The Sex Positive Coach

Inara de Luna, Relationship Coach & Sexuality Educator

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BDSM is to assault as sex is to rape

Posted by [email protected] on April 10, 2015 at 5:25 PM Comments comments (0)

 

I recently had a discussion with someone who is relatively new to the Scene, who was trying to figure out if it’s actually okay to be kinky, to enjoy being hit. This is a person who works with domestic violence victims and has been having a hard time wrapping her head around the lifestyle and her own desires.

 

So I asked her, “When someone puts a penis into a vagina, what is that?”

 

With a confused look on her face, she answered hesitantly, “That’s sex.”

 

“Okay,” I said. “What if the person who owns the vagina did not want the penis there?”

 

She still wore a guarded expression, but answered more firmly this time. “That’s rape.”

 

“But it’s the same actions, whether it’s sex or rape, so what’s the difference?” A look of comprehension began to cross her face, and she said, “Consent, right?”

 

“Yes, consent on the part of the receiver and intent/motivation on the part of the doer. That’s the same difference here.”

 

I went on to share with her my maxim on this topic: BDSM is to assault/abuse, as sex is to rape. The same actions can often be seen in both healthy, consensual BDSM and in dysfunctional, abuse or assault cases. The difference is huge, but involves consent and motivation.

 

I remember when I realized how much I liked “rough sex” and BDSM play. I was struck with a similar quandary. I have always identified as a feminist, determined to help stop violence against women. So how could I, an anti-violence feminist, enjoy being hit so much? What was wrong with me? After much soul searching and talking through these issues with some trusted friends, what I finally arrived at is that what looks like violence is simply the inflicting of intense sensation. The mind and body determine whether it’s good or bad, pain or pleasure.

 

The body can take more intensity than most people realize. Those who have been in traumatic situations, war, or childbirth begin to understand that the body can take way more than they ever thought beforehand. My own experience of participating in a mini-bootcamp, as part of my junior ROTC membership in high school, was one of the things that proved this to me. I was not particularly in shape, I didn’t work out much, my primary exercise was yoga. So I was not really prepared for such a physically demanding experience as we went through that week. And yet, I found that under pressure, I could do probably 10 times the number of push ups as I’d ever done before. I stepped up to the challenges and was surprised and delighted with myself. It actually felt good and I discovered a lot about myself and what I could handle as a result of that experience.

 

The body and the brain have ways of dealing with intense sensations and demands on the system that can even sometimes be experienced as pleasurable. I won’t go into all the science here, but most seasoned members of the kink community know that there’s a complicated mix of chemicals that gets dumped into the system during a scene that results in a complex series of reactions to the intensity experienced during that scene. Some people experience pure pleasure from things they might normally perceive as painful. Other people go deep into trance-like states of mind, and some of those actually experience spiritual moments, including seeing visions and feeling euphoria.

 

The mind, too, has a lot of power and influence over the way sensations are interpreted. It has been shown that when people who hold the hand of someone with whom they are in a happy relationship, their experience of stressful and painful stimuli are much lower than when they are subjected to the exact same stimuli but do so alone. Our perceptions can change our physical experience.

 

A BDSM relationship is one in which great amounts of trust, negotiation, and consent have already occurred. So a very strong, deep bond has been formed, such that when these people play out a scene, the bottom already has the advantage of having their loving partner there AND the top often helps the bottom to reach states in which the intensity can be experienced as something other than pain. Because the people involved have communicated far more than most vanilla couples and they have all consented to the activities, what then transpires is NOT assault. However, if the pre-negotiated limits are exceeded or the safeword/safesign is ignored, everything that follows then becomes, at the very least, a consent violation, and at worst, assault. CONSENT is the difference. And different people consent to different things at different times, and that is why so much communication and negotiation occurs.

 

So, no, #BDSMisNotAbuse. In fact, vanilla couples could learn a thing or two about relationship negotiation and communication skills from the BDSM crowd, who have necessarily had to become masters at such skills.

 


Painful Sex & Endometriosis Awareness Month

Posted by [email protected] on March 2, 2015 at 7:00 AM Comments comments (0)

Did you know that March has been deemed Endometriosis Awareness Month? What do you think your awareness levels of this disease are? For instance, did you know that at least 6.3 million women and girls (about 1 in 10) suffer from this condition in the U.S. alone? Did you know that it typically takes women 6-11 years of living in pain before they receive an accurate diagnosis of endometriosis? Did you know that endometrial tissue has been found in the brain and the lungs? Did you know that men can develop endometriosis? Do you know what endometriosis is?

