Re-air - NextAge: Call and Response

Funding for This is Nashville comes from Vanderbilt Blair School of Music, presenting the first Nashville concert by jazz vocalist Lucia, an evening of Latin, jazz and pop music with Lucia on Friday, September 18th in Ingram Hall. Tickets available at Blairtickets.com. I'm Blake Farmer, and this is Nashville. It's a roundabout edition, meaning it's your turn to talk. It's not just us here trying to figure out the way to say some things in polite company about intimacy, relationships, and our changing bodies. Our guests today, an open-minded geriatrician, a no-b-sex therapist, and a former megachurch pastor who has a lot to say about the way religious shame hangs over much of this discussion, especially here in, I don't know, some might call the buckle of the Bible Belt. Next stage season two is made possible by Blue Blue Shield of Tennessee and by the West End Home Foundation, advancing aging with dignity and strengthening communities. Let me welcome our guest as I, you know, pitch them here to the audience and they aren't so sure about what I'm saying about. Dr. James Powers of Vanderbilt, a geriatrician who's back to share his expertise on this topic. Welcome to the show. Thank you, Blake. Good to be here. Raven O'Rourke's a certified sex therapist with Between the Lakes, as in the Lakes around Mount Juliet. Between the Lakes Therapy. Welcome. Thank you for being here. Thank you for having me. And Jim Palmer is a former pastor at a certified megachurch who has. left the faith and written about the shame and stigma around sexuality that can follow us even into old age, which I think is a pretty incredible topic that we'll broach here shortly. But Jim, thanks for being here. Thanks, Blake. And flying in from Costa Rica, where you call home these days after many years in Nashville. Phones are open this hour, and we are happy to tackle anything that might have come up for you over this series. I don't mean to suggest that you've been listening. the wall, but, you know, we've been talking dating apps. Broadening our definition of intimacy. Big discussion yesterday about menopause. Perhaps you have thoughts. I know I was sending that episode to a few folks. We're going to loosely organize this episode into some of the physical issues, medical, then sexuality and relationships. And we'll close with a discussion of spirituality. The number to join us is 615-7602,000. You can also drop a comment in the chat on the video stream if you're watching. Hello. It's YouTube.com. com slash at WPL and just open that chat and the team will get me some of those messages to have on the air. You know, before the show, we got this call from Angela Hobbs.

Hi. I was recently on an episode of This is Nashville and their new season on aging. And I wanted to call in and say what a really enjoyable experience I had. The whole team was really wonderful. I would love to see at some point in the future, maybe the topic of eating disorders. being discussed, particularly as it relates to menopausal women as they navigate this pervasive diet culture and wrestle with their changing bodies later in life. Thanks so much. Thank you, Angela. And for others who've been on the show over the last two weeks, perhaps you're as primed as anyone to join the conversation and help us fill in any holes we've left, the number 615-7602,000. Dr. Powers, what do you see with eating disorders in post-menopausal patients? Is that a thing? Well, we don't generally call it eating disorders so much as weight gain. And this is actually something very common as we age. Generally, we are less active. we also tend to maintain our intake, our dietary habits that we've had throughout life, and that adds weight to our bodies. It's also true that we metabolize more slowly as we get older. We have less muscle mass, and actually the fat buildup is very hard to control. And we generally try to get people to maintain weight. of the discussion is that if you lose excessive weight, particularly if we're talking about much older people like 70 and older, you actually lose a lot of muscle mass. Well, would this, is there anything related to menopause that is causing that weight gain typically? Not that I am aware of. It comes, I think, with aging by itself. Typically, the average age is about 49 and a half years. So these are not that really old population here. Thank you for saying that, actually. You know, one of the interesting things about doing anything about aging is talking to folks who don't feel like they are whatever you want to call them, the second half of life, seniors, older people. Raven, how often do you find body images? are part of what is plaguing people, you know, keeping them from sexual life they would like? I think a lot as it relates to older adults, right? There's cancer and there's things that happen to your body as you age that require some grief and loss over the course of life. But I think it's certainly the only sex education that a lot of people get is pornography. And that's... not their job. They're entertainers. They're not educators. And so if you're comparing yourself to that, then yes, that's a recipe for having body image issues and sex. And what about even sort of second half of life, someone who perhaps has thought of themselves is like, oh, I, I.

