To Improve Intimacy in Your Relationship, Get Off the Sexual Staircase

In their book, Desire - An Inclusive Guide to Navigating Libido Differences in Relationships, Lauren Fogel Mersey, PsyD and Jennifer A. Vencill, PhD., discuss the "Sexual Staircase" to describe the kind of routine, goal-oriented sex that people engage in when they're having sex with their partner (see my article: Understanding Your Sex Script).

Improve Intimacy in Your Relationship

What is the Sexual Staircase?

According to Mersey and Vencill, the Sexual Staircase, which is a metaphor, is how most people think sex is "supposed to be."

The Sexual Staircase is a list of hierarchical steps that usually start at the bottom of the staircase with foreplay and ends with sexual intercourse and orgasm.

Depending upon the couple, the sexual acts between foreplay and intercourse can include kissing, caressing, genital touch, oral sex, and so on.

For many people in long term relationships these steps don't deviate. They engage in the same steps in the same way most or all of the time.  

After a while, people in long term relationships often skip some of the steps as they prioritize a goal-oriented approach that always ends with penetrative sex and strives for orgasm.  

Having sex the same way all the time becomes boring after a while (see my article: What is Sexual Boredom in Long Term Relationships?).

What's the Problem With the Sexual Staircase?

If you and your partner enjoy doing the same thing, the same way all of the time and neither of you have a problem with it, then there's nothing wrong with the Sexual Staircase for you.

But many people find this approach to be too routine and unfulfilling.  The problem is that they think this is the way they're supposed to do it, so they just keep doing it the same way.

People who find the Sexual Staircase boring, sexually unfulfilling or not applicable to them often have the following problems with it:

• It's a heteronormative sex script that focuses on cisgender heterosexual men. For heterosexual men, sexual intercourse is one of the most reliable ways to have an orgasm, but this isn't the case for most women (see below).

• It assumes that most people want penis-in-vagina sex even though there are many people who don't want it or it doesn't work for them because of problems with dyspareunia (persistent or recurrent genital pain that occurs during penetrative sex) or erectile unpredictability (a persistent or recurrent problem with getting and maintaining an erect penis) or because they're not heterosexual (see below).

• Sexual intercourse is the least reliable way for most women to have orgasms because they need direct clitoral stimulation, which they often don't get from sexual intercourse or clitoral stimulation is skipped altogether (see my articles: Closing the Orgasm Gap - Part 1 and Part 2).

• The Sexual Staircase emphasizes goal-oriented, performative sex instead of focusing on sexual pleasure (see my article: What is Performative Sex and Why Is It a Problem?).

• In many long term relationships, the Sexual Staircase gets shorter and shorter over time so that there is little or no foreplay, which has a negative impact of women's sexual pleasure. The focus becomes getting sex over and done with it as quickly as possible because it's unsatisfying.

• In addition to problems with painful sex and erectile unpredictability, penetrative sex isn't always possible for a variety of reasons, including childbirth, certain disabilities, age-related physical limitations, surgery or other types of problems.

• When penetrative sex isn't possible (for whatever reason), many couples skip having sex altogether because penetrative sex is the only way they know how to have sex.  Over time, one or both of them become frustrated and dissatisfied.

• The heteronormativity of this model isn't useful for LGBTQ people, as previously mentioned. Many LGBTQ people assume that since they're not having penis-in-vagina sex, they're not having "real sex," which, of course, is false.  This often leads to feelings of shame, guilt and self consciousness about their sexual orientation.

The Wheel Model

The authors of Desire cite the Wheel Model, which was inspired by Robert T. Francoeur in his book, Becoming a Sexual Person (1991).

Picture a wheel that's divided into different sections with sexual activities represented in a non-hierarchical way.  

Rather than the linear, hierarchical model represented in the Sexual Staircase, in the Wheel Model none of the sexual activities has a higher priority over any of the others.  Other than sexual pleasure, there are no goals, which usually means less pressure for both people and more enjoyment.

In addition, with the Wheel Model, people can engage flexibly pick and chooe what they like, in whatever order they like without being constrained to the rigid model of the Sexual Staircase.

The authors provide an example of what sexual activities might be included in the Wheel Model:

• Kissing
• Caressing
• Touching
• Massaging
• Using a sex toy
• Showering together
• Cuddling
• Oral sex
• Orgasm
• Penetrative sex
• Manual stimulation

And more.

The sexual activities included with the Wheel Model are only limited by your imagination.

But this is not to say that you and your partner should engage in the activities they write about or that you should stop having sexual intercourse if it's enjoyable to both of you.  You can do whatever you both enjoy.

