If you’re in a same-sex relationship, do the rules change? Or are there universal principles of relationship that foster intimacy and passion no matter what kind of relationship you’re in? Today’s guest is Rick Miller, author of Mindfulness Tools for Gay Men in Therapy and Unwrapped: Integrative Therapy with Gay Men. Rick Miller has also been featured at the Couples Conference, and is on the faculty for Esther Perel’s Sessions Live 2018. Rick and I chat about the unique challenges faced by same-sex couples, particularly gay men in relationship. How do you address the uniqueness, while at the same time staying true to what we know about what works in relationships? In this far-ranging conversation, we cover the particulars as well as what we can all learn from how to have a successful same-sex relationship.

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Neil Sattin: Hello and welcome to another episode of Relationship Alive. This is your host, Neil Sattin. We've had so many relationship experts on this show, and there have been times where we've talked about the principles of relationship and whether they apply or not to everyone, and particularly to same-sex relationships, are there these universal rules of relationships that apply? And up until now, the best answers we've come up with have been things like, "Well, yes, of course." But it's not necessarily based on any empirical evidence, or just a statement that's... And of course, these things apply to same-sex couples as well, you just have to make a few adjustments, that sort of thing. So, you hear that enough times and if you're me, you start to wonder, "Well, what is different?" I think it's important that we know, both for you, if you're listening and you are in a same-sex relationship, and I think there's something for all of us to learn as we learn about each other in this world, in this project that is so important, of just understanding other humans, and how we operate and recognizing that we don't all think about the world in the exact same way, and we don't all have the same kinds of experiences.

Neil Sattin: So today's conversation is meant to be helpful on so many levels, and I hope that it is. We have an esteemed guest with us today, his name is Rick Miller, and he is a clinical social worker from the Boston area, who I found out about when I was chatting with Jeff Zeig about this topic, and you may remember Jeff Zeig, he was on the show back in Episode 102 and in Episode 114. We were chatting about, "Well, who would be an awesome person to have on the show to chat about this?" And he mentioned Rick, who among having presented at the couple's conference on this topic of gay male relationships, he's the author of, Unwrapped: Integrative Therapy with Gay Men: The Gift of Presence, which is a book primarily for therapists, and then another book, Mindfulness Tools for Gay Men in Therapy. Both books are amazing in helping you really wrap your brain, and I think that's kind of ironic, right? 'Cause we're talking about unwrapping. But it helps you wrap your brain around just how different this experience can be, and also where the similarities lie.

Neil Sattin: So, I'm really excited to have Rick with us today to talk about gay male relationships. We will as always, have a detailed transcript of today's episode, which you can get if you visit neilsattin.com/miller, as in Rick Miller, M-I-L-L-E-R. Or you can always text the word, "Passion" to the number, 33-444 and follow the instructions to download your transcript. I think those are all the details, so let's dive in. Rick Miller, it's such a pleasure to have you with us here today on Relationship Alive.

Rick Miller: Thank you for the great introduction!

Neil Sattin: You’re welcome! So Rick, perhaps a good place to start is this question of where we all might share principles of how to have an amazing relationship in common. Then from there, we'll go into the places where we diverge. What do you see as the principles that hold true, no matter who you are in trying to have a successful relationship?

Rick Miller: I do believe that there are universal principles that are a part of every intimate relationship, and some of them include vulnerability, self-expression, expression of intimacy and sexuality, dealing with conflict, dealing with trust, dealing with betrayal, so many things like that. I think what's unusual for male couples is that they were raised as boys and as men. So the development of the gay male is different from a man and a woman who end up being together.

Neil Sattin: Yeah, and it also, from reading your book, Unwrapped, I was struck by not only are gay men raised as men, but then there's also this underlying dichotomy or tension between being raised as a man and what it's like to grow up gay in a world that doesn't fully support people who are gay.

Rick Miller: Yes. So I have a lot to say about you're pointing this out. First, and most important is that for the majority of gay boys growing up, they know that they're different, they feel different, they feel ashamed of being different, on some level they're attuned, probably unconsciously attuned to their parents and their society, aware that they're not the child that their parents want them to be. So by the time they reach adulthood, they've learned to constrict themselves and they've become masters at hiding. So, what do you do in an intimate relationship when you've been accustomed to being so hidden all these years? And then suddenly it's expected that you'd be communicative, open, unguarded, and all that stuff.

Neil Sattin: Right. Where those are really the essential ingredients in staying connected when things get challenging?

Rick Miller: Yes, yeah.

Neil Sattin: Yeah, it's a great question. One thing, one nuance that I really appreciated that you brought up in your book was that it comes even literally down to how I might feel in my body and distancing myself from that. So that even that might be a challenge to overcome, this feeling at home and at peace in my physical experience.

