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Top Questions of our Time Series: Sex Slam bam thank you Ma’am or Mr.? That’s some people’s method and it works for those who mutually agree they want a quick fix. But for most people this is not the method of choice. So, why is it that this is so prevalent? The reason for this could be that American culture is simply not accepting of sexuality in general and that is why sexuality leaks into what many consider to be ‘shadow’ areas, such as pornography, strip clubs, and prostitution. Carl Jung, one of the founding fathers of psychology, would definitely label sexuality as the shadow side of our culture. For most people who watch or visit these areas, it’s not something they discuss with their acquaintances or even their family and friends. In fact, the actual act of having sex with a person is not discussed too openly in our culture. Alfred Kinsey was one of the first and most famous people to openly discuss this cultural issue in public. Sure, sex is flashed in our faces on TV shows, movies, and advertisements, but few people actually openly discuss the act of having sex with another person. For whatever reason that is, this is an article that is going to discuss one of the top questions of our time: What is a great way to have sex, even for those who are inhibited. I am going to explain a term, I am certain I am not the first to use it, or explain concepts like it, however, I have not seen the term before. That term is Mindful Sex. Mindful sex involves slightly slowing down in every aspect of the act of sex, from creating the setting, to the foreplay, to the actual act of sex, whatever you consider that to be. The following is the gist of it: Setting: This part is not necessary if the act of sex is spontaneous in any given moment. If it is not spontaneous, sometimes it is a good idea to set the setting. When creating the setting, whether you are lighting candles, putting on music, or preparing special lingerie, moving slightly slower than you usually would. As you move slower begin to pay attention to your senses. If you are lighting candles, notice what you are lighting it with, is it a match, a lighter? Notice what the flame looks like, how it moves, does the candle have a smell, if so, take a moment to inhale it. If you are setting up special lingerie, take a moment to feel the lingerie. Is it made of silk? How does the silk feel? Are you spraying perfume/cologne on it? Take an extra moment to inhale that. You get the idea, with anything you are doing, move slightly slower and take a moment to pay attention to what you are seeing, hearing, smelling, feeling, and tasting. You do not need to think about any of this, just notice your sensations. If you notice you are thinking about something, notice that and then simply bring your attention back to what you are sensing. By moving slightly slower you have the opportunity to do this and in return make the process more meaningful and enjoyable. Foreplay and Sex: Some people consider foreplay to be sex, some consider intercourse to be sex. So I am putting them together because these ideas apply to both of them. There are many aspects to foreplay and sex and different people will have different variations on what they like. The tragedy of it all is that most people, having not felt free to discuss sex in public and they have only relied on what the media has influenced them to think about how sex should be. While they’ve had sex, they have never freely explored it on their own. Some people like to start out with oils and massage, some people like to start out with kissing all over the body, while others are into more fetish areas such as acting out a fantasy of being ruled over by a dominant figure of some kind (e.g., dominatrix). As far as fetish goes, this goes as far as our imagination can take us. As you practice Mindful Sex you will give yourself the chance to discover what it is that you really like and you will begin to feel more comfortable communicating that to whomever you are having sex with, even if that person is yourself (i.e., masturbation). Here is the gist: As you begin to practice mindful sex, it is important to remember one thing: Whatever it is that you are doing, do it slightly slower than usual. This does not mean go in slow motion, it means just go slightly slower than you would think to go. As you move slightly slower, you give yourself the opportunity to really be there in that moment and notice things that you may not have noticed. If you are giving a massage, you get to feel how the person’s skin actually feels, is there a scent to the oil? If so, inhale it. If the oil is edible, take an extra moment to lick it and truly taste it in your mouth. Look over your partner and take a moment to take in all the little nuances of the person’s body. By slightly slowing down, you also allow yourself to relax a bit, and this not only helps in making this a richer experience, but also helps reduce anxiety if that is an issue (e.g., being overly sensitive or premature ejaculation). You can apply this in every moment of sex that you find yourself in. For example, when you are giving oral sex, go slightly slower and notice the smell and taste involved, feel the texture of the other person, is it soft/rough? What does the person’s vagina or penis look like? As you go slightly slower you’ll find that it is not so difficult to notice these things and it will draw you deeper into the experience and give you the gift that you have not been privy to experience in the past. Ofcourse, you can apply this to intercourse as well. No matter your gender or sexual orientation, there is often some sort of sexual intercourse involved. It is important to let your partner know that you want to go slightly slower this time in whatever way you feel comfortable communicating that. As the intercourse begins, notice the sensations you are feeling. All parts of you are experiencing sensations from your head to your penis or vagina to your feet. If you find yourself thinking about something, notice that you are thinking about something and gently bring