Sometimes you just need simple strategies to give yourself a boost. In today’s episode, we’re going to cover ways that you can increase your sense of wellbeing and connectedness - by harnessing your own biochemistry to foster oxytocin production. This can all be done solo - no partner required (though you can do them with a partner too). Our guest, Dr. Jessica Zager, is a Pelvic Health Physical Therapist, and one of only 5 physical therapists in the world with an AASECT certification in sex counseling. Along with these simple oxytocin-boosting strategies, you’ll also learn a bit about how pelvic floor physical therapy can help with pain during sex. It’s a lighthearted conversation full of practical ways to keep you feeling good, and connected, that you can use whenever...but especially during these times of social distancing.

Click here to receive the Jessica Zager transcript!

As always, I’m looking forward to your thoughts on this episode and what revelations and questions it creates for you. Join us in the Relationship Alive Community on Facebook to chat about it! 

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Resources: 

Check out Jessica Zager's website to pick up her free cheat sheet to boosting oxytocin, and to find out more about her work.

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http://www.neilsattin.com/oxyboost Visit to download the transcript, or text “PASSION” to 33444 and follow the instructions to download the transcript to this episode with Jessica Zager.

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Transcript:

Neil Sattin: Hello and welcome to another episode of Relationship Alive. This is your host, Neil Sattin. It's an interesting world that we're living in right now with social distancing or sheltering in place happening in most parts of the world to combat the spread of COVID-19, the coronavirus pandemic that's affecting the world. And I think that there's probably not many of us who can escape the impact that it's having on the degree of closeness and intimacy that we're experiencing with the people in our lives. And if there aren't people in our lives, like if we're single or solo, or if we're separated from people who are important to us, then it brings a whole different dimension to it. Potentially, loneliness and missing out on the benefits of even just connection with close friends or going out on dates.

Neil Sattin: And then, of course, those of us who are cooped up together, that has its benefits and also the challenges as well. So it's an interesting time and for the past several weeks, I've wanted to give you a wealth of resources to help you get through this time, staying sane, staying connected, and feeling connected not only to yourself, but to the people in your life that matter. Today, we're going to cover a special subject. We've talked on the show before about oxytocin, which is sometimes labeled the love hormone. Maybe a bit of a misnomer if you really dive into the scientific literature. But what we do know about oxytocin is that it is one of the chemicals that is in our bodies, and is primarily responsible for pair-bonding and it is also a chemical that helps us feel really good, and when we are connecting to ourself or to others, we can enter into blissful states of transcendence which are different than the ways that we feel when we're focused on activities that are more dopamine-driven.

Neil Sattin: So a long time ago, in Episode 37, we had Sue Carter on the show, who is one of the leading researchers, who discovered oxytocin and its effects on pair-bonding. She was studying prairie voles at the time. But since that research has gone on to cover what happens within humans as well as prairie voles and if you want to listen to that episode, you can visit neilsattin.com/oxytocin. Now, I wanted to have someone new on the show. We were... This person actually happens to be a friend of mine, and we were talking the other day and she mentioned to me that she knew a lot of ways to foster oxytocin within us during these times of social distancing. So I thought it would be great to have her on the show to talk to you about these special techniques.

Neil Sattin: Her name is Dr. Jessica Zager and she's a doctor of pelvic health physical therapy. She's also a sex counselor and a sex educator. She is one of the five physical therapists certified by AASECT, which is the American Association of Sexual Educators, Counselors and Therapists. She is one of the only five physical therapists certified by them in the entire world, which is pretty amazing. And so, she's here to share her vast knowledge of this particular narrow topic, and we'll get also a sense of some of the other things that Jessica does as well. But she is, in my experience, a profoundly kind and generous soul who has lots to offer the world. I know that she does sex counseling for people who have pain during intercourse or who have trouble with desire or libido and arousal. She also works with people around gender identity. And she's friendly to... No matter where you are on the gender spectrum or the kink spectrum, she is a open-minded, open-hearted person who is doing great work in the world.

Neil Sattin: It's a pleasure to know her and call her one of my friends. And Dr. Jessica Zager, it's a pleasure to have you here today on Relationship Alive.

