Saturday, November 22, 2014

We Will All Leave Each Other

We will all leave each other at some point in time. How we know each other now will not be the same in the future. All things change with time. We hope to change for the better, but shifts will occur in all of our relationships in any case. We will all leave each other—the questions are how and when.

For the purposes of this article, I am not that concerned with why things change. Things will change whether we are doing things well in our relationships or not. It does not matter if we screw up totally or are being perfect. In reality, we are probably not doing either but something much more complex and in the middle. No matter the situation, it is still just a matter of time before things change. It’s a normal part of life.

When I say we will all leave each other, I am talking about death and dying, but not only that. Our society encourages the denial of not just death and dying but loss of all kinds. Loss of any kind can hurt us and remind us of what we don’t have control over.

One loss that affects many people is the heartbreak of a relationship ending. One of the reasons I love talking about intimacy and sexuality is the mystery and the diversity in how intimacy works from one person to the next or one situation to the next. And the intimacy we have with another person (and even with ourselves) changes constantly in each moment, if we are paying attention.

We are getting either closer or further apart or discovering more about each other or shutting down. We are changing on an individual level, and that can change our relationships. Many things can be happening in our interactions with or without our awareness, but basically nothing will remain the same. At some point, we will discover that things have shifted, that things are not the way they used to be in our relationships.

I say often that obligation is not love. However, that does not mean not having commitment. It does mean a sincere attempt to have healthy connections. I feel strongly that there is not one right way to do anything; I pay attention to the context, rather than some arbitrary rule. So only you know what would be healthy or right for you, and only I know what that would be for me. I think if we are listening to our inner wisdom, we will often know intuitively if something feels healthy or right. The answers really are within. And if we don’t know the answer in this moment, paying attention into the next moment may reveal the answer.

What is the difference between obligation and commitment? Obligation is when there is no longer a choice. We feel we have to do something even though we would rather not. Of course, no one can make someone feel something, but our interactions with each other do affect the relationship going forward.

Commitment does not mean knowing what I will do in every instance in the future or knowing for certain I will be able to continue a relationship (including a friendship) into the future. But it does mean a willingness to have a conversation about the relationship if at all possible and take ownership for my part in it and make efforts to shift or change an unhealthy dynamic if one exists.

Commitment may also look similar to doing something that feels obligatory. For example, I may decide to help someone move. On moving day, that may be the last thing I feel like doing. But I may still want to help with the moving and follow through on my commitment. It may not be convenient for me to show up, but that is different from feeling as if I can’t say no or that I truly don’t want to do it. There are many things I may not love doing, but I choose to do them because I value a connection or my integrity for how I want to be in the world.

Of course, things can get messy. Even if I am not feeling obligated and would like to show up, I may, still, disappoint someone by not showing up or following through. Interactions are not simple. It may be easier to see the bigger and more obvious things in a relationship, like someone not showing up for the most important day in your life or not being there emotionally for you when you are in need or grieving. This is a call to pay attention and notice the many subtle nuances we share as well. What are we saying? What are we not saying? Are we listening? Where do we interact? Are we expecting something? Are we true to our words? Do we really know what we want on a deep level? And how are we communicating it?

Maybe years ago we had some things in common with someone, but we change and lose interest in an activity, or we want to try something new. Perhaps we experience something that is life changing—a loss of a job or a death—and it affects the way we live our lives and all of our relationships.

This is a call to notice and pay attention and choose intentionally in our interactions in each moment. We can make a conscious choice each day about how we are being in relationship, rather than letting years go by until all of a sudden we are not enjoying the friendship, or we are feeling festering anger because of what we have not dealt with, or we experience a loss of sexual interest that developed slowly over time—all because we did not actively address something or even notice what was happening right before our eyes.

Noticing, taking responsibility for ourselves, being self-aware are all important. But we can only start where we are. I will acknowledge that sometimes it has been too hard for me to say something at the time, and so it got left unsaid for way too long. There have also been times when I did not notice something about me or the situation I was involved in as soon as I would have liked. If we left something unsaid or didn’t notice something until too late, all we can do is address it at this moment in time and go forward from there.

We can’t change the past or control the future. All we can do is be present in this moment and notice what is happening now and communicate in a way that brings more awareness, is loving and, we hope, brings some resolution if needed. But the truth is that we may not find resolution.

And being present and paying attention is not just for romantic or sexual relationships. It is about noticing and being our best selves in loving relationships of all kinds—and about much more than that. Even if everything is going wonderfully, things change in our romantic relationships, our friendships and even our relationships with children.

