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May 29
  • Written By Scott Drochelman

    • #186 – Ask The Expert – Dr. Kate Balestrieri

    Dr. Kate Balestrieri

    Reclaiming Your Sex Life After Trauma

    Dr. Kate Balestrieri, Psy.D., CSAT-S, is a Licensed Psychologist, Certified Sex Therapist, Certified Sex Addiction Therapist, and PACT III trained couples’ therapist.

    Dr. Balestrieri earned her Doctorate of Clinical Psychology from the Illinois School of Professional Psychology, Chicago, and completed her Post-Doctoral Fellowship through the Northwestern University Feinberg School of Medicine, with a concentration in Forensic Psychology. 

    Dr. Balestrieri is a passionate advocate for mental health, relational and sexual health and wellness. Throughout her work, Dr. Balestrieri focuses on helping people build resilience and recovery from what ails them to move from a position of pain or discomfort to one of thriving, holistically in their lives. 

    As a sex positive provider and human, Dr. Balestrieri is dedicated to helping people have a more expansive and integrated relationship with sex. 

    Dr. Balestrieri is a regular contributor for Poosh, YourTango, Psychology Today, House of Wise and has been featured in many other publications. She also has two podcasts, Modern Intimacy (focused on sex, mental health and relationships), and Without Consent (a true crime podcast deconstructing sexual violence). Both can be found on Apple podcast and Spotify.

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    Episode Transcript

    Ashley Loeb Blassingame:

    Coming up on this episode of The Courage to Change sponsored by lionrock.life.

    Dr. Kate Balestrieri:

    I think it’s a place that a lot of survivors have shame in either polarity. They often think to themselves, “Wow, I’ve really… I’ve extinguished my sexuality. I’ve lost that part of myself. I’m broken because it’s not accessible to me, and I don’t want it to be. Or I want it to be, but I don’t know how it can be, so I just keep it over here in a box on the shelf, never to be looked at or spoken of again.” And on the other side of that polarity, there are a lot of survivors who say, “No, my sexuality is mine and I’m going to express it in this big, loud, bold way, and have as much of it as I want.” And the thing that both polarities have in common is both are an exercise in autonomy and control as a way to heal from an experience that feels so helpless, so powerless, and so out of control.

    Ashley Loeb Blassingame:

    Hello, beautiful people. Welcome to The Courage to Change, A Recovery Podcast. My name is Ashley Loeb Blassingame, and I am your host. Today on our expert episode, we have Dr. Kate Balestrieri. Dr. Balestrieri, Psy.D., CSAT-S, is a licensed psychologist, certified sex therapist, certified sex addiction therapist and PACT III trained couples therapist. Dr. Balestrieri earned her Doctorate of Clinical Psychology from the Illinois School of Professional Psychology Chicago, and completed her postdoctoral fellowship through the Northwestern University Feinberg School of Medicine with a concentration in forensic psychology. Dr. Balestrieri is a passionate advocate for mental health, relational, and sexual health and wellness. Throughout her work, Dr. Balestrieri focuses on helping people build resilience and recovery from what ails them to move from a position of pain or discomfort to one of thriving holistically in their lives. As a sex positive provider and human, Dr. Balestrieri is dedicated to helping people have a more expansive and integrated relationship with sex, and has been featured in many other publications.

    She has two podcasts, one called Modern Intimacy, which is focused on sex, mental health and relationships, and another called Without Consent, a true crime podcast deconstructing sexual violence. Both can be found on Apple Podcasts and Spotify. Friends, this was such a fun expert episode. We talked about consent. We talked about who pleasure is for. We talked about whose responsibility it is when providing pleasure. We talked about a common path for sexual trauma recovery and what that looks like. And we talked about sober sex and the experiences of people coming into recovery and reclaiming their power in sexual relationships, what that might look like. We added lots of resources throughout this podcast, and of course gave information for you to contact Dr. Balestrieri directly if you are interested in her work. I hope you enjoy this podcast as much as I did. Without further ado, I give you Dr. Kate Balestrieri. Let’s do this.

    You are listening to The Courage to Change, A Recovery Podcast. We are a community of recovering people who have overcome the odds and found the courage to change. Each week, we share stories of recovery from substance abuse, eating disorders, grief and loss, childhood trauma, and other life-changing experiences. Come join us no matter where you are on your recovery journey.

    Dr. Balestrieri, thank you so much for being here.

    Dr. Kate Balestrieri:

    Thanks so much for having me.

    Ashley Loeb Blassingame:

    Tell me a little bit about how you got started in psychology.

    Dr. Kate Balestrieri:

    Psychology is a second career for me, and I used to sell employee benefit health packages, believe it or not. I really enjoyed that work, but I wanted something that was a little bit more artful, and something that offered a bit more nuance if I was going to spend the next 40 years of my career doing it. So, I decided to go back to school and change careers in my late twenties. In the field I started working initially as a clinical and forensic psychologist and did a lot of work in prison systems with convicted sex offenders and non-sexually violent offenders, and learned so much about the human condition in that space. So, when I eventually got a bit burnt out working in the prison systems, transitioned into other forensic work, and then eventually private practice, and really decided to specialize in working in an area that allowed for more sex positivity, and allowed for a closer connection to the human experience. So, working as a sex therapist for me has been all about renewal and integration, and helping people create a relationship with thriving pleasure and abundance that feels really rewarding.

    Ashley Loeb Blassingame:

    I love that. I love that. And I think it’s such an important piece. You talked a bit about working with sex offenders, and I want to ask you a little bit about that. When you were working with sex offenders and talking to them about things that had happened or things that they had done, what kind of revelations did you have about sex and all its forms and how you could be helpful in the world?

    Dr. Kate Balestrieri:

    I really appreciate that question. I think one of the things that stood out to me the most in working with sex offenders was the narrative that they had about sex was so undereducated, first of all. There was a lot of misinformation and a lot of knowledge that they really didn’t have about sexuality and their own relationship with sexuality. And the other thing that became so perfectly clear to me, although I know we talk about this in the world when we talk about sexual violence, the thing that became so crystal clear was that sex for them was a vehicle to communicate so many other needs. And that’s true for most of us.