Jessica Zager: I'm so excited to be here with you, Neil. Thank you for that very generous introduction.

Neil Sattin: You are welcome and you deserved every word of it. I just want to let you know that we will have a transcript of this episode as always, you can get that if you visit neilsattin.com/oxyboost, that's O-X-Y as in oxytocin, and boost, B-O-O-S-T. And the things that we're going to talk about today, Jessica also put together a little cheat sheet guide that you can download, that'll have it all listed out in a condensed form for you and you can get that if you visit her website, which is drjzager.com, that's D-R-J, and then her last name, Zager, which is Z-A-G-E-R.com and you'll be able to download the free cheat sheet to all the things that we're going to talk about today to boost your oxytocin in a world where we have to stay six feet apart from each other.

Neil Sattin: And I was just seeing, Jessica, an article today that had this picture of people who were all hanging out on their... In their pick-up trucks, and in their backyards and they were six feet apart from each other. And apparently, this is not what they mean by social distancing. The idea is if you go out in the world, stay six feet from people. But you're not supposed to just like hang out with people staying six feet away from them. That defeats the purpose and you might still... We don't know enough to know if that over a longer period of time would expose you to something from that person or expose them to something from you.

Jessica Zager: Correct.

Neil Sattin: So it's really important, I think, to be observing these... What do we call them? Orders from on high? But they're really kind of orders from within, 'cause we're trying to take care of each other, and at the same time, we don't want to miss out on some of the most treasured aspects of the human experience, the ways that we feel connected to ourselves and to each other. And anyway, that's why we're here, so...

Jessica Zager: I think that's why this has been... One of the reasons why this has been so difficult for people right now is because we're in the midst of this global, worldwide pandemic, and we're being forced to be apart, and it's necessary, and it's beneficial, and then it's what we all need to do in order to help slow the spread, to, as they say, flatten the curve so that we're not overwhelming the healthcare system with as many hospitalizations and crisis situations at one time. But the drive for human connection is so strong that I think it's easy for people to do things, like you just said, and convince themselves that, "Well, as long as I'm six feet apart from my friends, we can hang out." But you're absolutely right, we don't know a lot about this virus, and we don't know exactly how it's transmitted. We keep hearing over and over again that if you are within six feet of somebody for 15 minutes, that puts you at a greater risk for catching the coronavirus. But we don't know about extended periods of time near others but greater than that six feet.

Neil Sattin: Right. Yeah. And I like what you're bringing up, that there's such a drive within us to connect, and I think for many of us, we don't realize just how pervasive... If we're people who are connectors, we don't realize just how much we get from bumping into a friend every so often, and getting and giving a big hug. Or if you're dating, that even if you're just going out and you don't have a steady partner, just that act of being out with someone is igniting something in us that helps sustain us.

Jessica Zager: Definitely. Whenever we are in close contact with people, especially people that we care about, to begin with, that will help to... Help our brains to start to release oxytocin. And as you mentioned, sometimes it's called the love hormone, it's also nicknamed the cuddle hormone, which I think is a little bit more accurate than the love hormone.

Neil Sattin: Well, the challenge, though, is in this world, it... The state of things as they are right now, it's challenging to do the things that would typically ignite oxytocin. But I'm wondering if you can talk a little bit about why we care, like, why focus on oxytocin in the first place? Why would we want to produce that within ourselves? And also I just want to mention to you listening that we're going to go over these things. We happen to be in a time of pandemic right now, but these are things that will be helpful for you no matter when you're listening to this episode, because they're the kinds of things that are always there as a resource for you to boost your own inner experience and reserves of the cuddle hormone, as Jessica was just mentioning. So yeah, why? Why do we care? Why do we want to boost oxytocin within ourselves?

Jessica Zager: When oxytocin is released in our brains, it fosters an increased sense of well-being and a sense of social connection, like, we're not just isolated beings that exist and are walking around in the world, that we're actually connected to a larger network of others. And so oxytocin helps to really drive that sense of connection to those around us, and I think that's really important, because part of that drive helps us to be responsible for caring about others in times like this. And so it's kind of a catch 22, but right now, the best thing we can do to care for others is to stay away from people, yet when we're with people, that's what helps us to care more about others and create that sense of connection with others.

