Sex & Your Mindset
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“When it comes to sex, the most important six inches are the ones between the ears.”
Dr. Ruth was ahead of her time when she made this statement.
Clients are always surprised when I begin the discussion of mindfulness in a sex therapy session. Many clients expect that sessions are inundated with “tips and tricks”. Don’t misunderstand…that is a topic of discussion at times. However, the key to embracing sexual pleasure almost always involves mindfulness. Why is that?
According to Gurney (2020), the conditions for good sex involve 3 things:
Psychological Arousal
Physical Touch
Being in the Moment
It is pretty easy to recognize that 2 of the conditions for good sex involve your mind. In this article, we will discuss those two conditions for good sex as we would discuss them in sex therapy.
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Psychological arousal pretty much refers to how you are able to take in what is happening around you and view it as erotically stimulating. This involves everything from the environment, how safe & comfortable you feel, the excitement you experience in someone’s presence, visual stimuli, eye contact, sexuality and the connection between you the your partner. Another way to consider this is how you relate to your environment from an erotic or sensual perspective. Ask yourself questions like: Does seeing her in that red dress arouse your senses? Does the timbre of his voice signal attraction for you? If these elements are piqued, arousal is afoot.
How can you maximize this, you ask? You guessed it. Mindfulness. With mindfulness, you focus every part of your being on the aspect of interest. If it is her dress, you begin to become focused on various aspects of the dress that may be easily overlooked if your focus is fragmented. You notice the seam of the dress of the side, the way the fabric moves. How it clings to her body. In a sense, you become seduced by the dress or whatever aspect on which you are focused. We naturally do this when we are introduced to something new or intriguing. We pay much more attention to the details of something new than something that we see everyday. We become mindful of every aspect and, in turn, become seduced by it. This seduction that we commit on ourselves translates to a psychological arousal. We can do the same thing with aspects of our mate. We may focus on the curvature of one’s body, the tone of voice and how it fluctuates etc. This is a psychological arousal.
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The best way to create psychological arousal is by being in the moment. Genuine presence is essentially the very definition of mindfulness. In sex therapy, we focus profoundly on keeping our thoughts in the present moment. If your focus is turned only to what is happening at the time and you allow yourself to become immersed in the moment, you allow yourself to be seduced by the little details that are easily missed when our thoughts are in the past or the future. Your focus is on being present with 100% of your being with your partner. If your thoughts are turned to the report that you need to complete while your mate is holding your hand, you are missing the connection that is literally right in front of you. Years of missing that connection gradually slides into ambivalence in the relationship.
Granted, it is completely natural to be distracted by a mental thought from the day or what is needed for tomorrow. However, the more comfortable you become with redirecting your attention to the present moment, the less pull the distractions will have. The reality is that we might exist somewhere between distraction & presence, but the closer we are to being present, the better the connection with our mate.
In sex therapy, we talk quite a bit about mindset. Our mindset is the most valuable key to sexual pleasure that we have. And it really is true that the most important sex organ is between your ears.
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Reference
Gurney, K. (2020). Mind the gap: The truth about desire, and how to futureproof your sex life. Headline Home.
4 Types of Sexual Dysfunctions & How to Cope
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What is sexual dysfunction?
Sexual dysfunction is any issue that hinders someone from experiencing satisfaction during sexual activity. Sexual dysfunction affects people of all gender identities and sexual orientations. These issues are categorized into 4 areas:
Arousal Issues: Something that impairs one’s ability to become aroused or maintain arousal.
Desire Disorders: Lack of sexual desire or interest.
Pain Disorders: Pain related to sexual activity.
Orgasm Disorders: Inability to experience orgasm or a delay in orgasm.
How common is sexual dysfunction?
Sexual issues are very common. Roughly 43% of women and 31% of men report some version of sexual dysfunction. The well-known issues include erectile dysfunction, lack of desire, ejaculation that is delayed or premature & premature or delayed orgasm.
What’s the cause of sexual dysfunction?
The causes can range from medical, hormonal, medication-induced to psychological. When these issues impact one’s emotional well-being or relationship, a sex therapist may be able to help.
