Reflections on National Vagina Appreciation Day (by Amanda Stem)

While scrolling Instagram, I stopped at a post about “National Vagina Appreciation Day,” (April 23rd). Yay, my vagina has its very own day! Before hitting “add post to story,” I decided to take another look at the photo. It was a pretty pink vulva accompanied by a floral arrangement with parts identifiers in delicate lettering (think mons pubis in a modern garden). Cute. 

Wait. 

Vulvas and vaginas aren’t these delicate, flowery pillows that society - with the demand and wealth of the patriarchy - have spent decades, centuries making them out to be. Vulvas and vaginas do things like: 

• Shed an organ on a regular basis

• Have their own unique ecosystem with secretions and bacteria (lactobacilli)

• Serve as home to the only body part meant for pleasure and nothing else (the almighty clitoris)

Some vaginas rip and get shredded while ejecting another human, and in its natural state, the vulva is meant to be covered in coarse, rough hair as a first line of defense. 

Vulvas and vaginas are metal AF. 

This isn’t meant to dismantle anyone’s own personal ideas about their vulva and vagina. This is a shout out to the people in the back - those whose personal stories about their vulvas and vaginas aren’t represented in our society. To the trans men who are vulva and vagina owners, trans women who have had vaginoplasties, the folx out there whose vulvas and vaginas are in pain or a source of shame, y’all who let your pubic hair grow freely, the vulvas that are aging, and anyone who doesn’t see their vagina at a garden party, you are seen. 

While this is a shout out, it’s also a call to action for widening our preconceptions of who is and isn’t a vulva and vagina owner. Inclusivity can quite literally save lives. Inclusivity means people of all genders who are vulva and vagina owners can be safer in accessing healthcare services, people with vulva pain won’t be dismissed for having a true condition and have to wait years for the appropriate care, people of older ages won’t be overlooked as a human with reproductive organs and/or genitals that still need healthcare, and so much more. If you know a person with a vulva and vagina or provide care for people with vulvas and vaginas, this is for you (pretty much everyone). 

So as we admire the power of vulvas and vaginas every year on April 23rd, and each day in between, let us not think of feminine, small, and tight but instead strong, rugged, supple, and resilient.

Recommended reading:

The Vagina Bible by Jen Gunter, MD 

Amanda (she/her) is a psychotherapist with Out Of The Woods Therapy.

Click here to learn more about her therapy. When not in session, Amanda enjoys reading, running, and being a part of a cuddle puddle with 2 cats and an 11 month old.

Behind the scenes of a growing practice (by Jamie Brazell)

It feels exciting to have some good news - and also a bit strange because I think we are all so used to bad or scary news these days. I have noticed myself hesitating when something great is happening in my personal or professional life, waiting for the right time to make any kind of happy announcement. And then I remembered that most of us are also really needing to hear something positive right now. So here it is…

I have started hiring therapists to work with me through Out of the Woods Therapy!

The decision to grow my practice came out of several places. Mostly:

• I was tired of telling people, “No, I can’t take new clients.”

It is an incredible honor to receive referrals from various members of the community or to receive an email from someone who wants to work with me. I do have referral options, but often those options are also full.  

• The need for sex-positive therapy is overwhelmingly high. Most of my colleagues who specialize in this type of work are consistently full.

• I really want to be a good boss. This is how I introduced myself when I was in a Zoom class with Mountain Bizworks earlier in the fall: “I’ve had a ton of shitty bosses in my life. I really want to be a good boss.”

What being a good boss means to me is to lead with my values of empathy and viewing vulnerability as a strength rather than a weakness. It means that I desire to create an environment that is nurturing, supportive, and encouraging. I’m still doing my best to be a smart business person in the process of creating this dream - but I reject the idea that being in a position of power automatically means that you treat people as if they are less than human. 
And truth be told - I fully recognize that all of the time and energy I have spent on growing this practice has been a healthy coping mechanism for dealing with the burnout I was feeling from the pandemic and the overall state of the world.

So what do I consider most when hiring therapists?

