Stephen Snyder's Blog, page 3
October 23, 2023
Interviewing Sex Surrogate Cheryl Cohen Greene
What is a sex surrogate? And how is a sex surrogate different from a sex therapist?
These questions go all the way back to the origin of both professions in the 1960’s. The simple answer is that sex surrogates get naked with their clients, and sex therapists don’t. (One might say sex therapy is the lecture course, and sex surrogacy is the lab).
Actress Helen Hunt received an Academy Award nomination in 2013 for her performance as sex surrogate Cheryl Cohen Greene in the movie The Sessions. The film wasn’t a perfect account of either sex therapy or sex surrogacy. But it took on sex, love, disability, religion, and a host of other issues with courage and grace.
A few months after writing about The Sessions, I happened to hear from Cohen Greene herself, the sex therapist whose work had been the subject of the film. She had recently written a memoir, An Intimate Life, about her life and work. We spent some time afterwards on the phone discussing many subjects of mutual interest.
Here’s an excerpt—
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So you do have orgasms with your clients?
Yes, I do. When I’m feeling like I can. But the client has to be ready.
Ready?
He’s usually still trying to perform for me. It’s hard for men just to be for themselves. They need to be able to do that, before I can let myself go with them.
Where did you learn about men needing just to be for themselves?
My husband Michael was the first man I met who could do that. Michael knew how to be selfish about his passion. Michael would get into himself, and if I didn’t follow then that was my business. He didn’t care if I had an orgasm. It was liberating. He didn’t base his masculinity on it.
And that’s what happens with a client eventually?
Sure. If and when he’s ready, when he feels more comfortable with himself and can really be present — then, if I feel excited, I might let myself go with it.
Like you did with Mark O’Brien in The Sessions?
Yes, the movie was accurate there. Sometimes afterwards a client will say, “Wow, you were there.” And I’ll say “Yes I was. I wasn’t worried about you. Just like you shouldn’t be worried about your partner.” But I have to be careful not to let myself go and move too fast if they’re not ready.
You sound a little maternal there.
I see men who have been so wounded by life experiences, and have gotten so little compassion from the people around them. Being a sex surrogate is kind of like raising kids—paying attention to them, distracting them from negative paths, coming up with ideas – “oh, let’s try this!”
Do you think being a mother influenced your work as a sex surrogate?
Absolutely. It’s like you see a child crying, and you want to know what’s going on. With a man, I’m listening and I know his story. I know what happened when he was a child, and in his early sexual relationships.
A month after Michael and I got married, I found out I was pregnant. I’d ask Michael whom he’d save in a lifeboat. He said, “You, because we could always make another baby.” Then I looked at my first baby and I told him, “Remember that lifeboat? Forget it. I’m saving the baby, and you’re going to save yourself.” He said he knew that was going to happen.
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See also:
Sex Therapist at the Academy Awards — Helen Hunt in The Sessions
Sex Therapist at the Academy Awards, Part 2 – The Courage to be Seen
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Your husband Michael was a habitual liar, rarely earned any money, and fathered children with another woman. But you stayed with him.
I LOVED him. He was the first person who told me I was intelligent. I am dyslexic, and it affected my confidence.
I still think of him a lot. In good ways.
But how did you handle your feelings about all the bad things he did? How did you become so forgiving?
Life brings you these things. You don’t let that be the end of it.
From your book, it’s clear that your husband Michael’s insisting on an open marriage was pretty traumatic for you. Yet you eventually embraced a non-monogamous married life, and it eventually led to your work as a surrogate. The line between adventure and trauma can be a confusing one for people. What’s your take on non-monogamy at this point?
I did get into it, for about a year and a half. There were about six men. Some of the sex was fantastic. But I always picked men that I knew I wouldn’t have married.
How did you handle the jealousy?
Jealousy is a cancer of the emotions. It eats you up. In Berkeley in the 70’s, Michael met another woman, and she asked me to speak to one of her women’s groups—because they were confused about my work and my lifestyle. They asked her, “Is THIS your Michael’s other partner?” I said, “No, he’s OUR partner.” They asked about jealousy. I said “I’m extremely jealous of her. She’s young, beautiful, and so intelligent. I thought he was going to leave me for her.” She said she had TRIED to get him to leave me, and that he said he loved me and wouldn’t. I couldn’t believe we were saying all this in the public in the middle of this group.