What to do about sexual dysfunction
Embracing your support system or your tribe is an important first step in dealing with sexual dysfunction. Support can present via your family, friends, partner(s), medical doctor, sex therapist, etc. Talking about our issues can be therapeutic.
What prevents our from talking to our support system? Sadly, there is immense stigma surrounding sexual dysfunction. With that said, silence perpetuates the issue. People do not like to discuss their problems in general. Once you layer in the sexual component, many people find it even more difficult to discuss.
Disclosing sexual dysfunctions to your partner(s) provides them with the opportunity to be there in a supportive role & help navigate the issue effectively. While the dysfunction may only be happening to one partner, it undoubtedly affects everyone within the relationship.
Without talking about it, many people may attempt to engage in sexual activity only to end up frustrated when the dysfunction makes it difficult to perform or enjoy sex. Another common outcome is that people stop engaging in sex as often or even all together as a form of avoidance. Forced abstinence for the sake of avoiding disclosing sexual dysfunction is the antithesis of living life authentically and with joy.
Consult a Medical Doctor
Medical or psychological treatment is usually necessary for sexual dysfunctions. Consulting with your medical doctor (primary care physician, OBGYN or urologist) to assess for physical or homonal causes that should be treated medically would be the first step. In cases where medication or medical intervention is not necessary or not an option, seeing a therapist who is knowledgeable in this area can be beneficial.
Talk Therapy with a Sex Therapist
Once medical issues are ruled out after a physical examination with a physician, then therapy is a logical next step. However, if a medical condition is identified, therapy can still be beneficial as it may assist you to learn how to cope with the identified issue. Individual therapy for the person experiencing the difficulty with a trained sex therapist can be key.
The idea of working with a therapist may be intimidating, but it has the potential to be incredibly helpful. A sex therapist provides a safe space to discuss the issue and how it affects you. You will also learn techniques to help you manage it.
Couples therapy with a sex therapist can help the couple navigate the problem more effectively as a team. You and your partner can learn ways to improve the issue or how to work with the issue in ways that still promote healthy sexuality. Communication is key.
Sexual dysfunction does not have to dictate your sexual future. Men with erectile issues can still have amazing sexual connection & women who experience pain during intercourse can embrace their sexual selves.
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Sex Therapy: How It Can Improve Intimacy, Relationships, and Sexual Wellness
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First things first: What exactly is sex therapy & what does a sex therapist do?
Sex therapists are licensed mental health professionals (psychotherapists, psychologists, psychiatrists) that engage in talk therapy to assist clients in resolving mental or emotional aspects of sex-related issues. Sex therapists engage in additional education beyond licensure have a more profound understanding of human sexuality. Sex therapists use psychotherapy (talk therapy) to help clients work through sexual issues. Sex therapists work with individuals, couples & polyamorous partners.
Sex therapists can help treat various iterations of sexual dysfunction that have psychological aspects. As many relationships have a sexual component, the mental and emotional facets of our relationships play a role in sexual health. Sex therapists should work with clients in a supportive, nonjudgmental, inclusive and safe environment.
How does sex therapy help?
Sex therapists utilize various evidence-based treatments to assist clients with improving their sex lives. Most often, sex therapists use psychotherapy (known as talk therapy). Psychotherapy involves cultivating a talking relationship to establish and assess a client’s feelings, thoughts and behaviors. Options of psychotherapy for sex therapy may include:
Existential Psychotherapy.
Emotionally Focused Couples Therapy.
Mindfulness-based interventions.
Couples communication techniques.
Cognitive behavioral therapy (CBT).
Is sex therapy confidential?
Confidentiality is integral to the field of sex therapy. As part of a licensed sex therapist’s code of ethics, it is required that sex therapists prioritize confidentiality and maintaining your privacy. Psychotherapists who violate client confidentiality risk losing their ability to practice therapy.
What issues do sex therapists treat?
Sexual activity & intimacy is a complex experience that involves your emotional, mental and physical self. If one is desirous of sexual activity in any way, sexual function is an important contributor to quality of life and your well-being. If clients have sexual trauma in their history, this can also play a role in how they present sexually. Sexual trauma therapy also falls within sex therapy.