Rick Miller: Absolutely. One of the points in the book, and a lot of the work that I do, and the trainings that I do is that gay men and gay boys dissociate from their bodies because their bodies are dangerous to them, partially because of the conflict of growing up gay and feeling disenfranchised and shutting that off, or partially because many gay boys are not good at athletics, and they don't trust that their coordination will get them where they want.

Neil Sattin: So there's this need to build trust with your body?

Rick Miller: And so many people don't even recognize this tension that I'm describing, and I do a lot of hypnosis with my clients, which is a really fascinating process and a part of what it includes is relaxing, going inside, noticing what's taking place inside the body and creating space for openness, warmth, and resourcefulness. Frequently, what comes out for many gay men is that they've been tightening themselves and hiding themselves and dissociating themselves without even realizing that they've been doing it because it's their automatic go-to place for day to day life.

Neil Sattin: So listening right now, how would I know? How would I know if that is part of my normal state of being, and I wasn't even aware that that was happening for me?

Rick Miller: Well, the easiest way to know is simply to take a moment and put your attention inside of yourself in your body and notice what is your breathing like? How are you holding yourself in this very moment? Are you tightening up a particular part or a particular place of your body? What are your neck and shoulders like in this very moment? Even as I'm asking you these questions, what are you noticing? So if you'd like to be the guinea pig, perhaps you can answer these based on your own observations.

Neil Sattin: Yeah, well, I'm happy to be a guinea pig, and what I was noticing was just as you were talking, that there was a smile developing on my face.

Rick Miller: Nice.

Neil Sattin: And at the same time, I always feel a little... It's a combination of nervousness and excitement as these conversations get underway. I was feeling that like an unevenness to my breathing as opposed to just like a regular, smooth breathing. Yeah.

Rick Miller: So one of the lucky things is that our cameras are not connected to each other, so I can't make any observations or have you here. So I'm gonna go at face value with what you're saying. I like the openness that you have, that a smile can come to your face. And if I were sitting across from you, I might point out little things that I'm seeing, and ask you to make slight adjustments, and all that kind of thing. It's exciting. What's interesting about really being attentive to the body is that there are so many answers that we have available inside of us that many of us don't even pay attention to.

Neil Sattin: Yeah. Yeah, and it's coming to me really clearly right now and just so you know, and you listening know this, this is not planned, but I just became suddenly aware of how when I was reading your books and getting prepared for this conversation what it was like to grow up in this world, and I'm a product of the mid to late '70s and the '80s, I was born in '74, now I'm truly dating myself here and recognizing in relation to this dialogue, what my experience was, which is, I would not say that I'm gay and yet at the same time, I did experience a lot of, I think more things that might be considered more feminine and more connection to emotions. I'm realizing now just how much the fear of being labeled a certain way impacted me in terms of being fully in my expression of who I am. I wouldn't say that's the case for me now, but I think what came up for me was even a little bit of grief in recognizing like, "Oh, yeah, this was actually an obstacle for me in truly connecting with myself and with the people around me because I was afraid, afraid of being labeled."

Rick Miller: I totally appreciate your openness in talking about this, and I think the experience of feeling different or even being noticed as being different is universal for people, but everyone has their own reason why. You strike me as a male who is sensitive and able to be open. That, especially back then in the '70s was perceived as possibly being gay. Fortunately, we live in a time now where being an expressive man is no longer a curse of being gay. It's allowed, it's encouraged. I'm very interested in the whole topic of masculinity in general, and what straight men can learn from gay men and what gay men can learn from straight men and how gender can be so fluid at this point in time.

Neil Sattin: Absolutely.

Rick Miller: Times are exciting and things are changing. The problem is, is that many gay boys who grew up in the era that you're referring to, or gay boys growing up now who live in very conservative areas still have the same difficulties that I grew up with and that you grew up with.

Neil Sattin: Yeah, yeah. And even in parts of the country that are more liberal, I wouldn't say that, it's not like homophobia has been eliminated or discrimination, or just even people's maybe unconscious but still expressed biases around same-sex relationships in society.

Rick Miller: Well, I'm glad to hear you say it because I do a lot of training, and frequently people come up to me and say, "The world is so much better. Why are you doing these workshops? Gay men don't have to worry anymore. Everything is fine." On one hand, I guess many gay boys or gay men don't have to worry about being killed or being abused, but it's still an issue. People are still struggling and my premise, as you know, is that people are struggling without even realizing how much they're struggling. That's my job as a psychotherapist when I work with people, but it's also my job as an educator to let people know that deep down, there are still parts of the self that are vulnerable and protective.

Neil Sattin: Yeah, so that brings us back to where we were, which was this inner inquiry and experience of our bodies and how that would show up if we were shutting down or having ways in which we are hiding our experience.

Rick Miller: So sometimes it's a physical sensation that people are aware of. Sometimes it's a thought that comes up in the mind, or sometimes it's an image, our ability to use imagery is pretty profound. There are moments where things just pop into our awareness and we may not understand why or what it means, but if we dig a little bit deeper, we can usually make sense out of these things.