The Wheel Model helps to dispel the myth that there's one right way to have sex or that everyone should have the same predetermined sex script.  

Making Changes to Your Sex Script

Once again, I want to reiterate that if you and your partner are happy with your sex script, you can continue using it without a problem.

But if you're stuck in a routine and you're getting tired of doing the same thing over and over again, consider how you can work towards making changes  in your sex script (see my article: Changing Your Sex Script).

As Emily Nagoski, PhD., sex educator and author of the book, Come As You Are, says, "Pleasure is the measure."

This means "good sex" is what's pleasurable for both of you.

Getting Help in Sex Therapy

A skilled sex therapist can help you to overcome sexual problems.

Sex therapy is a form of talk therapy where the focus is on sex and relational problems getting in the way of sexual enjoyment (see my article: What is Sex Therapy?).

Individuals and couples seek help in sex therapy for a variety of reasons (see my article: What Are Common Issues Discussed in Sex Therapy?).

There is no nudity, physical exam or sex during sex therapy sessions (see my article: What Are Common Misconceptions About Sex Therapy?)

Rather than struggling on your own, seek help in sex therapy so you can lead a more fulfilling life.

About Me

I am a licensed New York City psychotherapist, hypnotherapist, EMDR, AEDP, EFT, Somatic Experiencing and Sex Therapist.

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.

 

How Women Who Have Lost Sexual Desire Can Get It Back

There is no such thing as "normal" when it comes to sexual desire. Each person is different.

How Women Who Have Lost Sexual Desire Can Get It Back

What Are Some of the Reasons Why Women Lose Their Sexual Desire?

For women a decrease or loss of sexual desire can occur for many reasons. 

Here are just a few of the many reasons why women can experience a loss of sexual desire:

• Stress
• Anxiety
  
• Depression
• Painful sex
  
• Unfulfilling sex
• A negative body image
• A partner with sexual problems
• Problems in a relationship
• Problems in the family
• Unresolved grief
  
• Hormonal changes
• Medical issues
• Side effects from medication
• A history of sexual abuse
• A history of other unresolved trauma
• Financial problems

Tips For Getting Back Sexual Desire That Might Be Helpful

Although every woman is different and there is no one-size-fits-all answer for getting back your libido, consider the following tips which might be helpful for you:

• Start by Visiting Your Medical Doctor: Don't make assumptions about why you're experiencing a loss of sexual desire. Before you do anything else, visit your doctor to rule out any medical problems.  Once medical problems have been ruled out, you can consider other options listed below.

• If There Was a Time When You Used to Enjoy Sex, Think About What Changed Since That Time: If there was a time when you enjoyed sex more, think about what you used to enjoy. Make a list of these experiences. Then, consider how changes in your life might have had a negative impact on your libido. Next, think about what you can do to address these issues and write them down. This list could include:

• The birth of a child 
• Elder care responsibilities
• A death in the family
• A major disappointment at home or work
• A downturn in your finances
• A relationship betrayal
• Sleep problems
• Other losses or changes in your life (see the list at the beginning of this article).

• Reduce Your Stress: Stress can be a major factor in decreasing your libido. Think about how stress might be affecting you and consider healthy ways to reduce, including:
• A doctor-approved exercise regime

• Yoga 

Reduce Your Stress

• Breathing exercises

• Mindfulness meditation
  

• Other stress reducing methods that are right for you

• Assess Your Sexual Turn-ons and Turn-offs: Sex therapist Dr. Jack Morin created two surveys in his book, The Erotic Mind: The Sexual Excitement Survey and the Sexual Inhibition Survey that help you to assess your sexual turn-ons and turn-offs.  Start by assessing the factors that dampen your libido and then consider the factors that get you sexually turned on. See my articles: 

• Getting to Know Your Own and Your Partner's Sexual Turn-ons and Turn-offs)

• Why is Context So Important For Sexual Desire?
  

• Consider How You Get Yourself in the Mood For Sex: Most women experience responsive desire as opposed to simultaneous sexual desire, especially if they're in a long term relationship (this is also true for many men in long term relationships). For people in a long term relationship, it takes more effort to get sexually turned on compared to when the relationship was new.  If you're expecting to automatically get turned on when you begin having sex with a long term partner, chances are you'll be disappointed. Instead of just looking at how your partner tries to get you turned on, consider how you get yourself in the mood for sex. What part of yourself do you bring to the sexual encounter? Do you take time to relax and get into an erotic frame of mind beforehand or do you approach sex as if it's a chore? In her TED Talk, sex and relationship therapist Ester Perel, Ph.D. suggests you consider "I get myself turned on when _____________" and "I get myself turned off when ________________."  You can fill in the blanks for yourself.

