Are you someone who believes that the “reality” you see on TV, in the movies, or on the Internet is real life?

Personally, I think that portrayals of life are getting increasingly unrealistic. When was the last time you saw a movie about someone like you, which portrayed people who live in a house that is similar to yours?

Whether we are talking about TV, movies, magazines, newspapers, or the Internet, the media present unrealistic ideals about beauty, fame, wealth, and success — but particularly about women’s bodies. And that message about what constitutes an acceptable body is toxic to personal and sexual self-esteem.

All the research points in the same direction. Reading fashion magazines has been correlated with negative moods and higher body dissatisfaction in women. (It’s not clear whether men’s health magazines, which focus on muscular bodies, have the same effect on men.)

Since body image mediates feelings about sexuality, consuming a lot of the popular media can be a hazard to sexual enjoyment.

One common scenario among older, committed straight couples is that the man loves and continues to be attracted to the woman, whose shape has shifted with childbearing or aging, but the woman is disgusted with her own body. She loves him too, but she feels defective — ashamed, really — because she is not as impossibly thin as the models on TV, actresses in the movies, or the people in magazines.

And because she feels ashamed of her body, she does not want to be sexual. She doesn’t even want to be seen naked. She may undress in a closet out of shame, or so that she won’t have to turn her husband down when he is interested in sex.

And on the times that she does agree to sex, she has self-objectifying, hateful thoughts that prevent her from enjoying sensations.

Sex therapists call this “spectatoring” — when you are not in the sexual experience, but remain outside o, judging. When this happens, your thoughts are critical, not erotic, and it prevents sexual enjoyment.

For the most part, this is a female issue. Men have ten times the testosterone of women, so many men who are critical of their looks still can enjoy being sexual. They still have sex drive.

But for women who continually compare themselves with media images, the libido can get shut down.

Of course, I have also seen cases where an older woman accepts what her body looks like, but her partner is so caught up with the ideal image portrayed in the media that he no longer finds her attractive.

If your sexual self-esteem is being hammered by immersion in the media, just go for a walk outside or go to the mall, and take a look at what real men and women look like.

One of my favorite techniques to combat media-induced sexual dissatisfaction is to hand my patients a copy of Greg Friedler‘s 1997 book, “Naked New York.” Friedler compiled portraits of very different people — lawyers, doctors, actresses, painters, electricians, security guards, Wall Street finance people, etc. They are thin, fat, and in-between. There is nothing erotic about the photographs. They are more like anthropologic studies.

On each set of two pages, you see the same person. On the left page they are clothed, and on the right page they are naked.

The thing that is so fascinating, and the reason I give it to my patients, is that the people who look the best in clothes do not look the best naked. They look too thin. Some of the actresses look so thin they look like children. The women with more meat on their bones look much sexier naked.

Men will inevitably compare penis sizes comparisons. That will likely be therapeutic too.