Neil Sattin: There's something that I love about hypnosis, among many things, and one is the way that it gives our inner world permission to communicate with the outer world. So there's something about that inviting that you just mentioned that is I think is so powerful. It's the willingness to just be open and then to experience what comes your way as a message and what does that message tell you.

Rick Miller: Well, what a beautiful way of describing hypnosis. Given that so many people are afraid of what's gonna happen and what they'll end up doing. Excuse me, it's pollen season in New England. So, the way that you described hypnosis was so non-threatening and so inviting, so I love that. As I do hypnosis with gay men, again, the constriction that has been part of their lives suddenly transforms itself into a beautiful openness and a self-reliance that is incredibly magical just to see.

Neil Sattin: Yeah. So I would love for you to share with our audience why you've been using hypnosis as a therapeutic tool, and in particular the tension between like why using hypnosis is so helpful? And on the flip side, why someone might resist wanting the experience that hypnosis is giving them?

Rick Miller: Sure. I forgot the first question. The first question...

Neil Sattin: Yeah, the first question is, what is it about hypnosis that you've found to be so valuable in working with clients?

Rick Miller: So I've always done guided meditation and guided imagery, and I never got formal training in it, and yet I was doing it with my clients and amazing things were happening. So when I decided to get more formal training, it was based on some of my friends that loved hypnosis, that I ended up pursuing it. What I realized as soon as I started doing it is that it's something that we all know how to do, and it's something that we do in our day to day lives over and over and over again without realizing it. For example, when we hear an old song on the radio and we immediately begin to have flashbacks about where we were, how we felt, who we were with, what our lives were like, that's one example. Another example of being hypnotized by ourselves is a scent. So today is a spring day and I can smell the pollen and I can smell that beautiful spring afternoon, and suddenly I have memories of being a child late in May as it was getting warmer outside, and I'm flooded with amazing memories. So that's another example of being hypnotized. So when I work with people in hypnosis, I'm helping them achieve a state inside of themselves, or to shift a state away from unpleasantness into comfort, or pleasantness or resourcefulness.

Neil Sattin: And how does that makes such a huge difference particularly for gay men who are dealing with maybe this problem that we were talking about initially, which is around dissociation from their physical experience?

Rick Miller: I think in general, anyone who is open to trying these things will love hypnosis, whether you're a gay man or not a gay man, but given how limited our experiences has been as gay men to be able to go inside and recognize that enjoyment is there, is revolutionary. The other generalization about gay men being men is that many gay men are type A, over achievers, and have compensated for feeling inadequate by overdoing things in the work setting or in academic settings and of course, the price that we pay to do that is not always paying attention to what's happening inside. So having the opportunity to slow down to connect with oneself is a pretty important gift, and it's overlooked way more than it ought to be.

Neil Sattin: Yeah. And you talk about that in terms of hypnosis and Milton Erickson and his viewpoint that all of his clients had the resources within them to do whatever shifting was necessary in their lives.

Rick Miller: Correct.

Neil Sattin: It also reminds me a lot, and I think you talk about parts work as well. It reminds me of Dick Schwartz in Internal Family Systems. Again, all about enlisting our inner resources to come online so that we don't feel like we're deficient in some way.

Rick Miller: So, let me say a little bit about parts work.

Neil Sattin: Please.

Rick Miller: Which is, inside of us are all these different parts. We're so busy living our lives trying to either be our best self, or trying to ward off parts of ourselves that are unformed or more primitive and the harder we try to push something away inside of us, the more it comes out in a way that we don't want it to. So in doing parts work, what we do is we welcome all parts of ourselves that exist inside. And as a psychotherapist, what I do is I work with people to have them bring these parts forward to allow each part to have an equal voice, the part of yourself that does greater work, the part of yourself that feels like an awkward adolescent, the part of yourself that feels like a five year old who's naughty because you know that you're different from other boys and I'll ask each part to recognize what they need or what they experience, and with this is a sense of integration and from this, there's a sense of well-being and mental health that is absolutely necessary.

Neil Sattin: Yeah, I love it. Let's bring that now, imagining that we've miraculously totally resourced ourselves [chuckle] in the past 15 or 20 minutes, and let's bring it to the question of relationships. We started out with identifying some of the universal principles underlying relationships, the ability to be vulnerable, to be courageous, to be who you are, to repair in conflict. What have you noticed that's particular to relationships between men that is different, or that makes their particular situation challenging in a way that a heterosexual couple might not experience?

Rick Miller: So the first image that comes to mind is, "How many gay male couples have arrived at my psychotherapy office sitting on opposite ends of the couch?" Of course, any couple can do that, but there's a particular way in which men can kinda shrink in and hope to disappear, which of course doesn't happen in a couple's therapy office and the ability to be tender and vulnerable and to listen carefully and closely as opposed to providing quick and instant solutions is something that a lot of men struggle with. The other thing is that men, as I said, are not experts at allowing vulnerabilities to come to the surface. So when you're in a male couple with two men who are fighting vulnerabilities, it's hard to know what to do when one or both are either feeling conflict or feeling scared. Another common issue that comes up a lot is that men frequently are lacking role models about how to be tender and intimate and loving towards their partners, and having growing up in a world of masculinity, it's not considered cool to do those things. But then suddenly when you're in an adult relationship, it's one of the necessary ingredients for a relationship to flourish.

