Ep. 56 - Keep Calm & Have Hot Sex

[00:04] Sex Therapy, Sexual Wellness & Dr. Caleb Jacobson

Dr. Bawa: Welcome back to the Dr. Sex Fairy Podcast. I am Dr. Kanwal Bawa and I am here to transform your life. I run Bawa Medical, which is a very successful hair restoration, skin rejuvenation, and of course, sexual wellness practice in Boca Raton, Florida. Given how many sexual and intimate issues I help my patients with, it is truly critical that I delve into their stories. I try hard to understand the reason behind their dysfunction. I have a really deep respect for clinical psychologists and sex therapists. And today I am joined by someone who leads the pack. My friend, Dr. Caleb Jacobson, is an internationally recognized clinical psychologist, sex therapist, and even a biblical scholar. He covers it all. He chairs the AASECT special interest group on sexuality and religion and is the host of the very popular and my very favorite Sex Therapy Podcast. I want to talk to Dr.

Dr. Bawa: Jacobson today about who should see a sex therapist. What is a sex therapist? So many questions. Welcome, my friend. Welcome back.

Dr. Jacobson: Dr. Bawa, thank you for having me. Have you missed me?

Dr. Bawa: I always miss you. That's why I can't seem to get enough of you. I keep having you back. In fact, my producers, you know, no, really. My producer says, Do you have anybody else you ever want to talk to? And I said, Yes, but I really, really want to talk to him.

Dr. Jacobson: Well, it's always a pleasure to talk with you, and I'm excited to have you on my show soon.

Dr. Bawa: Yes, I can't wait to record. So much fun. So tell me, let's start with the very basic burning question. What is sex therapy?

[01:45] What Is Sex Therapy?

Dr. Jacobson: So, sex therapy is a form of therapy that centers around sex, sexuality, and gender. So this could be dealing with someone who's struggling with their sexual orientation or gender identity. It could be a couple that's having trouble connecting intimately because sex just isn't working out. It could be someone who's struggling with their sexuality as they age. and it could be people who are having problems with sexual functioning and issues around being able to perform. So sex therapy basically recognizes the important role of human sexuality in the overall well-being of an individual and understands the vast influence that sexuality has on the person's overall sense of self.

Dr. Bawa: Okay. Now, that's a lot for me to take in at one point. That's a lot, but it's that's pretty good. That's very good. And you said it in one breath. Very impressed. So let's clear out some of the confusion regarding sex therapy when it comes to other specialties within sex. For instance, what is the difference between a therapist and a psychiatrist? Now, this isn't necessarily sex, but I have other questions I want to ask you that will stem from this. So therapist versus psychiatrist.

[02:58] Psychologists, Psychiatrists & Sex Therapy

Dr. Jacobson: So a psychiatrist can be a sex therapist, but they do not necessarily have to be a sex therapist. the more I guess the more specific question there would be the difference between a psychologist and a psychiatrist, which of course the psychiatrist prescribes medication. And in the U.S., psychologists can only prescribe medication in two or three states. I think I think Nevada, maybe, and and Louisiana. I don't know, probably the wrong states. Don't take my word on that. so that's the difference between the two. But there are some psychiatrists who do become sex therapists.

Dr. Bawa: But usually not.

Dr. Jacobson: I mean, normally psychologists don't become sex therapists either. Yeah, that's true.

Dr. Bawa: That's true. So tell me the difference between a sex therapist and a sexologist.

[03:51] Sex Therapist vs. Sexologist

Dr. Jacobson: So a sexologist is simply someone who studies sex. So they could be someone who's interested in studying sexuality or gender theory. They could consider themselves sexologists, but they are not trained professionals in actually treating and dealing with people, though some of them actually think they are, but keep that between me and you. But they're not actually trained to do it.

Dr. Bawa: Okay. And then what's the difference between a sex therapist and a sexuality counselor?

[04:22] Sex Therapist vs. Sexuality Counselor

Dr. Jacobson: So the difference between a sex therapist and a sexuality counselor is the approach. So they share a lot of similarities, okay? The biggest difference comes to the form of treatment. A sexuality counselor is typically someone who is a medical doctor, clergy, an RN who sees patients short term. They don't typically see the patient on a long term to have extensive therapy. Whereas with a sex therapist, you would have extensive therapy.

Dr. Bawa: That makes sense because I think every one of my patients is on some level being counseled by me, though I make absolutely no claims to be a sex therapist or a psychologist like you, because I just don't have that training. I do something very different. I handle the medical part of it. But as you and I have discussed before in other episodes, the psychological part of it is critical to healing them medically.

