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Sunday, January 31, 2021

Spontaneous Sexual Arousal and Responsive Sexual Arousal Are Both Normal

In recent articles, I've been focusing on sexual accelerators and brakes, as described in Dr. Emily Nagoski's book, Come As You Are: The Surprising New Science That Will Transform Your Sex Life (see my articles: What is Good Sex? - Part 1Part 2: Solace SexPart 3: Sealed Off SexPart 4: Synchrony Sex and Understanding Your Sexual Accelerators and Brakes - Part 1 and Part 2.

Spontaneous Sexual Arousal vs Content-Dependent Arousal

The concept of sexual accelerators and brakes is a metaphor for sexual arousal (accelerators) and inhibitions (brakes).

In my last article, the focus was on a fictional vignette about a couple where the wife was having some difficulty getting sexually aroused with her husband because of family stressors (problems with brakes).  We got to see that, typical of many woman, sexual arousal is often context dependent.

However, as I mentioned in previous articles, even though most women's arousal is context dependent, as explained in the prior article, 16% of women experience spontaneous arousal.  

Sometimes, women who experience spontaneous arousal get into relationships with men whose sexual arousal is more context dependent so it takes more sexual stimulation to get these men sexually aroused.  

Approximately 5% of men experience context-dependent sexual arousal, according to Dr. Nagoski.  If they're in a relationship with a woman who has spontaneous arousal, this can be challenging for the couple.

Clinical Vignette: Understanding Spontaneous Arousal and Context Dependent Arousal
The following vignette, which is a composite of many different couples, is about the problems of a woman with spontaneous sexual arousal who is in a relationship with a man who experiences context-dependent arousal and how they learn to overcome these difficulties in couples therapy:

Joann and Scott
Joann and Scott were both single/without children, in their late 30s, and dating each other for a year.

During their initial appointment with their couples therapist, Joann began the discussion by telling the therapist that she had always been highly sexual since her late teens.  She said all she had to do was see a man who was good looking and she felt sexually aroused immediately.  

In response to the therapist's sexual assessment questionnaire, Joann said she had many sexual encounters with men before she started dating Scott. She was much more sexually experienced than Scott, and she needed little to no sexual foreplay to have sex when they were together.

The problem, as Joann saw it, was that Scott often didn't seem that interested in sex unless she initiated first and then only after she performed oral sex on him.  At first, she didn't mind, but a few months into their relationship, she began to feel disappointed because Scott never initiated.  She said she really loved Scott and she was willing to make changes so their relationship would work out.

When it was his turn, Scott said he had never been especially sexual.  He had his first sexual experience when he was a junior in college and it was awkward for him.  As far as sex was concerned, he explained, he could take it or leave it most of the time.  But, he said, he loved Joann very much and he wanted to remain in a relationship with her, so he was motivated to try to change.

He liked when Joann initiated, and he always felt aroused with oral sex.  However, he admitted he never thought about initiating sex--not until Joann told him about her disappointment.  Now that he knew she was disappointed, he wanted to work on this issue, but he really didn't know where to begin.  His doctor ruled out low testosterone, so he didn't know why he didn't get more spontaneously aroused.  The whole problem made him feel ashamed--like he was "less of a man."

After the couples therapist listened to each of them, she assured Joann and Scott that there didn't seem to be anything "wrong" with either of them--they were just different.  Then, she explained the concept of sexual arousal in terms of sexual accelerators (sexual turn ons) and sexual brakes (sexual turn offs), and she recommended that they read Dr. Nagoski's book, "Come as You Are," together so they could understand their differences.

As she worked with Joann and Scott, the couples therapist asked Scott if he was willing to initiate sex sometimes even if, at first, he didn't feel sexually aroused.  Scott responded that he would be willing to do it because he knew that, once they got started, he would become sexually aroused.

During their couples therapy sessions, Scott also learned something about himself that he didn't realize before--his lack of sexual experience (as compared to Joann) often made him feel anxious when she approached him sexually.  When Joann heard this, she felt much more empathetic towards Scott, and she reached over to touch his hand to reassure him.  

Using the metaphor of sexual accelerators and brakes, the couples therapist advised Joann to slow things down (more brake than acccelerator), savor their foreplay, and give Scott a chance to become sexually aroused.  She recommended that they make a date night for having sex and find ways to anticipate and look forward to their time together.  

Following the couples therapist's advice, Joanne and Scott chose Saturday night as their date night for lovemaking.  Throughout the day, Scott deliberately imagined what it would be like to be with Joanne as a way to get sexually aroused.  This was something he never tried before, and he discovered that his sexual excitement began to build as the time got closer to their date.  Then, when they were together, they spent time relaxing together and being sexually playful.  

At first, Scott felt awkward and anxious but, over time, he felt less pressured.  Joann learned to slow down and savor the sexual foreplay, which she normally didn't need.  Slowing down and savoring the moment made her feel even more sexually aroused than usual.  She liked that by the time they were both ready to have intercourse, Scott was really into it, which was even more arousing for her. 

Within the next few months, Scott was initiating and enjoying sex more, which pleased Joann.  There was a mutuality to their sex life that they both found much more satisfying.

Everyone is different in terms of sexual arousal, and there is no right or wrong about this.