Neil Sattin: Now you also talked about the impact of the mythology of gay culture, and as I was reading about that I was thinking about, "Yeah, that must be so challenging to on the one hand be part of this larger culture that looks at you one way, but then to have this idealized version of what it means to be a gay man that you also might not fully resonate with, but it at least gives you a place to go."

Rick Miller: Well, there's a lot of pressure to be a certain kind of gay man and what's interesting is that before we had the internet or phone apps, being gay perhaps was more regional. That we were informed by where we lived and how people did things where we lived. Now, it's a worldwide experience and gay men are looking at other gay men all over the world and the pressure to be young, to look a certain way, to be professionally successful is what is driving many men in their desires to be successful. The problem with that is that many men are very successful in a variety of ways, but they don't feel like they measure up to this gay-male standard. It's a lot of pressure and frequently men will buy into this without even recognizing that it's what they do.

Rick Miller: So when I do trainings, frequently people will raise their hands and say, "Well I have many gay male clients that live outside of the city, and they live in rural areas, and they don't buy into what you're talking about." and I'll come back and challenge them by saying, "Do they go online? What are they looking at? What are the pornography sites that they're looking at? What are the websites that they're going to as gay men were they being informed about what their life ought to be like as a gay man?" I make the comparison of how women will look at fashion magazines regardless of age, regardless of their size, and then experience this uncomfortable feeling inside of themselves based on not meeting those standards.

Neil Sattin: Yeah, and how do you help a couple who were maybe one or both members of the couple is struggling with that issue? How do you help them support each other in finding who they really are in the midst of all of that?

Rick Miller: Well, one of the things is to verbalize what I just said to you about noticing how some of the pressure to be a certain way is coming from outside of themselves, and that they're internalizing that without even realizing it. So one of the gifts of being a couples therapist is that I get to help people shift their focus inward, and to be the person that they really are, and accept who they really are, rather than trying to be a stereotype of who someone is supposed to be. The other thing that I do, which is part of the same process as going inside, is helping people to identify what they want, what they need, what they expect from their partner, and to also learn how to give parts of themselves that they didn't know they could do or didn't allow themselves to do because it wasn't considered masculine.

Neil Sattin: Yeah, one thing that you mentioned, I think, in maybe the presentation that you gave for the Couples Conference that I can totally relate to, because I happen to think that just about everyone could use a bit of a sexual re-education. This idea that there's a discovery of what it really means to us as individuals to be healthy, to be sexual to... What gives us pleasure, what doesn't. And to really be able to explore that enough that we can take a strong stand for who we are in that, as opposed to just buying into some prescription that's been handed us.

Rick Miller: Part of the prescription that's been handed to gay men is that there are certain ways that we're supposed to be sexual and that we're all supposed to have open relationships and that every gay male cheats on his partner and that belief system reinforces something that may not necessarily be okay. If a gay male couple chooses to have an open relationship, that's their prerogative, but it needs to be done very carefully with a lot of questions and communication.

Rick Miller: The other aspects of sexuality that's very important with individuals and also with couples, is by being aware of sensory experiences. So here we are, going back in inward again, listening to the body. Each body, each person has their own preferences that feel good to them. Instead of having the norm of gay sex, have sex that you as an individual enjoy. What are the ways that you enjoy being touched? Where do you like being touched? How do you experience that? How do you like to give to each other, and what does your body tell you in these circumstances? Erection issues are common for all men and gay men tend to think that other gay men don't have erection issues. That's not true, but no one is talking about it because it's not a standard that's very cool to talk about. The harder you try to be sexual and pull off a great sexual act, the least likely you'll be able to be to have a great erection. It's like sleeping at night time. If you have sleep anxiety and you're trying to focus on sleeping well, you're gonna stay awake out of anxiety.

Neil Sattin: Do you have... 'Cause with what you were just talking about, and I think in this ideal world, we would be able to just be... Well, for lack of a better word, be innocent with each other and have that exploration. To me, the big word that leaped out when I was having that thought, was shame, and how shame becomes an obstacle to being a willing explorer.

Rick Miller: Yes. Yep, so shame, of course is a central experience for growing up gay. It's the backbone of one's being, and so as an adult, how do you rate yourself of something that's been embedded inside of you all this time? And so part of your approach in just being and finding comfort is a great way of working with shame and healing shame. So that's the good news about being in a relationship, is that the closeness and the tenderness that can be achieved is going to erode away these layers of shame. I also had an image of how men treat their animals, which is that they're able to speak in a high tone of voice. They're able to be very gentle, they're able to cuddle with them. Frequently partners will say, "If you treated me like you treated the dog, I would be so happy." and clearly, it's a less conflictual relationship. It's all about pure love, and for many men, they're not worried about being masculine with their dog. If only they could do the same with their partners, maybe they wouldn't need me.