    But the underlying needs that they had usually reflected some incredible vulnerabilities and insecurities. So sex was less about pleasure and it was more about finding a connection to power through violence that took on the iteration of sex. So it was a really interesting paradigm to work in because when the small faction of them who did have big progressive movements in their therapy, when they would have these revelations and be able to reposition sex as something that gave them access to their own vitality and creativity, but really pleasure without violence over someone else, they had a really different experience with sexual pleasure, sensual pleasure, and it was like seeing them reborn, honestly, as new humans, and it was really rewarding work.

    Ashley Loeb Blassingame:

    One thing I’ve wondered, as I’m sure you have experienced, I’ve worked with so many people with addiction, with mental illness, who have been abused. I’m also a person who experienced early childhood sexual trauma. We spend so much time helping people who have sexual trauma because it’s so prevalent, and we spend so little time trying to prevent it other than us hiding our kids away, or looking around every corner, or the comparison of what we do to try to prevent and what we do to try to help after the fact is really unequal. In your work with sex offenders, are there things that we could be doing on a communal level that would be helpful in making progress?

    Dr. Kate Balestrieri:

    Yes. I’m going to answer your question, but I’m going to start by sort of a, what what might seem like a bit of a non-sequitur for a second. There’s this really amazing assessment tool that some couples therapists use called The Marital Social Justice Scale. And this whole assessment tool is based on the idea that our smallest social system is that of two people in relationship. And primarily in our culture, we look at marriage or partnership as one of the sources for the most number of two person systems. So, when we look at the way that we can address sex offenders and the rehabilitation of perpetrators, and the prevention of sexual violence, we have to start by looking at our social systems, and looking at the ways that we talk about power dynamics, the way that we talk about our worthiness as humans, and start by approaching those dynamics in non-sexually violent relationships.

    Because when we start to explore things like power and equity and equanimity in our romantic relationships, for example, we start to see that those are some of the places where a lot of power inequities are acted out unconsciously, sometimes consciously. In many of those romantic relationships, sexual violence can be a way that power disparities are enforced, maintained and begeted. The other thing to note about sexual violence is that stranger danger is not really the place where we should be focusing our attention, because perpetration so often and far more frequently happens when the assailant is known to the victim. And it is often a very long, grooming predatory process before sexual violence ever happens. It sucks to think about it this way, but we really do need to look at our relatives, our friends, our neighbors, our teachers, our coaches. Those are the folks that we should be the most concerned about because they have access to our children, they have access to us as adults, and it’s the place where predation happens more often than this mythical strain, not mythical, but this less common stranger danger.

    Ashley Loeb Blassingame:

    Do you advise parents when you talk to them on things like not having sleepovers? Or are there things that very specifically you recommend as first line of defense, easy thing to do?

    Dr. Kate Balestrieri:

    Yeah, that’s such a difficult place to be with parents, because there are many benefits that come when kids have close friendships that include sleepovers with their friends, and there’s a lot of bonding and socialization that happens there that really can’t happen in other contexts. So, I don’t purport to believe that sleepovers are inherently good or bad. But what I talk to parents about is how well do you know the other parents? What kinds of boundaries and safety conversations would you like to have with your children so that they know when something is inappropriate, and feel comfortable coming to talk to you about it?

    How will you help be a safe harbor for those conversations so that they can preserve their friendships, and not be ostracized in their social groups at school and yet still have a lot of protective boundaries in place? For some parents, that looks like really getting to know the parents. Or it looks like, I’ve even worked with some parents who have sleepovers in the sense that they will each rent their own hotel room and rent a hotel room for their kids. And so they’re all there in space, but there aren’t unsupervised adults or age inappropriate folks hanging out with their kids. So, that’s one way that parents who are trying to have a more conscious approach to this can do it if they have the financial means.

    Ashley Loeb Blassingame:

    What is the prevalence of people who have experienced sexual trauma?

    Dr. Kate Balestrieri:

    It depends on the resource that you source for that information. But RAINN, which is the Rape and Incest National Network, RAINN is one of the go-to sources for statistics around sexual violence. They are citing something like one in three people socialized as women have been sexually abused in some way, shape or form prior to the age of 18. And I think it’s one in six people socialized as boys or men. The rates of incidents around sexual violence are exponentially higher for people of color and for folks in the LGBTQIA+ community. So again, folks who are in minority groups, folks who have lower positions of power, are often victimized and chosen because they are seen as easier people to target.

    Ashley Loeb Blassingame:

    And you’ve done work on the healing process. So, we do so much work on healing survivors, different types of EMDR. We really talk a lot in the mental health space about coming back from this, being a survivor. One thing that people don’t talk about as much is part of that rehabilitation is learning to have a healthy sex life in some way, shape or form. And that’s something that you have this incredible background in because you’ve worked with both the offenders and the survivors, and have this ability to help people come back from this unhealthy view of what sexuality is. Can you talk to us about what that’s been like and what your journey there has been?

    Dr. Kate Balestrieri:

    It’s just such a beautiful experience to see people find a place of peace in their own bodies. And that peace can sometimes be the thing that is robbed from survivors of sexual violence. It is so painful to think about how to even get started in sex again from a place of autonomy into place of volition, when that very construct has been something that’s been overpowered and challenged and consumed without your consent. So, working with survivors is really, from my perspective, it’s a collaborative process of helping that survivor find their voice, and find a place in their body again that feels not only safe, but comfortable, and from a place of safety and comfort, what feels pleasurable, what feels accessible in terms of expansion, what feels available in terms of creativity and growth and healing.