I think about a lot of things, but mainly I am paying attention to whether or not I can affirmatively answer the following two questions:

• Can I imagine my current clients liking this person? (This is not because I intend on passing anyone on my caseload to a new person, but rather because I value their opinions).

• If I were not hiring this person, would I want to see them for therapy?

Those questions, combined with other practical considerations, are what have driven me to select the folks who will be working for Out of the Woods Therapy. I am so excited to introduce each one of them as they become ready to see clients. We are all doing tele-health for now until it is once again safe to resume in-person sessions. 

This has been a big, personal post. I am following it immediately with another blog post to officially introduce Caroline because she deserves her own spotlight. 

Thanks for reading! 

on boundaries (by Jamie Brazell)

Over the past several months, I’ve been writing about qualities of healthy relationships. In prior posts, I’ve explored empathy, vulnerability, and curiosity. This time I’m diving into boundaries - how we communicate what we want and do not want in our relationships. 

One of my loved ones recently shared the thought that it’s absurd how most of us are taught about boundaries in pre-school and kindergarten, but the lessons usually end there. Could you imagine if you were taught math in kindergarten and then only again for a couple of days over the next several years? 

I wish we’d have more lessons that help foster healthy relationships throughout our development for the sake of reinforcement and growth - like communication skills, compassion, boundaries, and comprehensive sex education. I know that there are folks out there who strive to do that kind of work, but there are many systems in place that prevent these changes from happening on a larger scale.

I’m breaking down my thoughts on boundaries in two parts for this post. Part one explores attachment theory and boundaries. Part two includes my response to an anonymous question from a Vino & Vulvas panel event. 

part one: boundaries and attachment theory 

I love thinking about how boundaries relate to attachment theory - a framework that explores ways humans relate through secure and insecure (anxious, avoidant, or disorganized) attachment styles. 

Although we begin development of our attachment styles through experiences with primary caregivers, these styles are fluid rather than fixed. This means that if you started off with a more insecure attachment style, you can (through personal growth work and healing relationships) develop what is called an earned-secure attachment style. It also means that it’s possible to shift into an insecure attachment style if you’ve experienced significant relational stress or trauma. 

Attachment style is contextual. You might feel incredibly secure with a best friend, but anxious or avoidant with a romantic partner.

Boundaries can be messy, unclear, and sometimes change so regularly that it can be challenging to keep up. It is best to not assume when it comes to boundaries, but rather to communicate about your own or to ask about someone else’s. (Remember that old saying about assumptions? How they can make an ass out of you and me?)

Your boundaries are likely different in each relationship in the same way that your attachment style differs. In the book, “Coping with Trauma-Related Dissociation,” the authors outline examples of “healthy” versus “unhealthy” boundaries in three different lists.

*A quick suggestion before moving on: It’s tempting to see “healthy/unhealthy” and think “good/bad.” A challenge I’d like to offer is to simply consider them as they are rather than hold judgement. The truth is that we all go to insecure places when we’re stressed. Most people have both healthy and unhealthy coping strategies. The extent at which something is “unhealthy” depends on the person and how problematic this is for them.

When applying attachment theory to the examples from the lists (which you can find here), this is my interpretation:

secure attachment = “healthy” boundaries

anxious attachment = “too lax/collapsed”

avoidant attachment = “rigid”

disorganized attachment = combination of both “unhealthy” lists

A person with a mostly secure attachment style is likely to present with healthier boundaries. A person who is under relational stress or who has endured attachment wounds will present with more qualities on the unhealthy boundaries lists. Again, since attachment styles are fluid rather than fixed, it’s common to see examples that you might relate to in each category. I refer to this list from time to time as a way of re-evaluating how I’m showing up in my relationships. If I’ve noticed that my boundaries have been more on the unhealthy side (anxious attachment style tends to be my go-to under stress), I consider the stressors and reach for strategies to help myself get back to a state of regulation and security. 

We all need healing from relational wounds. If you’re finding yourself in more of an insecurely attached place, it can be very helpful to learn more about your attachment style so you can explore ways of better understanding your feelings and needs. I’m including resources at the end of this post that I think are quite helpful. 