Neil Sattin: Yeah, yeah, that's a really interesting thought that brings me in so many different directions. [chuckle] Yeah, I'm curious about one thing in particular that... And I'm just wondering if you can shed some light on this, because as you've described it, one of the key possibilities for someone growing up gay is this sense that, "There's something not quite right about me," or, "a shame about who I am," and I think in 'Unwrapped', you described a client who was struggling with this question of choosing a relationship simply based on someone accepting them and what it feels like to actually be with another gay man and be like, "Wow, it's actually okay to be gay," versus taking it to the next level where someone isn't just accepting you, they actually want what you want and you truly have a symbiotic relationship. Is this a common problem in gay relationships where someone might kind of settle because they finally at least feel accepted even if they're not really getting the relationship that they want?

Rick Miller: You're touching so many things that I could go in about 10 directions on [chuckle] but I think, again, the norms of the gay male sub-culture are such that gay men frequently are seeking out beauty over other qualities. The prize of a gay male is being with someone who turns heads and beauty is only skin deep, and what else is there? So in an ideal world, we don't just look for a partner who looks great on the outside. We look for a partner who complements us, who challenges us, who brings us tension and joy. One of the things I love about relationships is that there's an expectation that it's all smooth and hunky-dory and hearts and roses, when in fact, the truth about intimate relationships is that they're challenging, they're difficult, and there's a certain edginess that comes with this that's truly intimate, truly exciting, and keeps a certain freshness going. So this is much more about the insides of who we really are rather than how we appear on the outside or how people view us from the outside. I always say that every couple has their own particular hell that they keep secret from the rest of the world because they fear that if other people know, they're gonna blow the cover. But there is no such thing as a relationship that doesn't have this.

Neil Sattin: Yeah, and for someone who at one point relished the fact that they were accepted, but now is recognizing, "Oh, this isn't really a relationship where I'm being fully met, but I don't have hope that I could find what I'm looking for in another partner." How do you create a light of optimism there for those people?

Rick Miller: Basically, I will reassure them that the Hell that they're experiencing is normal. [laughter] So I have a timeline that I frequently tell people, which is that the first four months of any intimate relationship, not just men, is a time of such excitement and a time of great projection. During these moments, the rest of the world goes away when we're together and the other person is fulfilling all that has been unfulfilled, and it's so dreamy and it's so magical and obviously, there's a strong intimate and sexual component during this period of time. And around eight months or so, people really begin to see each other for who they really are, and this includes warts and all. So as people become more real, the challenges present themselves more and more regularly and frequently between this and about two years couples think that because this is happening, there's something wrong and a majority of people end the relationship because it isn't perfect when in fact, this is exactly what needs to happen.

Rick Miller: And when couples experience this, separating out their love and respect for their partner, along with what their hopes and expectations were, and experiencing disappointment, knowing that this is part of what the big picture is about, it enables people to move forward and really accept who they are, who their partner is, and what their couplehood is about. And that is what true intimacy really is. And so, again, going back to male couples, a part of this recipe is also in accepting our own limitations based on how we feel inside of ourselves, how we were raised, what was expected of us as men, and how to give a soft, intimate loving part of ourselves to another person when we haven't really been taught how to do it. If we use our mothers as our role model, then we're losing our masculinity. If we use our fathers as our role model, then we may have a struggle with how to be soft in these certain ways.

Neil Sattin: Yeah, that makes me think about the pull between the importance of attachment in relationship and creating safety and then the ways that we handle a lack of variety or things being maybe too safe in our relationships. Maybe this is a tension inherent in that stereotype that you mentioned. The stereotype that there are a lot of gay relationships where people have multiple partners or poly or open, and how that must be creating some tension and polarity with what's required to create a secure bond between two people.

Rick Miller: It's so fascinating to me that frequently gay couples come into my office and say, "I think we need to open up our relationship." And I'll say, "Why is that?" And they'll say, "Because we're having a horrible time with each other." Since when would opening up a relationship be the solution to a struggle that has nothing to do with the outside role that has everything to do with the two people working on these vulnerabilities? So I frequently try to slow people down and to allow their focus to be between the two of them and themselves long before running out and making life a little bit more complicated. In terms of thinking about attachment, what we expect and need from our partners is for them to have our back. Our partners become a safe haven in the world. Our partners become a representation of our parents, or they even become a representation of the ideal parent that we never had. So as our partners tolerate us and love us and care for us, they're compensating for things that we didn't get when we were younger. And frequently, partners, men and women, need to be taught how to do this in a context of couples therapy or in the context of educating themselves in order to be more fully available.