Whatever attractive to them is, that I am that when you maybe something changes, some kind of illness that has changed your body. I don't know. It seems like that's something you're going to deal with in a therapy session as much as other intimacy issues. Sure. I mean, bodies change as we age. And so if you're in a long-term relationship, it changes, right? You signed up for it. You know, Jim Palmer, we have you here kind of for your insights on some of the shame and stigma around intimacy, often related to religious upbringing. But you also happen to be, you know, a man well into second half of life. How are you handling all the ways the body changes? Well, I think that James put it well is that as you age, you have to be willing to accept your limitations. So I have a background of being an ultra-endurance athlete. Yeah. Do 100-mile races and long-distance triathlons and the recovery time it takes now in older adult years. And, you know, of course, my background is in religion. And I think that... One of the core things that some religions do is get you off on a bad foot in terms of your relationship to your body. Yeah. So that, you know, whether it's body image, sexuality. So there's kind of a lot that goes on in terms of thinking about how you relate to your body, you know, even to begin with. And of course, it's a little different for women than men in many cases. I have a daughter who's now 26 years old, so, you know, body image issues was obviously something that came up. And there are some ways that religion kind of reinforces this in terms of, you know, maintaining a kind of performative identity and, you know, your appearance and looking good. And, you know, so it has an impact for sure. Yeah. Well, you know, we had a lot of talk about experiences in menopause on the show yesterday. And then, you know, this week during The Talk 2.0, as we called it, we learned about genitoh urinary syndrome of menopause, which was, you know, an education for me that certainly sounds like it's under-treated. And we also talked about the benefits of estrogen, the power and limitations of the little blue pill for guys. To listeners, I'm asking, what changes have you experienced that have potentially gotten in the way of intimacy? Tough thing to call into a radio show to talk about, but I encourage you to consider it. It's an important part of this community conversation. Maybe you've got questions for Dr. James Powers here at geriatrician. Join us on air, the number 615-760,000. Or you can chime in a little more anonymously if you like at YouTube.com slash at WPLM where there's a live chat with our video stream. So a question from a listener named Bob that was about insurance coverage. He wrote him to say, it seems health insurance is more likely to cover ED meds, like erectile dysfunction meds, for men, but not HRT, hormone therapy for women. And I was looking up, Dr. Powers, you know, Medicare generally.

doesn't seem to cover either. But have you noticed a difference in maybe insurance covering things for men, maybe less so in this territory for women? I don't agree with that. It is true that for erectile dysfunction, it is not considered a disease, actually, by the insurance companies. And if they do cover it at all, it's a very limited amount. For instance, one pill a week is generally what is provided. Why would it cover it if it doesn't generally? Well, it... is not generally covered, but in some cases we have folks that do get it covered, a smaller amount. There's a large co-pay for this. I see. But as far as women, if the physician orders hormonal treatment, for instance, menopausal symptoms still can be appropriate. There are some risk factors that we have to be aware of. It's not for everybody. But that generally is covered. It generally is? Yes. Raven, obviously, you're not a prescribing physician, but I wonder if you have clients who are also kind of on the medical train and have insurance issues. Oh, sure. But some of the ED medications lately have become more of... more affordable than they once were. Definitely one can get them through other sources. Yes. Well, it used to be a big, it would be like, well, we're going to do this. This is like a $400 investment today. So today, it was very, it used to be much more expensive than it is now. So it's a big, it's a lot of pressure, which is not great for erections. I hadn't thought about that. You feel like you're wasting a, you're like, are we going to have to, this is going to have to happen tonight. I'm not taking this just. out of precaution. Yeah. The average cost of a generic Viagra or tablet is about $20. Yeah. So that's significant. All right. Well, you know, do the math. It's, uh, Dr. Powers, what kind of conversations do you have about intimacy when you've got a patient who's in, you know, just for, let's say their annual wellness visit? Is this a topic that you bring up intentionally? Yes, we are encouraged to do that. Often the individual will volunteer it if they are having some concerns. For instance, a gentleman might ask, hey, Doc, can you prescribe something for my ED here? Or it might be a woman just saying that, you know, I get together with my husband regularly, and it's much more uncomfortable. Can you explain this going to detail? And if they're uncomfortable, I'll often bring in an office nurse, a female nurse, to help with this. In general, I get a lot of questions. I would say about a third of my patients who are getting annual physicals.