Do you think he was a sociopath?
Things happened to him when he was three years old. He awoke from anesthesia from hernia surgery, and they restrained him and send his parents away for 2 weeks. He was inconsolable for a year afterwards. He loved women, but he had to abandon them first, before they abandoned him.
Are you still non-monogamous?
When I met my current husband Bob, his qualities and ability to love were so different from what I’d experienced before. I’d never met anybody until him that I’d felt all those things for. He’s helped me understand what “unconditional” means. I’d felt that way with my kids, but to have a partner treat you that way—I’d never experienced that. After meeting Bob, I chose not to be with anyone else except him and Michael. Now since Michael has died, Bob and I are strictly monogamous (outside of my work as a surrogate).
Has growing older changed your feelings about sex?
When I was a younger woman, I felt I was being dragged around by my hormones. Now I feel I’m in the driver’s seat. I’d hold back more with clients when I was younger. I’d often masturbate after a really great session with a client—especially if I had to be careful not to use that energy with them because they weren’t ready. Now if I’m with a client and that time comes, then I just let that happen.
Sex Surrogacy For Men with AnxietySo many men have anxiety problems that interfere with their being present sexually. What works best for that?
For very shy men, we’ll start with hand or face caressing. But most clients are OK to undress in the first session. I tell men, “If you get an erection that’s fine. But you’re not going to use it the first time you get one. And 90% of guys don’t get erect the first time. So if you don’t, then welcome to the 90%.”
In the fourth or fifth session, I’ll sometimes suggest I hold their hand and stroke my own vulva with it. Kind of like using their hand as a toy.
People are so serious about sexual matters. Very few parents are saying when they see their child masturbating, “Look at you! does that feel good? I like to do that too! But right now it’s distracting me a little. Why don’t you go in your room and take your time! Don’t rush!”
In The Sessions, you’re depicted as falling in love with your disabled client. Did that really happen, or was it just added for drama?
It was added for drama. We felt really strongly about each other. We really liked each other. But it wasn’t the kind of romantic love depicted in the movie.
I want clients to understand that they will have a better experience if they respect and like the person they are with. The work I do is really not about sex. It’s about intimacy and vulnerability. It changes people’s lives when they understand they are OK and lovable.
Copyright © Stephen Snyder, MD 2014
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What Turns Men On, Really?
“Wolfgang likes to look at images of female derrieres. He prefers certain poses: bent over, legs splayed, leaning on her knuckles. He like these images so much that he is willing to pay for the privilege of looking at them. Sometimes he pays several times a day. This might seem excessive, though not exactly remarkable, except for one fact: Wolfgang is a monkey.” — A Billion Wicked Thoughts, p. 23.
Of course. A monkey in an experimental lab, where his sexual preferences are being studied. Monkey or man, the phenomenon is instantly familiar, right? We discussed the subject last year in these pages, in “Men and their computers, alone together.”
The principal sexual cues for male humans, just like for male monkeys, involve visuals of a prospective sexual partner’s anatomy. The principal male sexual cues are anatomical, and visual. Young and old, gay and straight, all around the world, men seem to want to look at body parts.
Which parts? Both gay and straight men want to see something good in the chest area (breasts for straights, pecs for gays), something appealing between the legs, and a good butt. In addition, straight men seem to have a thing for small feet.
Huh?Small feet? Sure, of course. Remember Cinderella? A Billion Wicked Thoughts quotes psychologist Donald Symons: “In the Cinderella folktales the prince is never canvassing his kingdom in search of a girl whose feet will fill out a gravy boat of a shoe.”
In one of Ogas and Gaddam’s datasets, there were 93,885 sexual searches for feet and only 5,831 sexual searches for hands. Small feet represent a minor but definite male sexual cue.
As we’ll discuss in a future article, the presence of a small but definite male attraction to feet has far-reaching implications for understanding those individuals such as foot fetishists who are exclusively attracted to feet.
We’ll recall that body part fetishists are almost exclusively men. Getting stuck on one female body part, and an atypical one at that, seems to be an inherent vulnerability of the male sexual software. More on that later.