The clinical vignette in this article is between a man and a woman, but these differences are also found between two women and two men in LGBTQ relationships.

When there is a difference in terms of sexual arousal between two people in a relationship, they can learn to negotiate their differences so they can both be sexually satisfied.  

This is often complicated for a couple to do on their own because emotions, including securities, and doubts can get in the way.  They often need the help of a licensed mental health practitioner to overcome their problems.

Getting Help in Therapy
If you and your partner are experiencing sexual problems, you could benefit from getting help from a skilled couples therapist.

Rather than struggling on your own, you and your partner can learn ways to improve your sex life and your relationship.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR, AEDP, Emotionally Focused Therapy For Couples, and Somatic Experiencing therapist (see my article: The Therapeutic Benefits of Integrative Psychotherapy).

I work with individual adults and couples.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

Saturday, January 30, 2021

Understanding Your Sexual Accelerators and Sexual Brakes - Part 2

In my prior article, Understanding Your Sexual Accelerators and Sexual Brakes - Part 1, I began a discussion based on Dr. Emily Nagoski's book,  Come As You Are: The Surprising New Science That Will Transform Your Sex Life.  Dr. Nagoski is an expert on sexual well-being and healthy relationships.  In this article, I'm continuing this discussion with a clinical vignette to illustrate the points I made in Part 1 of this topic.

Understanding Your Sexual Accelerators and Sexual Brakes

To summarize Part 1: Everyone has certain sexual turn ons and turn offs that are particular to them. The turn ons function as sexual accelerators for sexual desire and the turn offs function as brakes.  Knowing what your sexual accelerators and brakes are and communicating them to your partner helps to improve your sex life.

For many people, this is easier said than done because they think something is "wrong" with them if they don't conform to certain societal myths in the media or what they've seen in porn.  

For instance, in porn videos women are shown as being instantly turned on with little to no foreplay when this isn't true for the vast majority of women.  They're also shown in these videos to experience orgasm through sexual intercourse alone when most women get more sexually excited with clitoral stimulation.  In addition, sexual taboos learned in childhood can interfere with sexual pleasure for individuals and couples.  

These examples are just a few of the many issues that can make women feel like they're not "normal" when, in fact, they are normal.

The vast majority of women need sexual stimulation to get turned on.  Their sexual desire is also context dependent.  In Dr. Nagoski's book she gives the example of being tickled.  

So, for instance, if a husband tickles his wife while she is hurrying to get their child ready for school, she's probably going to feel annoyed.  Whereas if he tickles her when they're being playful together in bed, she's more likely to experience this as a turn on.  In both cases, the husband is tickling the wife, but the context in each case is very different.

About 16% of women and almost all men experience spontaneous sexual desire, according to Dr. Nagoski.  In terms of understanding sexual accelerators and sexual brakes, they have sensitive accelerators and not-so-sensitive brakes.  Their sexual arousal isn't as dependent upon context as the women who are context dependent.  However, even these women can experience problems with sexual arousal if they're worried about their children or they're highly stressed in some other areas of their life (e.g, financial problems, health problems and so on).

Clinical Vignette: Understanding Your Sexual Accelerators and Sexual Brakes
The following clinical vignette is a composite of many different couples. All identifying information has been removed:

Dana and Bill
After being married for five years and raising two children, Dana didn't feel as sexually passionate at times as she did when she and Bill first got married.

Sometimes Dana felt like she was just going through the motions when she and Bill had sex while she kept one ear alert for the sound of their five year old son and two year old daughter in the next room.

At 45, Dana experienced vaginal dryness at times and during sexual intercourse, and Bill saw this as a sign that she wasn't turned on--even when she really was sexually turned on.  He thought she was just having sex to appease him, which was a turn off for him, and Dana couldn't would convince him otherwise.

They decided to leave the children with Dana's mother so they could go for a romantic getaway.  But when they were alone in their hotel room, Dana felt such pressure and anxiety to be sexually turned on that she just couldn't get sexually aroused.

Soon after that, they stopped having sex altogether.  Although Dana was concerned about this, she was also relieved not to feel pressured so she didn't bring it up with Bill.  And Bill thought Dana would feel uncomfortable if he brought it up, so he remained silent, even though he felt sexually frustrated.

Days turned into weeks and weeks turned into months.  Finally, after almost a year of no sex, Bill broached the subject with Dana, "We haven't had sex in almost a year. Don't you think we should talk about this?"

As soon as she heard Bill's words, Dana felt defensive.  She thought he was blaming her for the lack of sex in their relationship.  So when they sat down to talk, she was surprised that he wasn't blaming her--he just wanted to improve their sex life.

Dana told him that, even though she was still sexually attracted to him, she noticed she wasn't as sexually responsive since they had their children.  She also admitted that she didn't feel comfortable talking about sex because in her childhood home sex was a taboo topic, so it always made her feel uncomfortable to discuss it (see my article: How to Talk to Your Partner About Sex).

Soon after that, Dana went to see her gynecologist who ruled out any medical problems.  He recommended that she use lubricant when she and Bill had sex.  He called in Bill, who was waiting in the reception area, and explained to both Dana and Bill that women can be sexually aroused even if they don't experience vaginal wetness.  Bill was surprised, but he respected the doctor's words.  In addition, the gynecologist recommended that they see a couples therapist to see if they could revive their sex life.  