 

Most people, if they’ve heard of this disease, would probably know that it is generally associated with women and would be surprised to hear that some men have developed it. The endometrial lining of the uterus is the tissue that sloughs off and is expelled during a woman’s monthly menstrual cycle if no egg has been fertilized and implanted in that lining. Endometriosis is when that tissue grows in other places than the inside of the uterus, such as on the ovaries, on the outside wall of the uterus, along the vaginal wall, etc. A full description follows from the Endometriosis Association:

 

“This misplaced tissue develops into growths or lesions which respond to the menstrual cycle in the same way that the tissue of the uterine lining does: each month the tissue builds up, breaks down, and sheds. Menstrual blood flows from the uterus and out of the body through the vagina, but the blood and tissue shed from endometrial growths has no way of leaving the body. This results in internal bleeding, breakdown of the blood and tissue from the lesions, and inflammation -- and can cause pain, infertility, scar tissue formation, adhesions, and bowel problems.”

 

If you experience pain before or during your period, during sex, or painful urination or bowel movements during your period, and if you struggle with infertility , fatigue and other gastrointestinal issues such as diarrhea or constipation, you may be suffering with endometriosis, too.

 

The site, endometriosis.org, reports that this condition is the one of the most common causes of pelvic pain and infertility in women. “More than half of all women with endometriosis experience intense pain during sex. What’s more, women who have such pain have a difficult time talking about the problem with their partners, making it even more frustrating,” according to Everyday Health. The pain a woman experiences during a sex can vary in intensity and varies depending on where the lesions are located. There are some strategies for reducing pain during sex if the pain is related to your endometriosis:

 

1 - Communicate! Don’t let your partner think that you’re just no longer interested in sex or in him or her personally. Let them in on what’s going on for you. In most cases, a woman’s partner is going to want to do whatever is needed to make sex pleasurable for her. Educate your partner(s) about your condition and even invite them to doctor’s appointments so they can more fully understand what it is you’re going through. And invite them to help you brainstorm ways to reduce your pain. These conversations can help bring you closer together, like a team against this painful invader. And it gives you the support you need to deal with this issue.

 

2 - Experiment and try different positions and different sex acts! This could be an opportunity to have fun with your sex life. It is frustrating to always experience pain during regular intercourse, but sometimes switching things up will let you find a position that does NOT hurt, or doesn’t hurt as much. And getting away from the idea that sex always has to involve vaginal penetration is another way to enjoy sexual pleasure without having to risk pain.

 

3 - Experiment with different times of the month! Chart your pain cycles and observe the patterns of when your pain is greatest and when it is lowest. Make sex dates during the low-pain times of the month and generate excitement between you and your partner(s) about those upcoming dates. Rather than only focusing on when sex might be most likely to hurt, instead look forward to the days when it’s most likely to be pleasurable.

 

4 - Get therapy or other individual and relationship support! Seeking help is not a sign of weakness; rather it’s an acknowledgment that you are dealing with something affecting your whole life, not just your sex life. Chronic pain conditions take a toll on one’s sleep, mood, ability to socialize, work, and relationships. The fact that endo pain can greatly impact one’s sex life and ability to have children compounds all those other difficulties. Help and support during treatment, both medical and mental, will help you and your partner(s) weather this storm together.

 

A fantastic article on what a partner (of any gender) can do to help a partner who suffers from endometriosis was posted on The Good Men Project website. Please disregard the heteronormative bias evident in the article; the advice is too valuable to ignore.


 

Misusing Our Privilege in the 50 Shades Debates

Posted by [email protected] on February 18, 2015 at 3:20 PM Comments comments (1)



Wow, I just watched Eve Ensler’s TED talk on reclaiming your inner girl, and I find myself feeling humbled, enraged, and inspired, all at the same time. I am humbled by the harsh awareness of how privileged I am, that no matter what I have suffered in my life, it is nothing to that of so many girls and women around the world. I am enraged by how much I and others have been focusing on this ridiculous fictional tale of romance and kink, when there are girls and women elsewhere just trying to stay alive, trying to figure out how to educate themselves, running away from home to avoid being mutilated, enduring the harsh, torturous, repeated rapes of men who have been taught how not to feel or to regard females as less-than-human. I am inspired to take this lesson deep into my heart, my cells, my soul, and to put it back out into the world in such a way as to inspire others.