The authors claim to have found evidence for a variety of other male sexual cues as well.
Hail to the ChiefThe sexual excitement of a man’s partner appears to be a male sexual cue. Moaning and thrashing are always appreciated.
Another cue, interestingly enough, is the presence of another male who is perceived as physically dominant. As I noted in “The strange new science behind A Billion Wicked Thoughts,” — a possible explanation for the fact that many straight men like to look at large penises.
As Chris Ryan and Cacilda Jetha discussed in Sex at Dawn, early humans may have tended to mate promiscuously. Watching a female member of the tribe have sex with the chief would have been a big turn-on for the other men of the tribe — some of whom might now get a turn with her.
The idea of male sexual cues and male sexual software is intuitively appealing. The whole construct seems reasonable, and seems to fit with our everyday experience of male sexuality.
But is Male Sexuality Really That Simple?No. It only appears simple when it’s limited to clicking images on a screen. Remember — as I discussed in “Studying sexuality — one mouse-click at a time,” the authors of A Billion Wicked Thoughts didn’t set out to study sex. Their book is limited to the cues governing desire.
In bed with a partner, your average man needs other things as well. He needs to feel valued. Appreciated. Accepted. And yes, desired. He needs to feel good about himself.
Sometimes people forget this. They buy into the idea that men are just monkeys, needing only a glimpse of female anatomy to get turned on. Yes, the sight of one’s partner with her top off can be a big plus. But her welcoming gaze can be important too.
Sometimes both men and women forget that sex is part of the relaxation response. People occasionally do it when they’re tense, but that’s the exception. For most couples, sex is a way of relaxing together.
But one wouldn’t know that simply from looking at men’s mouseclicks.
Let’s hope that the readers of A Billion Wicked Thoughts don’t interpret the authors’ findings as a general guide to male sexuality. Because if they do, then many more people will be even more misguided about sex than they are already.
You’ll notice that we’re now at the end of Part 5 of this series, and we haven’t even begun to discuss the book’s findings about female desire.
That’s going to take some time.
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Why Men Can’t Ejaculate During Sex – Cosmo May 2015
For more information about how to understand and help men who can’t ejaculate during sex, you’ll want to take a look at two blog articles:
“Advice for Men Who Have Difficulty Ejaculating”
and
“Why Some Men Have Trouble Ejaculating During Intercourse.”
Atik used our interview (excerpted below) for her discussion of “Myth #7: It’s always easy for all men to orgasm during sex.”
Here’s an excerpt from our interview:
COSMO: It’s common knowledge that women can have trouble having an orgasm during sex, but it’s pretty assumed that guys have no issue with achieving climax. Is this a false assumption? Can it be hard for a guy to climax, even if he’s got an erection?
Dr S: Yes, some men find they can’t ejaculate during sex, particularly during penis-vagina intercourse.
Many women find this to be highly insulting. So lots of these men learn to fake orgasms — which is obviously a lot easier during casual sex, if you’re wearing a condom, than in a committed relationship.
What causes “delayed ejaculation” (DE)?
Sometimes it’s just how a man is wired. Like some women, some men just have a high threshold for orgasm, and as a consequence they can’t ejaculate easily.
But men don’t have as many options when it comes to climax.
If you’re a woman who has trouble climaxing from intercourse, you can stimulate your clitoris while he’s inside you.
But a man’s most sensitive spots are usually near the tip of his penis, which during intercourse is deep inside his partner so he can’t reach it with his hand.
Some men with high orgasm thresholds learn highly specific ways of stroking their own penises to get an orgasm, and then find they can’t produce the same effect with a partner. A vagina can’t move as fast or with as much precision as a hand. It’s analogous to the challenge faced by some women who require very fast, very precise clitoral stimulation for climax – except that unlike a woman, a man can’t do that so easily during intercourse.
Some men develop DE while taking “ssri” antidepressants such as Prozac, which have the same orgasm-inhibiting effect in men as in women. And some men (for reasons that are still a bit unclear) develop the problem on erection-stimulating medication such as Viagra.
Is it true that men are not naturally monogamous?
If you mean strict sexual monogamy, then no. Men are not naturally monogamous. But neither are women.
We do seem to have strong natural instincts for pair bonding. But it’s a big leap from pair bonding to strict sexual monogamy.