During their couples therapy sessions, the therapist explained to them that it wasn't unusual for there to be a decrease in sexual activity after a couple had children and experienced other stressors related to being married.  She also explained the concept of sexual accelerators and sexual brakes to them and assured them that they were both "normal" (see my article: What is Emotionally Focused Therapy For Couples?).

To remove the sexual performance pressure, the couples therapist recommended they practice sensate focus, developed by Masters and Johnson, where they touched each other sensually, but where they didn't have sexual intercourse during those times.  She said that sensate focus is a way to explore what turned each of them on sexually without the pressure of performing and the pressure to have an orgasm.

Dana and Bill felt awkward at first, but they soon began to enjoy sensate focus.  Dana felt more comfortable touching and being touched without worrying about sex, and they both enjoyed exploring what turned each of them on.

During this time, the couples therapist also recommended that Dana spend time on her own exploring her own sexual arousal.  She recommended that Dana try using sex toys, including a vibrator, to masturbate and learn what was sexually pleasurable for her.  She told Dana that she didn't need to worry about having an orgasm--she could just discover what was sexually pleasurable for her.  

At first, Dana felt uncomfortable.  Her thoughts went back to the time her mother found her in the bath tub, when Dana was 10 years old, running water over her clitoris and enjoying the sensation.  Her mother was shocked.  She scolded Dana and told her that what she was doing was "a sin."  After that, Dana never attempted to masturbate again.  She believed her mother when she said Dana would "go to hell" if she did it again.

Dana needed several individual sessions with the couples therapist to feel comfortable enough to masturbate on her own.  After these sessions, she was able to approach self pleasure with an open mind to discover what turned her on (her sexual accelerators) and what inhibited her sexual desire (her sexual brakes).

When Dana and Bill returned for their next session together, Dana said she was able to put her childhood memory aside, and she was surprised at how turned on she felt using the vibrator.  She said that even though she wasn't trying to have an orgasm, she had one of the most powerful orgasms she had ever had in her life.  Then, she turned to Bill and told him she hoped they could use the vibrator as part of their foreplay in the future, and Bill was thrilled to agree.  

When they were at the point where they were ready to have intercourse again, their couples therapist recommended that Dana use lubricant each time so sexual intercourse wasn't uncomfortable if she was dry.  

She told the couple to take as much as they needed for each of them to get sexually aroused and that pleasure was the goal--not orgasm.  She also told them to keep sex light and playful and that when Bill was pleasuring Dana that he focus on clitoral stimulation first (see my article: Sex Tips For Men: How Men Can Be Better Sexual Partners With Women).

Dana's mother took care of the children the next weekend while Dana and Bill enjoyed alone time.  To keep things playful and fun, they took a relaxing bubble bath together.  Then, they took turns giving each other a massage.  

Focusing on sensuality naturally led to sexual intimacy without pressure.  Even though they weren't focusing on it, they both experienced orgasms.  Afterwards, they cuddled in each other's arms and fell asleep peacefully.  

They were able to talk the next day about what each of them found pleasurable and what they wanted more of and less of when they made love again.  They also became more sexually adventurous and open to new experiences.

Many people are misinformed about sex because they have been raised with sexual taboos or they have learned about sex by watching porn, which has a lot of misinformation and distortions of all kinds.

Other people are worried that they're "not normal" either because they believe they should feel and act a certain way sexually rather than freeing themselves up to experience sex in a way that is most comfortable for each of them.

If a couple is open and willing to explore, they can learn what each of them enjoys sexually, their turn ons (sexual accelerators) and turn offs (sexual brakes) and develop a sex life that is pleasurable for both of them.

Getting Help in Therapy
If you and your partner are struggling with your sex life, you're not alone.  Help is available to you.

Seek help with a licensed mental health professional who works with couples so that you and your partner can have a more fulfilling relationship.

About Me
I am a licensed New York City psychotherapist, hypnotherapist, EMDR, AEDP, EFT (Emotionally Focused Therapy for Couples) and Somatic Experiencing therapist (see my article: The Therapeutic Benefits of Integrative Psychotherapy).

I work with individual adults and couples.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

Understanding Your Sexual Accelerators and Your Sexual Brakes - Part 1

I'm continuing to discuss topics from Emily Nagoski's book, Come As You Are: The Surprising New Science that Will Transform Your Sex Life.  My topic for this article is "Understanding Your Sexual Accelerators and Sexual Brakes (see my articles  What is Good Sex - Part 1).

Understanding Your Sexual Accelerators and Your Sexual Brakes

Sexual Accelerators and Sexual Brakes
Similar to the brakes and accelerators in cars, people can experience sexual desire in terms of brakes and accelerators.  While some men and women are less inhibited about sex (more accelerator than brake), others experience more inhibitions (more brake than accelerator).  

Back in the late 1990s, Erick Janssen and John Bancroft of the Kinsey Institute developed the dual control model of sexual response.  This model explains the central mechanism that governs sexual arousal, which controls how you respond to sexually relevant sights, sounds, sensations and ideas.

According to Dr. Nagoski, your central nervous system is made up of pair of accelerators and brakes that send signals to your brain.  For example, your sympathetic nervous system is an accelerator and your parasympathetic nervous system is a brake.  