yourself back to your sensations. If you find yourself judging your self or the other person, just notice that you are judging and gently bring yourself back to your sensations. Gifts: Paying attention to your sensations may also broaden your horizons on things you want to do. Maybe you notice that while having intercourse that you are not tasting anything so you decide to taste your partner by kissing or licking him/her. Maybe you want to smell your partner more to bring in that sensation. Maybe you open your ears and begin to hear what the sex you are having sounds like. Maybe you’re now noticing for the first time what other areas of your body are being touched during intercourse besides your penis, vagina, or nipples. You might just discover an erotic area of your body that you had not noticed before (e.g., back of the knees, toes). Having mindful sex is simply a teaching and a suggestion. If a spontaneous act of aggressive sex comes out and it is not a slightly slowed down process, than that is Ok too. This is simply an opportunity to broaden your awareness about yourself during the act of sex and deepening the richness of your experience. Of all things we have to experiment with on this planet, this is surely one of the top. So, responsibly, go off and try this out, have fun, and broaden your horizons! You may just find that sex is a far more sensual and sacred experience than you had previously imagined. medical penile enlargment natural penis elargement pnis enlargement testimonials penis elargement drug pennis enlargement stretcher penis enlagement fact best enlargement exercise pnis enlargement erection penis pill vimax penis enlargement information

Vimax is a new diet pill that is shown to significantly and relatively quickly increase penis length and girth, while at the same time hardening erections, increasing libido and boosting sexual energy. Heard it all before? You probably have. The truth is that people getting great results in their sex lives due to the use of Vimax and similar male performance enhancing supplements. Unfortunately for most unknowing customers there are some things that go on behind the scenes that don't get talked about. For example, tests have shown that natural supplements like Vimax don't work in SOME cases. Not a piece of information you are likely to find highlited in the products promotional material. Luckily enough, and in the hope that I can assure no one is left out from the benefits I believe Vimax can deliver...I have found out why. Study has shown that Vimax sometimes doesn't work ALONE. Here's why: Vimax works by its natural ingredients causing increased blood flow to the genitals. The idea is that upon increased blood flow and circulation the tissues of the penis are forced to expand and grow to accommodate this new volume. That's the theory anyway. While for many men this is the case, for others the simple act of increased blood flow alone does not do the trick. The penis itself has to be physically exercised in conjunction with this increased blood flow to ensure any kind of lasting results. Like a bicep at the gym, when put under physical tension, growth is forced and while the blood flow causes internal physical tension to some degree and expands the blood vessels inside the penis, the erectile tissue surrounding it is left unstimulated and quite often ungrown. There are some simple exercises you can do along with your supplementation program to assist in the speed and longevity of results from taking Vimax. These are known as jelqing and involved prolonged squeezing and stroking of the shaft of the penis in a semi erect state to physically squeeze more of the newly circulating blood into the expanding vessels and erectile tissue. This in effect doubles the effectiveness of the treatment because at the same time you are using two methods of expanding your erectile tissues rather than one. This can cut down on the time you are required to use the Vimax supplement and in doing to lessen the costs involved with continued usage. Also because when exercising as well, you are doubly increasing your blood circulation to the genitals you can safely double the recommended intake of Vimax to two tablets daily further increase the speed and lasting nature of your results! manual penis enhancement pnis enlargement pic penile enlargment product penile enlargement device penis elargement surgery picture cheapest pennis enlargement pills manual penis enlargement pennis enlargement surgery photo penis enlargement information

22 March, l968 As it turned out, Johnny would visit Jill’s room off and on during the following weeks. And that strange woman that left the Belmont’s room brought along another woman, and on occasion, he’d catch her on her way down the steps and invite her into his room, although she’d had preferred ‘Jill,’ so she said. Tasma was not aware of most of this, but a little. Also, she had received at this time several letters from home by her parents, in particular her father, but she did not respond back. She was not certain what to say, she loved them, and Jill assured them she was fine, but it was too stressful for her to talk or write them. She did have a profound desire to please her father, and wishful thinking to please her mother, but it seemed she needed to learn how to please herself first, and to Jill, she did not blame them for anything, not anymore anyway. And had she started a communicational dialogue, they may have persuaded her to return, the one thing she did not want at this time. —Jill was in the kitchen—the ironing board was pulled out from an inner-cabinet built into the wall, a wall-unite if you will, it was kept snugly in, in which there was a door attached to it; Jill was ironing Tommy and Johnny’s cloths, another lover circle had stared. Both were arranged in separate piles. Mrs. Belmont was sitting at the table talking seriously to her; it was most unusual thought Tasma, for seldom did she see Mrs. Belmont other than at the bar talking to Jill. As Tasma neared them to join them, the subject—whatever it was—changed, and what appeared on Mrs. Belmont’s face was an