 

We in the U.S. do not live in the hyper-patriarchal, sexist societies found in some parts of the Arab worlds and across tribal Africa and other places. We have no excuse as to why we’re continuing to cripple our children, both boys and girls, by withholding from them the information they could use, that they NEED, to protect themselves and to own themselves. This 50 Shades movie is an opportunity! An opportunity to have 50 talks about sexual agency, about knowing oneself, about consent, and so many other things. We have a responsibility to our girls and our boys, to teach them how to develop and determine their own value system, how to use critical thinking and practice compassionate judgment regarding what’s good and bad for them.

 

We need to be teaching our children how to think for themselves, how to become the most empowered, authentic, and sovereign beings they can possibly be, People who are not afraid to speak their truth, to engage in the type of physical pleasure they most desire, to interact and form partnerships with whomever they happen to fall in love. Let’s re-empower our children to feel and to learn the intelligence embedded in their emotions. Let’s quit shaming them for their feelings and for being girls or “like a girl.” Let’s convince them that they have the right to self-determine, to self-identify, and to self-realize. Let’s teach them to love themselves and to pleasure themselves. Let’s convey the message that they are good enough, smart enough, attractive enough, gentle enough, strong enough, tall enough, short enough - that they do enough, they have enough, and that they ARE enough and wonderfully unique and powerful beings deserving of respect, love, and pleasure in the ways that they most desire!

 

I, for one, am re-committing to this mission. I am going to pull out the sexual education workshops I’d designed for teens many years ago, and I’m going to brush them off, tighten them up, and perhaps I’ll publish them in ebook form. Maybe I’ll start leading workshops again for girls and boys and women and men and all those in between to learn to reclaim their power and agency, not only in their sex lives but in the rest of their lives as well. I will continue writing and promoting my ideals. I will continue reaching out and offering my coaching and counseling and consulting services to help individuals and relationships to heal and move forward. What will you do? How can you take what you’ve learned from 50 Shades and improve the world? Will you stop at writing or reading some stuff on the Internet, or will you get out into the world and do something to change it? Will you start by turning inward and seeing what needs to change within yourself, to re-empower YOUR inner girl, regardless of your gender? Will you reclaim your powerful Self and offer your unique gifts to the world? Will you?

 


Sexual Freedom For All - Or, Let's Quit the In-fighting!

Posted by [email protected] on February 10, 2015 at 4:40 PM Comments comments (0)

I originally wrote the following on another blog back in May of 2009. I’m kind of sad to say that it’s just as relevant today as it was then, six years ago. Change happens slowly, I suppose…


Why is it, when you've got an oppressed class of people, some within that oppressed class feel free to oppress others within that same group? Some proponents in the "gay marriage" movement stridently declare that same-sex marriage should be allowed, because they're still upholding the standard of only two individuals being in relationship, unlike those swingers and polygamous types. Some within the non-monogamous community, who call themselves poly, disdain those who follow a swinging lifestyle, claiming a more righteous stance because they're more about love and relationships, while swingers are just in it for the sex. In sex work, the phone sex operator says, "Well, at least I don't take my clothes off or have actual sex with my clients;" the exotic dancer says, "Well, at least I don't have sex with anyone;" everyone else intimating that their particular chosen aspect is somehow better, more moral, whatever, than anyone else's.

 

Hello? Wake up! We're ALL being oppressed, and turning on each other just supports the mainstream idea that we don't belong. Similar to what happened to the Native Americans when the Europeans started taking over - if they could have banded strongly together, instead of fighting amongst themselves, there might have been a different outcome for them.

 

We need to honor EVERYONE's relationship and sexual choices, whatever they may be, provided they involve consenting adults! Why can't that be our ONLY criterion for judging the morality of loving or sexual interactions? In the Kink community, there's a saying, "Your kink is okay, but it's not my kink." BDSM'ers have largely become accepting of whatever fetishistic, kinky behavior others enjoy, but even here, there are those who are still frowned upon sometimes, such as littles, furries, and scat players.