Neil Sattin: And when you say learning about how to do this, are you talking about really being aware that that is part of maybe the unspoken expectation in relationship and then deciding how you're gonna respond to that? Or will you be that ideal parent as much as possible? Or will you shine a light on that dynamic and try to dismantle it so that neither of you is putting that expectation on each other?

Rick Miller: No. I will shine a light on that dynamic saying that this is what it is, this is what a truly intimate relationship is, and that each person in the world that's in an intimate relationship has some challenges with how to be a parent figure to your partner, 'cause that's not how we go into it. So how do you learn how to do that and know what to do? And so that's what I mean, is that we all have to learn how to nourish and nurture other people, especially our partners.

Neil Sattin: Yeah. And what are your thoughts on how that creates... And I love this, we keep uncovering these little places of tension in relationship. Because as we show up more like a parental figure for our partners with unconditional love, unconditional support, not judging them, helping them through hard times, it sounds really great. At the same time, we potentially create a schism that makes problems with sexual polarity 'cause...

Rick Miller: Sexual polarity and all other kinds of polarity.

Neil Sattin: Yeah.

Rick Miller: First starting with a sexual polarity, how do you feel sexual toward someone that you've exposed so much of yourself to, and still keep things hot? And again, going back to sensations and sensory awareness is that sometimes what feels good sexually is a physical sensation, and people don't always pay enough attention to that.

Neil Sattin: Yeah. I wonder, are you familiar with Marnia Robinson's work?

Rick Miller: No, I'm not.

Neil Sattin: Okay. She was on the show, actually back in Episode 5, so a long time ago. She wrote a book called, Cupid's Poisoned Arrow, that's all about the biochemical effects of orgasms. And in particular, her whole thesis is based on this idea that if you have an orgasm, you're flooding your system with dopamine, and you're also creating this process by which you become desensitized to that dopamine and to your partner. So as we're talking about this and what keeps sexuality alive, it reminds me of her work because her whole thing is about how do you explore sexuality without orgasm in order to keep the sexuality alive and to keep the sexual chemistry going, as opposed to just repeatedly flooding your system with dopamine to the point where you're habituated to your partner and need to seek another person in order to get excited.

Rick Miller: So if you talk about gay men, gay men learn to be sexual as men, and of course, men's motive during sex is to have an orgasm. And frequently men have orgasms very quickly. So the suggestion that Marnia is discussing and that you're talking about, is something that I frequently assign to couples for homework. And it's very, very hard for people to actually do this, which is to spend a lot of time taking turns with each other and exploring each other's bodies without focusing on orgasm and without having an orgasm, so that they can really learn to identify other great feelings, how to give to each other, how to receive, how to instruct each other and to learn about what else feels good inside the body.

Neil Sattin: Yeah, and there's so much to learn there because I think for so many of us, men in particular, orgasms are a great way to dissociate from life and our pain and our shame and whatever stress we're feeling in the moment. So if that has become your gateway to sexuality, then you really do have to learn something new in order to give up the temporary relief and release that orgasms give you from something that we've been talking about for this whole hour is the question of shame and how that affects how we show up.

Rick Miller: I think one of the joys that can happen for couples, and I'm thinking about this a little bit more detailed as you've been discussing this, is how good it feels to be with a partner and to help him be able to have an orgasm and if both of your minds approach sex from a similar vantage point, then it's a sense of power and conquering that two people experience with the help of each other. That's a pretty amazing feeling and even if it doesn't last that long, it's a great metaphor for success in a relationship.

Neil Sattin: Yeah. How would you suggest someone when they're in a sexual situation with their partner and they notice shame coming up and starting to get in the way, their own sense of thinking that something going on with their body is gross or unacceptable? How would you suggest someone work with that in the moment with their partner?

Rick Miller: By exactly what you were just talking about and what Marnia talks about, which is to de-emphasize orgasm. I also ask people to not worry about whether they have an erection. Frequently, what happens is that as men feel vulnerable, either about how they feel physically about themselves, or how they're performing as a partner in comparison to how people are supposed to be performing, they lose their erection. And then, as they begin to lose their erection, just like the sleep thing, they worry about it and then their partner may get frustrated and then the mind takes over and they're gone. So really, what I have people do first and foremost is slow themselves down. It's okay if you lose an erection, it's okay to keep doing what you're doing, keep exploring the sensations and take a break if you need, and worry less, enjoy more, be in the present, allow expectations to drift further and further away 'cause they only get in the way.

Neil Sattin: I am so appreciative that you brought this up because another person whose work I so respect and admire, her name's Diana Richardson, you may have heard of her, she does a lot of work around Tantra. And her version of Tantra, she also calls it "slow sex", is all about just that, how you slow things down. One of the things that she talks about that I think is actually really missing from the common dialogue about what you do when you have problems maintaining an erection is this concept of, she calls it "soft entry." It's not the most glamorous term in the world, [chuckle] but it's this idea... Well, it's not an idea, it's a practice of if you don't have an erection, you can still get lubricated, and with the assistance of your partner, you can still actually be inside your partner even if you're not hard.