Neil Sattin: Yeah, so it's super complicated, [chuckle] the intricacies and how we're interwoven with each other. And it also strikes me too that the ways that our desire for connection might lead us to choose irresponsibly if we really start to feel like we're at a deficit, that I could see that being another reason why we might want to supplement our internal production of oxytocin so that we aren't doing anything stupid for the sake of a hug or a cuddle.

Jessica Zager: Yes. And there are many, many other benefits that are derived from oxytocin that can help us get through this time of social distancing and fear and worry about our loved ones and ourselves. So it also helps to decrease our blood pressure, it helps to decrease our anxiety in general, it helps to mitigate stress levels. So oxytocin is actually released during stressful situations to help counteract that stress response, which obviously would be a beneficial thing right now.

Neil Sattin: For sure.

Jessica Zager: And it also... You know, you already mentioned pair-bonding, which that I think is a lovely benefit, but also maybe one that is difficult right now, [chuckle] but it helps to decrease our sensitivity to pain... And one of my favorite benefits is because it stimulates the parasympathetic nervous system, it helps to improve our gut motility and our gut health and relieve constipation. So as a pelvic floor PT, I love that.

Neil Sattin: Yeah. You have like the sneaky side benefit of helping keep people healthy and regular.

Jessica Zager: Exactly. And that just makes everyone feel better.

Neil Sattin: For sure. For sure. Can you talk a little bit about what you do as a... I know that it's only one aspect of what you do as a pelvic floor or a pelvic health physical therapist, what does that even mean? I know it's a very specialized thing that not a lot of people do.

Jessica Zager: It is. It's a specialized field of physical therapy that focuses on the muscles between your hips that are responsible for bowel, bladder and sexual function. And so, as a pelvic health physical therapist, I specialize in helping individuals improve and enhance their bladder, bowel and/or sexual function because oftentimes a lot of issues can be interconnected. For example, when I treat people with pain with sex, it's not uncommon to have constipation as a side effect as well, but we don't often think about our bowel movements being related to our sexual function. But as a pelvic floor PT, it really helps give me a perspective on how the human body works and not just as an isolated unit, but because I help people with sexual dysfunction and pain with sex, I'm also looking at their connections with other people.

Neil Sattin: Right. 'Cause it's not a... It's not a closed system, those things are often... We're being impacted by the people that we're with as well as whatever physical condition just happens to be occurring in our bodies.

Jessica Zager: Exactly.

Neil Sattin: Yeah. So... And just... You know, this is something that will... Maybe we'll have you back on the show to talk about painful intercourse, 'cause I know that that's a problem for a lot of women, having pain during sex. What... For a woman who's experiencing that and thinks like, "Well, that's just how it is," or "My doctor can't see anything wrong, like there's no irritation, there's no obvious sign of why I should be having pain." Like I've heard that from women in the past. Can you just give us a teaser of what is sometimes going on in a situation like that and how the work that you do can actually help?

Jessica Zager: Yes, definitely. So what you just said is a very common experience for women experiencing pain with sex, but I will tell you that pain is not normal unless it's a planned part of the sex that you want to be having. And so, pain during penetration, for example, or pain with clitoral stimulation is never normal. And so, if you are experiencing those symptoms, I urge you to see your doctor and they might... To be honest, they might not even know what pelvic floor physical therapy is, but in my experience, if you ask for it, you will get it. So most physicians, especially if they're scratching their head trying to figure out why you're experiencing these symptoms, are very open to referring you to pelvic floor physical therapy.

Jessica Zager: And when somebody comes to me from a physician who has been having pain with sex and there doesn't seem to be a known cause, there's always a cause, it just hasn't been identified yet. So it's not in your head. It's not something that, you know, is... You're doing subconsciously, and what I do as a pelvic floor PT is I will help to assess your pelvic floor muscles to see if there's something going on with the muscles themselves that are contributing to your symptoms. So when a gynecologist looks at somebody's vagina who's having pain with sex, they usually push, they move the muscles out of the way with a speculum to take a look at the organs. So they're mainly concerned with how does the cervix look, how does the uterus look, they might do a scan to see if there's anything going on that they can identify with the ovaries or if there are any cysts that they think might be contributing to your symptoms, but if they can't find anything wrong with the organs, then the next step should be referring you to a pelvic floor physical therapist who can assess your muscles to see if there is any increased tension in the muscle that is actually contributing to your symptoms.