They will bring that up. Part of this is that we prime them because we give them a whole bunch of questions in the waiting room to fill out off and on a tablet. Yeah. But on the other hand, they're very willing to talk about it. But it comes into play if other problems are presenting, for instance, many older women will suffer from recurrent urine infections, and that gets into your genital function. And so we get to talk about those things a lot. Well, Jim Palmer, one of the things we've learned in this series is that as you age, you know, perhaps sex needs to become much more like a range of activities. And some of this could be even, you know, very PG. But also perhaps... Manual, oral stimulation, or even what we called on the show being a master of self-love to avoid an uncomfortable term for many listeners and ourselves. But why does some of this come with shame and stigma for folks who've had a religious upbringing? Well, I think there are several reasons. One is that generally some religious systems are going to indoctrary a person in the idea that their body is either bad or secondary, right? One of the key doctrines of a lot of Christian teachings is that you're born as a sinner so that there's something inherent about you as a human being that makes you bad. Like you can't trust your own desire. Right. And particularly the body, right? Like we're not... um you know disembodied spirits and corrupt flesh and so religion has a way of not really validating the fact that the lived human experience is an embodied experience and that's okay it's okay to have a human body it is okay to cultivate a life that honors our desire for intimacy connection pleasure but these are all things that religion some forms of religion will repress shame fear, pleasure can often be suspect. Religion often is teaching that self-denial is sort of the calling card of holiness. And so we don't listen to our desires, our emotions, our body. And particularly around sexuality, this is an area where there usually tends to be a lot of shame, fear, and repression. Yeah. Well, we've heard some shared that their experience, even as they age, could get better. Maybe they're less inhibited. They become less self-conscious. Maybe some of that shame has gone somehow. One woman talked about being far less concerned about pregnancy, which was helpful. Is this your story? I'm asking listeners. here. We'd love for you to tell us in a radio-friendly way. The number is 615-760,000, or you can jump in the chat at YouTube.com slash at WPLN. Raven, can intimacy really get better with age, or is this just a, you know, a few one-off anecdotes? No, I think it really does get better with age because you're not as worried about...

pregnancy, you're not as worried about your body. Perhaps your relationship with the person that you're having sex with is deeper and more connected. Less distractions. A lot of people will tell me hearing my kids walk around or even imagining the possibility is just a shutdown. And so once the kids are gone, hopefully that they've left that, that they left your house. then you have the whole house to yourself. And that creates some opportunity for people. And I think the limitations that come with older age sometimes creates a bigger menu so that it isn't as focused on intercourse. You can be sexual in all of these other ways that are desirable and pleasurable. Dr. Powers, are there physical benefits to remaining sexually active? I think there are certainly psychological benefits, emotional benefits. As far as physical benefits, I think that I would be neutral on that. I don't think that it's a detraction at all. And if it is part of the relationship that the individuals enjoy, then I think I would encourage it. Jim Palmer, I wonder if one of the issues here is that so many people were taught that essentially sex is for making babies. And if you're not doing that, then it's really not important. Yes, I think that that's definitely true that some forms of religion are very conflicted about the role of pleasure in a person's lived human experience. And that does often come up around sexuality. I mean, you can take the example of the way Jesus is portrayed, right, a virgin birth, and even married, depending on your belief and, let's say, the Immaculate Conception. The idea definitely was that for Jesus to be pure, for Jesus to be God, for Jesus to be holy, he could not in any way be contaminated by the act of intercourse and sexuality. And so I think that that kind of begins to, if we're going to say something like, what would Jesus do, or we're using Jesus as a model for our humanity, well, then we pretty much have to wipe out entirely the whole aspect of sexuality, right? Because Jesus wasn't born through normal intercourse. And the story around Jesus often in religion is, of course, he did not, in fact, have... sexual temptation sexual desire uh... maybe had temptation and desire but but stayed away from it. Right. Yeah, if you're asking, why are they talking about Jesus on this show? Well, listen, folks, this is ingrained very deeply in folks. And this is part of the conversation. We'll get more into some of the spiritual side of things coming up. We do need to take a quick break. When we come back, though, we're going to focus a little less on the body, more on desire and being intimate.