 

If you enjoy or can accept that anything beyond vanilla, monogamous, missionary-style sex and love is NOT automatically immoral, wrong, sinful, disgusting, degrading, etc - then let's unite under a banner of Sexual Freedom for ALL!

 

A teen's request to see "50 Shades of Grey" could be a teachable moment

Posted by [email protected] on February 6, 2015 at 9:40 AM Comments comments (0)

Forbid Your Child or Discuss with Them?


I stumbled across the Savvy Mom website today, while doing some writing research and discovered this article: “Should You Let Your Kids Watch ‘50 Shades of Grey’?” The author is a couples, childrens and family therapist and she offers a fairly well-balanced assessment of this question. For her, while she’d love to just outright forbid her 15 year old daughter from seeing the movie, she’s savvy enough to realize that teenagers often have access to adult material from sources their parents cannot control, and making fruit forbidden makes it all the more tantalizing. I appreciated her rational idea to instead talk frankly to her daughter about why she doesn’t want her to see the film, as well as her fears that it could skew her perception of what sex should be like and possibly how men and women are supposed to act in relationship.


Are You Condoning Behavior by Discussing It?


So many of the issues that carry emotional weight from the “What about the children?” fear-mongering argument could be used as springboard discussions to help educate children, to convey your values to this next generation. Shielding them from things you don’t approve of won’t actually help them in the long run. Eventually you won’t be able to hide things from them any longer and they won’t be prepared to deal with these difficult, challenging, controversial issues. Sex of course is one of the primary issues that get parents up in arms.


You Can Give Them The Tools & Ability to Decide


Let’s take a moment and breathe and see if we can conceive of bearing the discomfort of talking to our children about topics that make us queasy long enough to help them learn to navigate these difficult waters. Teaching your child about condoms does not have to mean that you’re condoning having sex too early. In fact, according to WebMD, there is evidence that teens who feel comfortable talking with their parents about sexuality actually delay first intercourse. You can convey your values and expectations at the same time that you’re giving them the tools to protect themselves when they do eventually start having sex. Even better, this is an opportunity to help them think about the issues and reason through rational decisions around whether or not, when, and how to engage in sexual activity.


Become Your Child's Trusted Resource

 

The blog, L.A. Parent, published a piece on how to use images in media and advertising as teachable moment opportunities. In addition to echoing a lot of what I’ve said in this article, she also mentions the excellent point that having these conversations with your kids helps to build trust between you. You situate yourself in your child’s mind as an expert and as someone they can come to when they have questions or problems around this delicate topic. Wouldn’t you rather they come to you, instead of hiding a problem from you and seeking help from their peers instead?


Let's Talk About How To Have These Talks

 

I have led workshops for and conducted private sessions with parents to help them learn how to talk to their children about sex and sexuality. If you’d like some guidance on how to do this, please contact me to schedule a session and we’ll map out a strategy or an approach that works with who you are and keeps YOUR values in the forefront of your discussions.

Teens Promoting Consent Culture, Petitioning School for More Comprehensive Sex Ed

Posted by [email protected] on February 4, 2015 at 3:10 PM Comments comments (0)

I was surprised this morning to stumble across this article in Yahoo Health news, “https://www.yahoo.com/health/13-year-olds-push-to-change-rape-culture-107979503182.html" target="_blank">13-Year-Olds Push to Change Rape Culture-Starting in Sex Ed Class.”

 

“In their petition, the two teens write: “Our society is scared to teach teens and young people about safe sex, and most importantly, consent. Young people will have sex, despite teaching abstinence in the classroom, so the most important thing is to educate us and other young people about consent. When young people don’t learn about the importance of consent in a sexual relationship, it can lead to unhealthy relationships and ultimately perpetuates rape culture.”

 

I am so in love with these young women! They’re really working on changing the culture of their school environment, and ultimately on the culture of the larger society in which they live. They’re well-versed in what kind of education they want, and the standards, and the organization that has put those sex-positive standards together. They are well spoken and articulate in their writing. I wholeheartedly support them in their mission.

 

Sexual Education Teachers Have Been Fired for their Off-Time Sex-Positive Activities & Associations

Posted by [email protected] on February 3, 2015 at 3:05 PM Comments comments (0)

I was appalled when I saw this recent Tweet from @CatalystCon:



 

I was further saddened when I read the Fox News story. It grossly and ridiculously misrepresents Planned Parenthood, CatalystCon, and Good Vibrations in an attempt to sway readers to believe and support actions and arguments based solely on emotion and not fact.