    Because when sexual trauma is something that someone is sitting with, sometimes sex can feel really scary, even if it is coming from a place of desire and consent and momentum in a person’s life. It’s a dance, and it’s one that I feel really honored to be a part of with folks. I am also a survivor of sexual violence, so I really come into this work from a place of humility and a place of constant growth myself. I’m learning always where to deepen and how to deepen my relationship with sex in a way that feels truly empowered.

    Ashley Loeb Blassingame:

    I knew people who were survivors of sexual trauma and they put on a lot of weight. They tried to be unseen, make themselves unseen, make themselves small in space and unattractive. And I don’t mean physically, I mean literally unseen by people, and as little sexuality as possible. My response was to go the complete other direction and be as loud, and in my space, and try to recapture power by taking it. Neither one is really great. They’re both just responses to those desires. However, you often will see these two ends of the spectrum.

    Dr. Kate Balestrieri:

    Absolutely. I’m so glad you’re bringing that up. I think it’s a place that a lot of survivors have shame in either polarity. They often think to themselves, “Wow, I’ve really… I’ve extinguished my sexuality. I’ve lost that part of myself. I’m broken because it’s not accessible to me, and I don’t want it to be. Or I want it to be, but I don’t know how it can be, so I just keep it over here in a box on the shelf, never to be looked at or spoken of again.” And on the other side of that polarity, there are a lot of survivors who say, “No, my sexuality is mine and I’m going to express it in this big, loud, bold way and have as much of it as I want.”

    And the thing that both polarities have in common is both are an exercise in autonomy and control as a way to heal from an experience that feels so helpless, so powerless, and so out of control. So, both are adaptations. They are both expected, typical adaptations. Neither is right or wrong, good or bad. And some folks choose to stay in those polarities for a longer period of time or even forever. And some folks choose to or find their way back to unconsciously more of a middle ground with their sexuality.

    Ashley Loeb Blassingame:

    What is the wreckage being done to people who experience some sort of sexual event where they cannot give true consent? And what I mean by this, and the reason I’m asking it with this dancing language is there’s so many different types of sexual trauma that often, and my experience is one of them, that often don’t feel super traumatic at the time because you know this person, and they’re not that much older than you, or maybe they’re in the same… So, these things happen and there’s a power dynamic you don’t even sense. Or you’ve been groomed enough that you think you’re an active participant. You don’t understand. So, what is the wreckage of these psyches being done in situations? And I guess I’m asking you to be very broad here, but in the broad sense of when these circumstances where consent is really not being applied to both parties.

    Dr. Kate Balestrieri:

    Such a great question. There are so many different impacts. I’m going to just run through a few different domains of our human experience that can and usually are impacted to varying degrees depending on each person and their pre-trauma experience of themselves, where they are in their neurobiological development. Sexual trauma can change the way our brains develop, so it can have lifelong impediments depending on the age of the victim. It can change the way that our brain and body communicate. A lot of survivors will, especially if they experienced significant amount of sexual trauma, or even a one-time experience that was very intense, the amount of dissociation that can occur during that sexual experience or confusion can actually interrupt the somatosensory networks between their brain and body from really being able to communicate.

    So, a lot of survivors will experience numbness or a lack of sensation in their genitals or the parts of their bodies that were affected by the sexual trauma, even if it wasn’t violent or aggressive trauma. And I think that’s a big thing that a lot of folks don’t understand. So much sexual abuse is not experienced as aggressive violence. It’s experienced as something that was told to them as enjoyable, pleasurable, a positive secret. A lot of child sexual abusers are very good at getting the children to think it’s a fun game. And for a lot of those children, they grow up later in life, and that’s when they have the reckoning of what happened to them. It can really create a lot of cognitive dissonance. It can change the way people think about themselves, other people, the relationships that they might have romantically, and the world. It can change the way people engage socially. It can interrupt their sense of security from an attachment perspective. It can change the way they trust friends even, or employers, or senses of authority in general.

    It can change people’s relationship with food and with money, because it ultimately can influence the sense of worth that people feel they have in this life. It can change their ability to function and provide for themselves. On the flip side, some survivors go headfirst into some sort of professional direction so that they can feel a sense of worthiness tied to their achievements or their financial status. Sexually, we’ve talked about that, it can create these polarities of hypersexuality or hyposexuality. It’s normal for people to have fluctuations in their amount of desire as they go through life. But for survivors, it can feel incongruent with who they are and the kind of sex that they’d like to be having.

    It can change our relationship with spirituality. It can change peoples relationship with parenting. A lot of survivors choose not to parent because it’s way too scary and they don’t want the vulnerability that comes with that, or they don’t want their body being taken over by a pregnancy. I know I’m leaving a whole lot out, but it is profound. And the experience of healing is such that people can assimilate their experiences and have a lot of joy in life, and have a really fruitful, rewarding life. But it may be that as they reach different milestones, they have to sort of re-experience that trauma and understand it in a new way, or understand something about themselves in a new way. It’s an interruptive process that is unfortunately often lifelong.

    Ashley Loeb Blassingame:

    Yeah, it sounds like it can do a whole hell of a lot of damage. There’s a great book called The Boy Who Was Raised As a Dog, And Other Notes, by a psychiatrist. And the book, as it seems like you’re familiar, it’s phenomenal, and it talks a lot about the different ages of when trauma happens and how that can affect the brain. And I remember reading that. And it’s really interesting how sexual trauma in your twenties is so, I mean, just worlds away from sexual trauma at six. It’s just not… Your brain is just going to process it so differently, and makes me wonder about how often we are changing what they end up wanting in a partner, or what they’re sexually attracted to as a response or result of that rewiring.

    Dr. Kate Balestrieri:

    Yes. That question comes up so frequently in the work that I do with survivors. Because a lot of survivors have big feelings about the fact that their erotic orientation or their arousal template, the things that they find exciting, include elements that were present during the sexually traumatic experience. And a lot of survivors have a lot of shame around that. A lot of survivors are shamed around that because a lot of folks will use that as an opportunity to victim blame. But the reality is our genitals don’t always know the difference between what is consented sexual touch and what is non-consented sexual touch. Sometimes our genitals do. A lot of times they don’t understand the difference, especially if it’s not a violent or aggressive situation.