Your sexual accelerator is what allows you to get sexually turned on when you're exposed to something that is sexually relevant to you.  When you feel sexually turned off or you're in a situation where you need to inhibit your sexual response (e.g., in a staff meeting), your sexual brake is operating.  

People can have different experiences depending upon who they're with and the context of their situation.  For example, a woman who is normally less inhibited (more accelerator than brake), can feel more inhibited (more brake than accelerator) if she's conscious of her children hearing her and her husband having sex in the next room.

Another form of a sexual brake is associated with anxiety about sexual performance or worrying about having an orgasm.  Stress and anxiety, in general, can be a powerful brake and get in the way of sexual pleasure.  

Sexual Arousal
To become sexually aroused, it's a matter of activating the accelerator and deactivating the brake.  

If you have a sensitive accelerator and very little in the way of brakes, you're easily aroused and you have a difficult time controlling your sexual arousal.  

According to Dr. Nagoski, who focuses on women in her book, approximately 2-6% of women have a sensitive accelerator and a much less sensitive brake.  This can often be associated with sexual compulsivity and risky sexual behavior.  This can leave some people feeling like they're out of control. 

If you have a sensitive brake and a not-so-sensitive accelerator, you probably have difficulty getting sexually aroused and difficulty having an orgasm.  

According to Dr. Nagoski, a sensitive brake is the strongest predictor of sexual problems for women.  Men, on the other hand, on average, have a sensitive accelerator and less sensitive brake (there are exceptions, of course).

Dr. Nagoski says in her book that approximately 15% of women are spontaneous sexual responders.  They are sensitive to sexual stimuli and they are easily aroused.  

Women who respond more based on context (women who score in the medium range on Dr. Nogaski's sexual questionnaire in her book) represent about 70% of women.  For these women, context matters.  These women need more sexual stimulation to get turned on.

The important takeaway from Dr. Nagoski's book is that regardless of whether you're easily aroused or you need more sexual stimulation to get aroused, everyone is different and there's no need to feel ashamed of it.

Becoming Aware of Your Sexual Brake and Accelerator and Taking Steps to Improve Your Sex Life
If you want to improve your sex life, recognizing if it's your brake or accelerator that's operating and knowing what turns you on and what turns you off is important.

For example, if you're under stress because you're worried that your children might interrupt you while you and your spouse are having sex (your brake is operating), plan to have sex when the children are out of the house, if possible, so that you don't have to worry about being interrupted.

Suggestions on How to Improve Your Sex Life
Here are some other suggestions from Dr. Nagoski to improve your sex life:
  • Create a Space and Mood for Sexual Desire: Set up a space and the right mood with intention.  Trust, affection, relaxation, privacy and peace of mind are all important for creating the right mood for sexual desire.
  • Communicate Your Sexual Turn Ons and Turn Offs: Once you understand your sexual brakes and sexual accelerators, you can communicate this to your partner. 
  • Be Open to Hearing About Your Partner's Sexual Turn Ons and Turn Offs: Take the time to discuss with your partner what s/he finds sexually desirable.  Check in with  regularly with each other to discuss this.
  • Learn to Be Playful During Sex: Rather than approaching sex as a goal-oriented activity that ends with an orgasm, relax and be playful, especially if you haven't had sex with your partner for a while.  Focus on enjoying and giving pleasure to each other rather than on having an orgasm, which can put too much pressure on you and your partner.

See Part 2 of This Topic: 

Getting Help in Therapy
If you and your spouse are having difficulty with with sex, rather than struggling on your own, seek help from an experienced psychotherapist.

The first step, asking for a consultation, is often the hardest, but it can be the first step in creating a happier relationship.

About Me
I am a licensed New York City psychotherapist, hypnotherapist, EMDR, AEDP, EFT, Somatic Experiencing and Sex Therapist (see my articles: The Therapeutic Benefits of Integrative Psychotherapy).

I work with individual adults and couples.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

Thursday, January 14, 2021

Relationships: What is Good Sex? Part 4: What is Synchrony Sex?

I've been focusing lately on the topic "What is Good Sex?" based on the work of psychologist Sue Johnson, who developed Emotionally Focused Therapy for Couples (EFT).  This article is the fourth in a series of articles on this topic, and the focus of this article is "Synchrony Sex" (see my prior articles: What is Good Sex? Part 1Part 2: Solace Sex and Part 3: Sealed Off Sex).

What is Synchrony Sex?

What is Synchrony Sex?
With synchrony sex, each person is open and emotionally vulnerable to their partner. They are emotionally attuned to one another.  

Whereas solace sex and sealed off sex are based on insecure attachment (e.g., an anxious or avoidant attachment style), synchrony sex is based a secure attachment style between the two people in a relationship (see my article: How Your Attachment Style Affects Your Relationship).

Synchrony sex occurs between two people when the erotic and the emotional connection come together.  Generally, each person feels safe and secure so they can be open sexually and emotionally with one another.  

This openness allows the couple to bond with each other and opens up the possibility for sexual exploration and a tolerance for sexual differences that can often be negotiated (e.g., differences in terms of frequency of sex, sex acts, and so on).