Neil Sattin: Got it, and then I gotta think that someone here, I know the answer to this, but someone's probably wondering, "Well, what do you do, how do you actually treat that?" What's that experience like?

Jessica Zager: So what I do is when somebody comes to my office, I do an examination, but the type of examination that I do does not involve a speculum. I use one gloved lubricated finger either vaginally or anally, depending on where the pain is and other factors to first of all see how the muscles function. Are they contracting well, are they relaxing well, do they know how to alternate between the two, how strong are they, how coordinated are they? And so, I gather all of this information about the muscles and their function and then based on that information, there are often patterns of things that I see happening when somebody has pain with sex, usually there can be increased muscle tension, there can be trigger points in the pelvic floor muscles, just like you can get trigger points in your shoulder if you sleep on one side for too long at night or you sleep with your arm up and then you wake up with a knot in your shoulder and a headache for the rest of the day.

Jessica Zager: The same thing can happen in the pelvic floor. And so as soon as we can identify what's going on, we can then address that specific component of the muscle function and treat it. And so I use a lot of manual techniques, using my hand, sometimes we'll do something called dilator therapy, which involves using graduated sized wands in the vagina to gently stretch the muscles. I also do dry needling in the pelvic floor and to trigger points, and that can really be beneficial as well.

Neil Sattin: Wow, so there are all kinds of possibilities for how you would treat that. And we said beforehand that we weren't going to go down this road, but it's so interesting, here we are. And if people are listening, and this is impacting them, I guess I want them to have a sense of what the course of treatment is like. So what you, everything that you said is super helpful. Do people recover, like people who have had pain with sex and had it, not known what's causing it and been able to work with the pelvic floor physical therapists. Do they get to a place where they don't experience pain during sex?

Jessica Zager: Yes, they do, and it's usually very, very successful. So I highly encourage anybody that's having pain with sex to please build up the courage to see a pelvic floor PT. I know it takes a lot of guts to go, 'cause this is a very emotionally charged type of pain and the idea of this therapy can sound very foreign to a lot of people because they haven't ever experienced anything like this before, but I will tell you that the people that come to pelvic floor PT almost always get better when it comes to pain with sex. So if this is something you're really struggling with, I highly encourage you to find a pelvic floor PT in your area.

Neil Sattin: Great, great, I'm glad that we... I'm glad we talked about that. And now, when I have a weird pain down there, I'll just know that I slept on my pelvic floor funny and...

Jessica Zager: Exactly. [chuckle]

Neil Sattin: I just need some treatment.

Jessica Zager: And this is worth being said too, but men also have pain with sex, and I treat men as well as women, so it's not just women that have pain with sex, men can also have pain with sex as well. But again, that could be a whole other podcast.

Neil Sattin: I was wondering about that, I can imagine that would also potentially impact their erectile function and...

Jessica Zager: Oh, yeah, definitely.

Neil Sattin: Or their ability to orgasm, and all of that. Yeah, okay.

Jessica Zager: Yeah.

Neil Sattin: Good stuff, Jessica. So we'll have you back at some point to talk more about that. And of course, you can always visit Jessica's site, drjzager.com, to find out more about that. And let's go back to... Let's pivot now back to talking about oxytocin, and here we are. I think we made a pretty good case for why it's a good idea to want to boost your own oxytocin in this time of feeling particularly disconnected from others potentially, and then these are things that you'll be able to always use as a resource for yourself, so to boost your well-being, your sense of connectedness.

Neil Sattin: As a side note, I was reading some of the literature before we spoke, and I saw that in one study, people who were given a nasal spray of oxytocin, they were actually less friendly to people that they perceive to be outside of their social group, or outside of their clan. So if you start doing these things and then find yourself feeling particularly xenophobic or something like... Just know that it's the oxytocin at work, that you haven't suddenly become someone who doesn't like people other than you. But I didn't read enough to know if that was a widespread phenomenon, or if that was just something they happened to notice in this one study. So, proceed with caution as you boost your oxytocin, but don't let it stop you, 'cause I think the benefits outweigh the risks.

