Samiksha Jain, Sexual Health and Relationship Counsellor & Vidya Bhat – Happy Relationships describe the changing attitudes towards seeking sexual therapy derived from a study they have conducted.
Seeking professional advice for sexual dysfunctions has, since time immemorial, been a huge taboo in India. Bearing the weight of a strong and virile archetypal male provider, the common Indian man, who has always satisfied his woman, feels ashamed and guilty of being unable to even “get it off the ground” or “hold the stage for a complete performance”.
The Dilemma of the Population
With quacks doling out bogus treatments, poor sources of knowledge amongst the general population, ignorance of facts in spite of practical experience most of the time, embarrassment and lack of courage to ask questions or seek solutions, is one of the main reasons why the stigma of sex is still very strong in the country. Many see this as a sign of weakness and shame to go to a doctor and worse still to a counsellor. Sometimes even when individuals want to seek professional help with a counsellor or Psychiatrist, it is the families that discourage them from seeking help for fear of marring the family reputation.
The Dilemma of the Professionals
From the side of professionals in the field including Sexual and Relationship counsellors, a lack of trained and certified professionals willing to offer genuine advice,counsellors being judgemental due to their own personal biases on sex, a general imbalance of female counsellors in the field handling the majority of male clients/patients, counsellors find themselves being ill equipped to handle their counselees even as the country sees an exponential rise in sexual dysfunctions.
How e-Platforms are helping the masses
With technological advances, genuine, and cost effective (sometimes free too) sex therapy and counselling to create awareness, understand and overcome sexual dysfunctions, is being made available to the Indian masses through various apps and websites. These include Lybrate.com, Cupid Care.com, Ask Mile (marriage and relationship oriented), etc. The biggest advantage these platformsoffer is anonymity and control to the patients in concealing their true identity. It has been a heart-warming experience to see males reach out and talk about their sexual and sexuality issues on these platforms guardedly at first, but with subsequent faith, opening up to share honestly their issues albeit embarrassing it may be to talk about it.
Our study suggests that 96% males vs. 4% females reached out to Dr. Sandip Deshpande, Happy Relationships, one of the experts in the area of Sexual Health in Bangalore, over a period of 6 months on an app where he offers his services. This means that there has been a huge attitudinal change from the previous practice, when men or women either kept their problems hidden and suffered in silence or consulted a friend or an elderly person for suggestions.
Ground Realities faced by the counsellor
The sex therapists or sexual health counsellorsworking in the field experience interesting cases which point out to a very impatient nature of clients to find immediate solutions. Many patients think that a prescription can solve all problems related to sexual dysfunctions. What needs to be understood that there are no quick fix solutions to such issues people face. Many issues crop out of ignorance and stubbornness of people thinking they “know what there is to know” about sex. This is leading to the men doing what they think is “right” without knowing actual facts, sometimes being misled by porn or wrong information from friends, leading to things going wrong during the actand subsequent suffering.
A common complaint that comes to many gynaecologists post the honeymoon is women with Urinary Tract infection that happens when the man tries to insert in the urethra instead of the vagina, which is the leading cause of pain and discomfort for a woman. This leads women to believe that sex is painful and their subsequent mind-set and attitude towards sex is anxiety and fear.
Anil (name changed for maintaining patient privacy) called to talk about his problem of Premature Ejaculation and how he was worried that his marriage will fall apart if he is not able to perform during his first night.He expected and demanded animmediate treatment because he felt insecure about his wife eyeing other men if he didn’t satisfy her sexually.
Another case was Radha who wanted tablets to get rid of the excruciating pain she experienced at the time of penetration since her mother in law was relentlessly pursuing her to conceive orKetan who wanted to pop pills to overcome his sex addiction.
One more problem faced by counsellors and Psychiatrist’s is regarding people lacking the interest to complete treatment and stopping midway during consultation. When some relief is seen, people discontinue with counselling. The ground reality is that out of 100 calls received, only 20% turn up for a consultation and maybe 2% come for follow up sessions. From these figures, we can conclude that the men have started gathering the courage to open up and seekprofessional help, but they demand medication for immediate relief, which indicates that they have either waited too long and the problem has worsened and/or their relationship has taken a toll, which makes them impatient to get instant relief.
A common notion amongst the Indian populace is that without giving out the embarrassing details to the doctor, they expect a common prescription to cure all ailments. Each case is different and needs medical attention and prescription only basis the Psychiatrist’s diagnosis. However, this notion has been encouraged by the practicing quacks and easy availability of over the counter magic potions and cures that offer a lasting hard on or one that promises day long performance. These solutions have been offered over the centuries in our country. However, this notion is far from the truth.
What is Need of the Hour?
Very simply, we need to destigmatize conversations about sex. What constitutes dysfunction can be quickly summed up as an issue which is commonly recurring and not a one-time occurrence. Secondly, it is something that causes deep anxiety and stress to individuals which affects his daily functioning and relationships.
Awareness needs to be created that sexual dysfunctions can be considered at four levels – mind, body, medications and at a relationship level. This can manifest differently in men and women. For example medications
We need to address the root of the problem which translates into at minimum of 3 -4 trips to the counsellor in order to share your history and then coming to understand the issue to enable a counsellor to make assessments and to refer to a Psychiatrist if and when the individual may need Psychiatric intervention. Else the whole issue can be resolved purely through counselling sessions. Yes, visiting a counsellor may cost higher than a visit to a normal physician to address a fever or pain. What we need to realize is that this kind of work needs hours of listening and understanding on the part of the counsellor. A qualified counsellor is hard to find as the field of sexual health counselling has not got its due share of attention from the Government or Medical fraternity making this a niche field and few professional and experienced counsellors in the space. A wrong counsellor can spell disaster as many counsellors are not equipped to handle sexual issues and can let their biases and sexual experiences guide them instead of taking a clinical and neutral stand on the issue.
Everyone needs to take this seriously and conduct awareness /destigmatizing workshops for the personal growth of every individual. How do you do this? By consciously taking up adult education programs at a CSR level at an organizational level as we see the effect of ignorance and misconceptions impact people at work in terms of their productivity, performance and work place relationships too.