Synchrony sex is associated with a healthy, committed relationship where emotional vulnerability between the two people increases the emotional intimacy in their relationship (see my article: Emotional Vulnerability as a Pathway to Emotional Intimacy and What is the Difference Between Sex and Intimacy?).

Even in a relationship with secure attachment, there can still be problems with sex. But these problems are generally more easily worked through, as compared to couples who experience an insecure attachment, because there is a healthy emotional foundation (see my article: How to Talk to Your Spouse About Sex).

Clinical Vignette: Relationships: Synchrony Sex: Working Out Differences in Sexual Arousal
One common problem in many relationships is a difference in sexual arousal, as will be illustrated in the vignette below, which is a composite of many different cases:

Jane and Mark
After 10 years of marriage, Jane and Mark, in their early 40s, sought help in EFT Couples Therapy to work out issues in their sex life.  Generally, aside from the problems in their sexual relationship, they were happily married with three children. 

Both of them described happy childhoods where they each felt loved and secure in their family of origin.  As a result, they both developed a secure attachment style, which allowed them to develop a healthy relationship with each other.

They told their couples therapist that they were devoted to each other and their children.  Jane told the story of how passionate their sex life had been in the early days of their relationship.  

She recounted how they couldn't keep their hands off each other during the first few years of their relationship, and they spent their weekends making love. But, she said, right after their first child, even though she loved Mark more than ever, she no longer felt as sexual.  She still felt sexually attracted to Mark, but she didn't feel as sexual as she did in the past.

Mark told the therapist that in the early days of their relationship Jane was always ready to have sex, but now he felt she was only having sex to please him, and this was hurtful to him.  

As Jane listened to him, she nodded her head in agreement and she admitted that she often had sex with Mark to satisfy him.  She said sometimes she got into having sex once they started, but just as often she felt too tired for sex.

Throughout the couples therapy consultation, Jane and Mark held hands and frequently looked at each other with affection.  It was apparent to the couples therapist that they loved each other and they experienced a secure attachment style, but they needed to work out the differences in sexual arousal that had developed over time between them.

Mark also talked about not wanting to always be the one who initiated sex between them.  As Jane listened carefully, Mark looked at her affectionately and said he would like her to initiate sex sometimes.  

In response, Jane said she didn't feel as sexually attracted now, at age 42, as she once did when she was younger.  She told Mark that she was very aware that she had gained some weight and her body had changed so much after the birth of their three children, "I just don't feel so attractive and sexy anymore to initiate sex now."

"I never knew you felt this way.  I think you're more beautiful now than when we first met," Mark responded by squeezing Jane's hand.

Jane also said, somewhat shyly, that she sometimes experienced vaginal dryness, which made sexual intercourse uncomfortable at times, especially if she wasn't sexually aroused.  

Hearing this, Mark seemed surprised and said Jane had never told him how she felt about her body before.  He was also surprised that, until now, she felt too embarrassed to talk about it.  

In response, the couples therapist normalized Jane's experience of vaginal dryness. She  recommended that Jane speak with her gynecologist to rule out a medical problem.  She also recommended that the couple experiment with different types of lubrication.

After Jane saw her gynecologist and learned that her vaginal dryness is normal for her age, she and Mark began to use lubrication so that sex wasn't uncomfortable for Jane.  Over time, Jane also accepted that the changes in her body were normal.  

During their couples therapy sessions, Mark and Jane learned that many factors were contributing to the change in their sex life, including stress. Their couples therapist told them that it was normal for couples to experience a change in their sex life, especially after they have children, more responsibilities to contend with and more stress.

Over time, Mark and Jane took steps to improve their sex life.  They both worked on reducing their stress by exercising and meditating.  

They also did things to increase sexual anticipation and arousal--planning a romantic evening while their children stayed with Jane's parents, reading erotic passages to each other, talking about their sexual fantasies, and so on (see my article: Sex Tips For Men: How Men Can Be Better Sex Partners in Their Relationship).

Jane developed more of a curiosity about what turned her. Specifically, she learned to be more comfortable masturbating alone as well as with Mark to find out more about what she liked sexually.  

On the advice of her couples therapist and her medical doctor, Jane began working out.  She realized, once she started exercising regularly, that she felt more sexually aroused after doing aerobic exercise.  All that heart pumping exercise translated into more sexual passionate.  She and Mark also got curious about using sex toys and used them to spice things up and add variety to their sex life.

During their couples therapy sessions, Mark and Jane opened up more to talk about what each of them found pleasurable.  This new sense of openness was exciting for them.  Jane said she felt more sexually confident about initiating sex, especially after a good workout, and this pleased both of them.

Both of them said they were happier with their sex life than they had been since the early stage of their relationship.  Since they were happy in the other areas of their marriage, they successfully terminated couples therapy.

Compared to solace sex and sealed off sex, synchrony sex involves both an emotional attachment and an erotic dynamic.  The vignette about Jane and Mark illustrate how a couple can develop a dynamic of synchrony sex.

Even when a couple experiences a secure attachment in an otherwise healthy relationship, there can still be problems that develop along the way.

Since a relationship based on a secure attachment style has a healthy foundation, these sexual differences, whether it's differences in how each person experiences sexual arousal or other differences, can be worked out in couples therapy.  

Getting Help in Therapy
If you and your partner need help to improve your sexual relationship, you could benefit from working with an experienced psychotherapist.