Jessica Zager: I would agree.

Neil Sattin: Neither one of us is a medical doctor, I'm just going to point that out right now.

Jessica Zager: Good to note, yeah.

Neil Sattin: Yes. Though you are a doctor of physical therapy, and that took lots and lots of training. So important to know, plus your AASECT certification. Alright, so let's get into the good stuff, Jessica, where do we start with boosting our own oxytocin?

Jessica Zager: So one of the first things that you can do to boost oxytocin is give yourself a nice, lovely light massage. Sometimes I call it tickling, but it's not the tickling that makes you want to squirm away from somebody, it's like lightly brushing and stroking your skin. And this can be done all over your body, this can be done on your scalp, If you have one of those head massagers that looks like it has little...

Neil Sattin: Little spider leg thingies...

Jessica Zager: Yeah, and it goes on your head, and massages your scalp, that's a fantastic thing. Or you can just get some nice lotion or oil, you can make it into a whole self-care experience, but lightly, stroking your skin, that light pressure is important for stimulating the release of oxytocin in your hypothalamus.

Neil Sattin: Yeah, I'm doing it right now. It feels really good.

Jessica Zager: It does feel good.

Neil Sattin: This reminds me actually of something else, which is that when... Light touch massage is something that was encouraged as part of the natural child birth or hypnobirthing courses that I did with my first wife before my kids were born. 'Cause oxytocin also is part of what can encourage uterine contractions during labor. Pitocin that people give to encourage childbirth to begin is actually oxytocin that's being applied in the body, right?

Jessica Zager: Definitely. So oxytocin is great for swift birth.

Neil Sattin: Oh. [chuckle]

Jessica Zager: And so it's most known for its effects on labor and facilitating labor and giving birth and allowing the uterus to contract to make that happen. So yeah, it's... You're spot on with that.

Neil Sattin: Yeah, so if you're in the late stages of pregnancy, maybe talk to your doctor before you do some of these things, just in case. Though I will say that I remember practicing light touch massage on my wife at the time, and nothing bad happened. In fact, it was a nice part of our night-time ritual together was practicing for the main event.

Jessica Zager: Did you do that for an extended period of... A certain period of time before her due date?

Neil Sattin: Well, the purpose was, I believe, to really just kind of perfect the technique. I'm really good at light touch massage. And also because you want to be able to rely on those things when you're in the intensity of labor and birthing, which can be pretty intense. So having that as a set thing that you can rely on. I don't remember there being a specific length of time. I think we would often do a little meditation or something, imagining the different colors of the rainbow or something while we were, or really while I was doing, I was giving the light touch massage, I didn't get much light touch massage during that time, I have to say. I'm making up for the deficit right now during this interview.

[chuckle]

Jessica Zager: Well, you can continue with the light touch massage.

Neil Sattin: Alright, I'm going to continue while we keep talking.

Jessica Zager: Yeah, so...

Neil Sattin: I'm going to feel very connected to you by the end of this conversation.

Jessica Zager: Well, oxytocin actually helps people feel connected to the source of the stimulation.

Neil Sattin: Oh, how about that?

Jessica Zager: Part of me wonders if that can be extrapolated to... If you're doing these techniques, on yourself really fostering a sense of self-love, I at least like to think that it would.

Neil Sattin: Yeah, I think we should have everyone report back after you've been light touch massaged... Light touch massage yourself for a week, not constantly, but over the course of a week, and then report back to how much you love yourself just from that alone. But we're going to give you more...

Jessica Zager: Yeah.

Neil Sattin: So okay.

Jessica Zager: Also stimulating the inside of your mouth.

Neil Sattin: Oh!

Jessica Zager: So your oral mucosa can facilitate oxytocin, so you can do this with sucking behaviors. Again, this kind of goes back to labor, but also breastfeeding. But sucking behaviors, like gum, hard candy, using a water bottle with a nozzle, sucking on ice, hell, go buy a pacifier, whatever gets you through this COVID-19 is fair game. There is no judgement here.

Neil Sattin: Right, it's all going to be happening in the privacy of your own home anyway, so.

