Feminist Therapy: Quitting porn, avoiding transference, and dealing with gynecologist trauma

I am a therapist, but I am not your therapist. Therapy, in my opinion, is not just about the information I give, but also about the highly individualized relationship I build with each client, getting to know their unique needs, strengths, and challenges. This column is not meant to substitute individual therapy. When in doubt, speak to a therapist about these issues — preferably someone who knows you, who you feel safe with, and who is equipped to support you exactly as you are.

** All of the questions I received were complex, and profoundly honest. Thank you for your submissions. The questions answered in this month’s column were edited for length and privacy, while attempting to preserve the original question.

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Dear Feminist Therapist,

I’m 21 years old, only been in one very brief relationship, and I have a very high sex drive. I feel unbearably desperate for a boyfriend, and relentlessly look up sex advice, forums, opinion pieces, and any other kind of writing about sex I can find. At my worst times, I go to porn sites, with the intention of just seeing what kinds of things are trending, but I always end up getting turned on by it, even though it’s disgusting and horrible. I think I’m starting to associate sex with violence, which is the exact opposite of everything I want.

I find myself fantasizing about sexual positions I once thought were degrading. Worse, I find myself thinking about graphic images of men sexually assaulting women while masturbating. I hate it. I don’t know if it’s socialization, or something wrong with me. Thinking about a man sweetly making love to me, which is what I really want, doesn’t fit well with my self-pleasuring — it’s detrimental to it. How can I break my addiction to looking at sexual content online and learn to align my emotional desires with my physical ones? How can I stop being so turned on by violent sexuality? How do I separate violence from sex? Or should I accept that this is who I am and not try to change it? It’s so deeply against all of my values…

–  S

Dear S,

I can sense the inner conflict in your writing — feeling pulled towards something you are simultaneously repulsed by. I’m sorry that you are struggling in this way, and I wish I had an easy answer for you.

When I read your question, I think immediately of a metaphor of the mind popularized by author Jonathan Haidt. The metaphor is of a person riding on the back of an elephant, in which our conscious mind is the rider, and our unconscious mind is the elephant. He explains that the elephant is much more powerful than the rider, and needs to be trained in order to for us to have more control over our behaviors and impulses. Together, our culture, watching pornography, and your implicit sexual desires all train the elephant, but in a way that your rider does not agree with. Your rider is a radical feminist wants to desire certain things that are in line with her politics and ethics. But the influences around you and the behaviors you engage in are training the elephant to do the exact opposite of what the rider wants.

You do not need to beat yourself up, but you do need to start making certain changes. Watching pornography, especially when it is compulsive, can be a very effective yet unsustainable tool for managing difficult emotions, like boredom, distress, fear, sadness, or the longing for excitement. First, it’s important to begin to examine what is driving your pornography use — the emotions you experience and what you think before you use pornography. Next, begin to learn to sit with those emotions.

It can be helpful to begin a mindfulness meditation practice. Continuing with the elephant and the rider metaphor, research on mindfulness has shown that it is one of the best ways to help “train the elephant.” (In order to help you practice mindfulness, you might want to start using an app on your smartphone like Headspace or Calm.) When you find yourself fantasizing about something you objectively think is degrading, stop, and change what you’re thinking about. This can feel painful at first, but doing mindfulness meditation can make this much easier, as it trains the areas of your brain responsible for impulse control, including redirecting your thoughts, sustained attention, and emotional regulation. If you find doing this on your own is too difficult, and that you are still engaging in the behaviour or fantasies you would like to avoid compulsively, try getting some extra support. Try, for example, getting a therapist, installing settings on your computer that make it difficult to watch porn, joining a support group, or picking up some new hobbies with friends who you can share honestly with. As for your interest in the trends you look up on porn sites, you might try reading academic articles about trends in pornography, if that does not feel arousing to you. Or, you might also just have to give up on an academic interest in pornography for now, because (right now) it is too easy for you to get sucked into watching it. Like for a person who struggles with substance abuse, even talking about it can be very difficult, and it can be necessary to avoid social circles, forms of media, or academic content in which the thing you struggle with is in any way glorified or supported.

Eventually you will begin to sensitize yourself and re-train your mind, but this can take some time. In the meantime, make sure to begin to practice being compassionate with yourself. Sometimes the elephant has a will of its own, but that does not mean you are defeated. But, to live a life which reflects your political values, you will likely need to make some serious behavioral changes, and you can support yourself to make those changes with a kind inner dialogue, instead of a self-abusive one.

Good luck.

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Dear Feminist Therapist,

I am currently in a relationship with a wonderful man who I consider the love of my life. He is kind, patient, understanding, smart, and pro-feminist. He makes me laugh and I am deeply attracted to him. I never expected this to happen to me, especially as my previous romantic relationship was abusive (mostly emotional and psychological), and I was cheated on multiple times. Since the beginning of our relationship nearly a year ago, I have experienced chronic anxiety centered around a fear that my boyfriend will eventually leave me. I will often have anxiety, panic, and nightmares about it.

I have a very difficult relationship with my mother, who I don’t speak to very often, and my biological father abandoned us both when my mother was still pregnant. Nonetheless, I am finding it increasingly difficult to understand why I am constantly feeling like this. I worry I will ruin our relationship with my insecurities. Sometimes when I become frustrated with the situation, I take it out on him. I don’t want him to feel bad, but just don’t know how I can get past all these anxieties, stop worrying about the future, and love him freely without fear.