Monogamy has always had more to do with property rights than with erotic pleasure.
It’s served us pretty well for thousands of years. But it’s not exactly natural.
From wearing shoes to enjoying air conditioning to practicing strict sexual monogamy, there’s not much in our lives that’s “natural” anymore.
My more recent blog articles: “Advice for Men Who Have Difficulty Ejaculating” and “Why Some Men Have Trouble Ejaculating During Intercourse” have a lot more information about delayed ejaculation, and what to do about it.
And since the 2015 Cosmo interview above, I’ve gone on to write what’s certainly one of the first sex books to focus exclusively on sexual emotions.
I believe are for most people that’s the most important part of sex.
Click HERE for more information about the book
Or click HERE to read Chapter 1 for free.
The post Why Men Can’t Ejaculate During Sex – Cosmo May 2015 appeared first on Stephen Snyder MD.
August 23, 2018
Why Some Men Have Trouble Ejaculating During Intercourse
Men who have trouble ejaculating are a misunderstood bunch.
Women’s and men’s orgasm difficulties are really very similar. As I explained in my article, Advice for Men Who Have Difficulty Ejaculating, an orgasm is really just a reflex. Male or female, people differ in what’s called their orgasm thresholds — how much stimulation they need to climax.
We’ve come a long way in understanding women’s orgasms. People now recognize that some women just need much more stimulation to climax. There’s nothing wrong with her. That’s just how she’s wired.
But our knowledge of men’s orgasm difficulties has lagged a bit. Lots of couples still put pressure on the male partner to orgasm, and they worry there’s something terribly wrong with him if he can’t.
In my previous article, Advice for Men Who Have Difficulty Ejaculating, I showed you four rules to follow if you want to make it easier for a man to climax.
Today, let’s go a little further . . .
Ask Him How He Masturbates
As a sex therapist, if you want to be able to help men who have trouble ejaculating, you need to to get comfortable asking them how they masturbate.
Men who have trouble ejaculating tend to masturbate in particular ways. The details can vary. But in working with many hundreds men with trouble ejaculating in sex therapy over the last 30 years, I’ve noticed some consistent patterns.
Here are the most common ones:
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1: “FAST”
Many men who have trouble ejaculating tend to move their hand very rapidly when they masturbate. Especially right before orgasm. To see examples of this, just watch some male porn stars in action.
Many male porn stars have trouble ejaculating. Look carefully, and you’ll see that many of them have to masturbate their own penises at the end in order to climax. If you look at their hands, you’ll often see a very quick motion — something of a blur.
It’s the same for many women who can orgasm by themselves but not with a partner. They need a very rapid stroke — which is something they can easily do by themselves, but that’s not so easy for a partner to do.
Same thing for a man who has difficulty ejaculating. He often needs to go fast at the end — which is obviously much easier to do with your own hand, since you can feel confident of not hurting yourself in the process.
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2: “FORCEFUL”
The second element of masturbation technique for many men who have trouble ejaculating is that they tend to grip the penis forcefully — more forcefully than a vagina can grip a penis, and more than a partner might dare to grip it.
Men who don’t have any trouble ejaculating tend to masturbate with a much looser grip. They may use a lubricant as well, since the skin of the penis tends to like something moist.
But for most men who have trouble ejaculating, a loose hand won’t do the trick. You need a really tight grip to get to climax.
Most men who do this kind of forceful technique while masturbating will also tell you they get a better grip with a dry, unlubricated hand. That presents an obvious disadvantage when it comes to ejaculating inside your partner’s vagina.
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3. “FRENULUM”
During masturbation, most men tend to focus strongly on a part of the penis called the “frenulum” — which is on the underside, close to the tip. Men who have trouble ejaculating often concentrate especially strongly on this spot.
To illustrate where the frenulum is, here’s a diagram — not of a penis, but of a rather famous Manhattan building, the “Flatiron Building.” One of the reasons it’s so famous is that viewed from a certain angle it looks like the underside of an erect penis.
The underside is basically just “bubble-wrap” to protect the urethra. Nature supplies both men and women with this protective tissue. And for both genders, this bubble-wrap tends to be erotic.