I had a wonderful opportunity years ago to have children in my life in a meaningful way for no other reason than that they lived next door and the parents were open to the children being in my life and me being in their lives. What developed could never have been predicted or planned. The children truly made me as happy as if they came from my own body or were my own children in the way this society would identify them. The family ended up moving away, and that has been one of the most painful losses I have ever experienced.

So even when everything is perfect and we operate out of our most beautiful amazing selves, we will all leave each other, and nothing will remain the same. All things are changing in each moment, and someday the shift may be very noticeable: more distance, a death or a transition of another kind.

This is a call to notice and be in the moment and make whatever attempts we feel we need and can and want to make to be present and live our lives not having regrets. There are deaths and endings while we are alive every day. Just as every fall where I live the leaves change color and die, every year, every week and every day our relationships change, whether in obvious or subtle ways. Sometimes that change occurs in a way we can welcome and sometimes in a way we experience as a loss.

May we notice what is happening in each moment and attend to our important connections—including with ourselves—as much as possible, and not take anything for granted.

Copyright 2014 by Susan Miranda.  All rights reserved.  No part of this writing may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without permission in writing from the copyright holder. For reprint permission, email

Friday, September 26, 2014

Storytelling Medicine: You of All the People in the World

I had decided that you of all the people in the world could be there when I die, and now you cannot be in my life at all.

For about a year, I had felt that I possibly had some terminal illness. Not being inclined to go see a doctor, I had Googled my symptoms for months, and the best guess I could come up with was that it was possibly leukemia or something of that nature.

It would not disappoint me greatly to die alone. But I also acknowledge that we can’t know how we will die and when. There is a reason that I live my life as though I will die any day. It is so that all that needs to be acknowledged, lived and said will be done well in advance of that day. I do not wait to say, “I love you.” When the day comes, there will be no surprises, no unsaid words and no regrets.

I thought long and hard this past year, when I thought I had some disease, about whom I would want with me during the final days of my life. I also knew my biggest health care wishes are to not be in pain and not be kept alive if I were dying naturally. So I picked you, a medical doctor I had never met before, to be there when I died, if needed.

I was so scared to make that first appointment. I dreaded it. I was so sure I would be mistreated and thought of disrespectfully because I don’t want to do health care the way it is done in our society. But you did not treat me disrespectfully. You treated me very well and with high regard and listened as I tried to convey what was important to me.

On the second visit, I told you I was not going to do any tests, and I gave you my health care wishes. I had decided that if I ever had a terminal illness, I would not treat it. My health care of choice in this instance was going to be better nutrition no matter what the test results showed, and I decided I could do that without spending any money on tests. I was, however, very willing to spend the money on the conversations with you about my health care wishes. And I decided I could live with the unknown of what a test might reveal, but I wanted to be assured I had a compassionate doctor available at the end my life should I need it.

So when I told you I would not get any tests done and told you my health care wishes, I could feel the resistance. I could sense that you were thinking that patients don’t do this. I could see the question on your face—Did she just think up these wishes on the spur of the moment? I showed you the date they were written—eight years earlier—and I told you that rereading them eight years later, I would not change a word. I told you that my family and friends—everyone in my life—knows these are my health care wishes. I just needed a doctor, someone who has authority in the system, to know about them as well.

Months went by, and I did change my mind about the tests. Living with the unknown is not always easy. Fortunately, all appears to be fine with my health.

But then, you told me you were taking another job elsewhere for people who need home health care. I know my face dropped, and I was so disappointed. You were the second doctor I would have chosen to be there at the end of my life who told me you were not practicing primary care anymore. I don’t yet need home health care or hospice care, but I know that it will be what I want at some point in time if I need it. However, the system is so compartmentalized that there is no way I could sign up now and keep you as my doctor.

I had decided you could be there when I die. I cannot even begin to describe how angry this health care system makes me for so many reasons, and here is one more. I had decided that you could be there when I die, and now you cannot be in my life at all.

I even went back one last time and asked you to continue to be my doctor and told you that I was willing to pay for your services all on my own, outside of the health care system. Of course, our system does not make that very possible either—although I believe you considered it.

And I told you how much I want the health care system to change and how much I want single payer health care and that this would be part of the story should I ever write what I am wanting to call “storytelling medicine.”

I had decided you of all the people in the world could be there when I die, and now you cannot be in my life at all.

Copyright 2014 by Susan Miranda.
All rights reserved.  No part of this writing may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without permission in writing from the copyright holder. For reprint permission, email

Wednesday, May 7, 2014

Pitching, Promoting and Offering: It Is Not What We Do But How We Do It That Matters the Most


I usually write about sexuality related topics. I am taking a little detour in my writing in this article to write about marketing, selling, pitching, promoting and offering our services to the world for money or for free.