    So, for a lot of folks, the experience of trauma can weave into their erotic template, and that is not their fault. And there’s nothing really they can do to prevent it because all of the experiences that we have as humans are fodder for what turns us on later in life. It’s a part of why our erotic orientation can be very flexible and expansive, and we can learn to be interested and aroused by different things if we give ourselves that permission. But for some folks, their desire is more rigid or more fixed, and it may take a long time, or may not really feel as possible to experience pleasure in different ways.

    So it’s okay for people to find pleasure in things that once brought them pain, and that in and of itself can be a part of the healing process. They can find a sense of control and autonomy in that. This dynamic is happening, but I’m in control of it. In fact, a lot of folks will employ kink as a method of healing because in a healthy, ethical, kinky situation, all partners involved are communicating the scene. They’re talking about boundaries. They have safe words. They honor each other’s nos. And that process can be incredibly empowering in playing with some dynamics around feeling overpowered, for example.

    Ashley Loeb Blassingame:

    How do you know when that process is empowering and when it is pathological?

    Dr. Kate Balestrieri:

    Great question. I just interviewed Dr. Holly Richmond on my podcast, and she and I were talking about this very thing. I love what she said about it. She said, “I often look at how somebody feels after they’ve had that exchange. Do they feel shameful? Do they feel guilty or they’ve done something wrong? Do they feel like a bad person? And if the answer to that question is yes, then it might be a trauma reenactment or a trauma repetition. But if the answer to that question is no, it might be that they’ve experienced an empowered way to be in these kinds of dynamics. And in a way that helps to build their sexual self-esteem and is a truly consented and pleasurable experience.”

    Now, the extra variable that I would add in there is that a lot of people do feel really good about the sex they’re having until someone else shames them for it. And so if that shame is coming from the outside, from a partner, from someone who’s judging you when you share your fantasies, it’s not intrinsic shame. I might argue that the problem is not what you like as pathological or that you’re in a trauma repetition, but perhaps maybe need to revisit your friend group or your partner.

    Ashley Loeb Blassingame:

    So, I have little boys, twin, six-year old boys, and we talk a lot about consent. And I feel strangely, very under-prepared to talk about consent. I’m a nineties kid and what was acceptable and how we did things then, and sort of what my palette is, is different and is different than what the norms are today. And I’m trying to get with the program. But there’s stuff that isn’t intuitive to me, to be honest. I’ve seen that there are lots of different ways to teach consent. And I’m curious, when you talk about consent, how do you describe it, and what are the different variations or cues that you give people who may not feel like it’s intuitive?

    Dr. Kate Balestrieri:

    Such a great question. Well, I just want to be clear. I don’t specialize in working with kids. But when I work with parents of kids, I’m often talking with them about bodily autonomy boundaries being the place to start in teaching kids consent. So, this is something that I learned both in my education, but really understood what I remember my own childhood. Like many people, I was one of those kids who was often encouraged to hug the elders in my family. Hug your aunt or uncle. Hug your grandparents. Hug these people. Give them a kiss. They’re here. They want to see you. They want to say hi to you. And that is a great place to begin the conversation about consent with your kids. Because by not creating an opportunity for your kids to say no to that, you’re teaching them that their body is in service of other people’s needs and wants.

    And it actually creates more vulnerability for your children to be perpetrated against by the adults around them, whether in your family or not. Now, a lot of older family members or parents will say, “No, no, no, my family’s safe.” Or, “You should kiss grandma because she misses you,” and all the things. And that’s culturally what we do. And I really appreciate that there are cultural norms around these behaviors. But just because something is a cultural norm doesn’t mean it’s good for our kids. And really looking at how to help our children understand that their body is theirs, and they get to say who touches them and when or why. That’s important. And it starts non-sexually. Work with the other adults in your family and talk to them and say, “Look, we’ve learned something new about parenting and this is what we’re doing. Please support us in this and honor our children’s no if they say no. And we’ll help generate other options for connection because we understand connection is important.”

    So instead of giving grandma or grandpa a hug or a kiss, if the child doesn’t want to, can you give a high five? Ask your child, “Would you like to give a high five or an elbow bump?” Or, “Would you like to show grandma or grandpa your favorite toy?” Instead, give them other options that promote different kinds of touch that they initiate and feel good about, or the option of no touch at all, so that they can really get clear around having to think about what they want in terms of a bodily exchange with another human being. Everything that we learn as kids starts in our family, and this is the great way to practice. Even with you as their parent saying, “Is it okay if mommy or daddy gives you a hug right now? You don’t want one? Okay.” And being okay with that, privately dealing with the heartbreak of hearing a no.

    Ashley Loeb Blassingame:

    Right, right.

    Dr. Kate Balestrieri:

    Because yeah, that hurts to hear that your kid doesn’t want to hug or kiss in the moment. But those are things that as parents, we have to model for our kids.

    Ashley Loeb Blassingame:

    Yes, yes. That’s been an interesting thing is starting with the non-sexual, and things that are culturally… I think we’re used to a lot of cultural things that we don’t realize have implications. There’s a Wheel of Consent that talks about the different types of consent, and what does that wheel entail? What does that look like?

    Dr. Kate Balestrieri:

    Yeah. Dr. Betty Martin created that Wheel of Consent, and she’s got a great book that talks about it, and the name of the book is escaping me in this moment. So, please look up Dr. Betty Martin if anyone’s listening. She’s got some great YouTube videos that talk about the Wheel of Consent. So in essence, the Wheel of Consent looks at two axes. It looks at the direction of who is doing the sexual activity to the other person, and who’s receiving the pleasure.