A woman’s urethra — and the bubble-wrap that protects it — is located at the roof of her vagina. That’s the origin of the so-called “G-spot.”
The most sensitive part of a man’s bubble-wrap is usually right under the head of his penis — just a couple of floors down from the top of the Flatiron Building, above. For most men, that’s the magic spot. That’s where most men who have trouble ejaculating tend to focus all that fast, forceful attention during masturbation.
During intercourse, his frenulum is mostly buried deep inside his partner’s vagina where it doesn’t see much action. So if he’s someone with trouble ejaculating who’s learned to need intense frenulum stimulation, it’s likely he may have trouble ejaculating during penetrative sex.
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Once you know these three basic elements — FAST, FORCEFUL, and FRENULUM — it’s easy to see why intercourse might be a problem for a man who has trouble ejaculating.
A woman’s vagina typically can’t move very fast. It can’t exert much force. And for the most part the most sensitive part of his penis, his frenulum, is buried deep inside her vagina where it doesn’t get much stimulation.
So what can be done about this?
Can Trouble Ejaculating Be Overcome By Changing Masturbation Technique?
You might think all a man who has trouble ejaculating would need in order to fix the problem would be to change his masturbation technique. to stroke his penis more slowly, and with less force, and with more attention to the entire shaft rather than just the frenulum.
That’s often worth trying. And sometimes it does help.
But it’s not always so simple. Here’s why:
Many men who end up using some variation of the FAST – FORCEFUL – FRENULUM technique use it to compensate for the fact that they have a high orgasm threshold. They develop this kind of masturbation technique because they need it — to compensate for their high orgasm threshold.
So in addition to adjusting their masturbation technique, many men find they also need to learn the methods for good partner sex that we discussed in the previous article.
On Being Accepted For Who You Are
But here’s the thing: A man’s high orgasm threshold isn’t usually something he control, or change.
Just like a woman who needs a lot of stimulation to climax. The only way you’re going to enjoy really great sex with her is to accept her as she is. Same with a man.
In my book, Love Worth Making, I call acceptance “Vitamin A” for good sex. Without enough Vitamin A, you won’t get very far.
In future articles, we’ll discuss even more techniques for managing this condition. But remember, no techniques have much chance of working unless you accept each other in bed for who you are.
That should always come first.
For more information about how to get more Vitamin A in a long-lasting relationship, check out my book Love Worth Making — available at the following online outlets, and wherever books are sold.
Or click the HERE to read chapter 1 now.
The post Why Some Men Have Trouble Ejaculating During Intercourse appeared first on Stephen Snyder MD.
August 15, 2018
Advice for Men Who Have Difficulty Ejaculating (and for their partners)
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If you’re a man who has difficulty ejaculating — or you’re the partner of a man who has difficulty ejaculating — don’t bother looking for advice on the internet, or on Amazon. You won’t find anything useful in either place.
Don’t bother asking your doctor either — or your therapist. We sex therapists who treat a lot of men with delayed ejaculation haven’t been very successful yet in educating our colleagues. So there’s still a lot of ignorance about what causes this condition, and how to treat it.
When I first started out as a sex therapist thirty years ago, I was taught that difficulty ejaculating was rare, that it was very hard to treat, and that it usually suggested deep-rooted psychological problems. We now know these are all total myths.
The reality is that difficulty ejaculating is rather common. It’s typically not that hard to treat — once you know how. And it commonly occurs in men who are otherwise quite emotionally healthy. You don’t have to be neurotic to suffer from this problem.
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Understanding Your Orgasm Reflex
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Let’s start at the beginning. Biologically speaking, an orgasm is simply a reflex. That’s true no matter which gender you are.
Your body is full of reflexes: The knee-jerk reflex, the gag reflex, the cough reflex, the sneeze reflex — they all basically work the same way. Sensory inputs get processed by the central nervous system. Then if they’re sufficiently intense, they trigger a muscular reaction.
Your orgasm reflex is a bit different, since psychological stimulation figures into it too. But the principle is the same. All the erotic inputs — physical and psychological — get added together. Then if arousal reaches a particular level — what we call a “threshold” — the reflex happens.
Women’s orgasm thresholds Vary. So do men’s. Some women have fairly low orgasm thresholds. They don’t need much arousal at all to climax. But most women’s thresholds are somewhat higher. They have to be seriously aroused in order to reach orgasm.