Dr. Jacobson: So, yeah, I think both of them are so incredibly important. And that's why a lot of times when clients come to me with a sexual issue, depending on what the issue is, one of the first things I do is send them to their medical provider so that they can be checked out to see if there are any physiological issues or medical issues that are causing their sexual dysfunctions and complications. So the two really do work hand in hand and are both very important.

[05:45] Misconceptions About Sex Therapy

Dr. Bawa: No, I agree a hundred percent. So, what do you think are the biggest misconceptions about sex therapy?

Dr. Jacobson: So, the biggest misconception about sex therapy is that we have sex with our clients. Okay. This does not happen. I mean, even clients, when they come to therapy, sometimes they're a little nervous, like they have to get naked. Oh, yeah, what's going on? I will tell you a funny story. a few years ago, I had a client come, a young girl, she was probably 19, and I asked her if she would like some water. I left the room to get water. I brought water back. She was on the couch masturbating.

Dr. Bawa: Oh my god.

Dr. Jacobson: I didn't know what to say. Like, you don't get trained. This isn't something they teach you.

Dr. Bawa: Like, what the hell?

Dr. Jacobson: Like, yeah, this doesn't happen. So I thought about it for a minute, and I thought, well, I said, you know, this isn't something that we do in therapy. You know, you'll remain clothed and we will just have a conversation. And she was very offended. I think she wasn't so much offended as in she was embarrassed, right? Like that was the big deal. And so she like jumped up, grabbed the water out of my hand, called me a dirty Jew, and walked out the door. So that was I love that. That was a that was a that was an interesting day. but yeah, so one of the misconceptions is that we have sex with clients or that there's nudity involved. This doesn't happen. the other misconception is that sex therapy is what you see Barbara Streisand doing in Meet the Fockers. Like, I get that often, like so often in media, they've kind of made a joke out of sex therapy, right?

Dr. Jacobson: So a lot of times when people find out I'm a sex therapist, they think, oh, you're just what, talking to people about sex? Like, what are you, what are you really doing? This this isn't really that important, right? Like, or this is dirty or whatever the case may be. And they don't recognize that we are dealing with real internal issues that affect every aspect of that person's life, the way that they relate to themselves, the way that they view themselves, their self-esteem, their self-confidence, and the way that they relate and connect with other people, whether it's family members, intimate lovers, or friends.

[07:52] Stigma Around Sexual Health

Dr. Bawa: Agreed on every level again, because I face that myself. People say, What is wrong with you? A good Indian girl raised in a very well-known family, educated family, you know, a family rooted in the military and academia, what's wrong with you? And ironically, it's not my family saying it, it's other people saying it. And people say to me, You went to the Cleveland Clinic and are so highly trained. What's wrong with you getting into such a dirty thing? And I said, What's dirty about sex? Am I not helping people?

Dr. Jacobson: I I'll never forget someone asking me one time, because I get asked a lot, like, what do your parents think about what you do?

Dr. Bawa: I know, me too.

Dr. Jacobson: And my parents are always like, you know, as long as you're happy, you know, you know, you're not doing anything illegal and asking us for money. As long as those three things were actually, my family is super supportive of the work that I do.

Dr. Bawa: That's awesome because initially my brother was a little worried about the whole, you know, sex thing in the sense that I told him I call what I do the Bawa Sutra. And he said, Why would you drag the family name into it? I said, Well, I am the modern, better version of the Kama Sutra. Am I not? I am taking the erotic and helping it, you know, come into the modern world with the medical. I combine the best of both. It's the Bawa Sutra, baby.

Dr. Jacobson: That's beautiful. The the only the only thing I ever get is my so my youngest sister, especially when I started the podcast, she was still in college, and people were listening, and she was supportive, but she thought, you know, when she got in the car, she turns it on and hears her brother talking about lubrication, not the best thing. She wants to hear her brother talk about. And sometimes she gets nervous if she has me on speakerphone that I'll say something embarrassing.

Dr. Bawa: Oh, I'm definitely not somebody you talk to on speaker. Guaranteed. See, this is why you and I get along well. We are cut from the same cloth. We really are. So tell me, who needs sex therapy in your opinion? I know this is a very broad question.

[09:51] Who Can Benefit From Sex Therapy?

Dr. Jacobson: Yeah. So I would say that a lot of people can benefit from sex therapy. So there are a lot of people who have guilt and shame related to sex. There are a lot of people who experience some type of sexual dysfunctions. There are a lot of couples who have trouble connecting intimately because of think about this. And I'm not, I'm trying not to go too deep for the audience because I don't want to bore them to death. But think about we all know we all have our hangups about sex, okay? Everyone has their hangups about sex. Now imagine putting two people together, especially who have grown up in different environments, different cultures, maybe, different family structures, different communities, okay, which have all influenced their this person's thoughts about sex.