Part two: boundaries and consent

(content warning: unwanted sexual experiences - head’s up if you’re not in the mood to read about this and also encouragement to do what you need to do to take care of yourself if/when you feel triggered) 

During a Vino & Vulvas event, we received an anonymous two-part question that I felt needed more time to answer and thought it would fit well into a blog about boundaries.

This was the first part of the question: 

“Please talk about the nuances to consent with regards to partnerships where one person may not have the ability/comfort/sex education to speak their needs. How is that navigated?”

All sorts of things can interfere with our ability to communicate about sex (with power dynamics being at the very top of that list of considerations). I happen to think that just because a person has more experience in terms of numbers of partners or years of sexually engaging activity, it doesn’t mean they have mastered the skills it takes to communicate well in all of their relationships - even though it’s easy to assume otherwise. 

If you suspect that you are the partner who has more of an advantage with ability/comfort/sex education, consider how your approach can empower your partner in a way that is fun or pleasant for both of you. 

Everyone differs in their ability to communicate clearly for all sorts of reasons and we can’t always guarantee that what we have communicated is interpreted accurately. This presents complications when it comes to advocating for one’s own needs. It also means that we share the responsibility in relationships for how we send and receive information. Reflective listening, asking clarifying questions, and having an attitude of curiosity can go a long way in developing these skills together. It takes practice, patience, and a dedication to creating a culture of good communication in any relationship. It can also be very helpful to learn about attachment theory (as mentioned above) and explore each of your attachment styles to better understand one another. 

When I think of comfort, I consider the various ways in which shame and sex are interconnected as a result of omnipresent negative messages about sex. And in terms of education, I’m convinced that most people in our culture haven’t had the sex education that I believe all of us deserve - which includes comprehensive information on pleasure, sexual diversity, and enthusiastic consent in addition to information about STIs and reproductive functioning. This has less to do with ability or disability than it does with overall lack of resources and cultural support around sex education. This type of education can be hard to find, but great resources do exist (see the end of this blog post for some of them). 

Ideally, you will feel empowered to communicate with your partner before, during, and after a sexual experience. If you aren’t feeling confident in your knowledge or hold shame about sex, seeking out ways of overcoming those barriers can transform the experiences. 

The second question stated:

“To what degree is it a person’s responsibility to say/communicate a “no” and to what degree does the more communicative partner “read them?”

I believe that we share responsibility in our engagement with others, but as I mentioned above, we must consider the power dynamics in any relationship. Many people have been socialized into being deferent towards others (particularly those raised female or other marginalized groups) and this can make saying “no” a challenge. It’s also possible that a person can be fairly assertive in just about every other area of their life until sex enters the equation. If you are the person in the relationship who holds more power in this context, having awareness of what that means and treating your partner with care and respect will go a long way. I can’t stress enough how important it is to be sure that you are getting an enthusiastic YES - especially when it comes to physical engagement with another person. 

It certainly helps to communicate about what’s going on for you before engaging sexually with another person. Nobody will ever have the ability to read your mind and it doesn’t matter if you’ve been together for decades. Some people will be better at attuning to your needs than others, but that kind of a rapport takes time to develop and can also change over time. It’s very important to pace sexual experiences to the level of comfort of the person who needs to take things the slowest. I can’t tell you how many times I’ve heard someone say that they feel afraid to speak up about their needs before, during, or after an experience. Some people will bear pain because they are afraid to speak up. 

I don’t believe that most people in relationships set out with a desire to cause unwanted harm to their partner. I do believe that people wound each other in relationships in all sorts of ways because that is an unintended consequence of being imperfectly human. In the context of a relationship, the lack of awareness of boundaries, communication of boundaries, or ability to advocate for selves can be very damaging for both people over time. 

The nervous system can respond with more options than fight or flight. For many of us (especially survivors of sexual trauma), a freeze response can happen as quickly as any reflex. If you have a sense that you might experience freeze responses in sexual situations, talk about this before you have sex with your partner. You can let them know that this is a thing that happens sometimes and that you might need to either slow down or stop altogether, but that you might not have the words in the moment to ask for what you need. Think about the possible answers to “What I may need for you for support is ________ or _________ if you notice me __________ or ___________” as well as, “You’ll notice that I’m enjoying myself when you see me __________ or hear me ___________.”