– K

Dear K,

I’m so glad that you are happy in the relationship you are in, and I’m pleased to hear that he supports and identifies with your political beliefs. When someone is really kind, consistent, and hasn’t given us any reason to suspect they may leave, but we feel anxious or  insecure nonetheless, we can start to guess that something called transference may be happening. Transference is said to be happening when we are transferring or redirecting our feelings about a previous relationship onto the present relationship. And, just from what you have said about how men have treated you in the past, I wouldn’t be surprised by this. You have been left, rejected, or abandoned by many important men in your life, and sometimes when this happens, our brain fills in the gaps and assumes this will happen again. How many times can we burn ourselves on the hot plate without becoming afraid to touch it again?

Another way of explaining this is through understanding attachment theory. In attachment theory, we look at how patterns of past relationships (especially important ones, romantic ones, and those we had in development) create a neurological “map” that shapes how we do relationships and what our role in relationships is. This can include patterns that are laid down about how we feel about ourselves when we are close to others, whether or not we can trust people, let people in, or believe we will be loved or left. Sometimes when our attachment “map” has included a lot of painful relationships, being in the present relationship – even if it’s safe and secure — feels like it will end the way our other relationships have, because that is what the map says will happen. This is a great time to start becoming aware of what is happening, and of your fears about this relationship, then ask yourself some of the following questions, when you feel afraid:

  • Is what is happening now bad or scary? Or is it just that it’s new, and I have been through bad and scary things in the past?
  • How is this person different than the people who have hurt me in the past?
  • How can I learn to comfort myself and work on self-soothing when I am scared and anxious?
  • How can I allow this new person to help me heal my old pain? How can I learn to do this without taking it out on him, and instead share my fear and vulnerabilities in a way that brings him close to me?

I think that it could also be a good idea to do some therapy with someone who specializes in early attachment injuries — relationship experiences that gave you a map that makes it hard to love and be loved as an adult. You might also want to learn some ways of coping with anxiety and distress. This can include anything from workbooks, exercise, taking certain supplements, having a friend to call when you feel like the old pain is coming up, journaling, or joining a group for support.

Importantly, the fear that you are feeling is not surfacing because you are broken or defective. Rather it’s a leftover mechanism that has likely kept you safe in the past — learning to afraid in situations where you’re likely to be hurt is very adaptive. But, when you’re not going be hurt, this leftover fear can keep you from really being present and engaged in the life you have. I’m impressed by your awareness and have hope for you.

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Dear Feminist Therapist,

Yesterday I had an appointment with a gynecologist for the first time. Before the exam, he described menstruation as a “mistake of nature” because, according to him, it is an inconvenient thing to experience. It felt like such an insulting comment. I have always felt like my period was a natural part of being a woman.

I hesitated a bit before getting on the table. He noticed that and, from behind, lifted up my dress, fully exposing my buttocks, and told me to go sit. I put my legs in the stirrups but was unable to spread my knees. I was shaking and clenching my fists. He told me to get over my shame and spread my legs. When he inserted the tube, he put his hand on the inside of my thigh, quite close to my vulva. I froze, afraid to tell him to take his hand away.

I left, shaking and upset. A friend said he probably just tried to make me feel more comfortable. Do gynecologists do that? Put their hand on the inside of a woman’s thigh? That’s never okay, is it? I’m still upset — it keeps running through my head. Am I overreacting? I don’t know what to do. I have to go back in three weeks for another exam but I really don’t want him to perform it.

– M

Dear M,

I’m horrified for you. That sounds like an incredibly violating experience. Just by the symptoms you report (the shaking, the flashbacks, the sense of being frozen), I’m inclined to says this sounded traumatic. During trauma, because a very specific part of our brain determines we are in an unsafe situation, certain biological processes begin to unfold which make us fight, flight, or freeze. This means that if you are having a reaction like this, even if it does not make sense to your friend, your body told you it was a terrifying experience and you felt unsafe. And, when that happens, you can’t do anything about it —  your nervous system is wired to respond this way, so you are definitely not overreacting.

If you don’t feel safe with him performing it, don’t let him do the exam. Ask for a female colleague of his, or ask for another woman to be present. In some of the medical clinics where I live, anytime a male performs a pelvic exam on a woman, another female needs to be present — either a nurse or female physician. You can always ask for that.

I’m wondering if this was severe enough that it would be appropriate for you to make a complaint to the college about this gynecologist? If you felt violated or disrespected, or that his conduct was unprofessional, you might consider discussing it with someone else. If you do not want to do this, you could write a letter to him to tell him about the impact of his actions on you.

Just by your response alone, it may be important for you to seek some support — perhaps counselling. Especially if you have had a history of sexual assault or trauma, events like these might be particularly overwhelming, not because you did anything wrong, but because of how our brain stores trauma. When we have been through trauma before — especially if it was developmental — when any kind of trauma happens again in the future, we may be more likely to freeze or dissociate. Again, this is not your fault. And, you did not deserve to have this happen to you. But to prevent this and other events from creating even more distress for you, I suggest seeking some support, or doing more reading about trauma.

You can send your questions for Hillary, our Feminist Therapist, to [email protected] with the subject: “Feminist Therapy,” or tweet her @hillarylmcbride using the hashtag, #feministtherapy. (We will anonymize your questions, unless you specifically ask us to include your name.)

Hillary McBride

Hillary McBride is a registered clinical counsellor working in the Vancouver area. She specializes in women's experiences and feminist therapy. Hillary is a PhD student at the University of British Columbia, where she researches women's experiences using feminist methodologies. She is the author of "Mothers, Daughters, and Body Image: Learning to Love Ourselves as We Are" and recently won the International Young Investigator Award in Human Sexuality from Taylor & Francis for her research and clinical work on sexuality in mothers.