    So, if you think about four quadrants on this Wheel of Consent, the person doing the behavior is the person responsible for obtaining consent. And when somebody provides consent, they’re providing consent for either the reception of their own pleasure, or for the other person to receive the pleasure that is happening in the doing of sexual behavior to another person. She looks at this in four quadrants and says, “If someone is doing something to another person, and that person is also receiving the pleasure, then they are taking and another person is allowing. And if they are doing something to another person and that person is receiving the pleasure, then they are providing a service and the other person is receiving the pleasure. They’re accepting it.”

    And so it’s an interesting way to think about not only consent, but the reasons and the purpose that we are doing things with each other sexually and who benefits. And it’s a really useful tool in talking about mutuality between two consenting adults. Because I see this so often in practice. One partner says, “I’m going to give you an orgasm.” Well, first of all, we’re responsible for our own pleasure. And even if someone is trying to give you an orgasm, if you are not allowing it, it’s not going to happen in your body. Except in cases of arousal and non-concordance where our body is kind of just reacting to stimulation, but our mind is saying no.

    But a lot of folks will say, “It’s my job to give you an orgasm. I want to give you an orgasm. I want you to have pleasure.” But what they’re really providing is the pleasure that they get. They’re receiving the pleasure of knowing that they are competent in giving pleasure. And so it’s not really about their partner receiving an orgasm. Somebody’s trying to kind of push the issue. They’re really making that person’s orgasm about their own experience of pleasure. So, it’s an interesting paradigm to think about when you’re talking about sex with your partner, and how to make sure that the pleasure that you’re providing with one another and co-creating together is in fact mutual and not just the intention.

    Ashley Loeb Blassingame:

    When we talk about the Wheel of Consent and what you’re describing is really around sort of an ongoing mutual consent relationship, how does consent fit in when you have the non-concordance, when you have, you’re saying receiving pleasure, well, when the body is reacting from the stimulus without the brain being involved, how does that fit on the wheel?

    Dr. Kate Balestrieri:

    It doesn’t because that’s a non-consensual situation.

    Ashley Loeb Blassingame:

    Okay.

    Dr. Kate Balestrieri:

    So, that would look like if my brain is saying no, if my mind is saying, “I don’t want this and I’m not consenting to it,” but my body’s still responding, that’s because the brain and the body are not communicating effectively, and or a person is being overpowered. And so even though their brain is screaming no, there’s not much they can do to align with that no in the body. But I think another useful acronym to remember is the FRIES model of consent. So FRIES stands for F, consent is freely given. So, if someone cannot say no, then they cannot say yes. And that’s where it’s really important to look at power imbalances in relationships. The R stands for reversible. So, if somebody cannot stop during sex, then their consent to be sexual is not valid. Someone has to be able to withdraw their consent at any point in order for it to be valid.

    Is their consent informed? Meaning do they know what’s actually happening? A great example of this is when folks engage in stealthing. So, stealthing is when someone thinks that there is a condom being used, but in fact, the person with a penis has removed the condom and is engaging in condomless penetration. The person who is being penetrated thinks there’s a condom on. That’s what they’ve consented to. They have not consented to non-barrier penetration. So, their consent is invalid. Doesn’t mean anything. It’s not informed. The E stands for enthusiastic.

    So, it’s a really big difference to be in a mental state of, “I’m not really feeling sex right now, but I think it could be fun. I’m going to go do that. Yeah, yeah, let’s go do it. Maybe I’m going to get into it once we get started. And I know that about myself,” versus an obligatory position of sex. “I have to be sexual with this person because if I’m not, they’re going to pout, or they’re going to withdraw resources, or they’re going to hurt me, or they’re going to guilt me, or shame me, or be a real jerk for the next however many days, so I have to have sex with them or I’m going to be punished.” That’s not consenting. That is coercion. I think a lot of folks really get lost in that space relationally because there is a lot of messaging around what are our roles with each other as partners.

    But the last component of the FRIES model of consent is that consent is specific. I’m consenting to these specific things in this specific sexual experience, and next time we have sex, we have to go through the process of consent again. And then some couples have an opt-in or an opt-out model of consent that they might talk about or think about with each other. And for a lot of couples who are long-term partners, they might know, “Oh, my partner’s really open to this. Yes, they love that.” We should still be asking for consent in case something changes or be open to somebody opting out. In general, anal sex is something that we both enjoy, so it’s on the table unless one of us says, “No, I’m opting out today.”

    So that’s what an opt-out looks like. Opting in looks like, “Ooh, we’re asking about every new thing because we don’t really know each other, and or that’s just the agreement that we have. So today, is anal sex something that you’re interested in?” “Yeah, I’m opting in to that. Yeah.” So, it’s two different ways to sort of think about how do you talk about consent with each other. Because some folks need that opt-in every time in order to feel like they can enthusiastically say yes. Other folks are like, “Nope. Here’s on the menu. Feel free to enact any of those things so that we can be spontaneous together. But if I say no, then it’s no.”

    Ashley Loeb Blassingame:

    What are some of the things that you see with people who are getting sober and have not engaged in any sober sex before? And maybe they come with trauma, maybe not, but what are some of the ways that you work with people in those circumstances?

    Dr. Kate Balestrieri:

    For newly sober folks or even folks who have been sober for a long time, I tend to see a couple of themes that come up. Of course, there’s all kinds of anxiety that whatever was happening during their addiction allowed them to not be aware of. So, whether they were addicted to alcohol and that was disinhibiting, or a different substance, or they have a different behavioral addiction, there’s a lot of disinhibition that comes with addiction. So, for a lot of people when they get sober, there’s a lot more vulnerability that they experience and a lot more anxiety they experience during sex that wasn’t present when they were in their addiction. So, there’s that theme.

    The other thing that I see a lot of is that sex is a lot less fun for people without the high of the substance, or the high of the behavioral compulsion that they were engrossed in. And that can be a real buzzkill for them. Their erotic orientation or their arousal template became so fused with the adrenaline of their addiction, that sober sex is something that just doesn’t feel as interesting or as hot. So, they’ve got to take some time to learn how to build other interesting elements into their sex that are in alignment with what sobriety looks like for them. And that can sometimes take a little while and can be frustrating for people sometimes.