I hate that I have to end this with the following words, but I feel that way because I wish it weren’t necessary to say this all of the time. If you have been assaulted or abused in any way, it’s not your fault. For most survivors - myself included - we need to hear that message with a certain amount of frequency in order to combat the internalized shame from enduring these traumatic experiences and from living in a culture where it is often difficult to find empathy or support. 

When it comes to the topic of unwanted sexual experiences, we usually hear the wrong questions asked that tend to blame the person who was harmed such as, “what were they wearing?” or “why were they in that place at that time?” or “why didn’t they say no?” 

We don’t hear, “why did this person harm that other person?” nearly enough. We don’t adequately focus on understanding why someone thought a no was a yes or why they thought a lack of a yes was a yes. And although I stated that I don’t believe most people in relationships intend to harm their partners, there are plenty of people out there who are being abused by their partners and who are even told they are not allowed to have boundaries. Sometimes people will fear putting up a boundary with a partner because they “don’t want to give them an ultimatum” (which tends to have a negative connotation). 

The more we normalize talking about our feelings and needs, understand healthier expressions of boundaries, and work to heal our attachment wounds, the healthier our relationships will feel overall. 

The next blog post will address accountability and repair in relationships. 

Resources:

sex education:

Drawn to Sex: The Basics by Erika Moen & Matthew Nolan (who also have a website where they review sex toys that you can find here).

Come as you Are by Emily Nagoski - for anyone who has or loves a vulva

local shops in Asheville:

VaVavooom - body-safe adult toys, books, and more

Firestorm Books & Coffee

other resources:

Scarletten website - Don’t be fooled by the fact that this website says it’s for “teens and emerging adults.” Every adult I know is an EMERGING ADULT. I refer to this site (particularly the page that this link brings up) with grown-ass adults all of the time. 

Savage Love Podcast - Dan Savage has been in the sex education world since he started his syndicated sex advice column, Savage Love, in 1991. Over the years, so much has changed and evolved - including Dan! So if you’ve ever been offended by him in the past, he’s worth a revisit.

Vino & Vulvas events are now available online if you are unable to attend the in-person monthly panels.

attachment theory:

My friend, Elizabeth Gillette, is an expert on attachment theory. She spends a lot of time thinking, writing, and now podcasting about attachment theory and relational healing which largely informs her approach as a therapist and as a human in general. I find myself resonating a lot with Elizabeth’s work and feel very grateful that I have had opportunities to spend time with her in workshops and in community. I very much encourage diving deeper by checking out Elizabeth’s work. A great post to start with is here. The first blog post she has listed includes a link for a really great attachment quiz.

trauma resources:

The Body Keeps the Score by Bessel van der Kolk - one of the best books written about trauma (in my opinion)

Complex PTSD: From Surviving to Thriving by Pete Walker - for child abuse survivors - emotional, physical/sexual abuse, or neglect

Boundaries list from Coping with Trauma Related Dissociation by Boon, Steele, and van der Hart - for those suffering from trauma-related dissociation.

Lost Connections by Johann Hari - this book normalizes depression and anxiety as parts of the human condition and explores ways in which a variety of disconnections can exacerbate these experiences. 

Mindsight: the New Science of Personal Transformation by Daniel Siegel

Pandora’s Project - support and resources for survivors of unwanted sexual experiences and their friends/families

If you struggle with attachment wounds that impact how you operate in relationships or if you hold shame in the area of sex, unpacking these feelings and thoughts with a therapist can be an awesome healing opportunity and a chance for you to deepen your relationship with yourself. If this is not accessible for you at the moment, I recommend looking for community support groups in person or online, utilizing book or website resources, and using free mental health apps. Also bear in mind that talk therapy is often not enough for many survivors of trauma. It’s common to need a multi-disciplinary approach to this type of healing journey. This can mean incorporating additions to talk therapy such as a meditation or yoga practice, Equine therapy, Somatic-experiencing therapy, EMDR (Eye-movement desensitization and reprocessing) therapy, TRE (tension and trauma release exercises), or other healing modalities.