Dr. Jacobson: And then they get into a relationship and then they wonder why the sex they're having isn't working, or why they're not able to connect, because they've all brought all of these influences into the bedroom with them. And a lot of times they're they are they are mutually exclusive and make it difficult for the couple. So couples, I think, benefit a lot as well as individuals.

[11:02] Body Image, Self-Esteem & Intimacy

Dr. Bawa: I think so. And I think body shaming is another issue you see in society, and that does not help anybody in the bedroom because if you're not confident about how you look, how can you be comfortable about your sexuality? They go what, you know, they go hand in hand.

Dr. Jacobson: Sure. And you know, body shaming often gets relegated to a person's size and weight, but it really is much more deeper than that, right? Like it's you don't have the right color hair or the right color eyes or the right nose or the right your smile, whatever the case may be. and this really does affect a person's ability because then they really have poor self-esteem issues, and they think, how can I be intimate with someone? One when I'm because they're not comfortable with themselves. So how can they open up to someone else when they're trying to close off from the world? And a lot of people have the thought of, who could ever love me if I really am this unattractive, or however they feel about themselves?

Dr. Bawa: Yet, you did you ever see that movie Eat Pray Love with Julia Roberts?

Dr. Jacobson: I have not seen it.

Dr. Bawa: So there's a there's a scene in it. Julia Roberts and her friend, a woman she befriended in Italy, go to Naples. And of course, they're trying to have pizza in Naples. I mean, what else do you do in Naples but have Neapolitan pizza, right? So one of them, her friend, is getting really nervous about eating this pizza because she says she's gained all this weight and she can't fit into her clothes. And Julia Roberts says something to the effect that have you ever been naked and had the man leave? I mean, he's just happy to be in the presence of a naked woman. Most people don't care.

Dr. Jacobson: So I would say that most often when a person has issues and they are in a relationship, one of the ways that I deal with this body image issue is like you just said, making them aware that their partner is attracted to them, right? What we seem to forget is that everyone has their own turn-ons and turnoffs.

Dr. Bawa: Yes.

Dr. Jacobson: Okay. Everyone likes a different body. I mean, I've had clients come in who say, 'I'm too fat.' Other clients have come in the next day and said, 'I'm too skinny. They don't like me.' Okay. The client who came in saying they were fat wishes they look like the person who was skinny. I'll never forget one day I had this younger guy sitting in the office. By all means, we would say generically what anybody would deem as being attractive. Okay. And he was talking about people ghosting him. or maybe maybe he wasn't so much something, he was talking about not wanting to show off. And I would say, and I said something along the lines of, well, it's not like they're gonna block you. And he goes, Oh, you don't think people blocked me, right? And it made me really realize that the way that we perceive other people's lives is not reality either.

Dr. Jacobson: And that's how it is with the way that we view ourselves. I think a great way to humble ourselves is to recognize we're never as great as some people say we are, and we're never as terrible as other people say we are. Like we're somewhere in the middle, like, and we need to recognize the qualities that we have that are positive and bring those to our relationships.

[14:21] How to Choose a Qualified Sex Therapist

Dr. Bawa: Absolutely. Now, I think it's very important to find the right sex therapist, too, and one that is highly trained and has the right experience. So, what should people look for when they are looking to find a sex therapist?

Dr. Jacobson: So, training is of course very important. Like it is important for a therapist to have specialized training in sex, sexuality, and sexual functioning. Now, what does this training entail that most therapists don't have? You know, believe it or not, except for in the state of Florida, a therapist can call themselves a sex therapist without any training.

Dr. Bawa: Really?

Dr. Jacobson: Only the state of Florida preserves the title of sex therapist. So when you go see a sex therapist, they are typically a mental health provider. They could be a social worker, they could be a marriage and family therapist, they could be a licensed professional counselor, they could be a psychologist or psychiatrist. After their degree, these people have gained their license and they've done training, 150 hours of training in sexology and in sex therapy training. So it is very important. Now you say 150 hours, this is a lot. I can tell you I have done well over 150 hours, at least double that. Okay. So do not just go find anyone who has the title sex therapist, ask them about their qualifications, ask them about the work that they are doing, what type of training they have.

Dr. Bawa: I must say that I am very proud that Florida, my state, is strict about this because what the hell? Anyone can call themselves a sex therapist? That's insane to me. I never knew that. I'm glad we had this conversation.