    Ashley Loeb Blassingame:

    When you talk about building things into people’s sex lives, what does that mean? What kind of things do you work with couples on or people who are building a better sex life?

    Dr. Kate Balestrieri:

    We’re really organized around novelty being something that drives a lot of excitement for us as human beings, and that is true in our sexual experiences as well. So, for a lot of folks who are in recovery, maybe novelty, but more importantly, dopamine, which novelty is a big driver of dopamine. So, dopamine is a huge component of addiction. And for a lot of folks, the intensity that they experienced in the dopaminergic areas of their brains, that’s not available now that they’re not engaging with a substance, or a different kind of high intensity behavior that was a part of their addiction. So, helping them become more expansive sexually, it really looks like helping them identify other aspects of novelty that are not a part of the ritual of their addiction, so that they can have some dopaminergic elements brought back into their sex life.

    So, that looks really different for different people. For a lot of folks, it’s exploring something kinky. For a lot of people, it’s creating an ethically non-monogamous relationship so they can experience the novelty of new partnerships, but in a way that is ethical and transparent with all of their partners. So, it’s really about helping people explore something novel, exciting, fun, and simultaneously helping folks to build a relationship with pleasure that is not intense, so that they can expand their other captures of pleasure, and enjoyment, and sensory experiences that feel really exciting and fun.

    Ashley Loeb Blassingame:

    That’s interesting, the intensity part that you can find working on that. That makes a lot of sense. What is a common path in sexual recovery?

    Dr. Kate Balestrieri:

    When you say sexual recovery, do you mean recovery from compulsive or problematic sexual behavior, or do you mean from sexual trauma or both?

    Ashley Loeb Blassingame:

    Let’s go with both.

    Dr. Kate Balestrieri:

    Well, a path out of problematic sexual behavior, whether it’s sexually violent, or boundary violating behavior, or if it’s compulsive behavior, is really about education and learning about containment, and redirecting those needs that are being expressed in the out of control behavior, learning how to articulate them differently in an assertive way, and really learning how to be more mutual, sexually and non-sexually, and to address the underlying inter-psychic or individual experiences that are kind of compelling those boundary crossing behaviors. Or out of control behaviors first. And then it’s about learning how to redefine a relationship with pleasure.

    And for survivors, it’s kind of similar, but on the other side of the coin. It’s learning about how to shore up boundaries, how to be discerning, how to be expressive, how to be trusting in yourself. Because unfortunately, we can’t prevent all sexual violence. And survivors are often given that task indirectly and directly by people who know about their sexual trauma. It shows up in the form of victim blaming and shaming and all of that. At the end of the day, sexual violence occurs because someone’s will was overtaken, and that is out of their control by definition. If they had any control, they would’ve stopped it, but they don’t.

    So I don’t like to really focus on what can people do to prevent, because there’s very little that we can do to prevent. What we can do is educate ourselves. We can learn about power dynamics. We can educate ourselves about empowerment. We can educate ourselves about boundaries. From there, we can revisit the relationship we have with self and learn how to trust ourselves, that even if things are painful, we are okay in our own skin and in relationships. So, it’s really about creating safer community and creating a relationship with self that feels more attuned.

    Ashley Loeb Blassingame:

    What is something that you want people to think about differently as it relates to sex that you would encourage people like, this is everybody, I want you to think about just food for thought?

    Dr. Kate Balestrieri:

    There are so many things coming to mind right now. I think one of the things that I really want people to understand about sexuality in our modern world is that the experience of pleasure has been completely co-opted by our political structures. And right now, and at other times in our country’s history and in world history, we’ve seen the policing of pleasure take place as a way of controlling different groups of people and maintaining that social hierarchy. The second thing that’s very entrenched in that dynamic is that our relationship with sex is a huge part of our identity, regardless of what kind of sex we like, or who we want to be sexual with, or how frequently we’re having sex. The way that we experience sexuality as a construct, as an idea, and as a set of behaviors, is in large part how we formulate our understanding of who we are in this world. And it’s so over coupled with identity because that is how it is policed in our social structures.

    So we really would be well-served to uncouple, or decouple, or disentangle, however you want to think about it, the relationship that we have with pleasure and the relationship that we have with the world and how we see ourselves in it. And when we start to deconstruct that, disentangle that, our experience of pleasure can be so much more rewarding. But we’re no longer attaching our experience of pleasure with our social currency in the world, and instead, pleasure is no longer a task that has to get us into different groups or protect us from other groups. It becomes an experience that is more embodied, and more holistic, and much more spiritual. And I’m not talking about religion, but it’s spiritual in the sense that it can connects us to ourselves, to the earth, to the world, to other people. It becomes a transcendent experience that is really powerful, and our sense of peace in this world just gets a lot better.

    Ashley Loeb Blassingame:

    How does pornography play into all of this?

    Dr. Kate Balestrieri:

    Great question. I don’t know that we have time to cover all of that. But what I will say about pornography is that there’s nothing wrong or immoral with erotic material. But in a capitalist society, we have commodified sex. It is an exploitative industry in many, many cases, not all. But pornography is such a brilliant microcosm of the ways in which sex is controlled, and there is a conversation on who is pleasure for, who deserves pleasure, who has to endure to provide pleasure for other people. So, when I consume pornography, I make sure that it is created from a feminist producer and director, and that it is ethically produced, and that pornography to me feels really celebratory of sexual pleasure, and inclusive of all people in that journey. And I try to make sure that I do not consume pornography that is not explicitly generated from a place of consent and high ethical nature, and has a higher risk of exploitation.

    Ashley Loeb Blassingame:

    Where would one find porn pornography that was more ethical?