My Secret Weapon Against Sexual Shame (by Jamie Brazell)

According to Carl Rogers, having unconditional positive regard for every client is essential to the effectiveness of the therapeutic relationship.

As a therapist trained in human sexuality, I tend to have a lot of interesting conversations about sex. I’m not just talking about with my clients, of course, because I have plenty of people in my life who want to engage me in discussions about sex and sexuality. (And yes, I can be a lot of fun at parties).

Sex is an interesting topic that is often incredibly personal - so I feel honored that people feel comfortable talking with me about their own sexual stuff.

From these various conversations, the number one underlying issue that I see when it comes to sexual issues or concerns involves a powerful force known as shame. 

Think about shame as this invisible assailant who can overwhelm a person to the point where they feel shut down or unable to take action. It can be devastating. Guilt, on the other hand, which is often confused with shame, will cause a person to take action out of this sense of feeling bad and wanting to make amends of some sort. Guilt is more of an action-oriented force while shame will make a person want to hide under the covers and hope nobody notices. 

Here are some ways I’ve encountered

sexual shame in others:

• Internalized Homophobia - One of the most heartbreaking statements I’ve ever heard someone say was, “I am an abomination.” And they really believed it at the time. 

• Underlying questions of: Am I okay? or Is this okay? about sexual behaviors- for example, “I get turned on by this particular kink…but I think it’s really weird.”

• Sexual abuse survivors often (not always, but often) express a variety of shame-based feelings.

• Statements like, “My body isn’t performing as it should and therefore I’m not man-enough (or woman-enough or person-enough); I’m somehow broken and it’s all my fault.”

• Slut-Shaming - “If I tell my partner (or anyone) the truth about my sexual history, they won’t accept me and they’ll think I’m a total slut.”

Sexual shame is particularly powerful because it tends to rob people of accepting sexual pleasure. It can create inhibition, insecurities, or isolation. It can convince someone that the sexual abuse they experienced was somehow their fault. It can convince a person that they are fundamentally flawed because they were taught that their desires are wrong. It can impact relationships and cause great divides between people. 

Because shame causes us to hide, it can be especially challenging for a person to communicate these feelings or parts of themselves. Think about how destructive that can be for relationships - because when there is no communication, the only thing people have to operate on is their imaginations. While it’s very typical (and probably an inherent biological survival function) for humans to create assumptions, imagine what would happen if we only operated on our assumptions. 

I believe that the first step in overcoming shame is to realize what it is, where it comes from, and how it is causing destruction on the self and relationships. Identifying that the shame is impeding the healing process can help to unblock movement towards goals. Overcoming shame almost always involves some form of self-acceptance. This can be challenging because it can involve undoing years of negative self-talk that may be based on repetitive messages a person has heard from their families, their communities, or other various cultural associations.  

It takes so much courage to fight shame of any kind, but sexual shame is a particularly challenging force because it is so deeply personal and because it can often stay hidden unless we decide to take the risk of reaching out. It can take an immense amount of trust to talk about issues involving sexual shame. I believe that trust can be built only when a person has room to be who they are and feel that they are accepted without conditions. And from earning that trust, my hope is that I can help people to overcome that shame and put it to rest for good. 

My secret weapon against sexual shame involves earning trust by offering what Carl Rogers referred to as unconditional positive regard. Trust is not always easily earned nor easy to give in every situation. The entire time I’ve been writing this, for example, I’ve been thinking about whether or not I believe there are exceptions to fighting shame. I considered the people who experience shame as a result of having done something very harmful towards someone else (such as a perpetrator of sexual violence). My thoughts on this are that it would still be beneficial to fight the shame and turn it into something else - something healing. Societally, we need to do a better job of addressing and treating sexual shame of that nature, too, so that people may receive better treatment options and increase potential for prevention of sexual abuse. 

SEVEN Ways That Therapy Can Really Help You (by Jamie Brazell)

In case I hadn’t mentioned it before, I consider myself to be a therapy success story. This post has been written with the consideration of two perspectives: from the person in me who greatly benefited from therapeutic counseling at various points throughout my life and from the therapist in me who has had the privilege of working with truly inspiring clients. 

