Once someone realizes they have a drinking problem, their next thought is often, "how to stop drinking alcohol." Learning how to stop drinking alcohol is not about one lesson or idea, learning how to quit drinking requires a change in attitude, thought and behavior. Answering "how to stop drinking alcohol," begins with the commitment and the desire to quit.

How to Stop Drinking Alcohol - Prepare to Stop Drinking

While it may seem easy to decide to stop drinking one moment and simply not drink ever again, in reality that approach isn't effective. When looking at the question of how to stop drinking, first set the goal to stop drinking and then prepare your environment to stop drinking.

How to stop drinking by preparing ahead of time:

• Set a date on which you will stop drinking and announce this date to others so you can be held accountable.
• Remove temptations, like alcohol and anything that reminds you of alcohol, from the home and office.
• Let everyone know you intend to stop drinking and don't be around those who don't support your goal to stop drinking.

How to Stop Drinking Alcohol - Get Help to Stop Drinking

The question of how to stop drinking won't get you far without considering help to stop drinking. Problem drinkers may be able to stop drinking without much support but alcoholics are addicted to alcohol and require help to stop drinking. Even for a drinker who has not progressed to alcoholism, he or she is much more likely to succeed with help to stop drinking.

Help to stop drinking may be in the form of:

• A professional rehabilitation program
• Self-help alcohol addiction treatment
• Alcohol abuse therapy
• Support groups
• Faith community outreach

The best place to start looking for help to stop drinking is at the doctor's office as they can refer you to the type of help to stop drinking that suits your situation the best.

How to Stop Drinking Alcohol - Stop Drinking Safely

When mulling over how to quit drinking, it's important to consider the help needed to stop drinking safely. Alcoholics will go through withdrawal when they stop drinking. Alcohol withdrawal can include symptoms like headache, shaking, anxiety and other problematic symptoms. While withdrawal starts within hours of when an alcoholic stops drinking, the withdrawal symptoms themselves may be at their worst in a day or two and then start to improve in five days.^x

For some people who stop drinking withdrawal is unpleasant. For others, alcohol withdrawal can be life-threatening. All alcoholics should get help to stop drinking from their doctor to see if they are at risk for severe withdrawal known as delirium tremens, or the DTs. The alcoholic's doctor may decide to prescribe medication or recommend supervised alcohol detoxification when the alcoholic quits drinking.

How to Stop Drinking Alcohol - Build a Life Outside of Alcohol

One of the most common causes of relapse after a person has quit drinking is continuing the same lifestyle as before recovery. If an alcoholic has the same behaviors, goes to the same places and sees the same people as he did before he quit drinking, it will feel natural for him to start drinking again in all those familiar patterns. Additionally, once a person has quit drinking, a void appears in their life that alcohol used to fill. Part of how to stop drinking is learning new ways to fill that void.

How to stop drinking by building a life outside of alcohol might include:

• Integrating ways of taking care of yourself in everyday life. Focusing on sleeping, eating and exercising will keep a body healthy after an alcohol abuser stops drinking.
• Making new friends and a new support system. The old friends may not be interested in supporting a goal to stop drinking and being around someone unsupportive can cause a relapse into drinking. Meeting new people that have never known the person as an alcoholic can create new, positive relationships.
• Getting a new hobby. One of the great ways to fill the time previously devoted to drinking is by getting a new hobby or volunteering. Doing enjoyable and rewarding activities helps to stop drinking by reducing alcohol's appeal.
• Continuing treatment. No one learns how to stop drinking in a day, or a week so continuing treatment puts the focus on maintaining recovery and adds additional support should the alcoholic have to deal with a strong urge to drink.
• Learning to deal with stress in a healthy way. Many alcoholics drink in response to stress and when they stop drinking, their way of dealing with stress is gone. Learning new ways to deal with stress is essential to successfully stop drinking. Meditation, relaxation exercises and yoga can be helpful.

How to Stop Drinking Alcohol - Know What To Do When Triggers and Cravings Occur

Learning how to stop drinking alcohol is a process that continues throughout recovery. Even once the alcoholic is sober, many things around him may entice him to drink; these are called triggers. Triggers are any thing, place, person or situation that creates a craving in the alcohol addict to drink. Cravings may also occur due to stress or no discernable reason at all.