    Dr. Kate Balestrieri:

    Yeah, there’s some really great websites for ethical porn. I’m a big fan of Erika Lust. She’s got fantastic material. And Dipsea is great for folks who like audio porn. It’s really hot, and it is also, I believe, female founded and really organized around inclusivity and ethical production. There are a couple of other ones. Make Love Not Porn is a great resource. And there are a few more. You can Google ethical porn websites and a bunch will pop up.

    Ashley Loeb Blassingame:

    Oh, cool. Yeah, I’ve never heard of ethical porn, so that’s amazing. Where can people find you? You have a couple podcasts that you do. And in your work, if people want to get ahold of you and the work that you’ve done, where can they find you?

    Dr. Kate Balestrieri:

    Probably the best place is our website. It’s modernintimacy.com. And on Instagram, people can find me at The Modern Intimacy, and also Dr. Kate Balestrieri. On TikTok, you can find us at Modern Intimacy and Dr. Kate Balestrieri. And I just started a Substack a couple of months ago, and I’m writing about these topics in more depth, so folks can find me there. You can look up Modern Intimacy or it’s drkatebalestrieri.substack.com. We have paid subscriber options as well as free options. And then I do have a podcast, The Modern Intimacy Podcast, and that is a place where I definitely have some of these conversations as well.

    Ashley Loeb Blassingame:

    Awesome. You’re amazing. Thank you so much for all the work and for coming on here and talking to me about this. I appreciate it.

    Dr. Kate Balestrieri:

    Thank you. This was such a wonderful conversation, and I really appreciate having a place to talk and being able to speak with you about it.

    Ashley Loeb Blassingame:

    Likewise. Thank you. Okay, what are your questions?

    Scott Drochelman:

    What are my questions? What is sex? Where our babies come from?

    Ashley Loeb Blassingame:

    Okay. Where our babies come from?

    Scott Drochelman:

    Where our babies come from?

    Ashley Loeb Blassingame:

    Where our babies come from? Okay, good. Got it. Writing that down.

    Scott Drochelman:

    Why mommy, daddy?

    Ashley Loeb Blassingame:

    Oh boy. I can tell we have small children.

    Scott Drochelman:

    Yep.

    Ashley Loeb Blassingame:

    Is that how you teach consent?

    Scott Drochelman:

    Is that how I teach consent? That was way more complex than the version that I have. We do the thing with the hug and the high five.

    Ashley Loeb Blassingame:

    Okay. You do? Okay.

    Scott Drochelman:

    Yeah, haven’t done the, I liked adding in, you want to show them a toy or something, some other non-physical thing. We haven’t done that. But yeah, we’ll like, to be honest, with grandma and grandpa, we kind of do push it. We’re just like, “No, give them a hug. They’re grandma and grandpa.”

    Ashley Loeb Blassingame:

    I know. I know. We’ve-

    Scott Drochelman:

    They’ve bought you thousands of dollars worth of presents.

    Ashley Loeb Blassingame:

    I know. I know. We’ve done it, too. And actually my dad is so… I mean, they always, for the most part, it’s not a problem. But a couple times my kids have been not interested in giving hugs. And my dad is like, “Don’t force them, Ashley.” And I’m like, “Oh my God. He’s more woke than I am.” My boomer dad is like, “God, don’t you know bodily autonomy?” I’m like, “Shit.”

    Scott Drochelman:

    Come on, dude. Yeah, and I haven’t said it out loud, but what I just said literally was like, “I mean, but if they do spend enough money on you.”

    Ashley Loeb Blassingame:

    Yeah, yeah. I know, right? Look at us.

    Scott Drochelman:

    That’s so great.

    Ashley Loeb Blassingame:

    We’re really…

    Scott Drochelman:

    That’s so great.

    Ashley Loeb Blassingame:

    Woo. We’re going to have to… Well, thank God we had her on because we clearly have some adjustments to make in our lives.

    Scott Drochelman:

    And we’re-

    Ashley Loeb Blassingame:

    How do we make things better? Except without we don’t want to make things better, because that sounds hard.

    Scott Drochelman:

    That sounds hard.

    Ashley Loeb Blassingame:

    It’s hard.

    Scott Drochelman:

    And it’s going to be a whole thing when they don’t hug them, and then they’re going to be upset, and it’s going to be a whole thing. And they’re going to be like, “But I’m leaving and I don’t live in town, and blah blah blah.”

    Ashley Loeb Blassingame:

    Exactly. We want to do it, but what’s the easy way? You know what I mean?

    Scott Drochelman:

    Yeah. But what’s the easy way though?

    Ashley Loeb Blassingame:

    I do like the high five. I hadn’t thought of that. Also, can I show… Can I tell my boys there’s ethical porn? I think my husband might leave me if I even bring that up. But I also want to be like, “Is the porn from a feminist perspective?” Like, I’m going to catch them watching porn. I’ll be like, “Okay.”

    Scott Drochelman:

    Let’s talk about the director here. Who directed this.

    Ashley Loeb Blassingame:

    Exactly.

    Scott Drochelman:

    Where did she go to school?

    Ashley Loeb Blassingame:

    How’s her mobility? This actress, has she been promoted in the last six months?

    Scott Drochelman:

    Good question.

    Ashley Loeb Blassingame:

    Is she getting a cost of living wage?

    Scott Drochelman:

    You could… Hold up. What’s that test they have in movies where it’s like do two female characters talk to each other not about a man. Have you heard? Do you know this test?

    Ashley Loeb Blassingame:

    Absolutely don’t know this.

    Scott Drochelman:

    Really. Okay, so this is a test, and now you’re going to start to notice it. It’s called the Bechdel test, and it basically is like to test what a woman’s representation is in the movie. And the test is pretty simple. And it is just do two female characters talk to each other about something other than a guy or a romantic interest? And it is a really shockingly low number of movies.

    Ashley Loeb Blassingame:

    Come on. Really?

    Scott Drochelman:

    No. Yeah. I mean, I think things are getting better, but if you go back and revisit it, two girlfriends will-

    Ashley Loeb Blassingame:

    Like recent?