Dr. Jacobson: And it's really important because what we just talked about, like these misconceptions about sexuality, right? Like, most people would never fathom that this sex therapist has that much specialized training in the area? So it's a lot of work to get certification as a sex therapist and to do this work.

[16:34] Nudity, Transference & Ethical Boundaries

Dr. Bawa: Now, I was listening to a podcast not that long ago, and I'm not gonna name the psychologist, but she believes in naked sex therapy. On what planet is that a healthy way of conducting or experiencing sex therapy? How does that end well?

Dr. Jacobson: It doesn't. one of the hardest things in any type of therapy. Let's let's just talk about, let's say I just did my PsyD and I am solely practicing cognitive behavioral therapy, working with clients with depression and anxiety. Let's say that's my practice. And there's nothing wrong with that. We need people who are doing this. One of the things that you are trained in often discuss is transference, number one. And when a when a client begins to develop feelings for their therapist, and vice versa, right? Like this is a big topic that you learn when you're studying. To sexualize your client in a way that they're nude, is is I think very problematic. And I would avoid anybody who espouses some of this. Now, with that said, let me say there was a well-known sexologist by the name of Betty Dodson, who died recently.

Dr. Jacobson: And one of the things she did, again, she was not a therapist, one of the things Betty did was she would have women use a mirror to look at their vulva. And sometimes she did workshops where women would all sit around in a circle with their mirrors, and she would explain the different parts of your anatomy that you were looking at. Now, she's a sexologist, she was providing education solely for other women in that type of scenario. and in some ways that was very important because so many women have never looked at their vulvas and they don't understand their anatomy. but at the same time, as a therapist, this is something I would never do. And I would caution anybody who's going to a therapist requiring such to stay away from them.

Dr. Bawa: It makes me very uncomfortable the thought of it. It's so inappropriate.

Dr. Jacobson: Ethically, it's it's very problematic.

[18:54] Boundaries in Medical and Therapy Settings

Dr. Bawa: Even in my office, to tell you the truth, and I'm dealing with penis enlargement, I do erectile dysfunction treatment, I do some unbelievable vaginal rejuvenation. So I do see my patients naked every day. But even then, we have drapes over them, we give them privacy, we respect their space, we knock before we enter, we say, May I this, may I that? Because you have to have boundaries. And something about naked sex therapy is just insane to me.

Dr. Jacobson: I'll tell you a funny story. soon after the pandemic was underway in 2020, that summer I had a young boy come to my office. he was maybe 20, 21 years old, but he was not he was not from here. He was from somewhere in the Middle East. I won't, I won't say where. But he came to me because he didn't speak German. He only spoke very broken English and thought that I could help him. And he was sitting on the couch talking in his accent, saying, my penis, my penis, a lot of pain. Okay, this is all the English he could he could get out. And I said, and I was trying to ask him what was wrong. Oh, my penis, a lot of pain. Please look, please look. I said, no, no, no, I don't want to see your penis. Please tell me. He's like, no, please look at my penis, tell me what's wrong. I tell him, I said, no, you need to go see a doctor. But you are a doctor, you are my penis, right?

Dr. Jacobson: Like, and I was trying to explain to him, I am not that type of doctor. I do not want to see your penis.

Dr. Bawa: No, I get it. I was in the ER once. As you know, I'm also a board-certified ER doctor, even though I don't practice anymore. And I remember distinctly, many, many years ago, I had this guy come in with dental pain and he wanted me to pull his tooth. And I said, Sir, I don't pull teeth. That's not what I do. I'm not a dentist. He said, But you're a doctor. I said, Yes, but I don't pull teeth. He said, Well, then what good are you? Like everybody should do everything, right? What do you see most often in your practice?

[20:56] What Sex Therapists See Most Often

Dr. Jacobson: You know, I find that that changes over time. And it's very, it's very funny because I've had this conversation with several other sex therapists. Now, there are some therapists I know, they're like, I only get kinky clients. Like, I only get people who are into BDSM and stuff. But a lot of the therapists that I know, it seems that you get all of one type of client at one time, and then this changes. So I remember at one point during the time I was all of my clients were people who had experienced sexual trauma. And this makes sense, right? Like everybody's on lockdown. Like all of these thoughts you're having to deal with. So it makes sense they're starting to come to therapy. I think often I deal with issues such as mismatched desire. That's when one of the partners wants to have sex more than the other partner. I deal a lot with erectile dysfunction.