To stop drinking, manage cravings and remove triggers:

• Remove anything that makes you want to drink. This can mean real changes in lifestyle. Drinking buddies, pubs you used to hang out at, places where you hid alcohol or did secret drinking all need to be removed when looking at how to stop drinking.
• Avoid situations where alcohol is served or be prepared to say "no" when someone offers. Just because your priority is to stop drinking, that doesn't mean that others know or even care. Be prepared committed to saying "no" to stop drinking in public.
• Know who to call when you feel the urge to drink. The urge to drink can happen at any time so planning ahead and knowing what to do, and who to call when it happens is key to stop drinking.
• Remind yourself of all the reasons you chose to stop drinking. Cravings and triggers happen but these can be fought with the knowledge and experience gained through recovery.
• Understand that no craving lasts forever. When an alcoholic chooses to stop drinking it may feel like he will always feel the urge to drink, but this isn't true. Every craving comes, reaches its peak, and then leaves again.

How to Stop Drinking Alcohol - Stop Drinking. Don't Give Up.

Part of learning how to quit drinking is understanding that there may be slip-ups and backslides along the way. These short-term mistakes cannot allow the derailment of the main goal to stop drinking. If a setback occurs during recovery, the important thing to do is to reach out, get help to stop drinking, learn from the relapse and move forward into sobriety. There is no shame in admitting to a setback and by learning from it, it is less likely another setback will occur.

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While being the most popular legal drug in North America, there are many short-term and long-term effects of alcohol. Some effects of alcohol can be seen as desirable, such as euphoria and increased self-confidence at lower amounts, or unpleasant - dizziness, vomiting and blurred vision at larger amounts.

The effects of alcohol are felt more or less depending on circumstance and physiology. Women become intoxicated after drinking less alcohol than men, and consuming alcohol after a heavy meal will lessen the physical effects of alcohol.

Effects of Alcohol - Short-Term Effects of Alcohol

Consumed in moderation, the short-term effects of alcohol are typically safe and pleasant, in fact, one 12 ounce beer is known to increase sleep time and reduce awakening during the night. This beneficial physical effect of alcohol is not seen when more than one beer is consumed. The effects of alcohol when consumed in excess of one drink disrupts sleep cycles and causes daytime fatigue.

The short-term effects of alcohol are dependent on how much alcohol is consumed, and thus how much alcohol is in the blood (the blood alcohol level). (read:  how much alcohol is too much?) The effects of alcohol also vary depending on the alcohol tolerance of the drinker.^xi

The effects of mild drinking (1 - 4 drinks depending on gender and size):

• Increased mood and possible euphoria
• Increased self-confidence, sociability
• Shortened attention span
• Flushed appearance
• Inhibited judgment
• Impaired fine muscle coordination

More negative effects of alcohol are seen in moderate to heavy drinking (5 - 12 drinks depending on gender and size):

• Sedation
• Impaired memory and comprehension, profound confusion
• Delayed reactions
• Balance difficulty; unbalanced walk; staggering
• Blurred vision; other senses impaired
• Emotional changes
• Inability to feel pain
• Impaired speech
• Dizziness often associated with nausea ("the spins")
• Vomiting

Once more than 12 drinks are consumed, only the negative effects of alcohol are present:

• Stumbling walk
• Lapses in and out of consciousness
• Unconsciousness
• Amnesia
• Vomiting (possibly life-threatening if done while unconscious)
• Respiratory depression (potentially life-threatening)
• Decreased heart rate
• Urinary incontinence
• Unconsciousness (coma)
• Depressed reflexes (i.e., pupils do not respond appropriately to changes in light)
• Death

Effects of Alcohol - Long-Term Effects of Alcohol

The National Institute on Alcohol Abuse and Alcoholism recommends women limit their alcohol intake to one drink per day and men limit themselves to two drinks per day. Consuming alcohol in larger than these quantities show the negative effects of alcohol. Long-term effects of heavy alcohol consumption can lead to brain shrinkage, dementia, alcoholism and even death.xii

There are a few long-term effects of alcohol that are beneficial, however. When alcohol is consumed in the recommended amounts, the following physical effects of alcohol are seen:

• Reduced risk of death from coronary heart disease
• Reduced risk of blood clot
• Reduced risk of gallstones
• Lower risk of kidney stones
• Reduced risk of rheumatoid arthritis
• Increase in women's bone density