Rather than struggling on your own, seek help from a licensed mental health professional.  A skilled couples therapist can help you to develop a more satisfying sex life and a happier relationship.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR, AEDP and EFT couples therapist (see my article:  The Therapeutic Benefits of Integrative Therapy).

I work with individual adults and couples.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.


Wednesday, January 13, 2021

Relationships: What is Good Sex? Part 3: What is Sealed Off Sex?

This is the third in a series of articles about what is good sex (see my prior articles:What is Good Sex - Part 1 and Part 2: What is Solace Sex?).  In this article, I'm focusing on what Dr. Sue Johnson, the psychologist who developed Emotionally Focused Therapy For Couples (EFT), describes as "sealed off sex."

What is Sealed Off Sex?

What is Sealed Off Sex?
Sealed off sex, as described by Dr. Johnson, is sex that is primarily associated with one-night stands or casual sex where novelty is primary (see my article: 7 Signs Your Relationship is Based on Lust and Not Love).

The primary focus is on lust, sensation, sexual prowess and having an orgasm.  Generally, there is little to no emotional connection with sealed off sex.  However, there are times when a couple's relationship starts off being based on casual sex and it has the potential to develop into a deeper, more committed relationship. 

If the couple wants to develop a deeper, more committed relationship that goes beyond lust, they would need to work on developing emotional connection and vulnerability (see my article: Emotional Vulnerability as a Pathway to Greater Emotional Intimacy in Relationships). However, if only one person is interested in having a committed/monogamous relationship, there will be conflicts.

Clinical Vignette: Sealed Off Sex
The following clinical vignette, which is a composite of many cases, illustrates the dynamics of sealed off sex in a relationship:

Sam and Beth
When they first met through a dating app, neither Sam nor Beth were looking for a committed relationship.  Both of them were in their mid-30s and they each had just ended a prior long term relationship.

Initially, they both agreed that they weren't looking for a serious relationship, they were both dating other people, and when they got together, it was mostly for casual sex.  

But as time went on, Beth began to feel emotionally attached to Sam, and she no longer wanted to date other men.  Even though sex was passionate with Sam, Beth was no longer  happy to just hook up with him. She wanted more of an emotional connection with him, and it was becoming too painful to her that he was seeing other women.

Due to their initial agreement to keep things casual between them, Beth was hesitant to talk to Sam about being exclusive. But when she realized that she had fallen in love with him, she knew it would be increasingly painful for her to settle for just a physical relationship.  So, she broached the topic one day when he came over to see her (see my article: Dating: Is It Time For the Talk?).

As soon as Sam heard that Beth had developed deeper feelings for him and she wanted an exclusive relationship, he told her that this wasn't at all what he wanted.  He reminded her that he said from the start he wasn't ready to be in a relationship.

Beth wasn't surprised by Sam's response, but she was disappointed.  Knowing that it would only become more hurtful to continue seeing Sam under the circumstances, she told him that they should stop seeing each other.  Sam was disappointed and he told her that he had hoped they could continue to see each other as they had been, but he realized things had changed for Beth and he understood why she didn't want to see him anymore.

Over the next few weeks, Beth tried to avoid looking at Sam's social media accounts. Part of her didn't want to see pictures of him with other women, and another part of her was very curious.  But as soon as she saw pictures of him out with other women, she was overcome with sadness.

Sam didn't think he would miss Beth, but as time went on, he realized he was thinking about her a lot.  So, he called her and asked her to meet for coffee to talk things over, and she agreed.

As they sat facing each other in the coffee shop, Sam admitted that he missed her more than he anticipated.  He asked her, once again, if she would consider resuming their casual relationship without any commitments, and she reiterated that she wasn't comfortable doing this, so they were still at an impasse.

Over coffee, Sam told Beth that, even when he was in a committed relationship, he had been unfaithful to his girlfriend.  Originally, Sam had told Beth that he and his prior girlfriend grew apart and that's why they broke up.  But he now admitted that his prior girlfriend found out about his infidelity with many different women. He said she gave him a chance to change, but even though he loved his girlfriend, he couldn't stop seeing other women for casual sex, also known as sealed off sex, so his girlfriend left him.

As Beth listened to Sam talk about how he destroyed his prior relationship and she saw how ashamed he felt about his behavior in that relationship, she realized his problem was much worse than she had ever anticipated.  She also realized that if he couldn't be faithful in his prior five year relationship, he probably wouldn't be faithful with her.

Sam told her that he wanted to change because he realized he would have no chance of having a meaningful relationship if he couldn't stop philandering, but he had problems controlling his sexual urges.

Shortly after that conversation, Sam sought help in therapy where he began to work on the underlying issues, including unresolved trauma, involved with his sexual compulsivity.  He began to develop an understanding about how unresolved trauma can affect relationships).

After a few months of working on his underlying issues, Sam was able to make a commitment to Beth and they got back together.  In the meantime, he continued to work on his issues in therapy.

Sealed off sex is casual sex which is usually devoid of emotional connection.  

Although the vignette in this article involves sexual compulsivity, this doesn't mean that everyone who has casual sex is sexually compulsive.  