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Men’s and Women’s Orgasm Thresholds
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Men tend to have lower orgasm thresholds. So most men can ejaculate even if they’re not very aroused — which can obviously sometimes interfere with good lovemaking. But there are lots of men with high thresholds. Like their female counterparts, they can’t get off unless they’re seriously aroused.
Today most people understand that if a woman can’t reliably climax with a partner, that’s probably just because she’s wired to need a whole lot of arousal to reach orgasm. But a man with difficulty ejaculating will still often get dragged to sex therapy, by a partner accusing him of harboring deep psychological conflicts around sex.
Which is totally unfair. Sure, some men have deep psychological conflicts around sex — as do some women. But for most men and women, how easily you can achieve climax mostly just reflects how high your orgasm threshold happens to be.
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Sex Therapy for Men Who Have Difficulty Ejaculating
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In sex therapy, most often the presenting problem involves trouble reaching orgasm in the presence of a partner. Most women and men with high orgasm thresholds eventually figure out on their own how to get aroused enough to climax. But they have trouble doing it in bed when someone else is present.
No matter what gender you are, the fact that you can achieve sufficient arousal for orgasm by yourself — and for yourself — is a very positive sign. It means you know how to cultivate your own arousal. All that’s needed in treatment is to take your knowledge of your own arousal and adapt it to partner sex.
When I say arousal, I’m not just talking about hardness or wetness. I’m talking about a state of mind where you get highly absorbed in the experience, you lose a significant number of IQ points, and you regress to a more child-like state of wonder. What in my office I call “getting dumb and happy.”
As I discuss in my article, Sex Tips for Married Lovers, many couples think that if he’s hard and she’s wet that they’re ready to have intercourse. Big mistake. Hardness in a man, like wetness in a woman, can occur even at fairly low levels of psychological arousal.
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Men With Difficulty Ejaculating Often Have High Orgasm Thresholds
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Let’s imagine arousal — the real, authentic psychological kind — on a scale from 0 to 100. Most young men only need about a 20 to get hard. But men’s orgasm thresholds vary.
If your innate orgasm threshold happens to be a 30, you’ll probably suffer from premature ejaculation. You’ll most likely expend lots of effort trying to keep your arousal very low, in order not to ejaculate immediately once lovemaking gets started.
But let’s say you’re a man whose innate orgasm threshold happens to be an 80. That level of arousal is not always easy to achieve.
So now let’s get to the nuts and bolts. What’s the best way for a man with a high orgasm threshold to get satisfaction in bed?
Four Steps to Overcoming Delayed Ejaculation
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As a sex therapist, I’ve successfully treated hundreds of men for difficulty ejaculating. Reading an article like this is no substitute for an office consultation. But here are the basics — what I typically recommend for men whom I see in the office:
1. Pay Attention to How Aroused You Are (or Aren’t).
Remember, genuine arousal is a state of mind. It typically involves losing a bunch of IQ points, or “getting dumb and happy” — as we discussed above. Chances are, you know just how to do that when you’re by yourself, and you don’t have to worry about anyone else’s needs.
But during partner sex, many men spend so much time thinking about whether their partner is aroused that they totally neglect their own arousal.
Such men assume the fact that they’re still hard means they’re fully aroused. But that’s just wrong. If you’re a young, healthy man, you can be plenty hard during sex and still be focused on lots of other things and not be that into it.
Sure, if your orgasm threshold is a 30, you could probably still ejaculate under those circumstances. But your orgasm threshold is up around an 80 (i.e. most guys who have difficulty ejaculaing), then just going through the motions isn’t going work.
To get better results, the first thing you need to do is start paying attention to how genuinely aroused you really are.
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2. Don’t Penetrate Unless You’re Fully Aroused.
Most straight couples put a lot of emphasis on penetrative sex. There are of course lots of other ways to make love besides penis-in-vagina intercourse. But most heterosexual couples don’t feel quite right unless intercourse is somewhere on the menu.
Accordingly, the most common clinical situation in sex therapy with men who have difficulty ejaculating is that they can’t ejaculate during intercourse. One important reason men with high orgasm thresholds have difficulty ejaculating during intercourse is that they hurry to penetrate before they’re really ready.
