Author: Margie Nichols, Ph.D.

Help For Insomnia: Tips From The CBT Playbook

By Margie Nichols, Ph.D. Some people have insomnia because they have medical sleep disorders like sleep apnea. But for the millions whose sleeplessness is primarily driven by anxiety, stress, racing thoughts, etc. the treatment of choice is cognitive behavioral therapy. It may take two to four weeks before the techniques start to work, and many of them focus on helping people develop better ‘sleep hygiene’, or habits around sleep. TIP NUMBER ONE: use your bed for only two things- sleep and sex. You are attempting to condition yourself so that the bed is associated with sleep. No reading or watching TV in bed. And if you try to go to sleep and can’t, after 20 minutes you get up and do something else. TIP NUMBER TWO:  it’s a little different for people whose problem is waking up too early.  The first thing you should do if this happens is to try a relaxation exercise, visualization, or meditation.  That may allow you to fall back to sleep.  If you don’t fall asleep,remain in bed and rest quietly- this is nearly as rejuvenating as sleep.  If you are too restless for that – get up and do something. TIP NUMBER THREE;  try to go to sleep… Read more »

The Flap About Flibanserin

By Margie Nichols, Ph.D. It seems a bit anti-climactic now, since the FDA Advisory Panel decided yesterday to advise against the approval of what was touted as the ‘female Viagra.’ The fact that they turned down approval because they found no convincing evidence that it worked better than placebo didn’t surprise anyone who studies female sexuality.  We know that female desire is a lot more complicated than the ‘plumbing problems’ involved in male erectile dysfunction.  But for a while, when it looked like the drug might actually work, the debates got pretty intense. On one side, there were feminists warning against the medicationalization of female sexuality and the consequent pressure on women to live up to a male standard. On the other, medical people were trying to prove there really is a ‘disease’ called Hypoactive Sexual Desire Disorder in women, and that this drug is a cure for it. I find myself in agreement with both sides. Yes, there are grave sociocultural implications to the classifying of a women as ‘diseased’ when for the most part what we are really describing is age taking its inevitable toll on body and mind. And these dangers are at least in part connected with the traditional sexual oppression… Read more »

The Problem with the ‘Problems’ with the Millennials

By Margie Nichols, PH.D. The Millennials (aka Generation Y) are the generation of people born between 1982 and 2002.  The oldest of them are in their late twenties, and for a while now there’s been a lot of bashing of these young folks as they have entered adulthood.  Dubbed “Generation Me,” they’ve been characterized as entitled whiners whose parents heaped on way too much praise for way too little, and who were ‘awarded’ far too many prizes for insufficient amounts of achievement.  As Judith Warner says in a piece in the Times called “The Why-Worry Generation” they’ve been assessed as psychological basket cases, narcissistic wimps.  Apparently, the latest piece of news about them is that they are “unreasonably” optimistic in the face of the recession, that they don’t second-guess themselves and they’re sure that bright days are ahead. This is a problem?  It’s called resiliency.  I’m glad Warner has taken on those who sneer at this generation’s more laid-back values (they are turning down jobs that require them to work more than 40 hours a week, even this year).  She points out that the young adult Millennials may be annoying to those of us raised on  Woody Allen-style anxiety about the future and… Read more »

Book Review: Women’s Anatomy Of Arousal: Secret Maps To Buried Pleasure

Reviewed by Liz Lipman-Stern, L.C.S.W., Certified Sex Therapist, IPG Staff Therapist Women’s Anatomy of Arousal: Secret Maps to Buried Pleasure by Sheri Winston, Mango Garden Press, 2010 You might think the discovery of the “G-Spot” and female ejaculation gave the world the most comprehensive information possible about female sexual anatomy. If so, you’d be wrong. Sheri Winston’s book recently won the 2010 Book of the Year award from the American Association of Sex Educators, Counselors, and Therapists (AASECT), the organization through which those of us at IPG who are certified Sex Therapists got our certification. And it richly deserves this honor. Winston’s book delivers important and generally unavailable (and unknown) information about female genital anatomy in a style that is entertaining and accessible to lay readers, thereby helping to pull back the curtain of cultural ignorance about female anatomy while also enabling women and their partners to enjoy more connected and orgasmic sex. In addition, in a society that tends to separate birth and sex, it makes the crucially important -and, again, often unknown- point that women have a single, elegant, integrated system for sexual pleasure and reproduction. The uterus, for example, often thought of as an organ ‘dedicated’ to gestation,… Read more »

THE BRAIN KEEPS THE SCORE PART TWO (continued apologies to Bessel van der Kolk)

Let me start Part Two with a personal story that reflects how traumatic memories are stored differently than ‘regular’ memories and how they can be problematic. My story is more dramatic than many, but nevertheless an example of how all trauma works, whether it be chronic moderate abuse in childhood, or the loss of a loved one in a hurricane. I lost my daughter Jesse six years ago on June 2, 2004. She was born on June 6, 1994 and her memorial service was June 6, 2004. You don’t need to have lost a child to know that those anniversary dates are probably more painful than most other times of the year for me- we all intuitively understand the power of implicit, sensory memories. This year was the first year since Jesse died that the dates and days of the week coincide. I’ve found, somewhat to my surprise, that this congruence of date and day of the week lights the old limbic system memory circuits– and the emotional affect associated with them-with more intensity than they’ve been fired with in years. Some days I feel, in a small way, the same way I did back in 2004, when I was… Read more »