Sex therapists and sex educators view sexual activity through Rosemary Basson’s circular model sexual response cycle:
Thomas, Holly N. et al. (2016). Biopsychosocial approach to women’s sexual function and dysfunction at midlife: A narrative review.
Maturitas, Volume 87, 49 - 60
Sexual issues can arise at any point during this sexual response cycle. Understanding how you respond mentally and physically during each phase can improve your sexual experience and help you pinpoint causes of sexual dysfunction.
A sex therapist can help help you uncover the mental & emotional aspects of various types of sexual dysfunction, including:
Lack of desire.
Lack of arousal.
Difficulty having an orgasm (anorgasmia).
Difficulty obtaining or maintaining an erection (erectile dysfunction).
Sex therapists can also provide insight & education regarding:
Sex education and correcting miseducation.
Sexual trauma.
Feelings of anxiety, fear or shame related to sex.
Issues around cultural, religious and societal views of sex.
Improving communication about sex and intimacy between you and your partner(s).
Mismatched sexual desire between partners.
Relationship issues related to sexual difficulties.
Body image and its relationship to sex.
Compulsive Sexual Behavior (commonly referred to as “sex addiction”)
What happens during a sex therapy session?
During sessions, you and your sex therapist will talk together to identify and evaluate concerns and behaviors that may be interfering with your sexual life. You may see your therapist as an individual or as a couple.
During a session, a sex therapist will ask questions about your health and sexual background, sex education, beliefs about sex and, of course, your specific sexual concerns.
As sex is considered taboo in western society, talking about sex can be awkward or uncomfortable. Sex therapists understand this and aim to make you feel comfortable during these discussions. As conversation is the main part of psychotherapy, clients need to be actively involved in conversation for therapy to be effective. Trust and rapport between you and your therapist are essential to working together effectively.
At times, sex therapists may assign activities and exercises that are completed after session & in the privacy of your home. This often involves experimentation, such as role playing or activities to build trust and intimacy, either individually or with your partner.
Common Misconceptions
It’s important to know that sex therapy sessions do not involve any physical contact or sexual activity between you and your therapist. Inapporiate behavior such as sexual contact with a client is illegal & cause for the revocation of the therapist’s license to practice.
It is important to note that sex therapists are not medical physicians (unless a psychiatrist is also a sex therapist) do not treat physical or medical conditions that affect sex, such as low testosterone or hormone therapy. Many times, a sex therapist may recommend that you see a primary healthcare provider, gynecologist or urologist for any sexual function issues first to see if there are any underlying physical causes.
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Just as your medical health is integral to your well-being, so is your mental and sexual health. Sex therapists are available to help.
Betrayal Blindness in Relationship & Sex Therapy
Do you know of someone that witnessed blatant proof that their mate was unfaithful, however the reality didn’t seem to register for them? As an outsider, you are puzzled as to how they could visually see this transgression with their own eyes and still excuse it away as if it never happened.
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Believe it or not, this happens and it is psychologically based. In psychology, we like to give a name to everything under the sun except breathing. In this situation, we have Dr. Jennifer Freyd to thank for her coined phrase of ‘Betrayal Blindness’ and many reading this have undoubtedly heard of Betrayal Trauma. Betrayal blindness used to be referred to simply as denial, but it is a little deeper than that. Don’t worry, there is no DSM diagnosis for it….yet. It is more of a phenomenon.
In my experience with helping clients in relationship & sex therapy, this comes up. Not often, but it happens. The first time that I was formally introduced to the concept was during a 44 hour narcissistic abuse therapy training (yes, it was 44 hours of my life that I cannot get back….). Nonetheless, it was incredibly valuable.
Picture this: A woman walks into her husband’s office to surprise him after work hours and she happens to walk in on her husband sharing a passionate kiss with someone that is NOT her. The husband calmly walks over to the wife, walks her out and tells her that was nothing and she didn’t see what she thought she saw. The wife walks out confused, but goes home. The husband comes home later, behaves as if it was a normal day and the wife responds accordingly. Eventually, she forgets all about it and carries on.
Yes, this is a true story.