I wonder for listeners, how have you kept desire strong or even revived your drive for romance and intimacy in the second half of life? We'd all love to hear. Stay with us. This is Nashville. Way back in 1952, the bronze mercury statue atop Union Station took a tumble. There's been a replacement up there for the past 30 years, and that prompted the question, The original. I'm wondering where it could be. Curious Nashville chases down the old bronze with some twists and turns along the way. Learn more and ask your question at WPLN.org forward slash curious. I'm Blake Farmer. This is Nashville. A roundabout edition. Our conversation on romance and intimacy in the second half of life continues today. And we're taking your calls if you'd like to join in. Our panel includes certified sex therapist, Raven O'Rourke, former pastor Jim Palmer, and Vanderbilt geriatrician James Powers. Taking calls on a range of topics today, but at this moment... Kind of moving the discussion to desire and relationship. Phone number 615-760-2000. Raven, we heard from our urologist this week who specializes in men that's saying for many, if they're having trouble with arousal, they just refrain from intimacy altogether. And you're nod in your head here, which makes me think that sounds familiar. They might even refrain from touching a partner. What's going on there? I think men have been socialized that the limited number of feelings that they're allowed to have, they're allowed to be mad for sure, and they're allowed to be happy, particularly about sports, and they're allowed to be vulnerable and touched. In sex, period. And so if I can't get an erection, then I'm not going to hug at all. And I see it, and it's so sad that that's the reality of many relationships. Yeah. Hearing those facts on their face seem almost hard to believe that essentially all intimacy hugging goes away. But I don't know. What does that tell you about the male psyche? I think culturally we've just put men in a box that this is what you're allowed. This is what you're allowed to do. And when I talk to heterosexual couples, the woman will often say, well, if I consent to this hug, then I'm consenting to sex. And it's like, whoa, whoa, whoa, no, no. So you're saying a woman often thinks that if there's any physical touch that you're sort of saying, yeah, we can. Yeah, that that's the path. This is the road that we're on. Yeah. And so a big part of my job is expanding the definition of sex and sexuality. Somebody on your show, Chuck Taylor, he mentioned that sex and physical touch are different things, which is, you know, is not revolutionary, but maybe is revolutionary. Wow. Well, um.

I wonder from this kind of scenario where it almost seems like the flame is gone. It's maybe totally out because of physical issues. Can you get back from that, rekindle the flame? Sure. I mean, I think... the really famous couples therapist, and maybe you guys can say this, it says that you're married to five people over the course of your life. And if you're lucky, it's the same person. That just things change. Your personalities change over time. And so that's a lot of what I do is people come to me. We haven't been intimate in all of these years. And what's the step? What are the steps back to that? Yeah. Well, I guess this topic is striking a nerve because the phones are lighting up. And if you're calling, just hold on. Josh Deepin will get to you in order. But Kai, you're on the line. You're on this is Nashville. Go ahead. Actually, it's Si, but. Oh, excuse me. Well, Cy, thanks for calling in. Go ahead. Well, I think sexuality promotes an influence on. People seek pornography particularly men. I'm not sure how it is for women. But the other thing is, I think when you have sex and you encourage it quite a bit, I mean, I don't think there's wrong with the intimacy. But maybe one partner or the other doesn't, isn't so inclined as the other one. And I think when there's a real emphasis put on it, that they can end up leading to... If I'm not getting it here, I'll go get it there because they've developed sort of an appetite for it over time. And then there's the... I just sort of missed your point about pornography. Can you say more of what you're getting at? Well, you know, men in particular, you know, if they're not... So you have an intimate relationship. You're with somebody five, then 10, then 20 to 25 years. You know, they say that in your lifetime, if you're with somebody long enough, you'll fall in and out of love with that person more than once. I'm not sure if that's true or not. I heard some old guy out of parking one day. But I think with the pornography thing, I think men in particular because it's kind of a barbaric thing. And maybe it's a... We say a natural or it's a primal thing, but they're not getting that there. Maybe it would influence them to seek entertainment sexually through pornography. Yes. Sy, I appreciate your point. And I may throw this hot potato over here to Jim Palmer. You know, obviously, I mean, you have many Christian churches who, you know, pornography is, you know, entire sermon series are on these such things. Can you kind of talk through some of the points size making here? Yeah, I think there's a couple ways to think about this. Certainly sexual repression that happens in high control religion.

pushes sexuality into secrecy because there's not a healthy outlet for a person to be sexual and so they go into a place of secrecy where they're able to kind of indulge their normal sexual interest and sexual desire. That's one thing that happens because when you repress something, it's not like it leaves. It's going to come out somewhere. It's going to take an expression somewhere. Now, the other thing that I would say is sometimes I feel like, you know, when conversations about sexuality, pornography, masturbation, this kind of thing, like maybe we need to step back and couples need to be able to have conversations about the kind of relationship. that they want to have based on what matters to them based on their deepest values you know trying to work out these individual issues is just symptomatic of something that doesn't happen with couples where they sit down and they talk about the kind of relationship that they want to have and then of course they want to they build that together the problem is is religion doesn't let people have that conversation often around sexuality because it can be very threatening. People can be misunderstood. It becomes an argument. And it's a poor communication issue. Raven, are you, I don't know, how often would you say with couples you're working with that really one of the issues here is pornography is a problem? I think some, I don't have a percentage, but I think certainly pornography for both men and women and masturbation is way easier. than being sexual with a partner where you have to be vulnerable and you have to meet them where they are and those kinds of things. Whereas pornography is like you type in your filters and you get the thing that you want to get, which is not reality in a relationship. You're saying it does threaten intimacy with other humans in a way, potentially. Sure. I mean, you don't want to put forth the effort to do it. Yeah, Jim. I was just going to say that You know, the other question here is consent, right? That this is like a core issue with sexuality, is that pornography and other things related to sexuality can happen in secrecy. So I think an important principle developing a healthy sexual relationship with someone is that there's consent in terms of discussion about what that sexual relationship is going to be like because... You know, I mean, we can all see here and say in every case, any exposure to pornography is inherently bad. But I think that that's a conversation that needs happen between partners and there's some consent about how they cultivate their, you know, sexual.