Negative Effects of Alcohol

There are far more negative effects of alcohol when it is consumed long-term in greater than recommended amounts. The long-term negative effects of alcohol include cancer; 3.6% of all cancer cases worldwide are related to alcohol drinking, resulting in 3.5% of all cancer deaths. The more alcohol is consumed, the more negative effects of alcohol are seen. Negative effects of alcohol include:

• Increased risk of heart failure
• Heart disease
• Anemia
• Brain shrinkage
• Addiction to alcohol (alcoholism)
• Dementia
• Stroke
• Brain lesions (effects of alcohol on the brain)
• Liver damage and multiple liver diseases
• Nerve damage
• Muscle weakness
• Electrolyte deficiencies
• Insomnia
• Tremors
• Depression (alcohol and depression)
• Pancreatitis
• Lung disease
• Loss of sexual desire, impotence
• Bone loss
• Skin disorders
• Multiple types of cancer
• Fetal alcohol syndrome in babies born to women who drank during pregnancy

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While the negative effects of alcohol on the body, like insomnia, are easily noticeable, the effects of alcohol on the brain may be more subtle. The effects of alcohol on the brain though, lead to many of the effects of alcohol that people take for granted such as difficulty walking, slurred speech and blurred vision, but there can be even more serious effects of alcohol on the brain.

Effects of Alcohol on the Brain - Blackouts and Memory Lapses

If you've ever thought about a night when you had too much to drink and can't remember what happened, you've experienced a blackout. A blackout is one of the effects of alcohol on the brain that impacts memory. Sometimes small details are forgotten and other times whole events are not recalled. Minor memory impairment is one of the effects of alcohol on the brain that can be seen even after only a few drinks.

Drinkers who experience blackout usually do so because of binge drinking. The effects of alcohol on the brain are more severe with binge drinking. Binge drinking is defined as 4 or more drinks in two hours for women or five or more drinks in two hours for men. Blackouts are particularly dangerous as people typically commit dangerous acts, like drinking and driving, in the period they later will not remember.

Effects of Alcohol on the Brain - Effects of Alcohol on the Brain of Women

Equal numbers of men as women experience blackouts in spite of the fact that men drink far more often than women. This indicates that the effects of alcohol on the brain are more severe for women, given equal amounts of alcohol. It is thought that all of a woman's organs, as well as her brain are more vulnerable to the effects of alcohol.

The effects of alcohol on the brains of women are thought to be more severe due to differences in size, body fat ratio and an enzyme in the stomach that breaks down alcohol and is four times more active in men than it is in women.

Mental Effects of Alcohol on the Brain - Wernicke-Korsakoff Syndrome

One of the severe mental effects of alcohol is Wernicke-Korsakoff syndrome, thought to be related to a thiamine deficiency in alcohol addicts. This is an example of one of the effects of alcohol on the brain that can be both debilitating and permanent.

Initially, Wernicke symptoms are seen:

• Mental confusion
• Paralysis of the nerves that move the eyes
• Difficulty with muscle coordination

Following these symptoms, 80% - 90% go on to experience Korsakoff's psychosis as one of the effects of alcohol on the brain. Korsakoff's psychosis is characterized by persistent learning and memory problem.

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Alcohol is a depressant, so one of the chief effects of alcohol on the brain is to depress central nervous system functioning which may be why major depressive disorder occurs in high rates in those who abuse alcohol. While some alcohol addicts may be drinking to self-medicate depression, research shows that long-term, excessive intake of alcohol causes major depressive disorder. (read: long term effects of alcohol)

Psychological Effects of Alcohol - Alcoholism and Suicide

One of the psychological effects of alcohol also appears to be an increase in suicidal behaviors:^xii

• A study of people hospitalized for suicide attempts found that those who were alcoholics were 75 times more likely to go on to successfully commit suicide than non-alcoholic suicide attempters.
• In the general alcoholic population the increased risk of suicide compared to the general public is 5 - 20 times greater.
• About 15 percent of alcoholics commit suicide.

Psychological Effects of Alcohol - Hepatic Encephalopathy

Many psychological effects of alcohol on the brain can also be seen in a form of a type of liver damage known as hepatic encephalopathy. Hepatic encephalopathy is a worsening of brain function that occurs when the liver is no longer able to remove toxic substances in the blood.

