NYC Psychotherapist Blog

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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.