• Consider Whether You're Unhappy With Sex in Your Relationship: If you have a sexual partner, think about whether you're not feeling sexually fulfilled during sex.  Sexual desire doesn't occur in a vacuum.  Even if you're able to get yourself in the mood for sex, no one gets turned on by unsatisfying sex. If you're having unsatisfying sex, the problem might not be with your libido, especially if you're turned on during solo sex/masturbation. It's a relationship and sexual problem between you and your partner, and you and your partner need to talk. See my articles: 

• How to Talk to Your Partner About Sex - Part 1 and Part 2 

Talk to Your Partner

• Heterosexual Women Can Be Labeled as Having Low Sexual Desire When the Real Problem is Their Sexual Needs Aren't Being Met)

• Closing the Orgasm Gap Between Heterosexual Men and Women

• Think About Whether You're Bored and in a Sexual Rut: Whether you're single or in a relationship, if you're bored and in a sexual rut, you could benefit from changing things up.  See my articles: 

• What is Your Erotic Blueprint?

• Creating a Sexual Menu With a Yes, No, Maybe List)

• Get Help in Sex Therapy: If your doctor has ruled out any medical problems and you're unable to get back your libido, consider seeing a sex therapist.  Sex therapy is a form of talk therapy for individuals and couples. People who attend sex therapy go for a variety of reasons. There is no physical exam, nudity or sex during sex therapy.  A skilled sex therapist can help you to revive your sex life so you can have fulfilling sex again on your own and/or with a partner.  See my articles:

• What is Sex Therapy?

• What Are Common Issues Discussed in Sex Therapy?

• What Are Common Misconceptions About Sex Therapy?

About Me

I am a licensed New York City psychotherapist, hypnotherapist, EMDR, AEDP, EFT, Somatic Experiencing and Sex Therapist.

I am a sex positive therapist who works 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 or email me.

Sexual Desire Discrepancy: What to Do When You and Your Partner Have Different Sex Drives

In my prior article, What is Sexual Desire Discrepancy?  I introduced this concept, which is when one person in a relationship has a higher sexual libido than the other.  I'm continuing with the same topic in this article by focusing on how couples therapy can help.

Overcoming Problems With Sexual Desire Discrepancy

Sexual Stereotypes

A common stereotype is that men have a higher sexual libido than women.  This stereotype is often inaccurate and misleading because many women in heterosexual relationships have a higher libido than their male partner (see my article: Women With High Sexual Desire - Part 1 and Part 2).

Sexual desire discrepancy (or high sexual libido vs lower libido) comes up in all types of relationships--whether these relationships are heterosexual, gay, lesbian, bisexual or transgender.  

Regardless of gender or sexual orientation, sexual desire discrepancy can be a significant problem in any relationship, and many couples don't know how to deal with it.

Although some couples minimize this problem, sexual desire discrepancy is often a significant stressor in a relationship, and it should be taken seriously rather than being ignored.

Sexual Accelerators and Brakes

Often the person in the relationship who is perceived as having a lower libido is labeled by the couple as "the problem" when the couple comes for therapy.  

But as couples explore their problem in therapy, they often discover that the person who seemingly has a lower libido just isn't turned on by what the couple is doing sexually (see my article:  Understanding Your Sexual Accelerators and Brakes - Part 1 and Part 2).

Spontaneous Sexual Desire vs. Responsive Sexual Desire

It's important for couples to communicate with each other to find out what turns each of them on sexually, how they get turned on, and under what circumstances.  

Some people experience sexual desire more spontaneously while others need more time to get turned on (see my articles: Spontaneous Sexual Desire vs Responsive Sexual Desire, What is Your Erotic Blueprint - Part 1 and Part 2).

When a couple is able to open up and speak to each other about how they experience sex in their relationship, they often discover that they each require something different to get turned on (see my article: Rethinking Foreplay as Just a Prelude to Sexual Intercourse).

So, let's explore this with some examples (the examples given below are composite cases with all identifying information changed).

Talk to Your Partner About Sex

Jane and Bob were in a three year relationship.  When they talked about their sex life in couples therapy, Bob discovered that Jane got much more turned on when Bob spent more time performing oral sex (cunnilingus) rather than rushing into sexual intercourse (see my articles: How to Talk to Your Partner About Sex - Part 1 and Part 2).