relationship. You know, religion is very good at judging everybody and deciding what the moral thing is to do. And I understand that. But I do think that this has to be a conversation for couples and the consent is the thing to focus on. Sure. And I think even defining what pornography is, sometimes I'll watch a show in the night with my husband. I'll be like, what? What channel is this on? Is this regular TV? Is this a... Yeah, streaming has changed a lot of that now that it's not on broadcast. Yeah, I'm like, is this allowed? So really defining what pornography is to you and how you feel about it. So I really appreciate the call. Let's take another call. Well, we may have just lost you, actually. I'm going to take a call from Alex. Alex, I think it says from New Mexico. Are you listening from New Mexico, Alex? Currently, yes. I'm here for work. Oh, lovely. We take calls from all over. We're all for it. But you're on the show. Go ahead. Absolutely. So my main question was, is that, you know, just, just for a background, I'm 24 years old. I've had, you know, a bunch of different experiences sexually, you know, throughout my entire life. And I've just kind of noticed that there's a trend to where people tend to usually be really nervous about talking about sex, not necessarily doing it, but just... You know, whenever it comes to, like, you're just, you know, let's say you're out at the bar, you're with your friends, you know, people will make jokes and comment and say, oh, yeah, this would be funny, this would be great. You know, I love to do this or I love to do that. But then whenever you're in an intimate moment with somebody, it just seems like that people tend to usually lock up. And I'm just trying to figure out if there's, like, what reason would be behind that? You know what I mean? Yeah, well, listen, I'm not sure it gets any better. My 21st anniversary is this weekend, and we don't talk about it much. Raven, what's going on? Well, who would have taught you to talk about it? Like, when would you have seen it? Presumably you didn't see your parents talking to each other about it. No. One of the gifts of being a sex therapist is that I get to ask, like, What did you learn about sex and sexuality? And nothing is a lot of the case. Or a parent would say, here's a book. Let me know if you have questions. And so I think it's a muscle that you have to exercise. Yeah, Jim. Oh, go ahead, Alex. Chime in. Sorry, yeah, I didn't mean to interrupt. And I think, and this could be said for probably most of the people my age. You know, I grew up in a time frame toward the Internet was pretty young. And I'm sure you guys did too as well, even though you guys are probably a little bit more older than me. So I imagine that you actually got to see the birth of it. I didn't.

But the Internet was very unrestrictive back then, and especially if you had parents that were busy or not at the house as much. I feel like you just kind of self-taught yourself to learn a lot more about these topics and, you know, just what things can happen, you know, in a bedroom and things of that nature. So from what I'm seeing more recently is that, you know, people aren't... kind of going that direction anymore. It's kind of going the opposite, actually, to where not even parents are talking about it, and also the Internet's more restrictive now. So whenever people get to that age to where they start feeling things and they start, you know, they're wanting to experiment. They just don't know what to do. They don't know what to say. They don't know how to ask. And like I say, it's just a weird thing for me that I've just been noticing recently. Like I've been with my girlfriend now for about four months, and she... You know, we'll get to the point where we're in the bedroom. We're having fun and things end. And then at the end, it's like, hey, I wouldn't like to do this. Hey, I wouldn't like to do that. You know, and it's like, why didn't you say that before? You know what I mean? Alex, thanks for this. Jim Powers, what's? Jim Powers, not, not. I knew it would happen at some point. I knew it would happen at some point. But, yeah, Jim Palmer, go ahead. Well, I was just going to say to the earlier point is that I think human beings. fear failure. And there's probably not any more of a catastrophic failure than for a man or a woman to feel that they have failed their partner sexually. Naked. Yes. How much more vulnerable could you be? Hence what Raven was saying previously, which is that there's no risk of that when you're either masturbating or watching pornography. Right. You can relieve yourself and you can satisfy a sexual desire, but there's not the threat of failing a partner. And so it's difficult. I think it gets into, well, there's many more reasons of that, but I think that that's one area that makes it difficult to discuss because do you want to hear like a partner give you a critique about your sexual life? It's kind of what you're doing, yeah. Yeah. Well, thank you so much for your call, Alex, and for listening even when you're on the road in New Mexico. Let's take another call. Chris in Nashville, sorry, I'm not sure what happened. Perhaps I hung up on you. But you're on the show. Go ahead. Hey, I wanted to make a comment earlier about one of your guests stating that generic Viagra was $20 a pill. You can get a 90-day supply of either the Tadalphil or Saldonepil, which is the Viagra or... The Alice from Costco or Cost Plus drugs for like $10. It's literally like 11 cents a pill at this point. It's very cheap. So anyone that isn't taking it, there are very few side effects. And I just wanted to make that clear to anyone out there listening that might be scared off by spending 20 bucks. But you do still need a prescription from a physician. Absolutely. Yeah. Absolutely. Chris, thanks for the call. Join the conversation. The number 615-760-2000. Dr. Powers will now bring you into this. The...