un-cheerful smile, not unusual, but quite sudden, and it was apparent. Consequently, feeling a little awkward she left the kitchen to work on her diary-novel (some poems), in the living room in her usual spot; in effect, she could overhear bits and pieces now of their conversation. It didn’t occur to her to get up and leave, rather the opposite; she actually pretended to be busy writing and was simply drawing a picture undiscernibly. “It’s been going on for a while mom, I didn’t think it was, I mean it would end up like this.” “Get rid of him, or all of them.” “No, no, I don’t think Johnny will go so easy. He likes me, and thinks he can have me, and he has me of course.” “What about Tommy?” “I like him, I like him a lot, but that’s the problem, I don’t love him, I just like him.” “He’s what you need though. He’s more anchored.” [With scorn] “What the hell does anchored mean!” said Jill. “Ok, ok, I could have used a better term, Tommy likes to work and go to school, he’ll be somebody someday.” “Tommy doesn’t pay you a dime; Johnny does and Johnny works hard.” “Yes, he works hard all right, hard at drinking, screwing you and god knows who else—smoking that weed.” “So Tommy was screwing me and working.” “You’re going to lose him to that cousin of yours if you don’t hang on to him.” “Tasma,” she looked at Tasma reading, “you got to be kidding, she’s as naïve as a sparrow.” “So you say: does a pineapple come from a pine tree?” “No,” said Jill apprehensive, “now what does that mean?” “She’s not the little girl she was three, four months ago, or is it five or more? She has a good shape, and pretty face, and if Tommy can’t see it, I can. And so can a lot of men at the bar. Anyhow, Tasma is not the issue, Johnny and Tommy are.” (A long pause came, then with a cracking voice, and an almost whisper, she leaned over to her mother, and Tasma leaned over the arm of her chair): “I think I’m pregnant…” “Ay caramba,” she said in a sigh that slurred all the way to Tasma’s ears, “…now what?” “It’s Johnny’s, not Tommy’s, Tommy uses a rubber, and Johnny thinks it is not manly to do so.” It was momentarily hard for Jill to look her mother in the face; she was at this time, pacing the floor in a small circle as her mother followed her with her eyes. “Listen Jill, Johnny’s drinking with all the gang members at the bar, and he’s gambling, it’s just a matter of time before he gets in trouble with them.” (Some of the gang members had motorcycles, others cars, it was somewhat an unofficial bunch of criminals, in that they were but twenty of them that hung out at a number of bars). 23 Shan’t be a Minute Tasma found herself walking upstairs to her room, it was quieter in the kitchen, and figured, she had heard enough, a voice said, “Where are you going?” it was Jill, polite but to the point. “Shan’t be a moment,” was her answer. She wanted to tuck away her diary-novel, she had written some exposing things in it. And so she tucked away, under her pillow, as if it was safe, and her place was off limits to others, which in presumption it seemed to be. For the most part, she did not want to leave it laying about for someone to pick up accidentally. Life had seemed uncomplicated she thought, and now with Jill’s mother it seemed somewhat speculative, if not downright disjointed. It had now crossed her mind Tommy would find out the secret, the secret being Johnny’s behavior and her being pregnant, or so she said she was, and ‘I know about it,’ she felt as if she was a betrayer, be it to Jill or Tommy, or even Johnny. Down the stairway, into the living room she went. She looked outside through the bay-window and there was Mrs. Alice Whitehead getting into the car, she looked at Tasma, Tasma waved at her, she was a nice old lady, and it always seemed to her she had concern on her face for her. As she turned around looking towards the kitchen she noticed Mrs. Belmont sorting out bills: ‘I suppose she’s done talking to Jill now,’ was her thinking. “I talked to your mother a few days ago Tasma, she’s doing well and I told her likewise, you were doing well.” Tasma simply made a polite gesture, no verbal adjectives. “I want to do something today, a surprise, come with me,” asked Tasma, for some odd reason something had popped into her head. “What, may I ask, is on that devious mind of yours?” laughed Jill. —Tasma and Jill were gone for several hours, and arrived back home at about 6:00 PM. Johnny and Tommy were sitting in the living room watching TV. As they both walked into the house, both the boys were somewhat taken back a bit at Tasma’s appearance—if not down right, star-struck. Her long reddish hair was cut to where it reached only the nape of her neck. And she was wearing more makeup than she had before, the result: she looked a little fresher and less school-girlish, than before. Thought Tommy, ‘…before she seemed more delicate and fragile..,’ as he glanced at the poise she displayed as she smiled and stood in the middle of the room awaiting the verdict of the two young throbbing hearts, the heart breakers themselves. Johnny noticed her slender bones, and her nicely shaped neck was more defined (front and back). Tommy for some reason noticed her neatly-set breasts, small as they were—just above her small waist they were a hand full no more. Yet her slyness somewhat removed, still left her with a harmless effect. Her nervousness was repressed for the most part. Along with all that, with all the money she had saved up, she also purchased some bath salts, talcum powder and a small mirror, which she duplicated for Jill as a gift for allowing her to stay. She had spent her $100-dollars she had saved. For some odd reason, Tasma had glanced back into the kitchen, expecting to see Mrs. Belmont, but of course was not surprised when she was not there, she usually would go to the bar around this time, either she had missed her, or she was in her room preparing to go. The boys looked at one another in jest, and laughed. Said Johnny with his normal side joking way, “So now you’ve grown up, welcome to the real world kid, looks like you’re willing to join us.” Tasma knew Johnny’s ways and knew