sex is and should look like and what you should be doing come from the media and popular culture. And of course, pornography, I really encourage people to be savvy consumers of the media. And to really work towards separating what is presented on screen from what is reality. And this can be really tricky for people.

A lot of what people see in the media too, is sex that is very influenced by Western culture. So people who are thin, white, able bodied, cisgender and heterosexual. So if you are not seeing images of sex that represent you, which is going to be most people. Then it makes sense that you would have some anxiety about how you are supposed to engage sexually.

Melanie Cole: Well, that is so true. And generations of women specifically that didn't even acknowledge sex for so long. And as you pointed out, so many of those, you know what we're. Seeing in the media and the views of our bodies, our sexual needs, our insecurities. The negative self talk that so many of us give ourselves, we look in the mirror at our naked body and go, Ugh, so all of these things you've just mentioned tied together, are there some triggers, things that we can identify so that we know if we are someone experiencing sexual What questions would you suggest we ask ourselves when we're exploring our own anxieties?

Joanna Goldsmith: Right. That's such a good question. So I really challenge people to think about what are the assumptions that you're making in your mind? So what are you thinking that other people are doing and what does it mean to think that you should be doing something? And part of answering this question really has to do with knowing yourself. Knowing what you do like sexually knowing that you can communicate that to a partner. And of course also being okay with possibly not knowing.

And not knowing it means that you're figuring it out and you can do that collaboratively with somebody it's a really great way to get consent, to be able to communicate to a partner, I'm willing to try this and I will let you know how it's going. I think a lot of people have this concern about being experienced enough, which I think is a version of the question. Am I going to know what to do? If I have sex with this person? And my response is that experience is not nearly as important as communicating with your sexual partners.

And if you've not had sex with someone before experience, doesn't matter because you've never experienced sex with them. And is often the case in therapy, there's this big difference between knowing something and having an internalized experience of it. So it may take time to just feel like you know this in your body and not just your mind. And I like to quote sex researcher, Emily Nagosky who says we have to really engage non-judgmentally with how we feel. So if we feel bad about being anxious, it's going to be much harder to enjoy sex.

Melanie Cole: As we're talking about our own sexual anxieties. It's our partner that's experiencing that. The one that's feeling that anxiety. I'd like you to kind of compare and contrast and give us a little bit of your best advice on if it is someone that we love our partner, how we can help them while also helping ourselves.

Joanna Goldsmith: Sure. That's such a great question too. I think it's important to really intentionally make space to listen to your partner. And if it's anxiety related to sex, then I would suggest making that conversation a separate conversation then like during a time where you might be anticipating having sex or you are engaged intimately. Like take sex out of the picture for that conversation. And really being, be open and willing to listen to what, how does someone's anxiety show up?

What does the fear that drives that anxiety? What might be something that you as a partner can do to help in that moment? Is it just listening? Is it asking more questions? Is it working toward a solution with them? So just really have an openness, and recognize that someone bringing their anxiety and vulnerability to you is a really brave act and probably means that there's a lot of trust there.

Melanie Cole: What a great point you made about separating it from the actual time of intimacy to a separate time, to a separate conversation to really bring it out in the open. As we get ready to wrap. When do you feel it's important that somebody seek help in this context regarding trauma, violence? Can you share some resources for what we've been discussing today?

Joanna Goldsmith: Yes. Absolutely. If you are someone or you have someone that you're concerned about as being someone who has experienced some kind of sexual trauma or sexual violence then absolutely, coming to student mental health and counseling is a great resource for you. At MIT you can also have the support of violence prevention and response. So they're going to work with people who have experienced trauma and violence, or are wondering if they have and they're gonna be able to get you appropriste support and support you in the process should you decide that is what you want to do.

They can also connect you to pleasure educators who are peer educators at MIT who are really trained to handle like all sorts of questions related to six. And again, today we're talking about such, such a small topic about such a big thing. And also just for general wellness, there's community wellness and they offer general stress management. So, we know that managing, you know, stress in all areas of your life will have a positive impact on your sex life. So just getting some tools for being able to manage stress, incorporate more mindfulness is a healthy approach as well.

Melanie Cole: What great advice this. Such an informative podcast. Thank you so much, Joanna for joining us today.

That concludes this episode of Conversations with MIT Health. Please visit Health.mit.edu for more information and to get connected to one of our providers. Please remember to subscribe, rate and review this podcast and all the other MIT Health podcasts. I'm Melanie Cole. Thanks so much for joining us today.