Jessica Zager: Exactly. You can massage the inside of your mouth with an electric toothbrush, massaging your gums with it, the inside of your mouth with it, but gargling is a way to also stimulate the inside of your mouth and your hard palate, and the hard palate is connected to the vagus nerve, which is the nerve that's responsible for the parasympathetic nervous system, which is our rest, digest, chill out nervous system, which is one of the reasons why oxytocin helps us decrease our stress, decrease our anxiety, decrease our blood pressure.

Neil Sattin: Wow, yeah, and I don't think we mentioned this on the show. I think enough time has passed that I can mention it now that one of the leading researchers around the polyvagal theory, as he calls it, Steve Porges, he's actually married to Sue Carter, the oxytocin woman, and Steve was on the show as well talking about polyvagal theory and its role in helping us stay regulated and feeling safe under stress or in relationship. He was on an episode 34 of the podcast, in case you were curious, but that's so interesting about the hard palate. I didn't realize that it was part of that, that it was wired into that system.

Jessica Zager: Yeah, I know. And also gargling is shown to help with upper respiratory tract infections. So it's kind of a...

Neil Sattin: Win-win. Yeah, yeah, salt water, I think, can be good. So...

Jessica Zager: Yeah, nice salt water... Sea salt water gargle.

Neil Sattin: Yeah, then a little mouthwash in case you are stuck with someone, they might appreciate that as well. Awesome.

Jessica Zager: Another thing that you can do is make yourself warm. So literal warmth. For example, the easiest way to do this is maybe taking a bath. You can create your own oxytocin ritual, like COVID-19 social distancing, I feel lonely ritual, where you would take a bath, and maybe you come out of the bath and you use oil on your skin, and you lightly stroke your skin, and then you brush your teeth, and you gargle, and you go to bed. And so all of those things would help to stimulate the release of oxytocin.

Neil Sattin: I like it. And I think it's so interesting that, one, there are probably a lot of people who are doing that sort of thing anyway and not totally getting like why it's so beneficial for them. And I also think that in general self-care practices like that when there's more attention paid to the intention behind it. So even if it's your ritual to have a bath, and brush your teeth, and gargle, like knowing, just knowing that that is going to be boosting your oxytocin I think enhances the effect of that on your physiology.

Jessica Zager: I agree. I think we tend to go through our rituals without thinking about what we're doing and without being present during these activities, and really feeling what does it feel like when I brush my gums, what does it feel like when I apply lotion to my skin, what does it feel like when I'm taking a bath? Because our minds are in so many other places typically and right now it's really easy to do that with, if you're constantly looking at the news and it can be difficult to get in the moment, but if you use these guidelines, these ways to bio-hack your oxytocin as almost like meditations in and of themselves, like to practice being in the moment and experiencing what you're feeling in that moment, you're going to get multiple benefits from doing something as simple as brushing your teeth or gargling.

Neil Sattin: Yeah, absolutely. I can't wait till tonight with my kids where we go to do our self-love ritual, which they like to do as quickly as possible and I'm like, "No, this is how you love yourself, kids. We're going to really brush our teeth tonight, and now brush your gums. See what that's like." Yeah, it's going to be good, it's going to be a beautiful thing and I'll set them up for a lifetime of self-love and hopefully cavity-free teeth.

Jessica Zager: There is a myriad of benefits. Another thing that somebody can do to release oxytocin is fostering positive warm interactions, and those interactions don't have to be in person. So FaceTiming with somebody you care about. And the research was very particular about this in that it works best if you're talking with somebody you have strong warm feelings towards. If you have a tumultuous relationship with your mother or your father and you're FaceTiming with them, that's not going to help you release oxytocin the way that we're talking about.

Neil Sattin: Sorry, mom. Talk to you tomorrow.

Jessica Zager: So choose wisely.

Neil Sattin: Yeah, yeah I like that. And that connects in with one of the techniques that I often offer people for regulation, is this heart-centered breathing technique that the HeartMath Institute promotes. So it's all about increasing your heart rate variability as a way to down-regulate your system. And one important part of that technique is to focus on an image of a scene or a person that brings you joy. So it strikes me that that... It makes sense that that's an important part of choosing wisely around who you're FaceTiming with, like think about who brings joy to your life and make sure that person's on your speed dial.

