I wanna show you something.

(Sexplanations Intro plays)

In 1974, a man named Jack Annon came up with a model to address sexual health issues called the PLISSIT model, and I love it!

PLISSIT is an acronym that stands for Permission, Limited Information, Specific Suggestions, and Intensive Therapy. So much of what I knew about behavior change and cognition, theories of helping professionals who came from other fields, like psychology and social work. When I found out about the PLISSIT model, there was this really cool sense of pride that there was a model that my field, sexology, could contribute to others. And so it has! You're not sexology bound, this model is still going to help you.  

Jack Annon proposed that sexual health issues go through four tiers. I've got containers. So if a hundred people have a sexual health concern, many of them can resolve it with permission. Permission to stay the same, permission to change, permission to get help.

From there, about half need more: limited information. Limited, as in specific for what that person needs for their specific sexual health issue. I'm not going to share everything I know about sexuality, I'm going to share what pertains to them at this moment. I'd like to joke that if this wasn't the case, if my information wasn't limited, then it would be called the PISSIT model. Right, so limited information looks like statistics, vocabulary, anatomy drawings, whatever pertains to the topic at hand.  

From there, maybe there's 20 of the original hundred that need specific suggestions. What exactly to do, home assignments and instructions. These three tiers are what comprise the work of clinical sexologists. The last tier is pretty rare for clinical sexologists, they'll usually refer our to those handful of folks that need intensive therapy. It depends on the profession, whether or not this person is qualified to do the counseling, give the extensive time and investigation needed to address these folks. This is things related to family of origin, abuse, complex underlying causes of the sexual health issue.  

Let's take for example women experiencing anorgasmia. Anorgasmia referring to not being able to have orgasm, not ever having one or not knowing how to get one back, they're uncommon or difficult to achieve.

Here's the permission: "This is not unusual or wrong.  You are not broken.  You have my permission to masturbate, to talk with partners, to talk with a clinical sexologist, and to grieve."

If that doesn't cover it, limited information. "It's common for women to not orgasm and seek help if they want it. The National Survey of Sexual Health and Behavior, big comprehensive study of sex behaviors in the United States, found that 36% of women reported not having an orgasm at their most recent sexual event. Other studies have found that 15% of women have difficulties with it, and 1 in 10 haven't orgasmed ever."

Still need more? Specific suggestions. "Today there are a number of effective solutions to address your concern." The solutions I offer greatly depend upon the person's unique sexuality. Typically, though, women not experiencing orgasm are also not masturbating. So I may suggest writing a letter to your vulva and letting it respond. Or you could watch The Sun's music video, 'Romantic Death'. So there's this website called Beautiful Agony where people upload torso shots of themselves masturbating, and this band called The Sun has a song called 'Romantic Death', where they take a compilation of these Beautiful Agony videos and they display people masturbating while their lyrics play.

Remember, I know my clients' sexual histories, their entire health and well-being, their fears and needs before I make recommendations. I really like 'Romantic Death', but not everyone has given themselves permission to engage in watching sex acts. Alright, so back to more specific suggestions, I may recommend styles, positions, or other masturbation techniques and fantasies. Truth: a lack of fantasy correlates with sexual dysfunction or what I call 'sexual difficulties', there is a connection between the mind and body. From there, the situation requires more psychological approach or time, I may refer out. Maybe they need marriage counseling, maybe they need a grief therapist, I do the sex stuff. Like I said, intensive therapy is pretty rare, this is based on my experience and Jack Annon's.

Three tiers cover just about everybody. Awesome, right? Those of you really interested in this, Davis & Taylor extended Jack Annon's PLISSIT model in '06. They stress that permission giving should be incorporated in all four tiers, and that it is the responsibility of the helping professional to really look at their biases. They noted this explicitly. Get it? Extended PLISSIT, EXPLISSIT.

Sadly, and I say selfishly, Jack Annon isn't around anymore to teach you this himself, he passed in 2005. Someday, I'd really like to commission a sculpture in his honor, or you have my permission to do so.  

(Endscreen plays)

Lindsey: From there, there's even another--

Nick: This is going really well.  

Lindsey: Mittelschmerz.