As I reflect on my career so far, one of the things that stand out is the diversity of cultures I have worked with. I grew up in Lebanon, studied and trained in London, practiced in Beirut and in Dubai, then moved to New York City, and am now in Orange County, California. During these times I had the pleasure of working with people from all sorts of backgrounds – Arabs, Indians, Pakistanis, Europeans, Americans, Australians, Asians, South Africans, Muslims, Christians, you name it.
One of the questions I get asked the most when I tell people I lived in Dubai is “What was it like working as a sex therapist there?” People assume that it is more conservative than western cultures because it is an Arab country, and in some ways, it is. However, what I realized and continue to learn about as I connect with more people in the U.S. is that we are all more similar to each other than we think.
Sure, in some countries and cultures, people are freer and more liberal, sex isn’t shameful, and people talk about it more openly. And in certain parts of the Middle East people are more relaxed about sex than in others. But shame around sex exists everywhere, and even if people live in the most open-minded of cities, if they grew up in a conservative home or society, it stays with them on some level. The difference might appear in the way that shame manifests itself.
Throughout my practice in the UAE, one of the most common sexual dysfunctions clients presented to me with was some form of Vaginismus or Sexual Phobia. That was not surprising as most of the women who came to me for this issue came from a very conservative background where no sex education was provided at all. If anything, the messages they may have received growing up was that sex and the sexual body are dirty/shameful. A lot of patience and dedication had to be put into the process of therapy to get them to become more comfortable and confident with their own body and with sexual contact with their husbands, before even discussing anything about pleasure.
Though less clients have presented to me with Vaginismus in the U.S. (so far), the messages are the same. A male client can present to me with orgasmic difficulties, or a woman might see me for desire issues, but if you scratch the surface, they all share the same underlying factor – shame. For that male client, the shame may be about ejaculation, and ejaculating inside a woman, especially when the sexual organs and functions have been described as disgusting growing up. For that woman, the shame might be about female pleasure – a concept that is often seen as degrading/disrespectful for a woman.
When I had moved from one culture to another, I had anticipated a more significant adjustment than I actually experienced in terms of understanding how to work with different clients. Sure, there are certain culture-specific issues and terms I needed to learn, but ultimately it was less about our differences and more about the things that we all had in common. Though shame has many faces, and expresses itself in different languages, in the end, whether we are white, black, or brown, we are all just human.
Dr. Maha Nasrallah-Babenko
PhD in Psychology