Jessica Zager: Exactly, yeah.

Neil Sattin: Do we even have speed dial anymore? I don't think that exists.

Jessica Zager: That's such an outdated term. I know you can program people into your phone buttons or can't...

Neil Sattin: Can you? I don't know.

Jessica Zager: I don't even know. Now, we just talk at our phones.

Neil Sattin: That's right, I just let Siri handle that for me.

Jessica Zager: That's what she's for.

Neil Sattin: Yeah, she manages my Rolodex.

[chuckle]

Jessica Zager: Again, another very outdated term.

Neil Sattin: Yeah, no, I don't think, however, that Siri is very good at fostering it. For the number of times that I've sat with my kids, or I'll admit, alone, trying to get Siri to respond in ways that are connecting and amusing. I don't think, I wouldn't recommend that you rely on Siri or Alexa to foster your oxytocin needs.

Jessica Zager: No. There hasn't... We have yet to have a lot of research about the release of oxytocin in human-robot interactions, but I don't think there's a lot of empathy and warmth coming from Siri and Alexa.

Neil Sattin: Not yet, although we probably just had everyone's iPhones and Amazon devices like going a little bit haywire if they're... Sorry about that if you're listening to this, you'll apologize to Siri and Alexa for us later. Okay, so we've got a pretty good list. What else comes to mind?

Jessica Zager: So this is something I know you do very well, and that's singing.

Neil Sattin: Oh!

Jessica Zager: So singing out loud, like with gusto for 20 minutes, helps to release oxytocin in...

Neil Sattin: For 20 minutes?

Jessica Zager: 20 minutes, that's what the research says. It helps to release our oxytocin and foster increased feelings of happiness and decreased feelings of sadness and worry.

Neil Sattin: Very cool.

Jessica Zager: I don't know, four or five songs.

Neil Sattin: Yeah, I can do that.

Jessica Zager: Yeah. That's easy.

Neil Sattin: I mean, not right this instant, but I did just put something on the quarantine karaoke group on Facebook. I don't know if that was actually started by someone here in Maine, where I live. Last time I checked, it had over 150,000 members now. But it's a Facebook group where people are singing popular songs to each other doing karaoke style. Now, we know, isn't that interesting, 'cause not to necessarily be promoting Facebook here, but as a way to stay connected during these times and add in the singing component, it makes sense why people are responding so much to that.

Jessica Zager: It really does. And I always find it amazing how as humans, we tend to figure out ways to create what we need, what our bodies are lacking or missing without even really realizing it. And I see a lot in pelvic floor PT, people will come in and say, "I started doing this particular stretch," or "I started doing this other thing and I don't know why." And there will be a very good explanation why they've done that, and it will be something that I often recommend people do in their situation. And it's just amazing how our bodies figure out what they need.

Neil Sattin: Yeah, there's this innate intelligence, especially if we're listening.

Jessica Zager: Yes.

Neil Sattin: Yeah, I like that one, singing.

Neil Sattin: And then this next one is, I alluded to it earlier, when we were talking about sucking. But nipple stimulation is a really big one. So labor and breastfeeding are the two activities most associated with releasing oxytocin, and so stimulating your own nipples can be a way to facilitate oxytocin release and create that sense of well-being and closeness, and decrease stress and anxiety, and all of those wonderful juicy benefits of oxytocin in the comfort of your own home. I was looking to see if this was just studied in women or if this was studied in men as well, 'cause as we know, men have nipples.

Neil Sattin: Yes.

Jessica Zager: We don't know why.

Neil Sattin: I just discovered mine. [chuckle] Just this moment. [chuckle]

Jessica Zager: Surprise, you have nipples. And, but there is some research to show that nipple stimulation in men works the same way as it does in women, even though men don't breast feed. So stimulating your own nipples can really help to release that hormone. I was also reading this really interesting article about nipple simulation that was conducted at Rutgers and published in the Journal of Sexual Medicine, about how nipple stimulation lights up the same part of the brain as clitoral stimulation or stimulation of the vagina or the cervix. So that kind of helps to explain why nipple stimulation for some people and in men too with the nipple stimulation lit up the same part of the brain as the genitals, so that kind of helps to explain why for some people, nipple stimulation feels really good and can even lead to orgasm, and, but also aside from that, it is a really big avenue for releasing oxytocin, so even if generally your nipples aren't very sensitive or you haven't really enjoyed nipple play in the past, doing it for non-sexual purposes, and for mitigating the effects of social distancing, it can be really effective for this particular reason.