If there is one thing I have learned in my marketing class, it is that everyone has to market—businesses, nonprofits, change makers and social justice workers. Marketing is about influencing, persuading and getting people to take action. The marketing professionals I listen to would add: doing all of that with integrity.

Even if we are working for societal change, we need marketing skills to make it happen. Even if we are working in a nonprofit organization and the business model is not based on profits, we need marketing to promote our mission and get funders or donors or clients to take certain actions.

I am not a marketing expert. But what I have noticed in my numerous online business groups is that promoting, pitching and making offers have all of a sudden become undesirable. Rules have gotten made to try to control promotion much the way that rules get made around sex and sexuality trying to keep us safe.

In various groups I participate in, there are statements such as “Don’t link to your blog.” In another group no one is supposed to link to their websites. In one group, the rule is it is okay to link to your blog if you want to start a conversation, but otherwise it is not okay.

The conversation is also, fortunately, about being intentional in our online promotions. I fully support people getting intentional, thoughtful and respectful in every area of their lives. I believe building relationships and not pressuring people are important ethical principles in marketing just as they are in sexuality. Those are the same concepts I teach in my sexuality and intimacy workshops.

But I’m also very sure that everything we do is promotion. As I have been saying consistently, it does not matter so much what we do or say as how we do or say it. These arbitrary rules about not promoting our websites or blogs or only posting offerings in a designated marketing group as opposed to the main group or only posting offerings on Thursdays or Fridays or in a specific thread for offerings are not solutions to me.

I believe everything I do is a promotion.

One of the conversations I have listened in on is about not promoting yourself but being helpful to people—and therein you may find your customers. I am coming at this idea from the perspective of being someone who is incredibly giving. I have helped more people move than I can count. I am known for being generous to people by helping take care of their children and in many other ways. Most of my paid work has been in the human services.

We should help someone because we really want to, not because it is the only way to ultimately get noticed for our paid offerings. I place great value on doing something for people unconditionally and not because we secretly are trying to sell something or find clients.

It is hard to guess at someone’s motivation or intent. I like to trust that people have good intentions unless I know otherwise. I also appreciate and feel more comfortable when people are upfront, direct and clear about what they want. If we are proud of our offerings and they truly would help people, there’s no reason to keep quiet or get clever about how we let people know about what we have to offer.

Someone asking my opinion about their website or logo design has started to feel uncomfortable to me. In this marketing environment I am describing, it is really hard to know if the person genuinely wants feedback or they just don’t have any other way to get their website or business in front of me and other potential clients.

We all have individual preferences and tastes. So one person’s style and way of promoting may not be appealing to me but could be appropriate for someone else. Deciding that something is not my cup of tea is very different from deciding that all promoting, selling and marketing are bad.

It is similar to deciding that sex is bad because we don’t share someone else’s preference. It is unrealistic to think that we would like all offers or all ways of promoting. And it is not helpful when someone draws broad generalizations or attempts to control it, especially in the area where they are selling their own expertise, programs or offerings.

I honor the people I know who are identifying marketing that is done ethically and with integrity and marketing that is not. To me that is a much better approach than just deciding that all promoting is unacceptable.

If we don’t like a certain promotional effort, we need to ask what we would change rather than making it impossible to promote. It is the same conversation I would have around sex and sexuality. I have done workshops such as one called “Sex Is Not the Problem; Touch Is Not the Problem” trying to get at this very issue. Yes, there are problems with sex and sexuality, but let’s be specific about those problems rather than draw broad generalizations about sex, touch, intimacy and relationships that make them all “bad.”

Similarly, we should ask what makes quality pitching and selling. Marketing is not going away any more than sexuality is going away. Marketing is the way we get the word out about everything. And, again, it is not what we do but how we do it that matters the most.

Consent and respect are what are most important to me in all areas of our lives. What is consensual and respectful or done with integrity could be talked about fairly endlessly in sexuality and also in regards to marketing. But that is a valuable conversation to have.

I welcome the complex conversation as to how to do it rather than a straight-out attempt to control it. And I also recognize this may not be any easier to do with marketing than with sexuality, given some of the contexts of where it happens. For example, how do you have these conversations online or in a group of thousands? Not easy at all.

However, if we really believe that marketing is good—and we should if we are teaching it or using it in any way—then it is imperative we engage in a way that makes it clear what we want to change. Just like sexuality, it is not something we can turn off at will. Everything we do is promotion in a similar way that sexuality is a life force energy within us at all times. My hope is that we act in both of these areas consciously, intentionally and with as much consent as we can verify in our complex individual and social interactions in person and online.