Many people enjoy casual sex and it's not a problem. However, for people who have problems because they experience their sexual behavior as out of control, sexual compulsivity with underlying trauma is a possibility that should be explored with an experienced mental health practitioner.

Getting Help in Therapy
If you are struggling with sexual problems, you're not alone, and you could benefit from seeking help from an experienced psychotherapist who can help you to work through your problems.

Taking the first step, setting up a consultation, is often the hardest, but it can also be the first step to transforming your life.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR, AEDP, EFT and Somatic Experiencing therapist (see my article:  The Therapeutic Benefits of Integrative Therapy).

I work with individual adults and couples.

To find out more abut me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

Monday, January 11, 2021

Relationships: What is Good Sex? Part 2: Are You Using Solace Sex in an Anxious Attempt to Stay Emotionally Connected?

In my prior article, What is Good Sex?, which was Part 1 of this topic, I began a discussion about three different types of sex, as defined by Sue Johnson, Ph.D., who developed Emotionally Focused Therapy For Couples (EFT).  In the current article, I'm focusing on solace sex.

What is Solace Sex?

What is Solace Sex?
Dr. Johnson defines solace sex as occurring when one or both partners are unsure and anxious about the relationship so they seek reassurance in their sex life together.

With solace sex there is a focus on gaining reassurance about the relationship by trying to please the other partner as a way of winning over their approval and through seeking physical proximity.

People who have an anxious attachment style often engage in solace sex.  Also, people with an anxious attachment style often unconsciously choose partners with an avoidant attachment style, so this exacerbates the problem (see my article: How Your Attachment Style Affects Your Relationship).

With solace sex, there is an emphasis on cuddling and being affectionate rather than the more erotic aspects of sex.  In addition, the person with an anxious attachment style, who is insecure, is highly sensitive to any signs of rejection.  

For example, if their partner is too tired to have sex, they often experience catastrophic thoughts where they believe their partner doesn't love them and they try to pressure their partner to have sex to feel reassured that the partner cares for them (see my article:  Are You Catastrophizing?).

This often leads to more arguments and conflicts in the relationship, especially if the relationship is already unstable.

Clinical Vignette 1: Solace Sex in an Uncommitted, Unstable Relationship

Pam and Ed
When Pam and Ed, both in their mid-30s, first met at a party, they were drawn to each other immediately and they began dating soon after that.

From the beginning, Ed was upfront with Pam. He told her that he wasn't looking for a serious relationship--he only wanted a casual relationship with her.  He also let her know that he had never been monogamous in any of his prior relationships, and he was currently dating two other women. 

Although Pam didn't like that Ed was seeing other women, she believed she could eventually change his mind and convince him that she was the woman for him.  Whenever they got together, Pam felt it was an opportunity to change Ed's mind.  She would do everything she could to try to please him in terms of the way she dressed, the meals she made for him, and the little gifts she bought for him.  

During sex, Pam sought constant reassurance from Ed that he liked her, which annoyed Ed.  He couldn't understand why Pam needed so much reassurance.  

After a while, Ed realized that he was thinking about the two other women that he was dating whenever he was with Pam and wishing he was with one of them.  

Three months later, Ed felt tired and bored with the relationship. He told Pam that he didn't want to continue dating her.  When Pam heard this, she flew into a rage, and Ed left her apartment abruptly slamming the door behind him.

Eventually, they reconciled, but over the next six months, Pam and Ed had an on-again/off-again relationship (see my article:  The Heartbreak of the On Again/Off Again Relationship).  

The pattern was always the same: Pam wanted more from Ed than he wanted to give her.  She wanted a monogamous relationship and he wanted to continue to see other women.  The more they argued about this, the more these arguments eroded Pam's self confidence, which was low even before she began dating Ed.  

Whenever they got back together again after a breakup, they never discussed their differences about monogamy.  Instead, they brushed those issues under the rug, and they reconciled by having sex.  Whenever they had sex, Pam felt reassured--until the conflict about monogamy came up again, which led to another breakup.

Pam's friends could see that she had highs and lows in this relationship--mostly lows.  They told her that she would be happier if she dated someone who also wanted to be monogamous.  As they saw how unhappy Pam was with Ed, they couldn't understand why she pursued him after each breakup.  And they really couldn't understand why Pam found Ed so compelling.  

Pam and Ed in EFT Couples Therapy:
Although Ed was reluctant, Pam persuaded him to go with her to EFT couples therapy.  

After the first session, the couples therapist told them that they each wanted something different--Pam wanted to be monogamous and Ed didn't.  She pointed out that, even though they kept coming back together after their frequent breakups, their problems hinged on this issue and they were far apart on it.  She told them that, as long as they were so far apart on the issue of monogamy, she didn't see how couples therapy could help them because what they wanted was so fundamentally different.  She recommended individual therapy for each of them.  

Soon after that, when Ed broke up with Pam again and he refused to reconcile, Pam entered into individual therapy to try to understand why she stayed in such an unstable relationship.  In her individual therapy, Pam learned that her unresolved childhood trauma in an unstable family drew her to Ed.  She also saw that she had a tendency to seek out men who were emotionally unavailable.  She worked on resolving her trauma in individual therapy so she wouldn't continue to repeat this pattern.  