Prior to this, Bob thought of Jane as having a low libido, but he soon discovered he was mistaken.  Also, based on their work in couples therapy, they changed how they engaged in sex, and he realized that her libido was just as strong as his (see my articles: Understanding Your Sex Script, Changing Your Sex Script - Part 1, Part 2, Part 3 and Part 4).

Once Bob did the things that got Jane turned on, she became much more orgasmic (see my article:  Closing the Orgasm Gap Between Men and Woman- Part 1 and Part 2).  This made sex much more enjoyable for both of them (see my article: What is Good Sex?).

As Jane and Bob became more comfortable talking about what they did and didn't like sexually and they made changes to their sex script, their sex life improved (see my articles: Reviving Your Sex Life By Discovering Your Peak Erotic Experiences - Part 1 and Part 2).

They also discovered in couples therapy that they each had particular sexual fantasies they liked to think about and possibly explore (see my articles:  Exploring and Normalizing Sexual Fantasies Without Guilt or Shame).

What If You Feel Too Ashamed to Talk to Your Partner About Sex?

There are many couples who feel too ashamed to talk to each other about what they enjoy sexually.  This can be due to their cultural background, family history, religious background, unresolved sexual trauma or many other issues.

For instance, Jack and Alice, who were married for five years, both came from traditional religious families where sex was strictly forbidden before marriage and was never even spoken about.  

Prior to getting married, they both agreed they would wait until after they were married to have sex.  They both assumed sex would automatically be enjoyable once they were married.  But neither of them had been sexual with anyone else prior to their relationship, and they both felt shy and inexperienced with each other.

Since they wanted to have children, they focused on procreative sex where the goal was for Alice to get pregnant.  Both of them thought of procreative sex as a duty to each other and their community rather than something that either of them could enjoy.

After Alice got pregnant, she wasn't interested in being sexual and Jack felt he would make Alice uncomfortable initiating sex until they wanted to have another child.  Although he felt like sexual enjoyment was missing from their marriage, he didn't dare bring it up because he felt ashamed of his need for sexual enjoyment.

As time went on, Jack secretly masturbated in the shower.  But one day Alice walked in on him.  They both got embarrassed and she quickly walked out. Afterwards, they were awkward around each other for the rest of the day.  

At night, when they were both in bed with the lights off, Jack suggested they talk.  At first, Alice was silent, but she eventually responded. She said she didn't masturbate and she wasn't sure how she felt about Jack masturbating.

Later that week, they decided to speak with their pastor about it.  Neither of them felt comfortable talking to him but, after a period of awkward silence, Jack told the pastor about the incident where Alice caught him masturbating in the shower and how they wondered if this was "unnatural" or a sin.

The pastor assured the couple that masturbation is common and not sinful at all.  Both Jack and Alice were relieved.  Then, Jack told the pastor that both he and Alice were inexperienced sexually before getting married, neither of them felt comfortable talking to each other about sex, and they didn't have anyone in their lives they felt comfortable talking to about it.  In response, the pastor encouraged them to seek help with a couples therapist who works with couples on sexual issues.

With their pastor's encouragement, the couple sought help in couples therapy.  During the first few sessions, they both felt hesitant, but their couples therapist normalized their feelings and encouraged them to talk (see my article: Why It's Important to Talk to Your Therapist About Sexual Problems).

Their couples therapist also provided them with psychoeducation about enjoying rec-relational sex and about sex scripts.  She also encouraged them to talk to each other about their sexual fantasies.  At first, Alice said she didn't think she had sexual fantasies, but as she learned more about fantasies, she realized she did, in fact, have them from time to time.

Over time, Jack and Alice gradually discovered they could change their sex script to include oral sex, which would be more pleasurable for Alice.  When they returned to their next couples therapy session, Alice was happy to report that she had her first ever orgasm.

Up until that point, they both thought Jack had a much higher sexual libido than Alice.  But, as they experimented sexually, they discovered that she just wasn't turned on by what they had been doing before they incorporated oral sex.  They also learned that many women weren't able to have an orgasm by penetrative (penis in vagina) sex alone, so including oral sex made sex much more pleasurable.

Over time, Jack and Alice developed a much more satisfying sex life together as they became  more comfortable communicating with each other and they became more sexually adventurous.

Conclusion

Many couples feel shy and awkward talking to each other due to a combination of problems.  Some of them were raised to think that sex was shameful.  Others, who were inexperienced sexually, believed that sex was only for procreative purposes and they didn't feel comfortable actually enjoying sex.  