You've SO got this.

1. Accountability.

When you are in therapy, you are the most important person in the room. That’s not such a big surprise, of course. But it is interesting when you consider that most of the magic that happens “in therapy” is a result of the actions that you take outside of therapy. I believe that there is an accountability factor that happens - that simply the idea of being in therapy can be enough to motivate a person to start making positive adjustments or thinking about setting new goals. I’ve heard from numerous clients (individuals and couples) about how they started acting differently as soon as they committed to the idea of making the first appointment. And we hadn’t even met yet!

2. The Relationship.

    The therapeutic relationship is so important that I can’t stress enough how critical it is to find the right fit for your style, your personality, and your needs. I know enough to know that I can’t possibly be the right fit for everyone. Sure, that breaks my heart ever-so-slightly (because I have that human response of wanting everyone to like me). But the reality is that therapists have different styles, personalities, and specializations. 

    When it comes down to it, you want someone who you feel that you can talk to, who you feel like “gets” you, and who you feel like will encourage you to do the things that you want to do to improve your quality of life - no matter how big or small those goals may be. The therapeutic relationship is unique, of course, because the primary focus is all about you and your needs. Also - you may have different needs for different life experiences you are having. The therapist who helped you when you were a depressed teenager may not be the same person you want to talk to when you are having relationship issues in later adulthood. 

3. Saying it Aloud & Realizing It for the First Time.

Some of us are really good at being in our own heads. This can be true for introverts and extroverts. Sometimes we carry our thoughts with us and don’t have opportunities to exercise where those thoughts could go. Have you ever had one of those moments when you were talking to someone about things you’d been thinking of (or ruminating over) and had a realization that had not been evident before (even though you’d spent a great deal of time thinking about things that were relating to this epiphany)? I’ve experienced this firsthand and I’ve also seen it happen with clients hundreds of times as a therapist. 

4. Educational Component.

Therapy provides an opportunity for you to learn more about yourself and your relationships with others. No, your therapist doesn’t know you better than you do. You are the ultimate expert on yourself and you know your relationships better than your therapist - but your therapist can offer you tools for creating positive changes or provide a different perspective that may uncover things you had not discovered prior. And if your therapist has a specialization or is an expert on certain topics, you might just learn something new that can contribute to your life in a meaningful way. 

5. Explore Parts of Yourself In-Depth without Judgment or Ridicule.

You may have plenty of loved ones in your life who you can talk to about most things, but maybe you can’t talk with them about all things because they might not always know how to respond in the most loving and compassionate of ways. (And sometimes people are so well-meaning, but they really don’t know what to say). Or maybe you have a hard time talking with anyone about things that are deeply personal, but need to work some things out by talking with another human being. Therapy, at its best, provides the opportunity to express your thoughts and feelings without judgment or ridicule. I know that not all therapy experiences come with this built-in philosophy of acceptance, but it is extremely important and can be a good indicator that you’ve found your right fit when you feel comfortable expressing yourself to your therapist. 

6. Repeating Stories.

This helps people to move on, take action, or sometimes just make sense of it all. Sometimes you might need to talk about something over and over again until you don’t need to talk about it anymore. You may find that the narrative changes over time because your feelings may start to change about the experience after processing it and thinking from various perspectives. 

7. Therapy Can be Reassuring and Empowering.

I think of this person often who told me they wanted me to fix them. My response was, “What if we find out that you’re not really broken?” But sometimes we feel broken when we’re going through something terrible or when terrible parts of our past have come back to haunt us in the present. Therapy may be a chance for you to discover that you’re okay for who you are, that you have reasons for feeling the way that you do, and that you have options for making positive changes in your life. 

So do you always need a therapist in order to obtain a therapeutic experience or a therapeutic relationship? Not always. Animals are really great listeners who won't judge or ridicule (most of the time, at least). They also provide a lot of teachable moments, too. 

Thank you for reading this. Have an amazing day. 

In memory of Artemis - who provided a therapeutic relationship without ever knowing he was doing that.