Hard Conversations – Details, episodes & analysis

Today Tim has a wide-ranging conversation with Dr Chris Donaghue, a therapist, educator and host of the relaunched "Loveline" radio show. They talk about how body positivity impacts sexuality, being sexually honest and authentic when hooking up with someone you meet online and alternatives to an erect penis during a sexual experience. They also cover shame, prioritizing pleasure, how much porn everybody is watching, and how culture and social media invade the bedroom.

Tim has a unique conversation with Dr. Luana Colloca - a top scientist in placebo studies - who shares insights on how our brains filter our experience of reality. This has profound implications for the ways men can get in their heads about erections, and how different aspects of our sexual environments can trigger negative placebo effects. The placebo effect can also have major impacts on pelvic pain. For clarity, an episode transcript is also available on the website.

This week, Tim talks to Barry McCarthy, a giant in the field of sex therapy. Dr. McCarthy is a marital and sex therapist, and a tenured professor of psychology at American University. He literally co-wrote the book on erectile issues - "Coping with Erectile Dysfunction" - just one of many books helping men and couples achieve satisfying sex lives. They have a wide-ranging conversation about sexual intimacy, including “good-enough” sex, aging and sexuality, sexual performance, and of course, erectile issues.

Today, Tim interviews Robert Nicholson, founder of edtreatment.info, which covers all aspects of erectile issues including causes, treatments and how to find help. They talk about priapisms, erections before and after prostate cancer, and men's first-hand experiences with penile injections, shockwave therapy, and penile implants.  Robert has also collected research on personal struggles with erectile issues, including the impact on partners, and how intimacy - not erections - are what couples really miss. 

Today, Tim talks to Dr. Howard Schubiner, a world renowned specialist in psychogenic pain (pain with a psychological rather than physical origin). Dr. Schubiner explains how the brain can create pain without a corresponding physical injury and the implications for treating chronic pelvic pain. Tim and Dr. Schubiner find the similarities between treating chronic pelvic pain and chronic erectile issues and discuss the profound healing effect of retraining your brain to not regard pain and sex with fear.

This week Tim talks to Stephanie Prendergast, an internationally-acclaimed pelvic floor physical therapist and author of “Pelvic Pain Explained." It can be hard identify the causes of pelvic pain, so they talk through types of pelvic discomfort and various treatment options for these chronic conditions. Stephanie also outlines the overlap between pelvic floor disorders and erectile issues, and explains the differences, providing hope and answers for people who suffer from this understudied condition.

• Pelvic Pain Explained by Stephanie Prendergast
• The Pelvic Pain and Rehabilitation Center 
• The Pelvic Pain panel discussion at USC
• The latest comprehensive research study about chronic pelvic pain and prostatitis
• Directory of pelvic floor physical therapists

In this week's episode, Tim talks to Dr. Steven Hayes, the founder of  Acceptance and Commitment Therapy (ACT) - a groundbreaking update to Cognitive Behavioral Therapy that helps people better manage obsessive thoughts and become more mindful of their core values. Dr. Hayes offers invaluable insight on how obsessive thoughts affect erections, and how to change your relationship to those thoughts instead of hiding from them. If you make peace with them, they won't control your behavior, or your penis.  

Today Tim interviews to Dr. Johanna Hannan, an award-winning professor at East Carolina University's Brody School of Medicine. She studies the internal pudendal arteries (arteries that supply our genitals), and their impact on aging, cardiovascular disease, diabetes and obesity. They cover why it's difficult to gather clinical data, erectile issues caused by prostate cancer and why diet and exercise make such a big difference. Please note: Dr. Hannan discusses animal testing in her research.

Today's guest, Conor Creighton, is an Irish writer living in Germany.  Conor opens up about suffering with erectile issues in his twenties, his frustrations with Viagra and how a ten-day Vipassana (silent meditation) retreat changed his life, including how it helped him address his erectile issues. It's a story of heartache, shame and perseverance.  Enjoy!

Tim talks to neuroscientist Dr. Nicole Prause about the neuroscience of erections (of course!), the ins and outs of conducting sex research, and how porn and partnered sex affect the brain differently. She dispels myths about the correlation between testosterone levels and erections and talks about how neuroscience likely validates the effectiveness of sensate focus. They also get technical, discussing penile salience networks, transcranial magentic stimulation and what neuroimaging tells us about sex.