The psychological effects of alcohol from hepatic encephalopathy include:^xiii

• Sleep pattern changes
• Changes in mood and personality
• Depression, anxiety and other psychiatric conditions
• Cognitive effects such as shortened attention span and problems with coordination

Other known psychological effects of alcohol include anxiety, panic disorder, hallucinations, delusions and psychotic disorders.

article references

Alcohol withdrawal, sometimes called alcohol withdrawal syndrome, refers to a set of symptoms that appear once an alcohol addicted person ceases drinking. Once a person becomes physically dependent on alcohol, such as in alcoholism (read: definition of alcoholism), alcohol withdrawal will occur when the alcoholic stops drinking.

Most of the symptoms of alcohol withdrawal are due to the fact that alcohol is a central nervous system depressant and when it's removed, the central nervous system become hyperactive. This hyperactivity can result in tremors, seizures and even death.

Alcohol Withdrawal - Symptoms of Alcohol Withdrawal

Alcohol withdrawal often begins after sleep but sometimes almost immediately after the alcoholic stops drinking. There are many symptoms of alcohol withdrawal and their severity is dependent on how long the alcoholic had been drinking, how much alcohol they consumed, age and individual genetics. Alcohol withdrawal symptoms tend to be more severe with repeated alcohol detoxifications.

Symptoms of alcohol withdrawal include:^xiv

• Agitation, restlessness
• Anorexia nervosa
• Anxiety, panic attacks, fear, irritability, depression
• Catatonia
• Confusion
• Delirium tremens
• Derealization
• Euphoria
• Fever
• Gastrointestinal upset, nausea and vomiting, diarrhea
• Hallucinations
• Headache, migraine
• High blood pressure
• Insomnia, increased REM sleep
• Palpitations, tachycardia
• Psychosis
• Seizures and death
• Sweating
• Tremors
• Weakness

Alcohol Withdrawal - Alcohol Withdrawal Duration

Alcohol withdrawal duration is unique to the individual and some alcohol withdrawal symptoms last longer than others. In general, alcohol withdrawal begins twelve hours (sometimes less) after the alcoholic stops drinking. Alcohol withdrawal symptoms tend to peak within two to three days but alcohol withdrawal duration could be a week or more.

Some alcohol withdrawal symptoms are known to have longer alcohol withdrawal durations, in some cases more than a year. Alcohol withdrawal symptoms with longer duration include:

• Alcohol cravings
• Inability to experience pleasure
• Disorientation
• Nausea and vomiting
• Insomnia

article references

Alcohol detoxification, also known as alcohol detox, is the abrupt cessation of drinking alcohol combined with medications used to combat the symptoms of alcohol withdrawal. Alcohol detoxification is always done under medical supervision, either as an inpatient or outpatient. Alcohol detox may be handled at an alcohol treatment center or at a hospital.

Alcohol detoxification is typically five to seven days after the alcoholic has stopped drinking. It is during this time that the most severe withdrawal symptoms can occur and be medically dealt with. Alcohol detoxification can be deadly if done outside of medical care.

Alcohol Detoxification -Alcohol Detox Symptoms

Alcohol detox symptoms are the symptoms of alcohol withdrawal. These range from mild to severe but the goal of alcohol detox is to minimize the effects of these symptoms.

Delirium tremens, also known as the DTs, is one of the most severe alcohol detox symptoms. If an alcoholic is considered at risk for delirium tremens, inpatient alcohol detoxification may be chosen to ensure proper medical intervention, as delirium tremens is fatal without alcoholism treatment in up to 35% of cases.

Alcohol detox symptoms of delirium tremens include^xv:

• Confusion, disorientation
• Diarrhea
• Fever
• Agitation
• Uncontrollable tremors, seizures
• Hallucination
• Other signs of severe autonomic instability (fever, tachycardia, hypertension)

Alcohol Detoxification - Alcohol Detox Medications

The goal of alcohol detox is to minimize the alcohol detox symptoms and this is done through medication, typically benzodiazepines. Benzodiazepines, often referred to as benzos, calm and sedate the alcoholic and the alcoholic's central nervous system, reducing many of the alcohol detox symptoms. Typical medications used during alcohol detoxification include:

• Chlordiazepoxide
• Lorazepam
• Oxazepam

article references

No one is sure what causes alcoholism although social, psychological and genetic factors can play a role in the cause of alcoholism.