Rick Miller: That's great.

Neil Sattin: So you're overcoming this barrier and I'm making those finger quotes in the air around the word "barrier," you can overcome the barrier to intercourse by simply using some lubrication, some patience, and really gentle movement to actually penetrate your partner and to rest there.

Rick Miller: And what a difference that makes to not have to rush so quickly and how freeing it can be. I don't know the statistics, but what percentage of people then experience erections as a result of allowing themselves to softly enter and be relaxed?

Neil Sattin: Yeah, I wish I had the statistic on that. But...

Rick Miller: Good one.

Neil Sattin: I gotta think that it's a lot. It's a lot because what you end up giving yourself is that time and relaxation and the presence that you need to ignite that part of your system.

Rick Miller: Can I shift gears for a moment?

Neil Sattin: Please.

Rick Miller: Because I'm thinking of a specific couple that I work with, where one of the guys frequently would lose his erection because he felt as though he wasn't being as good or as strong of a partner as he ought to be and through some exploration in my office, what was clear was that expectations were driving their sex life and it was getting in the way. Part of being more real included talking about sex more, but also sharing fantasies. It was hard for them to do that because it was considered naughty for them to be talking about these fantasies and ironically, gay men love porn. So instead of keeping it out of the relationship, why not bring it in and share the enthusiasm about it to help things along? So this particular couple started talking more about their fantasies and sharing the visual images of the pornography that they really liked, and their sex life transformed itself really quickly because they were no longer keeping a part of themself a secret from their partner. Instead, they were bringing it back home and it worked beautifully.

Neil Sattin: Yeah, I love that and that sounds like a very healthy, strategic use of that kind of pornographic stimulation to bring a couple together.

Rick Miller: It was great.

Neil Sattin: I'm wondering though when you brought that up, it also made me think about... You used the word "expectations," their expectations of each other, and the ways that this is true across the spectrum now, especially because of the prevalence of pornography.

Rick Miller: Yes.

Neil Sattin: The way that people think they're supposed to be when they're being sexual.

Rick Miller: That's right.

Neil Sattin: And I'm wondering how you encourage people to abandon the scripts that aren't serving them?

Rick Miller: Good point. Everything goes back in a circle to listening to your body and the pornography industry is thriving, and people are pursuing it and losing fact of their own humanity as they're doing so. I'm saying that not as a moral judgement, but more as a mind-body clinician who wants people to function highly and successfully inside of themselves. Again, it all comes back to the body. I'm constantly slowing people down, asking people to notice what they enjoy, what turns them on, what their fantasies are, and to use pornography as a help or as an aid for themselves, rather than as a way of being in the world. And incidentally, another thing that's happening is that many men have an unrealistic view of what their penis should look like, because they compare their penis to pornography who frequently hire men who are very well endowed. These days, men are barely naked in front of each other, locker rooms are more segregated and separated, and men don't have an opportunity to see other men's dicks to realize that there isn't a problem there where they think it's their own problem that they feel ashamed about.

Neil Sattin: Right. Yeah, yeah. And even if you are seeing dicks, you're probably not seeing erect dicks, so...

Rick Miller: Right.

Neil Sattin: That's another place where you wouldn't necessarily know where you stack up against the average that's out there.

Rick Miller: It's kind of incredible how much private shame people are living with and not doing much about it.

Neil Sattin: Yeah. Yeah, and that makes me wonder in your book Unwrapped, you offer, for therapists reading that book, scripts to help them guide their clients through trance experiences, to give them that sense of safety and being alive in their bodies. Obviously, we can't do a hypnotic induction right here for the show. I'm wondering though, if you have some hints around language that partners could use with each other in a intimate situation, let's say, in the bedroom, language that they could use to help invite each other into that experience of being alive with each other, being present, or let's start there and then I'll maybe add on to that.

Rick Miller: Yeah, so I think language is actually too limiting, because what I'm imagining as you were describing this is a shared moment together where there's plenty of time, where maybe soft music is playing, where there's no rush, and the experience to enjoy is what feels good. And sometimes it isn't through words that we can convey to our partners what it is that feels good. We can take our hand and move our partner's hand, or we can move our body in such a way that communicates what feels good. So I guess I would use the word language in a very broad metaphorical way, which is to expand the language that we experience sensations, and experience, and expand the ways in which we communicate our pleasure in these sensations, so that our partners can enjoy what it is that we're enjoying, being perfectly clear to convey that we're enjoying it.

Neil Sattin: Yeah, so that's perfect. I love that notion of expanding language and expanding the ways that we're communicating in those moments. How about... And it makes perfect sense too, in the context of, that you said, I loved the soft music and I was kind of painting the picture for myself there.

Rick Miller: Yes. Yeah.

Neil Sattin: Too bad my wife is out in California right now.