Ed never sought individual therapy for himself. He was content being nonmonogamous and sought out women who were only interested in casual relationships.  Even though these relationships didn't last long, Ed felt comfortable going from one relationship to the next.

Clinical Vignette 2: Solace Sex in a Committed Relationship

Liz and Joe
Liz and Joe were both single and in their early 40s when they met.  During the first six months of their relationship, they had an active sex life together, and they agreed to be monogamous.  

Liz preferred cuddling with Joe and she often wanted reassurances from him that he cared about her and that he found her attractive. At first, Joe didn't mind that Liz needed so much reassurance, but after a while, he was getting tired of it.  He couldn't understand why Liz needed to hear him tell her every time they were together that he cared for her and that she was beautiful.  He felt Liz was nagging him about this.  He also didn't like to cuddle all the time, but he did it because he knew that if he didn't, Liz would become anxious and she would begin to have doubts about his feelings for her.  

By the time they were together for six months, Joe had taken on a second job to pay off his debt, so he was often tired when he saw Liz on the weekends.  He was especially tired on Friday nights after a long work week.  As a result, he was often too tired to have sex on Friday nights and suggested they have sex on Saturday morning.  

Initially, Joe didn't think Liz would mind because, after all, they would be together all weekend.  So when Liz reacted angrily and accused him of not caring about her anymore, he was very surprised.  

He thought Liz was overreacting and he tried to reassure her that his feelings hadn't changed--he was just tired.  But nothing he said helped to soothe Liz, and after a while he felt Liz was being inconsiderate and too demanding.   

As time went on, Joe wondered if he wanted to spend so much time with Liz.  His preference would have been to spend less time together because, compared to Liz, he needed much more down time (see my article: Compromising About Time Together and Time Apart).  

But when he told her this, she became highly anxious and upset, and Joe felt himself withdrawing from her emotionally.  And, as is typical in the dynamic between a person with an anxious attachment style (Liz) and a person with an avoidant attachment style (Joe), the more he withdrew from her, the more she pursued him.

Liz and Joe in EFT Couples Therapy: 
Liz and Joe exemplify a typical dynamic with solace sex.  Liz has an anxious attachment style and Joe has more of an avoidant attachment style.

As such, Liz needed a lot of reassurance from Joe that he cared about her and she sought this reassurance through solace sex.  

She was the emotional and sexual pursuer in the relationship and he was the withdrawer.  After a while, the more she pursued, the more overwhelmed he felt and the more he withdrew from her.

Even though they had problems, Liz and Joe were both committed to their relationship.  Neither of them wanted to see other people.  So, when they realized they weren't able to resolve their problems on their own, they sought help in Emotionally Focused Therapy for Couples (EFT).

Their EFT couples therapist helped Liz and Joe to see the negative cycle in their relationship.  Rather than fighting with each other, they learned to pull together to change their relationship dynamic. They each realized that they were repeating a cycle that was part of their family of origin history.  

Liz learned to recognize her catastrophic thinking and, rather than accusing Joe of not caring for her, she calmed herself first and then she was able to approach Joe to tell him what she needed from him.  She also learned not to take it personally if he was too tired to have sex.

When Joe felt less pressured, he felt more drawn to Liz.  Rather than withdrawing from her, Joe was more affectionate, even when he was too tired to have sex.  

In addition, they were able to compromise more about spending time together versus spending time apart, so Joe was able to have more down time, and Liz stopped feeling insecure about Joe's need for time for himself.

Working together in couples therapy, they were able to change their relationship dynamic so they had a more satisfying relationship.  

In the vignettes above, the people with the anxious attachment style who sought out solace sex were women.  They were the pursuers in their relationship and the men were the withdrawers with more of an avoidant attachment style.  However, even though pursuers are usually women and withdrawers are usually men in heterosexual relationships, there are also male pursuers and female withdrawers.

As previously mentioned, people who seek out solace sex usually feel anxious and insecure in their relationships.  This is exacerbated by the fact they often unconsciously choose partners who are less emotionally available, which often repeats a family of origin dynamic.

In unstable relationships, as in the vignette about Pam and Ed, the pursuer (Pam) often finds the instability of the relationship to be compelling--even though, at the same time, the pursuer is trying very hard to get her emotional needs met.  

An insecure attachment, like an anxious attachment style, which develops at an early age, contributes to this dynamic.  The more the pursuer pursues the withdrawer, who has an avoidant attachment style, the more the withdrawer distances himself.  And the more he distances, the more she pursues, which leads to ongoing problems.

Emotionally Focused Therapy for Couples helps couples, who are committed to each other, to understand the negative cycle in their relationship so they can work on changing the cycle.  Rather than blaming each other, they learn to work together to improve their relationship.

Getting Help in Therapy
If you and your partner are having problems you haven't been able to resolve on your own, you could benefit from seeking help from an experienced psychotherapist.

Research has shown that EFT Couples therapy is an effective evidence-based couples therapy that has helped many couples to resolve their problems.

Rather than struggling on your own, seek help from a licensed mental health practitioner who is skilled in helping people overcome their relationship problems.

About Me
I am a licensed psychotherapist, EFT couples therapist, hypnotherapist, AEDP, EMDR and Somatic Experiencing therapist in NYC (see my article:  The Therapeutic Benefits of Integrative Therapy).

I work with individual adults and couples.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.