that was better left alone. “It makes you feel good,” commented Jill; meaning spending money on oneself for preservation purposes, or simply for a change in one’s life. But there was concern in Jill’s unseen eyes, in her cerebellum. She was no psychologist, like Skinner or Pavlov with his salivating dogs (who worked on association), but the boys were kind of salivating, restlessly slobbering might be a better way of putting it, if not downright uneasy, with this new Tasma look. Everyone had gone to bed now, it was Jill’s turn to sit downstairs in the sofa-chair for once, wondering, thinking, not sure of her next move. ‘I just don’t get it,’ she asked herself, ‘why am I so attracted to Johnny, and going with Tommy? Tasma wouldn’t have the answer even if I asked her, nor mom, facts are facts, feelings are feelings, I don’t sense they are neither right or wrong, they just are. Johnny makes love as if he was a mad man and seems almost barbaric, and I think of him when I make love to Tommy—it’s just unthinkable. I wonder how Tommy’s new book will turn out. Can you love two people at once, at one time? A good question; I think I do, or maybe it is lust, how do I know, I’m just…(pause) will be nineteen in a month. Mom said: love is a choice. I say love is a feeling. I wonder what Tasma would say. I know Tommy feels love through his penis, like Johnny, all men do, kind of, sort of—most of the time; but Tommy is more willing to be dedicated, I think. I have learned men are attracted by looking, but I like touch.’ On her way to her bedroom, she stopped at Tasma’s room, knocked lightly, “Can I come in just for a moment?” she asked. “Why sure you can,” answered Tasma with a thoughtful voice. “I had a great day with you today, and thanks again for the things you bought me (this was a good lead-in she thought to bait her for a question to be soon asked), but I have a question, somehow I think you’re going to oversimplify the answer but I’ll ask it anyhow. How do you know if you’re in love with a person?” Surprisingly, Tasma answered Jill with foreknowledge, “You mean you are having a hard time trying to figure who you want, Tommy or Johnny?” (A tight look went over Jill’s face.) “Yes, yes, that is where I’m coming from; I didn’t know it was so obvious.” “It’s becoming obvious Jill, it was the first day Johnny came through the door, and it has progressively taken a greater shape to it. But in regards to your answer, I’ve never been in love so I might be the wrong person to ask, but I do know this, as simple as it may be: if I wanted to go out with Johnny, I couldn’t be in love with Tommy—that much. I mean, I’d think whoever you were in love with—you’d not want to go out with anyone else; you’d kind of want to stop shopping around for another person, or so I believe. If I was to get married, I’d not want to go out with anyone else: and if I did, I’d know that I was not ready for marriage, to him or anyone, if that makes any sense.” But to Jill it made all the sense in the world. She was sleeping with Tommy at night, and wanted to be with Johnny. “What do you think I should do?” asked Jill. “I think you already know; I don’t think I need to say anymore. My heart is with you, no matter what the outcome is.” Then Tasma hugged her tightly. 24 Reset As the next two weeks passed a kind of silence took over the house, people talked less to one another, I suppose you could say, Jill was the life of the house, and now she was deep in thought. Everyone tried to keep busy and pretend things were normal, but they of course knew they were not. The Belmont’s kept their normal schedule, and the pretense lingered. Tasma had finished up with Tommy’s book on San Francisco, and had explained to him how she liked the ending of ‘Bustling,’ by his fake name Colleen Grant; she commented to Tommy: “The younger woman fell in love with the older man, but she had psychological issues, and she was too fragile for him to care for her emotional illness, and he was too sick biologically for her to care for him. It was a sad ending I thought, but had they married: love would not have been enough, as they wished, they’d both had ruined the life of the other. Yet they remained friends as they parted, matter of fact they remained friends until he died at the age of eighty-years old, and her, at eighty-two.” She then read a poem she was working on for him: “I haven’t put it in my book or diary yet, but here it is I’ll read it to you from the paper (Tommy sat inquisitively on the edge of her bed): The Maiden from Seattle When she walked into the light The door to life, grew black as Night, And her earth began to swell (This youthful beauty of Seattle); At first glance— Fell this youth from high Aching to touch the morning sky. Who dare take this maiden’s hand? To help her though this silent land! Ah! From hair, to heart, to breast: Like faded flowers in the ground Fleshless alms, could not be found, And so she remains—bound! Said Tommy in surprise, “I like it, I think a little or maybe a lot of you is in the poem; I think you’re going to be a Mrs. Plath, or Dickinson some day.” —The following day Tommy had come into Tasma’s room unexpectantly, “Are you still writing your story?” he asked. She looked at Tommy, “Just some poems, and dairy notes, really haven’t gotten into the plot or theme of anything in particular yet; not sure how to get it going.” “Let me see, maybe I can help you” he said. Yet Tasma was still bewildered of his rudeness to just kind of enter at will; she liked him and didn’t want to scare him away, on the other hand, she was not going to join any love-circle. She leaped quickly to her pillow, then it dawned on her, she had much information in it about Johnny, Jill, Tommy and, none other but the: The Lady in Black, as she referred to her in the diary. But had she not jumped, she thought afterwards, had she not jumped she’d had not given away her hiding place, although it was no vault for sure—I mean, a mouse could have found it had it looked for it. “I, I have too many personal things in it, private things, I’d rather you not see,” said Tasma as she currently held the book