Remember, it only takes an arousal level of 20 or so for most young, healthy men to get hard. But if you start intercourse at an arousal level of 20, you’ve got a big climb ahead to get to 80.
Sure, intercourse can be exciting. But if you’re like most men, the most exciting part is right at the moment of penetration. Like most things in life, intercourse just doesn’t deliver the same thrill on the hundredth thrust as it did on the first.
So don’t penetrate the minute you get hard. Instead, see if you can get to a 60 or more of arousal before penetration. That way, it won’t be such a big jump to get to 80 before intercourse gets boring.
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3. Be a Bit More Selfish in Bed
Having a high orgasm threshold has certain advantages. If you’re a man who has difficulty ejaculating, chances are you can have sex for hours. You can be a perfect gentleman, and make sure your partner lots of orgasms. But after being a perfect gentlemen, most men with this condition have difficulty ejaculating.
To reach orgasm yourself with a partner, you need a different approach — one that maximizes your own arousal.
Let’s say you’ve followed my advice above and waited to get to an arousal level of 60 before penetration. Good. But now that you’re fully hot and bothered, this is not the time to act like a gentleman. Now is the time to be a bit of a beast.
Assuming you have a good, trusting relationship with your partner, chances are they won’t mind if you focus entirely on your own arousal for a bit. If you’re like most men I see who have difficulty ejaculating, your partner will probably be thrilled that you trusted them enough to “really let go.”
Most partners enjoy being treated a bit ruthlessly in bed — assuming you’ve properly relished them first.
If in doubt, check with your partner of course — since people’s tastes do vary. But I’ve treated many men who had difficulty ejaculating where it turned out the main thing they needed was to know it’s okay to be a bit rougher in bed.
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4. Have a Back-Up Plan
If your orgasm threshold is an 80 and you’ve been thrusting away for a half hour or more and you’re nowhere close to being able to come, then for God’s sake please do something else!
The truth is, you can’t always reliably reach an arousal level of 80 with a partner. Some days, for whatever reason, it’s just not going to happen. A modern man with a high orgasm threshold should expect the same consideration most modern women get under the same circumstances.
Most modern couples don’t automatically expect a woman with a high orgasm threshold to climax every time. And if she wants an orgasm, most modern couples find it perfectly acceptable for a woman to give herself one in bed with a partner.
In my sex therapy office, I encourage couples to give a man who has difficulty ejaculating the same consideration. Don’t assume he has to have an orgasm every time. And if he wants one after you both feel intercourse has gone on long enough, for heaven’s sake let him pull out and give himself one.
Sure, it’s nice to ejaculate during intercourse. But make sure you have a back-up plan, just in case.
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Further Reading for Men with Difficulty Ejaculating — and for Their Partners
Lots of other factors can be involved when a man has difficulty ejaculating. In sex therapy, it can be important to consider his masturbation habits, his age, his neuro-psychological wiring, and any medications he might be taking.
But the four rules above are a good place to start.
If you’d like more advice on how to nurture your own genuine arousal — and how to enjoy it for life with someone you love — check out my book, Love Worth Making: How to Have Ridiculously Great Sex in a Long-Lasting Relationship (St Martin’s Press, 2018).
Love Worth Making is available online at any of the following retailers, and wherever books are sold.
The post Advice for Men Who Have Difficulty Ejaculating (and for their partners) appeared first on Stephen Snyder MD.
August 14, 2018
Difficulty Ejaculating: How to Manage Delayed Ejaculation
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If you’re a man who has difficulty ejaculating — or you’re the partner of a man who has difficulty ejaculating — don’t bother looking for advice on the internet, or on Amazon. You won’t find anything useful in either place.
Don’t bother asking your doctor either — or your therapist. We sex therapists who treat a lot of men with delayed ejaculation haven’t been very successful yet in educating our colleagues. So there’s still a lot of ignorance about what causes this condition, and how to treat it.
When I first started out as a sex therapist thirty years ago, I was taught that difficulty ejaculating was rare, that it was very hard to treat, and that it usually suggested deep-rooted psychological problems. We now know these are all total myths.