Copyright 2014 by Susan Miranda.  All rights reserved.  No part of this writing may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without permission in writing from the copyright holder. For reprint permission, email

Monday, April 14, 2014

Death Work, the New Sex Work

Twenty-five years ago, when I began to educate people about unlearning homophobia, biphobia and sexphobia, I always acknowledged the complexity of sexuality, intimacy, relationships and orientations of all kinds. And I decided that the three topics I would address because they are not talked about enough are sex, money and death and dying.

As I educate people about sexuality and write about all the topics I can think of—abortion, STIs/AIDS, monogamy, polyamory, sex toys, pleasure, orgasm, self-pleasuring, sex work and more—I emphasize consent, respect and our intentions, whether it involves sex, money, death and dying or any other area of intimacy.

Death is a taboo topic in the United States—possibly more taboo than sex. Yet it is another form of intimacy, involving interactions with people like doctors, nurses and hospice care providers. But I am suggesting something beyond what is the norm today when I use the term “death work.”

How many of us talk about and plan for our death and dying? Not as though we can’t wait for it to happen, but as though we know it will happen. The quality of all parts of my living and dying has always been important to me—so important that it is worth considering carefully today how I would like things to go at the end of my life.

It is strange to me that it is okay to pay for numerous services—from doctors, massage therapists, chiropractors, talk therapists, coaches, mentors, trainers, yoga instructors—but when it’s in the realm of sexuality, it becomes not okay. Well, what about in the realm of death and dying?

Intimacy is everywhere, even where we may not be comfortable with it. It is at our day jobs and our professional work, in classes, in social media, in bars and pubs. It is in the events and conferences we attend, in our conversations, in our touch, in our eye contact and in our hustle and bustle. It is in our transit: in cars and on the buses and trains I take on an almost daily basis. And it is in sex work or paid sex as well as almost every other service offered out there. Intimacy is also part of death and dying. And all that really matters to me is consent, respect and our intentions.

I recently wrote an article called “Obligation Is Not Love.” For me, that includes any obligation to show up or any sense of “I have to” when someone is sick or dying. I am not planning on people just showing up when I am dying.

Money gets exchanged all the time. It is not good or bad; it all depends. And there are other kinds of exchanges whose value depends on whether we feel good about the exchange. The value is not usually dependent on society’s rules or norms.

As intentional as I am with my intimate interactions in every other part of my life, I want to work at doing the same with death and dying and maybe even more so. For years I have let friends and family know my health care wishes. But more recently I have started having conversations with people I would like to be there with me when I am dying. That is, I have started the conversations with individuals as I take into consideration the fact that I may need to pay money to be able to choose the people I want near me when I am dying.

I am not a fan of a health care system that focuses more on life-saving events than dying gracefully. I know what kind of health care I want and what kind of dying I want. And it is with full intention that I move toward the taboo topic of death and dying as though I were hiring someone for business coaching or yoga instruction.

Copyright 2014 by Susan Miranda.  All rights reserved.  No part of this writing may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without permission in writing from the copyright holder. For reprint permission, email

Saturday, February 1, 2014

Friendship Is Just as Important as Any Other Relationship We Could Ever Have

The title for this article could have been “Friendship Is Just as Important as Any Sexual Relationship We Could Ever Have.” But then I realized that some of us have sex with our friends.

My only rule for all relationships is that there are no rules other than that they be healthy. But then, the question always follows, what does that mean?

I honor however people do relationships as long as it works for them. There is no one right way to do anything, and the complexity of how we all do intimacy and sexuality in our lives is fascinating to me.

Nothing is more important than how we do love, and sometimes that can include affection or sensuality or sexuality—and sometimes not. Whether we call the person we have a relationship with a “friend,” “partner,” “significant other,” “spouse,” “husband,” “wife” or any other label does not matter to me. Labels don’t tell us much of anything. If we really want to know, we still have to ask the person what they mean when they use that label and what their relationship entails. What’s important is how we do love—how we love ourselves and how we love our work, where we live, and all the people in our lives.

Sex is not more important than other forms of physical or emotional intimacy. Sexual love is not more important than non-sexual love. Romantic and sexual relationships are not more important than non-sexual relationships and friendships.

In all the joy I can find in the complexity of my relationships—in my attractions, desires and levels of intimacy and ways of doing emotional and physical intimacy and sexuality—the highest compliment I can pay to anyone is to call them a friend.

I prioritize the traits and qualities that go into my friendships, like trust, care, loyalty, authenticity, honesty and love. I protect them in my relationships regardless of all the other unique characteristics or arrangements possible in a particular relationship.

Having care and intention in how we do everything in our lives matters. Being conscious and intentional in each moment of relating is my only goal, knowing I may or may not do even better in the next precious moment I have with someone I love.

Copyright 2014 by Susan Miranda.  All rights reserved.  No part of this writing may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without permission in writing from the copyright holder. For reprint permission, email