in the middle of her chest; as she got off the bed with her one knee, fully turning about now, she tripped on her shoe and the book fell, Tommy quickly grabbed it and opened it. Tasma saw him reading it, and needed to do something quick, she grabbed it out of his hands and jumped on the bed, her dress flying above her waist showing her underwear and all. Somehow Tommy found the child in him, and jumped on her bed trying to grab the diary from her as they rolled around in the bed; now Tommy hovering over her, his legs between hers. “What are you two up to?” questioned a voice in the background, it was Jill: she had heard the ruckus. “My fault, I was trying to get her diary from her, I started to read something quite interesting,” he looked at Jill halfheartedly. Had he gone back any farther, thought Tasma: The Lady in Black was there. Jill looked at Tasma in an indefatigably way, “I see I wasn’t invited to the party—”and slipped off to her bedroom where she just looked out the window aimlessly. In a way it didn’t bother her about what she’d seen, but on the other hand, she was jealous. When Tommy left the bedroom to join Jill he didn’t know whose child it was; he had only read up to ‘I overheard her say to her mother she was pregnant today by….” He could not ask Tasma to betray Jill, it would be too much to ask, if anything, Jill might be betraying him, it was indicative of her. —In the following days, Tasma noticed Tommy and Jill fought quite a lot; and Tommy was not a person to be irritated easily, it must be that she was leading Tommy to believe it could be his child, Tasma thought. Then one evening she noticed Tommy sleeping on the coach, and Johnny still remaining in his bedroom. During this interval, Johnny entertained himself in his bedroom, hoping Tommy and Jill would sort things out—thus he remained in kind of a queue, waiting for Jill’s signal to return, somehow he had come to that conclusion she would. He found himself pacing the floor at night, saying, ‘I wish, whatsitsname, would…’ and never ended the sentence. —I must make this awkward at this point, his mind broke off the subject of Jill and Tommy after the first week, his insides became external. He looked at himself, pretending he was not feeling this serge; he had not guessed at this until it engulfed him, there was stern on his face—and, toil in his hand. A cold shower might work he thought, but it was too far away. He felt he was on a fast run; he hardened his body like a weightlifter, a boxer ready to take a punch. This lasted two weeks, finally an agreement came about, Jill would sleep with Johnny, and Tommy would sleep in Johnny’s room, and in due time Tommy would have to leave, approximately in a few months, considering once she started to show it would only provoke issues within the household, or so she felt. The real problem was that Johnny did not have the heart to tell Jill he liked the way things were, and he really liked Lorie to a higher degree. He wanted his sex, but could find it elsewhere if need be, now he’d have to resort to living in her bedroom, and his alone time would be altered. In addition, Lorie was somewhat out of the picture for he had not seen her in weeks as he waited for this all to settle, but he’d see her again is what he was planning. Again, everything seemed in the air now. But to resist the plan would be too premature at the moment he deliberated out. In spite of the tension, things appeared to move about on a regular base for a few more weeks. However, Johnny was starting to hang out with the gang more often now, with their motorcycles, and customized old cars. He was doing a lot more drinking and gambling with the gang members. They had even stopped on a few occasions at Jill’s house looking for Johnny, taking pains to find him, going out of their way it would seem. It came to her attention; Johnny owed them money, how much it wasn’t said (but it was close to $6,000-dollars). They’d not go to his work; it was one thing the groups forbid: that being, to endanger a man’s livelihood was not being a man at all. They could do almost anything else, even kill you, but not jeopardize your job: that was considered a low blow. Out of nervousness, Tasma started to keep her distance from the group at the bar, if she could, she would have vanished into thin air. pnis enlargement operation penis enhancement pic before and after vimax penis girth enlargement cheap pennis enlargement natural penis enargement get vig rx pennis enlargement excersizes vimax penis enlargement device penis enlargement information

Many people assume they need to consume Alcohol to have Good Sex? For most Americans, consuming alcohol seems to be part of our cultural heritage. We drink at weddings, funerals, birthdays, and pretty much to celebrate anything and everything. We learned from a young age by watching our parents and other adults, that drinking is a sign of maturity. Many people, especially young adolescents, expect that alcohol use will lower tension and anxiety and increase sexual desire and pleasure in life (Seto & Barbaree,1995). About 1 in every 7 adults in the United States meet criteria for alcohol dependency, according to a large NIMH epidemiological study (Grant, 1977). Men are four times more likely than women to be heavy drinkers and are twice as likely to be alcohol abusing or alcohol dependant. Most males and many females find it difficult to imagine not drinking any alcohol at least on weekends and find it almost impossible to think of having sex without previously having a few drinks. These fundamental values appear to be deeply embedded in our culture. Somewhere along the line, we got the message that we need alcohol to have good sex. Does Alcohol Enhance or Hurt our Sexual Performance? I recently heard a stand-up comedian refer to the term, “Whiskey – Dick” when describing his “friends who had drank too much and had difficulties with orgasm even while using Viagra. Shakespeare once said that excessive drinking, “provokes the desire but takes away the performance.” Alcohol reduces inhibitions and gives us a mellow feeling. It makes us more relaxed and