    Scott Drochelman:

    … Talk to each other, but it’ll be about a guy they’re interested in.

    Ashley Loeb Blassingame:

    Come on.

    Scott Drochelman:

    For real. It’s shocking. And again, I think this test has been around for a while.

    Ashley Loeb Blassingame:

    Interesting. This is going to sound cocky, but-

    Scott Drochelman:

    Oh boy.

    Ashley Loeb Blassingame:

    Yeah, I know.

    Scott Drochelman:

    Oh, boy.

    Ashley Loeb Blassingame:

    I know. I know. May have to… We’ll see how it comes out. But I sort of thought that it was understood that when a guy is like, “I’m going to give you an orgasm,” that that was obviously about him. I thought that was a known thing, that it was about that if they’re freaking out about it or whatever, that it’s really about… Usually, usually about their feeling of incompetence or competence with whatever. But I thought that was… I was like, oh, yeah. I just sort of thought that was a given. I didn’t know there was a community that wasn’t aware that that’s what was going on.

    Scott Drochelman:

    I think of that in the same way that I do when somebody says, “I got a funny story for you.” And you’re like, “I’ll be the judge of that.”

    Ashley Loeb Blassingame:

    Yes, yes.

    Scott Drochelman:

    Right.

    Ashley Loeb Blassingame:

    Or someone first-

    Scott Drochelman:

    You’ll know if I laugh. That’s how you’ll know.

    Ashley Loeb Blassingame:

    Yeah. I also thought it was interesting about how much your sexuality… I mean, this is really, I get straight white girl talk, but how much it really plays into… It informs so much of your life and all the other things in your identity, and your sex goes to your sexuality, goes like it works back from how you feel about yourself, how you feel about others. We talked about the wiring, and and I liked the erotic template that she talks about. I didn’t have that language before. Things that happen to you, or things you see, or whatever, curate kind of your erotic template starting very young.

    Scott Drochelman:

    Without somebody to be able to put a voice to that, like how complicated that would feel internally, where it’s like there’s no control over the wiring, or what turns you on, or what you’re interested in or whatever. And how those things can be shaped by something that could feel like one of the most painful moments of your life. And then to feel so conflicted that it’s like, “Why do I want that? Why is that part…” But for her to be able to… I loved the little indicator that, not it was a hundred percent foolproof or whatever, but the idea that you can somewhat gauge based on how you feel afterwards, like okay, was that something that I’m actually into, or was that like…

    Ashley Loeb Blassingame:

    Did you flash back to situations, situations, Google situations-

    Scott Drochelman:

    Situations.

    Ashley Loeb Blassingame:

    Did you Google situations? I flashed back to situations where it was like, “How did I feel?” Were you like, “I shouldn’t have done that”? When she was like, “Well, how does it make you feel afterward?” And I was more thinking of decisions and people where you’re just like, “You know, I really got caught up in this.” I like the word she used, momentum. I was like, “I think there was a lot of momentum. That may have been missionary, but it was wrong.” I used to joke with a friend of mine. We were joking. He’d be like, “Do we really have to count that? Is that… What constitutes a sexual part? If it didn’t feel in my head, do we have to count that?”

    Scott Drochelman:

    Just like an NA. Can I put a NA next to it?

    Ashley Loeb Blassingame:

    Yeah, yeah, yeah. What do they do when you withdraw from a class?

    Scott Drochelman:

    Oh.

    Ashley Loeb Blassingame:

    What is that, right? The W, like…

    Scott Drochelman:

    Yes. Just the W. That’s what it is.

    Ashley Loeb Blassingame:

    The W.

    Scott Drochelman:

    And we don’t mean a win. Withdraws.

    Ashley Loeb Blassingame:

    We don’t. We mean a withdraw.

    Scott Drochelman:

    A withdrawal. This was a redacted encounter. If we could redact all of this.

    Ashley Loeb Blassingame:

    There it is. It was a redacted encounter. It is top secret black ops. So, basically, I’m a very healthy sexually person.

    Scott Drochelman:

    Very healthy sexually person, yep.

    Ashley Loeb Blassingame:

    That’s what I put on my profile. Oh, God.

    Scott Drochelman:

    Very healthy sexually person looking.

    Ashley Loeb Blassingame:

    Who’s also sexually healthy person.

    Scott Drochelman:

    Yes.

    Ashley Loeb Blassingame:

    There’s a fantastic book called Mating in Captivity by Esther Perel, and it talks about all the different types of relationship configurations that people come to. It is really, really, really, really, really, really, really, really good, and I highly recommend it. And then also The Art of Receiving and Giving: The Wheel of Consent, is the book by Betty Martin and Robyn Dalzen.

    I guess what intrigues me about the whole conversation, generally speaking, is that people don’t understand the prevalence of this stuff. And when you work in addiction, and trauma, and mental health, it’s everyone. It’s so many people are affected by these topics. I mean, just a overwhelming number of people experience sexual trauma, which means that an overwhelming number of people need to experience sexual recovery. And then you add in the perpetrators and you have this very big societal topic that is often sort of pushed away.

    And I just find it fascinating that when we get to talk about it, because it’s such a big part of what I see as an underlying societal sickness that we have. It’s not the popular stuff to talk about.

    Scott Drochelman:

    Yeah.

    Ashley Loeb Blassingame:

    Look up Modern Intimacy on TikTok or Instagram, great, great content. Check it out. It applies to all of us, and we can all be doing our part to make more healthy sexual choices and spaces for the next generation. So, definitely check that out. We’ll see you next time.

    This podcast is sponsored by lionrock.life. Lionrock.life is a diverse and supportive recovery community offering weekly over 70 online peer support meetings, useful recovery information, and entertaining content. Whether you’re newly sober, have many years in recovery, or you’re recovering from something other than drugs and alcohol, we have space for you. Visit www.lionrock.life today and enter promo code COURAGE for one month of unlimited peer support meetings free. Find the joy in recovery at lionrock.life.

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