Neil Sattin: And, but what about... Because now we're coming back to shame, I don't wanna end on shame, so but what I do wanna do is, there's gonna be this dynamic where if you're being really present with your partner in sex, then you're either gonna maybe have moments of shame that you might recognize in yourself, or as the partner you might perceive that something is going on with your partner, that your partner's experiencing shame. What, again, we'll use the word language but broadening it to mean how would you communicate in a situation where you notice that your partner is in shame about something?

Rick Miller: So this is when language really does come in handy. Frequently, what I suggest to people is if they don't need to focus on being sexual, don't worry about ending the act and ending in orgasm. Let it be. Let it be fine. Sometimes sex is great. Sometimes it isn't great. Sometimes it works. Sometimes it doesn't work. So with language what I suggest is when things are a little bit more neutral and a little more okay, to have a simple basic conversation about what it is that one is noticing, either in themselves, or observing in their partner and just converse about what it is that's coming up. And so, again, we've gone full circle to how we started today, which is to be able to talk openly and honestly about what experiences are taking place and what partners are noticing in themselves and in each other.

Neil Sattin: And is there something that you've seen as you work with clients around issues of shame, as like a common theme and for some reason, I don't know why this is coming up for me, but it's this question of something about my body that I don't necessarily like, as to why those things stick with us? Because intuitively, that doesn't make any sense. It's our bodies, they're... We were gifted these amazing vehicles for living in the world. Yet, sometimes they betray us, like you lose your erection when you wish it were there, or you fart at the wrong moment, or whatever it is, or your gut's a little flabbier than you wish it were. Do you see some commonalities around what makes those thoughts about ourselves sticky? And what the path is to letting them go?

Rick Miller: Yep. So first, about shame, what I frequently do will generalize the experience of shame as a gay man and remind people that this is a common universal experience. It isn't just you, this is what most gay boys have experienced and internalized while growing up. So, that's at the baseline, and then in the here and now in terms of body image or sexuality, again, focusing on sensation rather than images of perfection, figuring out why it is that people are experiencing a sense of self-consciousness and shame. I love doing this with couples. I ask them, "When your partner gains five pounds how do you feel differently about him? And how do you feel differently about your sex life?" And, for the most part, what happens is that people don't care. Partners don't care.

Rick Miller: At a certain point in the relationship it isn't necessarily the abs that are creating great sex, it's the connection, it's the way in which people communicate with each other, it's the way in which people give to each other, the way in which they're attuned to each other and they enjoy these sensations. That's what sex is, and that's what makes it nice. In all long-term relationships, beauty dies down in a certain way and being with the same partner has a certain level of predictability. So, regardless of how hot one is, or how one is perceived at the beginning of a relationship, over time that hotness shifts and changes into a much truer kind of intimacy. So again, we go back to expressing what feels good, aiming towards pleasing oneself and pleasing each other, and enjoying the moment for the moment, and enjoying the moment in the moment.

Neil Sattin: I love it. I love it. Rick, thank you so much for all of your thoughts, and...

Rick Miller: Absolutely.

Neil Sattin: And I think as we've been dancing, we are really weaving the sense of where there's overlap and where there isn't, and I feel like we've just covered such valuable terrain in today's conversation.

Rick Miller: Thank you, we could go on for hours, I'm sure.

Neil Sattin: We absolutely could, but in lieu of doing that, I would love for you to share what you're working on, how can people find you. Of course, we will have links to all of your stuff in the transcript and show notes, but I'd love for people to hear from you directly.

Rick Miller: Absolutely. So my website is rickmiller.biz, B-I-Z, rickmiller.biz. I'm working on a great project and maybe it's about how gay men learn to be intimate in the first place called, Gay Sons and Mothers. So it's gaysonsandmothers.com. I'm also on Instagram. I have a Facebook page, Rick Miller Psychotherapy+. I have a blog on Psychology Today called, Unwrapped. Where else can I be found? I think those are the main ones.

Neil Sattin: Great. Great. And you're obviously in private practice, so people can see you.

Rick Miller: That's right.

Neil Sattin: And then you're also involved in doing trainings for therapists as well?

Rick Miller: Yep, I do a lot of mental health conferences all over about working with gay men.

Neil Sattin: Great, and I think you mentioned that you have some coming up, the Brief Therapy Conference and the International Society of Hypnosis. So there're a couple ways, but you probably have your events listed on your website as well.

Rick Miller: I do, and I welcome any questions and any emails from people, so give me a holler.

Neil Sattin: Awesome. Well, Rick, thank you so much for your time again today. If you are interested in downloading a transcript, you can visit neilsattin.com/miller, M-I-L-L-E-R. You can text to the word "passion" to the number 33444 and follow the instructions, which will also help you download the transcript, and we'll have links to Rick's site and all the ways that you can get in touch with him and to learn more about his work. Other than that, thank you so much for being here on the show with us today Rick.

Rick Miller: Thank you very much. Take care.

Neil Sattin: You too.

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