more talkative. It can make shy people fe//el confident and bold. These effects can facilitate our sexual desires by developing our social skills. However, these positive effects are only present in the early stage of intoxication i.e. when we’ve consumed 1-2 drinks (assuming you haven’t already developed a tolerance for alcohol). Sexual Impotence On the other hand, alcohol’s negative effects on sexual performance have been widely documented. Men and women who have several drinks may find it very hard to achieve orgasm. Difficulties with achieving orgasm after alcohol consumption can be understood because alcohol dilates small blood vessels all over the body so that there is less engorgement of blood in the sexual organs. This leaves the penis flaccid or only partially erect so that sexual penetration is difficult. Women may find that they have decreased vaginal lubrication making sexual intercourse unpleasant and sometimes painful (Raff, 2006). Impotence is the constant inability of a man to maintain an erection for sexual purposes. It is estimated that impotence affects over 30 million men in the United States (NIHCS, 1992). Masters and Johnson, identified alcohol as a common factor in impotence in their monumental work on human sexual inadequacy. Alcohol damages the central nervous system and destroys brain cells, and if the damage is prolonged enough, it can result in irreversible sexual impotence even while a person is sober. Alcohol is also a factor in loss of sexual control or premature ejaculation. Even a couple of beers before sex can spoil a man's erection and ruin his ejaculatory control. Up to 80 percent of men who drink heavily are believed to have serious sexual side effects, including impotence, sterility, or loss of sexual desire. Heavy drinking over a long period of time can irreversibly destroy testicular cells, leaving men with shrunken testicles. Both sexual drive and sexual capacity can be damaged. Alcohol also suppresses testosterone levels even in social drinkers by suppressing the secretory activity of the Leydig cells (Flatto, 1990). Alcohol and High-Risk Sexual Behaviors A history of heavy alcohol use has been correlated with a lifetime tendency toward high-risk sexual behaviors, including multiple sex partners, unprotected intercourse, sex with high-risk partners (e.g., injection drug users, prostitutes), and the exchange of sex for money or drugs (Windle,M.,1997). There may be many reasons for this association. For example, alcohol can act directly on the brain to reduce inhibitions and diminish risk perception (MacDonald,T.K.,2000). However, expectations about alcohol’s effects may exert a more powerful influence on alcohol-involved sexual behavior. Studies consistently demonstrate that people who strongly believe that alcohol enhances sexual arousal and performance are more likely to practice risky sex after drinking (Cooper,M.L.,2002). Some people report deliberately using alcohol during sexual encounters to provide an excuse for socially unacceptable behavior or to reduce their conscious awareness of risk (Derman,K.H.,1998). According to McKirnan and colleagues (McKiran,D.J.,2001), this practice may be especially common among men who have sex with men. This finding is consistent with the observation that men who drink prior to or during homosexual contact are more likely than heterosexuals to engage in high-risk sexual practices (Avins,A.L.,1994). Alcohol and AIDS People with alcohol use disorders are more likely than the general population to contract HIV (human immunodeficiency virus) - the agent that causes acquired immunodeficiency syndrome (AIDS). Similarly, people with HIV are more likely to abuse alcohol at some time during their lives (Petray,N.M.,1999). Alcohol use is associated with high-risk sexual behaviors and injection drug use, two major modes of HIV transmission. What are signs of problem drinking? The primary signs of problem drinking are: Having health, legal, social, academic or financial problems as a result of drinking. For example, missing class or work because of drinking or hangovers, not be able to have fun or express oneself without drinking, fights or problems with roommates or significant others, spending excessive amounts of money on alcohol, blackouts/passing out, trips to the ER, being defensive when someone mentions your drinking, needing to drink more to achieve the same effects (tolerance), frequently drinking with the primary purpose of getting drunk, and/or repeatedly driving under the influence. These are only guidelines and each case is different. If you're concerned about your drinking or a friend's drinking, get more information! Screening for Alcohol Dependence Screening tools are available to assist counselors and therapists with diagnosing alcohol abuse and dependence such as the SMAST below. Short Michigan Alcoholism Screening Test (MAST) 1. Do you feel you are a normal drinker? (By normal we mean you drink less than or as much as most other people.) 2. Does your wife, husband, a parent, or other near relative ever worry or complain about your drinking? 3. Do you ever feel guilty about your drinking? 4. Do friends or relatives think you are a normal drinker? 5. Are you able to stop drinking when you want to? 6. Have you ever attended a meeting of Alcoholics Anonymous? 7. Has drinking ever created problems between you and your wife, husband, a parent, or other near relative? 8. Have you ever gotten into trouble at work because of drinking? 9. Have you ever neglected your obligations, your family, or your work for two of more days in a row because you were drinking? 10. Have you ever gone to anyone for help about your drinking? 11. Have you ever been in a hospital because of drinking? 12. Have you ever been arrested for drunken driving, driving while intoxicated, or driving under the influence of alcoholic beverages? 