In addition, some individuals, who have responsive desire, need more time to get turned on, so their partner, who might get turned on more easily, needs to be patient to take the time to pleasure their partner.  For instance, if one partner has been under a lot of stress and they have a hard time making the transition from their stressful day, the other partner might initiate with a pleasurable massage.

Most couples respond well in couples therapy with a therapist who can provide them with psychoeducation about sexual pleasure, help them to overcome any guilt and shame and also assist them to change their sex script.

Getting Help in Therapy

Problems with sexual discrepancy are common in committed relationships.

If you and your partner are struggling sexually, you could benefit from seeking help from a couples therapist who helps couples to overcome sexual problems.  

About Me

I am a licensed New York City psychotherapist, hypnotherapist, EMDR, AEDP, EFT, Somatic Experiencing and Sex Therapist.

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.

Relationships and Mismatched Sex Drives: What is Sexual Desire Discrepancy?

Sexual desire discrepancy is a common problem for many couples (see my article: Have You and Your Spouse Stopped Having Sex?).  In fact, it's one of the most common problems for couples seeking help in couples therapy (see my article: The Paradox of Love and Desire in a Committed Relationship).

Mismatched Sex Drive: Sexual Desire Discrepancy

What is Sexual Desire Discrepancy?

There are times in relationships when individuals aren't in synch with regard to having sex. This isn't unusual.  

But for many couples desire discrepancy is an ongoing problem in the relationship (see my articles: What is Your Erotic Blueprint - Part 1 and Part 2).

What Are Some of the Reasons Sexual Desire Discrepancy?

There are many factors that can cause differences in sexual libido.  Here are some of the most common issues:

• Hormonal issues
• Medication side effects
• Stress
  
• Unresolved trauma
  
• Negative body image
  
• Unresolved resentments within the relationship
• Trust issues
  
• Lack of sexual experience
• Lack of emotional intimacy and vulnerability

And so on.

Many couples who had a satisfying sex life at the start of their relationship develop problems over time (see my articles: What is Good Sex? and Discovering Your Peak Sexual Experiences).

The problem is exacerbated when couples feel uncomfortable talking about sex (see my articles: How to Talk to Your Partner About Sex).

Since this is a big topic, I'll continue discussing it in my next article: Overcoming Sexual Desire Discrepancy in Your Relationship.

Getting Help in Couples Therapy

If you and your partner are experiencing sexual desire discrepancy, you are not alone.  

Get help from a licensed mental health professional who works with couples.

With professional help, many couples are able to overcome sexual desire discrepancy.

Rather than struggling on your own, seek help.

About Me

I am a licensed New York City psychotherapist, hypnotherapist, EMDR, AEDP, EFT, Somatic Experiencing and Sex Therapist.

I am a sex positive therapist who works 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.

Spontaneous Sexual Desire and Responsive Sexual Desire 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.

Spontaneous and Responsive Desire

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 desire is often context dependent. However, as I mentioned in previous articles, even though most women's desire is context dependent, 16% of women experience spontaneous desire.  

Sometimes, women who experience spontaneous desire get into relationships with men whose sexual desire is responsive desire or 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:

The following vignette, which is a composite of many different couples with all identifying information changed, is about the problems of a woman with spontaneous sexual desire 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 in their late 30s and dating each other for a year.

During their initial appointment with their couples therapist, who was also a sex 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 desire immediately.  

In response to the therapist's sexual assessment, 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 feel sexual desire until they got sexual with each other.  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 desire 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 explained the concept of . Then, she asked Scott if he was willing to initiate sex sometimes even if, at first, he didn't feel sexually desire at first.  Scott responded that he would be willing to do it because he knew that, once they got started, he would feel sexual.

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 (to use more brake than accelerator), savor their foreplay, and give Scott a chance to feel sexual desire.  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 having sex.  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 their sexual foreplay.  Slowing down and savoring the moment made her feel even more aroused than usual.  She liked that by the time they were both ready to have intercourse, Scott was really into it, which increased her desire. 

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.

Conclusion

Everyone is different in terms of sexual desire, and there is no right or wrong way 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.

Couples 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 insecurities and doubts can get in the way.  They often need the help of a licensed mental health practitioner who is a sex therapist 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 sex therapist.

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

Also see my articles:

Understanding Your Sexual Accelerators and Brakes - Part 1 and Part 2.

About Me

I am a licensed NYC psychotherapist, hypnotherapist, EMDR, AEDP, EFT (for couples) Somatic Experiencing and Sex Therapist (see my article: The Therapeutic Benefits of Integrative Psychotherapy).

I have over 20 years of experience helping 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 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.

Conclusion

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.