 

My biggest surprise came when I dug deeper, trying to find anything written by someone NOT negatively biased toward sex or sex ed. And I found NOTHING in my initial search. There are several articles and blog posts and op ed pieces available, but all of them are written from a sex-negative perspective. I am not going to link to any of those, as I don’t want to contribute to their placement in search results. You can Google the story; I used the search phrase, “catalystcon sex ed teachers california.”

 

Today, I found TWO pieces, though both are also blog posts like this one, not official or professional media outlets. But both have some good things to say and do serve to balance the conversation a bit. Angelique Luna wrote on her site, Living a Sex Positive Life, an article titled, “Who is Qualify to Teach Our Children.” Brenda, the owner of a sex-positive shop in Edmonton, Canada, has a blog called Talk Sense with Brenda, and she wrote “The Exact Kind of People You Want Teaching Your Kids Banned From Teaching Sex Ed.” Brenda actually commended all three of those institutions, correcting the misrepresentations that Fox and other outlets are pushing.

 

Unfortunately, I haven’t yet been able to track down the names of the two teachers who have been fired, though I’d love to, in order to give them a chance to tell their own side of this story. I can imagine how much they’re dealing with right now, though, and I wish them both well in their future endeavors. Perhaps they can be like Kendra Holliday of The Beautiful Kind, who boldly and bravely came out after being fired from her job when they discovered her private, personal, sex-positive blog. She ran with the publicity and has gone on to to become a driving force in the sex-positive movement.


Sex positive activists and educators need to be speaking up and mobilizing together to counteract this poison. Can’t we conduct our own movement? Let’s put together a list of sex-positive media outlets and writers, so that when we hear an inkling of a story such as this one, we can submit it for coverage by someone on our side. Yes, I’m biased, in favor of people having choice, of being given the information to make informed decisions about their bodies and their sexualities and their relationships, of being free of coercion to conform with the most conservative element of our society, of being free of the fear of persecution for being true to themselves, whatever that may look like!

 


 

Promoting a Sex Positive Culture by Challenging Rape Jokes

Posted by [email protected] on October 18, 2014 at 3:25 PM Comments comments (0)

I have felt disturbed lately at a couple of the topics people are joking about these days, in the supposedly sex positive and consent-driven kink community of which I am a part. I went to a social event in which I heard one woman say to a male friend, “I have to run to the restroom, would you watch my drink? And remember, no more than four roofies!” Then she giggled and rushed off, only to return to her companion who jokingly reported he’d only “put two roofies” in her drink. They laughed and went on. A bit later, at the same event, I witnessed another young woman say to her partner, “Can I take you home and rape you now?” He grinned.

 

It’s interesting to note that both of these interactions were initiated by women, and so perhaps the impact of their statements is somehow lessened. If men were to say the same things as these women, they’d likely be regarded as dangerous or at least insensitive. But it’s become okay for women to joke like this for some reason.

 

I just read an article on sex positivity, in which it was defined by Carol Queen as,

 

“It’s the cultural philosophy that understands sexuality as a potentially positive force in one’s life, and it can, of course, be contrasted with sex-negativity, which sees sex as problematic, disruptive, dangerous. Sex-positivity allows for and in fact celebrates sexual diversity, differing desires and relationships structures, and individual choices based on consent.”

 

I’m guessing that one of the reasons that joking about rape and consent violation by women has become acceptable is that it’s a misguided attempt to remove its power in some way, to allow the women themselves to feel more empowered somehow. I’m totally guessing, because I honestly don’t understand this.

 

What I do understand is that these kinds of jokes can have a detrimental effect on the way society takes seriously these very important issues, and the legitimate victims and their claims can lose credibility and be dismissed more easily. I feel the same way about horror films. As Americans, we watch, for pleasure and recreation, so much violence and blood that we have become gradually more tolerant of it. It is no longer as disturbing as it once was, and so the very real violence that occurs every day doesn’t receive the attention it should.

 

Building a sex positive culture requires us all to take action, to reverse the effects of the sex negative culture in which we live. I love what Maximilian Tabet said in his article:

 

“Removing the stigmas surrounding these topics, changing the way advertising overly sexualizes women and taking a strong stance against sex-negative values will hopefully create a world where young people feel free to discuss their sexuality openly, without having to search aimlessly for more accepting fringe communities.”