Alcoholism is a result of a dependence on or an addiction to alcohol. The reason why one person develops alcoholism and another doesn't has been the subject of much study. Twice as many men are alcoholics. And 10-23% of alcohol-consuming individuals are considered alcoholics. (read about: alcoholism statistics)

What Causes Alcoholism?

Researchers have suggested a variety of possibilities for the cause of alcoholism:

• social factors: such as the influence of family, peers, and society, and the availability of alcohol
• psychological factors: such as elevated levels of stress, inadequate coping mechanisms, and reinforcement of alcohol use from other drinkers can contribute to alcoholism.
• biological (genetic) susceptibility: certain genetic factors may cause a person to be vulnerable to alcoholism or other addiction. If you have an imbalance of brain chemicals, you may be more predisposed to alcoholism.
• learned behavior
• youthful social practices

Although this research has produced no conclusive evidence, there does appear to be a genetic predisposition to alcoholism. According to the National Council on Alcoholism, a child of an alcoholic runs four times the risk of becoming an alcoholic than does a child of non-alcoholic parents.

Some alcoholics begin drinking to the point of intoxication from their first drink. For others, the disease is progressive, beginning with acceptable social drinking, and later developing into alcohol abuse. Although family members and friends can take practical steps to help an alcoholic, the key to recovery is getting them to admit that they have a drinking problem.

Sources:

• Annals of General Hospital Psychiatry 2003, 2(Suppl 1):S37
• Substance Abuse and Mental Health Services Administration

article references

What are the reasons to find time for sex? Importance of spontaneity in sex. Tips for talking, taking turns, and why quality not quantity should count

Too busy for sex?

With all the demands of modern life, many couples can find it hard to schedule in time to have sex. To nurture this vital part of your relationship says psychosexual therapist Paula Hall, you need to dispense with a few bedroom myths and make time to make love.

Sex in the early days When you meet someone and fall in love, your whole life revolves around getting to know them better, particularly their body. After a while, however, you realize love won't pay the bills and you settle down to 'normal' life.

This is generally when sex becomes something you do at night in bed - preferably before you fall asleep. But, after a hard day's graft, sometimes there just isn't enough energy left.

Quality not quantity

At this stage, quality becomes more important than quantity. When you're having sex as often as you like, it doesn't really matter if you have the odd unsatisfactory encounter. But if you're only managing it once a week - if you're lucky - you need make the most of it. Which means making sure you're not hanging on to any unrealistic expectations.

Sex and spontaneity

It's a myth that sex is better when it's spontaneous. That holiday you've been looking forward to for the past six months - would it have been more enjoyable without any planning? Not necessarily. In fact, on the contrary, it might have been a disaster. Although a surprise sex session can be fantastic, planning builds anticipation. And anticipation builds arousal.

If you have kids or you work long hours, you'll probably need to schedule in time for sex. This means you can make sure you feel your sexiest by planning what to wear and taking a relaxing bath or shower. You can also spend days teasing each other with what you've got planned for when the time comes.

Taking turns

Another myth is that sex should be entirely mutual at all times. Apparently, you should caress one another at exactly the same moment, fuelling passion in perfect synch. But that's a bit like patting your head and rubbing your stomach. Yes, it's possible, but it means you can't concentrate properly on either activity. How can you focus your attention fully on giving pleasure at the same time as luxuriating in the sensation of being touched? It's not possible. Someone will miss out.

So take it in turns. Enjoy the look on your partner's face as you build them into a frenzy of sexual excitement. Then relax and enjoy when it's your turn. Mutual sex is great for a quick one. But if you have to plan the time together, use it to the full.

Start talking

Some people believe good sex should be instinctive. If you really love your partner, they say, and if you're really in tune with them, you'll know exactly how they like to be touched. Your bodies will writhe in mutual passion without a word being uttered.

For some reason, sex is the one arena where we expect our partners to read our minds. Rather than simply saying a word or two about what we like or don't, we go to extraordinary lengths to give encouragement by groaning and moaning at exactly the right moment. The opportunity for miscommunication with this method is huge.