Neil Sattin: Is there a preferred way to or a length of time or...

Jessica Zager: There wasn't a length of time associated with it.

Neil Sattin: Okay.

Jessica Zager: In the research, and when they study it, they often look at actions that mimic like a pulling or sucking, kind of like a baby's mouth would do on the nipple. But there are multiple, I would say again, do what feels good and play with it and your body will kind of lead you in the right direction.

Neil Sattin: Trust your body, got it. Well, I've been, while you've been talking, I've been experimenting with all these different ways of playing with my own nipples, this is a very interesting interview. It's... [chuckle] Can't say I've played with my nipples while I've spoken to anyone else before, but I feel comfortable with you, Jessica, so thank you for giving me this experience.

Jessica Zager: I take that as a compliment. [chuckle]

Neil Sattin: Cool. Well, that's a lot. Have we exhausted the list yet, or is there more?

Jessica Zager: We've exhausted the list.

Neil Sattin: Okay, well, those are some...

Jessica Zager: We don't want to overwhelm people.

Neil Sattin: No, that's a healthy number of things to try to boost your oxytocin, which will have the benefit of increasing your sense of well-being, increasing your sense of connectedness within, because you will be the source of your own stimulation as well as your connectedness to others. And I'm really curious to hear from you. So if you put these oxytocin-boosting practices into use in your life, keep track of what that's like and let me know. You can find me in the Relationship Alive community on Facebook. You can email me, Neilius, N-E-I-L-I-US, @neilsattin.com, yeah, let us know and I'll make sure to pass this along to Jessica as well, 'cause I think it's really helpful to hear your experience and how this sort of thing has been helpful for you, and it seems obvious that everything we've mentioned is something that you could then, you could do that with a lover, knowing what it does, you could do that with yourself as part of being with another person or just as part of your own rituals, even when we're not forced to be apart from other people. That, all of these things we can bring into what we do to our repertoire of how we enhance the way we feel in life in general, to be more connected, more attuned. Yeah, I see you nodding.

Jessica Zager: That's beautifully stated.

Neil Sattin: It's powerful, powerful stuff. Well, I'm really glad that you let this idea fall just so casually in a conversation that we were having, 'cause I think it's perfect for the time that we're in right now, and I'm really excited for everyone to try this out. And again, if you want to download the condensed version of, like the cheat sheet version, then definitely visit Jessica's site, drjzager.com, D-R-J-Z-A-G-E-R.com and she has it there available for you to download, you can also find out more about the work she does helping people with sexual issues, or issues around gender identity, painful intercourse, etcetera.

Neil Sattin: And thanks also, Jessica, for being willing to talk a bit more about your work as a pelvic health physical therapist. I had never heard of that before, when we were talking about it. And so, I'm going to guess that a lot of people haven't and, as you mentioned, even there are many doctors who don't know that it exists, and yet it's such a huge resource for people who are experiencing very common problems.

Jessica Zager: Definitely.

Neil Sattin: Yeah.

Jessica Zager: And I hope we do get to do another podcast about that, because I think it's really important that everybody know that this exists because there are so many people suffering with issues that can really be easily treated.

Neil Sattin: Yeah. Yeah, we will. We'll do another episode together. In the meantime, if you do also want to get a transcript of this episode, visit neilsattin.com/oxyboost, so you can get the full transcript, and I'll also have links to Jessica's site there as well. Or you can always text the word "passion" to the number 33444 and follow those instructions. Dr. Jessica Zager, such a pleasure to have you, thank you so much for offering your inspiring wisdom and being willing to handle me touching myself while we spoke. [chuckle]

Jessica Zager: Always a pleasure, Neil. It was great.

Neil Sattin: Awesome, we'll have you back soon.

Jessica Zager: Sound good, I'll hold you to that.

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