Are there not really negative side effects related to these ED medications that are so easy and cheap to get now? Well, yes, there certainly can be. What they do chemically is that they promote the dilation of blood vessels, and that is the... All over the body? Right, everywhere, not just in the penis. And so... But that is how they work and they'll last for usually several hours or several days depending on the agent that you're using. So people with certain cardiovascular conditions, people that would have problems if their blood pressure got too low, there have to be some risks that the physician has to accept and counsel before prescribing. And one of the comments from one of the callers was that you can get these. prescriptions are cheaper at different discount places. That is true. You can also get mail order where there's a position who's writing this or a practitioner or this license in some state writing these prescriptions and really just taking information. that the person provides, which may not be true. In other words, it doesn't take much to get a prescription these days. That is true. Yeah. Do you have concerns about that? I think in general, most people that are asking for medicine for ED are going to be okay. I think that but there are a few people with cardiovascular risks that I would have some concerns about. We need to take one more break. When we come back, we're going to focus a bit more on the spiritual aspects of intimacy in the second half of life or whatever part of life you're in. I love that we're getting phone calls from young folks as well. We'll keep taking your calls. Has religion been a blocker for you to expand your views on intimacy later in life? Or have spiritual aspects of sexual connection helped you keep intimacy going? We welcome your insights on the air at 615-7602, or in the chat of the video stream. It's YouTube.com slash... at WPLN. Stay with us. This is Nashville. I'm Blake Farmer. This is Nashville with a roundabout edition.

We're wrapping up next stage season two on romance, intimacy, and our changing bodies with a community discussion. We welcome any responses you may have about what you've heard in this series. Our panel includes sex therapist, Raven O'Rourke, geriatrician, James Powers, and former pastor Jim Palmer. And, you know, we have said it kind of throughout this series. But some topics of discussion may not be right for all ears. And, you know, this... show certainly is included in that, but we're going to close out talking about some of the spiritual parts of intimacy and connection. And I actually want to start a little bit about a discussion about language. So to listeners here, have you been comfortable hearing words that have been said on the air? You don't hear much. clitoris, erection, orgasm, on the radio. The list really goes on, and I wonder why even in the second half of life, do most of us still avoid these very direct, even clinical terms? We welcome your input on the air. Be nice to our ears, but this is an interesting discussion, and it's one that we had ahead of this series as well. 615-760-2000. Jim Palmer, is this just a matter of, you know, what was taboo in Bible school kind of hangs with us? Yes, I think that if I could get everybody to repeat, the body is not the enemy would be a good place. The body's not the enemy. Or the desire is not the equivalent of corruption or that pleasure is not inherently immoral, that sexuality is not bad or dirty. And unfortunately, these are some of the things you can learn from some religious systems that... treat sexuality, desire, pleasure in the body as being corrupt, unholy, ungodly, or secondary. So I think that if you were indoctrinated from a young age into a religious system, the enforced purity culture and other discussions around sexuality that induce people with shame, then it's going to be a real problem. You know, Raven, our team discussed, you know, words that we're going to use on the air or words that we were going to try to use minimally on the air, just, you know, because we all have kind of different tolerance almost. One thing that was pointed out is that we are far more comfortable using the word rape in a news story than saying orgasm. What explains that? I hear it often from parents who are trying to do their best with video game restrictions. And they'll tell me that they're like very comfortable with these first person shooter games that are incredibly violent but like no nudity. And it's a wild conversation to be having. You're actually kind of blowing my mind right now. I, I.