Recreational Meditation Part 2: How it Helps

By Margie Nichols, Ph.D. In Part 1 (posted 4/27), I described myths about meditation – that you have to do it for a pretty long time, that you should have a blank mind, and so on. Here’s why meditating – any form you want – helps you, and a little about which type helps with what issue: • Relaxation: Meditation is deeply relaxing, with a type of relaxation that often renews you afterwards. It slows down the chattering mind a bit as well as the body. It’s useful just for this. If your main purpose is relaxation, I recommend guided visualization audios, or even just lying down and focusing your attention on meditation music. It has also been shown that after even brief periods of meditation, the “relaxation response” tends to last for hours, fading gradually. This “inoculates” you against stress and emotional over-reaction. • Improving Concentration: most of the meditation being taught today is a variation of ‘one-pointed focus,’ it involves focusing your attention on a sensation – the sensation of the breath entering and leaving the body is classic, but it could be a visual point, a sound, tactile sensations, a mantra, a candle flame, or counting. You… Read more »


By Margie Nichols, Ph.D. There is a Buddhist story about a man steering a boat on a river in the early dawn when the river is shrouded in mist. Another boat collides with him, and the driver of the first boat rails at the second boat and its driver, who is obscured by the fog. In a few moments, the mist dissipates….and the second boat is seen to be empty, adrift in the river alone. This story is used as a metaphor for human relationships. We rail at ghosts in the mists, ghosts of our own making. Every day I see the evidence in my office: a man describes his road rage, and slowly what emerges is that the rudeness of the other driver triggered the same fear and anger he experienced as a child being berated by a contemptuous father. A woman cowers when her husband scowls, because his facial expression mimics the look that was on her mother’s face just before mom used to terrorize her as a child. I’m not really analytic in my therapy approach- but I am a fan of neuroscience, which increasingly gives us explanations for our behavior based in biology, not theory. The… Read more »

Talkin’ Teen Sex Part 2

By Margie Nichols, Ph.D. Well, it didn’t take long for me to nix the Sinclair Institute DVD idea. For one thing, in the atmosphere of hysteria that surrounds anything combining under-age minor and sex in the same sentence in the U.S., the DYFS fear isn’t all that paranoid. But, more importantly, I realized that I don’t want to inadvertently send a message that I think it’s okay for a 12 year old (or 15 year old) to be watching real-life movies of sex acts on anything more than a one-time educational basis. I don’t want my ideology to get in front of common sense. Even if I can’t ultimately prevent it, I don’t want to do anything to encourage viewing porn when the real message I want to be sending is — I’ll help you understand sex, but you are too young, too tender, too wounded to be ready for it now. For now, I’m gonna become an expert on really good books and DVDs about sex for teens. And try to keep that conversation coming, try to stay one beat ahead of my daughter’s challenges. But even as I make this decision, I’m so upset that I have to,… Read more »

Talkin’ Teen Sex Blues

By Margie Nichols, Ph.D. The Guttmacher Institute tells us that 13% of teens have had sexual intercourse by age 15, and that by age 18 nearly 60% have. At my sex therapy and research conference two weeks ago, Surgeon General Dr. Jocelyn Elders told us that after a number of years of decline, teen pregnancy is beginning to rise again. And every media venue possible assaults us with news of changes in adolescent sexual mores, from ‘hooking up’ to ‘sexting,’ ‘friends with benefits’ to ‘oral sex is the new third base.’ Depending on your perspective, these facts are interesting, alarming, signs of decadence or signs of the failure of ‘abstinence only’ sex ed. But if you are the mother of teenage girls, you have a VERY different take on things. You know deep inside you that your job is to get your girls to postpone sex for as long as possible, preferably age 30, you know that is impossible, you worry constantly. Until recently, my only experience with adolescence was raising my now 26-year old son. Then, four and a half years ago I adopted a pair of sisters from a Guatemalan orphanage. They are now 15 and 12, and… Read more »


By Margie Nichols, Ph.D.  There’s a word for constant, unmitigated happiness about your life: denial. Barbara Ehrenreich skewers the positive psychology field in her new book “Bright Sided.“ It’s about time. First of all, it’s become a veritable industry, with top motivational speakers making tens of thousands of dollars and books on ‘happiness research’ flying off the shelves. The message of this research, some of which is quite solid and interesting, has become diluted down to: smile, be happy, and you’ll be healthier and have your dream life. But the research itself is more nuanced and ambiguous- for example, some ‘negative’ people are actually healthier than optimists. Let’s face it, at times pessimism is a more appropriate view of life. The skill is to learn to cope with life’s curve balls without melting down, not to look the other way in ignorance. More support for the nuanced view of ‘positive thinking’ comes from research reported in this month’s issue of Psychology Today (sorry folks, the actual paper magazine, not online yet). This study correlated scores on a test measuring trust in people with household income. Turns out there’s an optimal level of trust: too little and you miss opportunities because… Read more »