13. Have you ever been arrested, even for a few hours, because of other drunken behavior? Individuals that answer – Yes to three or more questions indicate probable alcoholism, two yes answers indicate probable alcoholism, and fewer than two yes answers indicate that alcoholism is not likely (Selzer, M., Winokur, A. & Van Rooijen, C.; 1975). Note: If after reading the above, you started rationalizing to yourself, “Well, I can stop drinking anytime I want to, but I usually stop when I run out of money.” (As my old graduate professor use to say) STOP BULL-SH#%ting yourself and go see a certified alcohol counselor. Co-morbidity & Alcohol Dependence Alcohol abuse and dependence are among the most destructive of the psychiatric disorders (Volpicelli, 2001). Addictions such as alcohol dependence and other addictions as a rule do not develop in isolation. Over 37 % of alcohol abusers suffer from at least one coexisting addiction and/ or mental disorder (Rovner, 1990). Individuals can shift from one addiction to another or sustain multiple addictions at different times. The National Co-morbidity Survey (NCS) that sampled the entire U.S. population in 1994, found that among non-institutionalized American male and female adolescents and adults (ages 15-54), roughly 50% had a diagnosable Axis I mental disorder at some time in their lives. This survey’s results indicated that 35% of males will at some time in their lives have abused substances to the point of qualifying for a mental disorder diagnosis, and nearly 25% of women will have qualified for a serious mood disorder (mostly major depression). A significant finding of note from the NCS study was the widespread occurrence of co-morbidity among diagnosed disorders. It specifically found that 56% of the respondents with a history of at least one disorder also had two or more additional disorders. These persons with a history of three or more co-morbid disorders were estimated to be one-sixth of the U.S. population, or some 43 million people (Kessler, 1994). Poor Prognosis We have come to realize today more than any other time in history that the treatment of lifestyle diseases and addictions such as alcoholism are often a difficult and frustrating task for all concerned. Repeated failures abound with all of the addictions, even with utilizing the most effective treatment strategies. But why do 47% of patients treated in private treatment programs (for example) relapse within the first year following treatment (Gorski,T., 2001)? Have addiction specialists become conditioned to accept failure as the norm? There are many reasons for this poor prognosis. Some would proclaim that addictions are psychosomatically- induced and maintained in a semi-balanced force field of driving and restraining multidimensional forces. Others would say that failures are due simply to a lack of self-motivation or will power. Most would agree that lifestyle behavioral addictions are serious health risks that deserve our attention, but could it possibly be that patients with multiple addictions are being under diagnosed (with a single dependence) simply due to a lack of diagnostic tools and resources that are incapable of resolving the complexity of assessing and treating a patient with multiple addictions? New Proposed Diagnosis Since successful treatment outcomes are dependent on thorough assessments, accurate diagnoses, and comprehensive individualized treatment planning, it is no wonder that repeated rehabilitation failures and low success rates are the norm instead of the exception in the addictions field. Treatment clinics need to have a treatment planning system and referral network that is equipped to thoroughly assess multiple addictions and mental health disorders and related treatment needs and comprehensively provide education/ awareness, prevention strategy groups, and/ or specific addictions treatment services for individuals diagnosed with multiple addictions. Written treatment goals and objectives should be specified for each separate addiction and dimension of an individuals’ life, and the desired performance outcome or completion criteria should be specifically stated, behaviorally based (a visible activity), and measurable. To assist with resolving this problem a multidimensional diagnosis of “Poly-behavioral Addiction,” is proposed for more accurate diagnosis leading to more effective treatment planning. This diagnosis encompasses the broadest category of addictive disorders that would include an individual manifesting a combination of alcohol and substance abuse addictions, and other obsessively-compulsive behavioral addictive behavioral patterns to pathological gambling, religion, and/ or sex / pornography, etc.). Behavioral addictions are just as damaging - psychologically and socially as alcohol and drug abuse. They are comparative to other life-style diseases such as diabetes, hypertension, and heart disease in their behavioral manifestations, their etiologies, and their resistance to treatments. They are progressive disorders that involve obsessive thinking and compulsive behaviors. They are also characterized by a preoccupation with a continuous or periodic loss of control, and continuous irrational behavior in spite of adverse consequences. Poly-behavioral addiction would be described as a state of periodic or chronic physical, mental, emotional, cultural, sexual and/ or spiritual/ religious intoxication. These various types of intoxication are produced by repeated obsessive thoughts and compulsive practices involved in pathological relationships to any mood-altering substance, person, organization, belief system, and/ or activity. The individual has an overpowering desire, need or compulsion with the presence of a tendency to intensify their adherence to these practices, and evidence of phenomena of tolerance, abstinence and withdrawal, in which there is always physical and/ or psychic dependence on the effects of this pathological relationship. In addition, there is a 12 - month period in which an individual is pathologically involved with three or more behavioral and/ or substance use addictions simultaneously, but the criteria are not met for dependence for any one addiction in particular (Slobodzien, J., 2005). In essence, Poly-behavioral addiction is the synergistically integrated chronic dependence on multiple physiologically addictive