Rather than gambling with your sexual satisfaction, start talking. You'll find it builds far more intimacy than a silent romantic failure. And it's not just in the midst of an ecstatic encounter that it's good to talk. Next time you realize you haven't had sex for weeks, get your diaries out and make a date. And as the date gets nearer, talk about what you're going to do to each other and how you're going to make sure it's a night (or day) to remember.

Tips for talking

• Whoever is doing the touching should do most of the talking
• Next time you're caressing your partner, ask for feedback. Would they like it harder or softer? Longer or shorter strokes? Up a bit or down a bit?
• For more ideas, see Bedroom talk

Reasons to make time for sex

Still not convinced it's worth penciling in a bedroom session? Research shows that regular sex can make you feel and look healthier. When you make love, your body releases substances in the brain that reduce stress and anxiety. It also produces chemicals that create stronger feelings of affection between couples; stimulates growth hormones that reduce fatty tissue and increase lean muscle; and burns off more than 100 calories per hour.

Many people with disabilities have misperceptions about sexuality and disability. Read how disabled people can develop sexual relationships and feel good about sex and themselves as sexual beings.

Self-concept refers to how individuals see themselves in the world. For example, people refer to themselves as male, female, smart, not so smart, attractive, unattractive, sexy, undesirable and so on.

We learn who we are by the messages we receive from our families, friends, church, culture, educators and the media about how to see ourselves, messages that tell us how people should behave if they want to fit into society.

Individuals begin to describe themselves in these terms during school years, specifically first through sixth grades. Based upon experiences we have with others and within our daily activities, we may change certain self-perceptions, but the ways in which we define ourselves usually follow us throughout life into adulthood.

As people with disabilities, we learn from society that we are child-like, fragile and non-sexual human beings. Many of us who grow up with disabilities learn from an early age that people with disabilities are not "sexy." Fashion models and TV and film stars rarely if ever have disabilities. We see few people with disabilities in everyday life, which reinforces the idea that having a disability is not a "normal" experience.

Acquiring a disability later in life is a completely different experience. People may have viewed themselves all of their lives as sexy and desirable, yet when they become disabled, this image of themselves shifts. Having a disability changes not only the way newly disabled people interact with the world, but also how they view themselves.

Mental health professionals have had many discussions about which experience is worse: growing up with a disability or acquiring one later in life. Some have said that when you have a disability all your life, you often learn early on that people do not see you as sexy, so you abandon the idea altogether that you have the potential to be a sexually desirable person. Whereas people who obtain a disability later in life, who have known themselves as sexual human beings, are now faced with a very different image of themselves and may have few tools with which to cope in this situation.

In terms of their life experiences and self-perceptions, people with disabilities vary as much as people without disabilities. Therefore, it is not surprising that mental health professionals have differing takes on this subject. The discussion really should focus on how people deal with these issues and proceed on in life as sexual individuals.

While we have begun to see more people with disabilities in the media, we still have far to go. In a recent review of persons with disabilities in films, it was still found that the majority of media portrays disabled people as unattractive, non-sexual, broken people. With these stereotypes continuing to be fed to society, it is not surprising that people with and without disabilities have misperceptions about sexuality and disability.

So, how do people begin to know themselves for who they are? Many people with both long-standing and recently acquired disabilities have found success with the following.

Talk About It

By talking with other people with disabilities and learning about the ways in which they have developed sexual relationships with themselves and others, as well as how they have engaged in sexual activity, you can save yourself a lot of time. Who knows? Other people may have found the solution you're looking for. If you don't know many disabled people, check out the The Ultimate Guide to Sex and Disability and read about what others in this community have to say about their sexual experiences.

Do a Reality Check

Given that self-concept is developed from information we receive from others, it is not surprising that when others find us attractive, we in turn feel attractive, as well. It may be that you have never felt sexy because of your disability; hearing someone tell you that you are sexy might sound like words in a foreign language. However, you need to take the opportunity to see yourself through the eyes of others. Use this experience as an experiment in thinking of yourself as a sexual person, and begin to challenge past ideas about feeling non-sexual.

Investigate Your Sexiness

Many people have said that because their disability has not "allowed" them to feel sexy, they really don't remember how to recognize the feeling. Some disabled people have experienced success with regaining a positive self-image of themselves as sexual beings by reading erotic books, playing with sex toys, watching erotic films and paying attention to what makes them feel good. Even though most books and films do not include people with disabilities, they can give us ideas about feeling sexy and what may turn us on.