I think I might have thought that same way. And you're like, yeah, what's up with that? Yeah. I mean, I think we're just so, no one's talking to us about it. Maybe we're getting a little sex ed in school. But even that is not great, usually. Well, and it was pointed out on the show this week that the restrictiveness of sexual education laws in Tennessee now really prevent how much of a conversation you can go. If you go read what's known as the gateway. law, it does really restrict a lot of what can be said. Jump in on this conversation, the number 615-760-2000. Let's take one call. It may take us back on topic, and that's all right. Jonathan in Nashville, you're on the show. Go ahead. Yeah, I have just a question about, like, is there any sort of in this generation and maybe the lack of intimacy that you read about, hear about, people are having less and less sex, and that's the more norm. Is there any correlation between that and how, like, stressful life is right now? Just trying to make ends meet, stress about paying bills and buying groceries and just being able to afford, you know, for yourself, afford life for yourself and your loved ones. Jonathan, thanks for, yeah, thanks for bringing up that question. And, you know, I think you hear these kind of stats a lot of times with younger generations. Raven, what do you see? Yeah, I think that's part of it. But I also think that we're, because of lockdowns, which were necessary, there are a lot of young people that didn't get normal social development. And so we're talking about how risky a sexual interaction is with somebody. Well, if you can't walk up to somebody at a lunch table, then, of course, a sexual interaction. If you didn't ask somebody to prom. That's right. because you didn't get to go to prom, you know, then, yeah, then this is way bigger. Wow. Yeah, and what if this idea that, like, we're almost too busy, or maybe there are too many easier options out there? Yeah, I mean, I think that there is the busyness. I, there's, there was, like, sexuality on the trains to the concentration camps. So, like, people engage in sex and sexuality. It's an existential sort of, thing that we do. You know, Jim does a lot of existential therapy. Yeah. So. Yeah, I don't know. Well, Jonathan, appreciate the call. Dr. Powers. Yeah, I wanted to comment on sexuality in aging. I have the pleasure of taking care of a lot of couples that have been together 50 years, 70 years. And when one of them becomes incapacitated or passes away, the grieving process is for many things. The relationship meant so much to the surviving individual. They also talk about the lack of being able to be spontaneous with their partner and just sexuality in its many forms, not just the sex act. And it's a real big part of grieving.

This is something that, particularly for couples that have been together for a long period of time, is very precious. Are you saying maybe they're grieving it before the person has passed away? Even so, yes, if they're becoming incapacitated because of some illness. Yes. Well, we, I mean, we had a guest, Philip, who was talking, he remembered very clearly the last time. And I'm sure that there are many who are listening who can identify. We're still taking phone calls, though, get in quickly because it's tough at the end of the hour. The number 615-7602,000 talking about intimacy, relationships, and our bodies in the second half of life. Dalton in Murfreesboro, you're on. This is Nashville. Go ahead. Hey. You know, I was just listening earlier, just damn, sorry, listening in. And the question of, like, you know, why people are uncomfortable to talk about sex. And I honestly think the biggest issue with it is just how clinical it sounds. Because, like, most people are more comfortable saying, excuse my language, dick, than penis. Yeah. Well, you're making me uncomfortable right now, which is interesting. I'm not totally sure what we're allowed to do. But no need to say it again. But you actually are making the point. You're right. because it's like that sounds so professional in a way is something that's supposed to be super fun you know and that's always been the biggest roadblock at least from what I've seen for people my age like I'm 19 so I've seen it a lot with people my age that it seems more like talking about like a transaction than an actual fun activity Yeah, and yet when you use stuff that might be considered slang, you know, it sort of feels like you're getting, you know, someone to tell you, let's not use language like that. Jim Palmer, what's going on here? Well, I think that part of what it... feels like he's saying is that sexuality is put in a category that feels removed from the normal lived human experience, right? The language around it, the threat of talking about it. It's just something that's over here that everyone's thinking about, but people aren't really, you know, talking about it. And so I think that... You know, it's starting a young age, helping people understand that sexuality is a part of being a human person. I mean, it's one of the few core things about ourselves as homo sapiens. And so I think that it needs to enter into more common language starting at earliest age where human people were entitled. You know, being human is difficult. There's a lot of hardship, but we're entitled to the joys of being embodied creatures, which are things like pleasure, sexuality. And so, unfortunately, religion will make those things negative or bad things or threats to, you know, holiness or something sacred. And it kind of maybe can put it into a category that doesn't feel very normal to discuss.