Dr. Jacobson: I deal a lot with early ejaculation. Notice I said early ejaculation instead of rapid ejaculation. And I think that this is an important. I don't like using the term rapid ejaculation. because what first off, what exactly does that mean that it's rapid? Some people would be some people, including the man's partner, might be happy that he ejaculates rapidly. Whereas early ejaculation more along deals with the anxiety he has because he's ejaculating sooner than he wanted to. So I use the term early ejaculation. I also deal a lot with shame around sex.

[22:30] Early Ejaculation & Sexual Shame

Dr. Bawa: You know, you talked about ejaculation, and I did a podcast episode about this recently. It was when fast and furious is not a good thing. So I actually spoke about how premature ejaculation is when you're ejaculating within about three minutes, and severe is when it's a minute or less. So that really keeps people from having a good sexual experience. But I but I get what you're saying completely.

Dr. Jacobson: Yeah, and you know, there are nowadays there are so many things to help men to overcome early ejaculation. there are topical products, there are sprays, for example, that are not transferable to the female partner. If you're buying a cheap desensitization cream, I I warn you against that because the last thing you want to do, the last thing you want to do when you have early ejaculation is to use a cream that also numbs your partner who's already having trouble orgasming because you're ejaculating too early. Like this is a problem.

Dr. Bawa: Yeah.

Dr. Jacobson: so I caution against that. but often what I found is that men who ejaculate early, there are typically cultural and societal issues, and often shame associated with sex that causes the ejaculation so early.

Dr. Bawa: The almighty shame. It's everywhere everywhere, whether you're in LGBTQ, whether it's in the bedroom, everywhere.

Dr. Jacobson: It doesn't matter. And you know, it's you mentioned in the introduction that I chair AASECT special interest group on sexuality and religion. And so so many people come to me talking about you know, the shame is all because of religion. It's all because of religion. But you know, I have just as many clients who have no religious background. I mean none. Like, you know, I I often make a joke. I had this Jewish client, his his family wasn't religious. They only they only went to the synagogue on the major holidays, Christmas and Easter, right? Like, because he, you know, there's aren't even Jewish holidays. people who are not religious, didn't grow up in religious homes, have no connection with religion whatever, come with shame around sex. So it's easy to blame religion, right? Just like it's easy to blame porn, we've talked about in the past.

Dr. Jacobson: but shame is there and and regardless of the person's background or their sexual orientation.

[25:00] How to Find Dr. Caleb Jacobson

Dr. Bawa: You give us such good information, and I'm sure some of our listeners want to get in touch with you. How can they find you?

Dr. Jacobson: So I'm all over the internet. That's the one thing. If if I am, I if I were ever lost, I'm easily found on the internet at Dr. Caleb Jacobson on Instagram, Twitter, and Facebook. I invite them to to check that out. They can also listen to my podcast, the Sex Therapy Podcast available everywhere. And if they go to my website, sextherapypodcast.com, there's a free gift waiting for them for the listeners of your show. So I invite them to visit sextherapypodcast.com.

Dr. Bawa: Tell them what that gift is. Get them excited.

Dr. Jacobson: They have a wonderful free book on 10 tools that will improve your sex life. Some of the things we talked about today when we talk about dealing with sexual dysfunctions. I talked about, you know, if you're wondering, well, I didn't tell you what type of cream or spray you should use if you have early ejaculation. Get this book. It's in there.

Dr. Bawa: That's awesome. And if they have any other questions, more of the medical questions, they can always contact me at askme at drsexfairy.com. And you didn't tell them you have a phone number.

Dr. Jacobson: I do have a phone number. I love your phone number. Very popular with the folks. So yeah, they can call me and I'll be happy to answer their questions at 616-DR-CALEB.

[26:29] Closing Thoughts

Dr. Bawa: And I said this to you before, I need a 1-800 Dr. Sex Fairy. Just saying. I need one of those numbers. So cool. So cool. Well, Dr. Jacobson, as always, you are wonderful. You are an absolute gem. Such a great addition to my podcast. Thank you for being here with me and for educating our listeners because sex therapy is critical to good sexual function. I've always said that. I've always believed that. And with your help, hopefully, and my medical expertise, we can help people achieve that.

Dr. Jacobson: Thank you so much for having me. It's always such a pleasure to hear from you and to talk with you.

Dr. Bawa: Thank you, my friend. Until next time. I hope you enjoyed the Dr. Sex Fairy podcast today. I would love to continue this conversation with you. If you would like to get in touch with me, email me at askme at drsexfairy.com. Don't forget to follow this podcast and leave me a five-star review. And make sure you follow my blockbuster hit TikTok account, Dr. Sex Fairy.