Picture this one: A woman is taking clothes out of the dryer and finds a used condom mixed in with the clothes. She initially becomes livid and confronts the husband. He makes up a story that a friend told him that masturbating with a condom on was more comfortable and less messy. She accepts the answer and never brings it up again, In fact, over time she forgets all about it.
Yes, this is also a true story.
Although this happens more often to people assigned female at birth, it can happen regardless of sex.
But HOW?
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Dr. Freyd says that this occurs typically, “when the people or institutions on which a person depends for survival significantly violate that person’s trust or well-being.” This deception does not truly register because our attachment style & behaviors overshadow betrayal detection.
Let’s consider what ingredients could lay the emotional and psychological foundation for this to happen. Here are some commonalities of the individuals to whom this can happen. Of course, these are not always the case, but these commonalities are, well…. common.
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Financially or emotionally dependent on the betrayer
The betrayed witnessed one of their caregivers betray the other caregiver or parent
Emotionally vulnerable
(possibly due to a prior emotionally troubling event such as the death of a meaningful person in their lives, something that may have shaken their confidence, becoming a new parent. Pretty much anything that places you in an emotionally vulnerable place.)
To put it plainly, because you are dependent on the betrayer in some way that is vital to your well-being, an acknowledged betrayal is simply too emotionally & psychologically disturbing to accept. Betrayal blindness often occurs in intimate relationships where one person derives their sense of identity or belonging through that relationship as opposed to deriving their sense of self independently. With that in mind, if you acknowlegde the betrayal and respond accordingly, that may place your livelihood and sense of self in jeopardy.
Remember that your mind is always trying to protect you, even if its methods are contradictory & disregard your version of logic. This process that I am laying out is not conscious for the betrayed though. The mind is a powerful protector. With that in mind, your mind will override your senses (what you saw) and convince you that that could not have possibly happened because if it did, that is the end of your world as you know it. That is just “too psychologically troubling to accept, hence it didn’t happen.” Usually at the outset, the betrayed will oscillate between awareness and oblivion. However, eventually the memory drifts into oblivion.
Something similar happens with emotional trauma, neglect and sexual trauma. Lack of conscious awareness assists the survivor to cope or even survive through the trauma, especially if this is complex trauma. Sounds like a type of freeze response, right? Exactly.
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So how do we heal from Betrayal Blindness?
Just as in sexual trauma therapy, we bring the event into awareness and address it to begin to heal.
Healing from Betrayal Blindness requires a few key ingredients. A safe, supportive relationship, the ability to emotionally face the betrayal directly or at least indirectly at first. We must also identify what is authentic to who you are and have the willingness to step back and identify toxicity. Only then, can you choose an authentic relationship if that is what you desire. Certain realizations also have to happen. Identify what scares you about facing this reality, what you stand to lose, what support system you have and identifiy how to strengthen your own will to proceed with whatever you decide meets your needs.
My style in therapy is never to judge. The reality is that we are not 16 anymore. Just walking away is easier said than done and may not be an option at that time for you. That may be a harsh reality in your life and THAT IS OK. The realities of life are real and can not be ignored. However, that does not mean that you can not spend the time that you are suspended by your obligations to strengthen yourself emotionally and psychologically. The time may not be today, but this too shall pass. When the time is right, you can ensure that you are emotionally ready to position yourself authentically.
The Ugly & Uncomfortable Truth
The uncomfortable reality is that betrayal blindness can stabilize a toxic relationship. If you have ever been in a relationship with someone that displays narcissistic patterns you are all too familiar with this reality. Unfortunately, that stability is costly. It will cost you your sense of self. By default, the betrayed relinquishes their authenticity and sense of self in order to continue on with everyday life, the kids etc. When you deem the time to be appropriate, one can confront and come to understand the betrayal. At that point, one can decide if the relationship could or should be resuscitated.
I am of the belief that whatever the betrayed ultimately decides is the right choice for them at that time. Noone can make that determination but you. Whatever you choose is the right choice for you. However, the timing of your decision, to make a move or stay, is everything.
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Reference
Freyd, J., & Birrell, P. (2013). Blind to betrayal: Why we fool ourselves we aren't being fooled. John Wiley & Sons.
Desire: Why We Want What We Can’t Have
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Have you ever been in a situation where you realized that you didn’t want something until someone told you that you couldn’t have it? It actually seemed to make you want it even more. Yeah…welcome to being human. But why are we that way?