 

So this is the beginning of my efforts to do so. To work toward a more sex positive culture, with more sex positive laws and politics. I am standing up, right now, and proclaiming that I am uncomfortable with jokes about rape and abuse and consent violation. I believe these sorts of jokes are harmful to us all and I’d be happy to engage in conversation about this, but I will not tolerate that kind of joking in my presence any longer. I will either ask the people involved to stop or I will walk away, letting those around me know why I’m walking away.

The movie, "Addicted," is NOT about sexual addiction

Posted by [email protected] on October 18, 2014 at 12:25 AM Comments comments (1)

*** NOTE: Spoiler Alert!! ***

 

I just went to see the movie Addicted for date night. I thought initially it was more of an erotica feature, and was told by a friend just before we went that it was a great portrayal of the consequences of sexual addiction. I was therefore slightly worried that this might not be great date-night material, but so be it. While I was impressed with the acting and the beauty of the filming itself, I must say that I was somewhat disappointed in the movie itself. For one thing, this movie does NOT portray addiction, per se. There is a lot of controversy over whether or not sexual addiction even exists. But in general, an addiction is defined as a compulsion that one has trouble resisting to the point of having severe lifestyle, career, health, and relationship consequences. While Zoe (the main character in Addicted, played by Sharon Leal) did experience significant negative consequences in her marriage and with her company, she was a woman who was experiencing a lack in her relationship at home, and so was vulnerable to the skilled efforts of the predator (the artist, played by William Levy). She committed adultery and fell in love with her lover. However, she did eventually figure out that she’d been played by a player and so went and got her needs met by yet a third man.


Who is responsible?


The therapist, although largely well-played by Tasha Smith, was apparently a sex addiction specialist who tried to fit everything about Zoe into her pet diagnosis, without helping Zoe to really own her shit and talk to her husband (Boris Kodjoe) about their marriage. She hyped up this idea and helped Zoe to abdicate responsibility by allowing her to blame her behaviors on this “condition.” By the end of the movie, Zoe had completely swallowed all the blame for the dysfunction in her marriage, and the movie shows her and her husband tearfully reuniting in her first SA meeting, as if one meeting and one confession could make it all better for her husband. I really wish the therapist had helped Zoe own her stuff more fully and had encouraged her to talk to her husband more, to get them into therapy AFTER confessing to him.


Propagating harmful myths


This movie conveys things in a way that’s going to do everyone a disservice by propagating some harmful myths about relationships, sexual addiction, infidelity, therapy, and AA-type meetings. Unfortunately what happened to Zoe happens all the time. We aren’t teaching people enough how to communicate, how to ask for what they need, how to say no, how to own and take responsibility for their stuff, how to set boundaries. We don’t teach people how to achieve long-lasting happiness and relationship success, through communication, negotiation, experimentation, and personal responsibility.


Meet the client where she is


How I might have treated Zoe would be to meet her where she was, to inquire about what she was getting out of these interactions with these other men, what was missing in her marriage. I would have encouraged her to talk with her husband about what was lacking, where she was dissatisfied. I might have taught her how to talk to her husband about sex, and I might have done some sexual education with her about her own body, and her desires, and how to achieve orgasm both by herself and with her husband. Because that’s what it seemed like to me. He was getting off and rolling over and going to sleep while she was nowhere near satisfied. And, because he was asleep, he did not know she was dissatisfied. This isn’t sexual addiction, this is a lack of education and understanding about her own needs and how to communicate them and get them met by her chosen partner. She also hasn’t been educated about how sex and orgasm sometimes affect men, and just knowing this could have alleviated some of her frustration and their misunderstandings about their sex life.

 

I probably would also have worked with Zoe by doing some role plays about how she could bring up these topics with her husband. She was likely embarrassed or ashamed to talk openly about these things, and may have been afraid to admit that she wasn’t being satisfied by her husband. And in a way, she’s been lying to him all this time. That’s also hard to admit to. The therapist also needed to do some more sexual education about how having children changes intimacy. She mentioned it once in the movie, which I commend, but it needed to be reinforced and some teaching done around it. In sum, instead of being badgered into accepting a useless diagnosis, Zoe needed education, help in taking responsibility and in talking with her husband.