Discovering yourself and what feels right to you is a life-long process, one that does not have a final conclusion. Keep an open mind while learning about yourself and begin your journey to knowing the sexual person that you are!

Dr. Linda Mona, a licensed clinical psychologist specializing in disability and sexuality issues and a disabled woman living with a mobility impairment.

Talking about potentially embarrassing issues is difficult in any relationship. However, talking about these topics can make people with disabilities feel even more vulnerable: How do we know when to bring "it" up? What will we say? How will our partner react? These are all common questions that many of us have asked ourselves when we are in romantic, sexually related situations. Fortunately, a little preparation -- and a sense of humor -- can make talking about sensitive topics a little easier.

A Common (Embarrassing!) Problem

Bowel and bladder accidents during sexual encounters are one of the most frequently discussed topics among persons with certain physical disabilities, such as spinal cord injuries or spina bifida.

The reality is that an individual may experience the release of urine or feces during sexual situations. Although this can be an uncomfortable topic to discuss with anyone, discussing it with a sexual partner can feel like the end of the world.

However, there is hope. Many couples have communicated successfully about this topic and have gone on to enjoy satisfying sexual relationships. Try these tips for handling this type of situation:

• Initiate the conversation before the sexual interaction takes place. Talk about it after a nice dinner, when both of you are relaxed.

• Start the conversation by stating this situation is very difficult to talk about, which will let your partner know you feel vulnerable.

• Talk about ways to handle a bowel or bladder accident during sex. State that you typically try to empty your bladder and bowels prior to sexual activity, but that you also keep towels, urinals, bedpans and handi-wipes nearby.

• Diffuse your conversation about this difficult topic with a little humor -- it will put you both at ease.

Body Differences

Having a body that clearly looks different from able-bodied people can be problematic, especially when it's time to think about getting naked with a partner. Given that our bodies can look very different from what the media tells us is attractive, we often feel we will be rejected when our partners see our bodies.

Even though many people with disabilities do feel comfortable with the appearance of their bodies, many others do not. Many people will go to great lengths to hide their bodies, such as wearing clothing that covers up their arms and legs or only undressing in the dark. While it can be hard to manage these personal feelings, there are some ways to deal with these issues in yourself and with your partner.

• Look at yourself in the mirror, and get to know what your body looks like. If you wear a prosthetic, look at your body with it on and off. Aim to get more comfortable with the way that you look. When you become more comfortable with your body, your partner will also feel this same sense of ease.

• Talk with your partner about your discomfort with your body's appearance. He or she may wonder why you feel uncomfortable -- your partner may be more accepting of yourself than you are!

• Test your partner's reaction by sharing one part of your body's appearance. When your partner gives a favorable reaction (as will surely be the case), you may feel increased comfort with taking more off! People often end up feeling better about their bodies when they realize their partner finds them incredibly attractive.

Lights On, Please

People who are deaf or who having hearing impairments require light to lip read and view sign language. Given this necessity, lights need to be on during sexual activity, unless both partners choose not to communicate with words during sex play.

Even though keeping the lights on may seem obvious, it may be helpful to communicate this information directly to your partner prior to sexual play. Having sex with the lights on can be erotic and exciting, but very different for those people who are not used to engaging in sex in this manner.

The need for this discussion may not be as critical if you are being sexual with a partner who is also deaf or hearing impaired. That is, your common experiences may create an understanding in which this does not need to be discussed.

However, if you do need to have this talk, consider the following::

• Find a way that feels right to you to launch this discussion. If it is important to you, talk about the fact that you like to communicate during sex and that leaving the lights on is the only way this can be accomplished.

• Use humor -- you may want to lead with, "You know, those of us who lip read do it with the lights on!"

• Practice with kissing before you engage in further sex play. "Making out" with the lights on can help familiarize your partner with being sexual in this type of environment.

Discussing difficult topics is not an easy process, but with some planning and forethought, it's almost painless! Above all, base your conversation on your own comfort level, keeping your partner's needs and preferences in the back of your mind, too. The more comfortable you are, the more comfortable your partner will be.

Dr. Linda Mona, a licensed clinical psychologist specializing in disability and sexuality issues and a disabled woman living with a mobility impairment.