Yeah, and I think it's interesting that the words are genital words, whereas there are other things that I might want to... compliment my partner about eyes or lips or finger you know there might be those body parts don't have different words in slang despite them being sexual yeah um well to colors here uh how have you normalized talking about intimacy with a partner even you know in your household in your community i can imagine you know caregivers who've had to find ways to discuss intimacy with clients or or family members what what's working what gets in the way 615 7602 but be quick if you're calling in you can also jump in the chat at youtube.com slash at wpln I wonder Dr. Powers if you find patients squirm with sexual language oh yes I think that that's very true and if we take an older adult they have had all of the cultural influences the education that Jim Palmer has mentioned to us and so We sometimes have to overcome that, particularly if we have to modify interactions. I'll just give a good example. We oftentimes at a nursing facility, people will be in wheelchairs and the nurses quite appropriately will want to get people together to do some activities and all. And people have probably never heard of wheelchair dances where one partner perhaps will move the wheelchair around, you know, in rhythm to some music and all. Very gratifying, very lovely sort of a thing to see and maybe end with a kiss. And that can be a very sexual, very gratifying sort of activity. Now, we're all picturing this with you. And it does seem like it could be beautiful. But I'm thinking of the practical requirements that maybe a caregiver has to set someone on someone else and kind of tell them what they should. I could see. people having to get very comfortable with something that might make them uncomfortable. How do you get past that? Well, I think that there's some education involved and perhaps having some feedback from the person that's uncomfortable. Let's say the person in the wheelchair who knows she can't get up and can't wear a fancy ballroom dress and all, but let her know that she's still beautiful in her own way. Something that hasn't come up in this series yet, but I want to talk to you about is dementia. In fact, it was mentioned because I believe some dementia medications can actually bring on a stronger sex drive, which of course would be a strange thing to happen. Maybe you've seen it occur. How does one deal with that when you have a patient with dementia who is coming on to someone else, let's say? Right. If they're unrelated and it's in a public space, it can be an issue. And often acknowledging and then redirecting is in general what clinical staff would do. Maybe that person does need to go talk with the other guys about football or watch the game. Sometimes you have to actively intervene. On the other hand,

It's a very real thing. And for instance, when we train staff, we ask them to recognize this. And we have to talk through with them so that they're comfortable dealing with these things. And on family visitors, you know, that's another layer of concern and responsibility that we have. Yeah. Raven. There's a worksheet kind of thing that I have that you can put in the show notes or whatever. A colleague did for me was called a loving will. And so it would be something that you would make. before dementia is onset. A loving will. Yeah. And you talk about like what what signals I will give or what's okay with me. What does consent look like as because it's not Dr. there's words for these, I'm sure, but there's not not dementia and tomorrow it's dementia. There's this whole there's all of this space in between. There is a continuum. Yes. And so. really defining for yourself when you are in a non-dementia state, what's acceptable for me. Yeah. Jim, do you want to tie a bow on this before our music starts and we have to go? Well, I would just say that one of the things I appreciate about this conversation is that it's recognizing that all stages of the human life are important. And so to navigate, for couples to navigate and work through, what does it look like for us? to have a healthy relationship, including sexuality. That question applies to almost every stage of life and it's worth discussing. Well, I must say thank you to our callers first. Wasn't totally sure if people would be calling in for a show like this and you did. In fact, a lot of younger men and a big surprise. Love it. Thank you very much. Let me say goodbye to Jim Palmer, former pastor who writes about deconstruction and sex after religion. Raven O'Rourke, a sex therapist at Between the Lakes Therapy and Dr. James Powers, geriatrician at Vanderbilt. Thank you for your insights. Thank you for having you for having this hour. Next stage, season two, made possible by Blue Cross Blue Shield of Tennessee and the West End Home Foundation, advancing aging with dignity and strengthening communities. This is Nashville's a production of Nashville Public Radio. If you missed yesterday's show, it was all about... menopause and I was not the one hosting. WPL and editor Latanya Turner was on the mic. Some of the stories were pretty wild like a guest who was misdiagnosed as bipolar, even put on powerful medications when it was just menopause. Listen to This Is Nashville.org or our podcast feed. You can also watch the video at YouTube.com slash at WPLN. Today's episode produced by Josh Deepin, all who is also working the phones. Live Lombardi making us sound and look good. The phone lines go to the voicemail after the show's over. We welcome your feedback, 615-760,000. Glenn, I'm Blake Farmer. Go in peace.