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In the Erotic Mind, Jack Morin (1995) presents the novel Erotic Equation. This equation provides insight into why we want what we have been made to believe that we cannot have.
Erotic Equation
Attraction + Obstacles = Excitement
If you already have a base level attraction to something or someone and then you add an obstacle, you will be drawn to it or them like a moth to a flame. For instance, if you had a colleague tell you that you can’t acquire something that you want (promotion, access to something beneficial) or even simply imply a roadblock, this probably inspired you to work even harder for it. Remember the shows Lifestyles of the Rich & Famous & Cribs (yes, I am aging myself). This was built entirely on that principle. Everyone has a base level attraction to wealth, but the obstacles to wealth are abundant. Hence, you are excited to watch the show to revel over everything that you do not have. Social media presents the exact same principle. Everyone on social media is living an amazing life, hence this sparks a bit of envy, deeper attraction and, of course, excitement.
Guess what? We are born that way. Have you ever seen a kid have a full-on temper tantrum when another kid plays with a toy that they haven’t thought about in months?
So Genevieve, what does this have to do with relationship therapy or sex therapy?
Have you ever found yourself a little bit jealous when the old partner that you broke up with is now in a new relationship?
In the context of attraction & human relationships, this equation is ubiquitous. Why are some people interested in someone that is taken? This new relationship is subconsciously an obstacle to the viewer. This obstacle (and the fact that they are clearly wanted by another) can make the person even more attractive.
Even within a relationship, obstacles can exist. The people in a long-distance relationship long to see each other and become enraptured in each other when they finally meet. The person that works alot is hard to access as their obligations keep them from being easily accessible. Yep, you guessed it. That is an obstacle that could make you desire them even more. The physical or emotional distance was the obstacle. Your mate makes reference to an old flame. Psychologically, the idea of the previous lover can become an obstacle to conquer.
Even for someone that is new or unknown to you, this equation is still present. The mystery created by the unknown itself is the obstacle. Now you have created the impression of mystery because they represent “something to be figured out” and then the base level attraction is sparked to a heightened level. The distance created by the mystery becomes the obstacle.
“When you’re erotically drawn to someone new, the mystery of the unknown creates a realization of distance.”
In this, lies a valuable key to maintaining attraction in a relationship.
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If you have been in a relationship for a while and the spark seems stale, ask yourself if you have both attraction and obstacles? Sometimes sex therapy sessions revolve around how to create & maintain both aspects of this equation. Let’s find out what you & your mate find attractive or erotic and lean into that as long as it aligns with your authenticity as well. Sometimes this attraction is learned simply by asking. Other times, we have to probe and ask “the right questions.” Sex therapy sessions are all about asking the right questions.
Next, we need an obstacle.
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In order to help us conceptualize helpful & healthy obstacles, we must first consider the Cornerstones of Eroticism hypothesized by Morin (1995).
The 4 Cornerstones of Eroticism
Longing and Anticipation
Violating Prohibitions
Searching for Power
Overcoming Ambivalence
(Think something new or adventurous about which you may have previously been ambivalent)
According to Morin (1995), these cornerstones are the commonalities observed in eroticism. SO, if the obstacle that ignites someone’s attraction is longing and anticipation, having a date night on the calendar can create the sense of anticipation, which in turn, fuels the attaction toward excitement. Think of how having the next vacation on your calendar fuels your excitement. We see this longing and anticipation with long-distance relationships or when the mate is out of town as mentioned before. This can also be created by the temporary creation of physical or emotional distance. Better yet, if the obstacle that ignites someone’s attraction is violating prohibitions, someone may consider some form of role play as they may have grown up in an environment where that was seen as naughty and becomes therefore attractive. With searching for power, these may be situations where one assumes the role of being either dominant or submissive (yes, there is power in both stances).
In sex therapy, everything is open for discussion. When we discuss attraction that may have waned in the relationship, this equation is one of the first considerations. If there are deeper issues, we uncover those and face them to empower your sexual well—being & relationship fulfilment.
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Reference
Morin, J. (1995). The Erotic Mind.
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