substances and behaviors (e.g., using/ abusing substances - nicotine, alcohol, & drugs, and/or acting impulsively or obsessively compulsive in regards to gambling, food binging, sex, and/ or religion, etc.) simultaneously. New Proposed Theory The Addictions Recovery Measurement System’s (ARMS) theory is a nonlinear, dynamical, non-hierarchical model that focuses on interactions between multiple risk factors and situational determinants similar to catastrophe and chaos theories in predicting and explaining addictive behaviors and relapse. Multiple influences trigger and operate within high-risk situations and influence the global multidimensional functioning of an individual. The process of relapse incorporates the interaction between background factors (e.g., family history, social support, years of possible dependence, and co-morbid psychopathology), physiological states (e.g., physical withdrawal), cognitive processes (e.g., self-efficacy, cravings, motivation, the abstinence violation effect, outcome expectancies), and coping skills (Brownell et al., 1986; Marlatt & Gordon, 1985). To put it simply, small changes in an individual’s behavior can result in large qualitative changes at the global level and patterns at the global level of a system emerge solely from numerous little interactions. The ARMS hypothesis purports that there is a multidimensional synergistically negative resistance that individual’s develop to any one form of treatment to a single dimension of their lives, because the effects of an individual’s addiction have dynamically interacted multi-dimensionally. Having the primary focus on one dimension is insufficient. Traditionally, addiction treatment programs have failed to accommodate for the multidimensional synergistically negative effects of an individual having multiple addictions, (e.g. nicotine, alcohol, and obesity, etc.). Behavioral addictions interact negatively with each other and with strategies to improve overall functioning. They tend to encourage the use of tobacco, alcohol and other drugs, help increase violence, decrease functional capacity, and promote social isolation. Most treatment theories today involve assessing other dimensions to identify dual diagnosis or co-morbidity diagnoses, or to assess contributing factors that may play a role in the individual’s primary addiction. The ARMS’ theory proclaims that a multidimensional treatment plan must be devised addressing the possible multiple addictions identified for each one of an individual’s life dimensions in addition to developing specific goals and objectives for each dimension. The ARMS acknowledges the complexity and unpredictable nature of lifestyle addictions following the commitment of an individual to accept assistance with changing their lifestyles. The Stages of Change model (Prochaska & DiClemente, 1984) is supported as a model of motivation, incorporating five stages of readiness to change: pre-contemplation, contemplation, preparation, action, and maintenance. The ARMS theory supports the constructs of self-efficacy and social networking as outcome predictors of future behavior across a wide variety of lifestyle risk factors (Bandura, 1977). The Relapse Prevention cognitive-behavioral approach (Marlatt, 1985) with the goal of identifying and preventing high-risk situations for relapse is also supported within the ARMS theory. Conclusions Considering the wide range of alcohol abuse and sexual behaviors in our world today, one should always take into account an individual’s ethnic, cultural, religious, and social background prior to making any clinical judgments, and it would be wise to not over-pathologize in this area of Dependency. However, since successful treatment outcomes are dependent on thorough assessments, accurate diagnoses, and comprehensive individualized treatment planning - poly-behavioral addiction needs to be identified to effectively treat the complexity of multiple behavioral and substance addictions. Since chronic lifestyle diseases and disorders such as diabetes, hypertension, alcoholism, drug and behavioral addictions cannot be cured, but only managed - how should we effectively manage poly-behavioral addiction? The Addiction Recovery Measurement System (ARMS) is proposed utilizing a multidimensional integrative assessment, treatment planning, treatment progress, and treatment outcome measurement tracking system that facilitates rapid and accurate recognition and evaluation of an individual’s comprehensive life-functioning progress dimensions. The ARMS hypothesis purports that there is a multidimensional synergistically negative resistance that individual’s develop to any one form of treatment to a single dimension of their lives, because the effects of an individual’s addiction have dynamically interacted multi-dimensionally. Having the primary focus on one dimension is insufficient. Traditionally, addiction treatment programs have failed to accommodate for the multidimensional synergistically negative effects of an individual having multiple addictions, (e.g. nicotine, alcohol, and obesity, etc.). Behavioral addictions interact negatively with each other and with strategies to improve overall functioning. They tend to encourage the use of tobacco, alcohol and other drugs, help increase violence, decrease functional capacity, and promote social isolation. Most treatment theories today involve assessing other dimensions to identify dual diagnosis or co-morbidity diagnoses, or to assess contributing factors that may play a role in the individual’s primary addiction. The ARMS’ theory proclaims that a multidimensional treatment plan must be devised addressing the possible multiple addictions identified for each one of an individual’s life dimensions in addition to developing specific goals and objectives for each dimension. Partnerships and coordination among all service providers, government departments, and health insurance organizations in providing treatment programs are a necessity in addressing the multi-task solution to Alcohol Abuse and Poly-behavioral addictions. 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