The reality is that difficulty ejaculating is rather common. It’s typically not that hard to treat — once you know how. And it commonly occurs in men who are otherwise quite emotionally healthy. You don’t have to be neurotic to suffer from this problem.
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Understanding Your Orgasm Reflex
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Let’s start at the beginning. Biologically speaking, an orgasm is simply a reflex. That’s true no matter which gender you are.
Your body is full of reflexes: The knee-jerk reflex, the gag reflex, the cough reflex, the sneeze reflex — they all basically work the same way. Sensory inputs get processed by the central nervous system. Then if they’re sufficiently intense, they trigger a muscular reaction.
Your orgasm reflex is a bit different, since psychological stimulation figures into it too. But the principle is the same. All the erotic inputs — physical and psychological — get added together. Then if arousal reaches a particular level — what we call a “threshold” — the reflex happens.
Women’s orgasm thresholds Vary. So do men’s. Some women have fairly low orgasm thresholds. They don’t need much arousal at all to climax. But most women’s thresholds are somewhat higher. They have to be seriously aroused in order to reach orgasm.
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Men’s and Women’s Orgasm Thresholds
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Men tend to have lower orgasm thresholds. So most men can ejaculate even if they’re not very aroused — which can obviously sometimes interfere with good lovemaking. But there are lots of men with high thresholds. Like their female counterparts, they can’t get off unless they’re seriously aroused.
Today most people understand that if a woman can’t reliably climax with a partner, that’s probably just because she’s wired to need a whole lot of arousal to reach orgasm. But a man with difficulty ejaculating will still often get dragged to sex therapy, by a partner accusing him of harboring deep psychological conflicts around sex.
Which is totally unfair. Sure, some men have deep psychological conflicts around sex — as do some women. But for most men and women, how easily you can achieve climax mostly just reflects how high your orgasm threshold happens to be.
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Sex Therapy for Men Who Have Difficulty Ejaculating
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In sex therapy, most often the presenting problem involves trouble reaching orgasm in the presence of a partner. Most women and men with high orgasm thresholds eventually figure out on their own how to get aroused enough to climax. But they have trouble doing it in bed when someone else is present.
No matter what gender you are, the fact that you can achieve sufficient arousal for orgasm by yourself — and for yourself — is a very positive sign. It means you know how to cultivate your own arousal. All that’s needed in treatment is to take your knowledge of your own arousal and adapt it to partner sex.
When I say arousal, I’m not just talking about hardness or wetness. I’m talking about a state of mind where you get highly absorbed in the experience, you lose a significant number of IQ points, and you regress to a more child-like state of wonder. What in my office I call “getting dumb and happy.”
As I discuss in my article, Sex Tips for Married Lovers, many couples think that if he’s hard and she’s wet that they’re ready to have intercourse. Big mistake. Hardness in a man, like wetness in a woman, can occur even at fairly low levels of psychological arousal.
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Men With Difficulty Ejaculating Often Have High Orgasm Thresholds
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Let’s imagine arousal — the real, authentic psychological kind — on a scale from 0 to 100. Most young men only need about a 20 to get hard. But men’s orgasm thresholds vary.
If your innate orgasm threshold happens to be a 30, you’ll probably suffer from premature ejaculation. You’ll most likely expend lots of effort trying to keep your arousal very low, in order not to ejaculate immediately once lovemaking gets started.
But let’s say you’re a man whose innate orgasm threshold happens to be an 80. That level of arousal is not always easy to achieve.
So now let’s get to the nuts and bolts. What’s the best way for a man with a high orgasm threshold to get satisfaction in bed?
Four Steps to Overcoming Delayed Ejaculation
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As a sex therapist, I’ve successfully treated hundreds of men for difficulty ejaculating. Reading an article like this is no substitute for an office consultation. But here are the basics — what I typically recommend for men whom I see in the office:
1. Pay Attention to How Aroused You Are (or Aren’t).
Remember, genuine arousal is a state of mind. It typically involves losing a bunch of IQ points, or “getting dumb and happy” — as we discussed above. Chances are, you know just how to do that when you’re by yourself, and you don’t have to worry about anyone else’s needs.
But during partner sex, many men spend so much time thinking about whether their partner is aroused that they totally neglect their own arousal.
Such men assume the fact that they’re still hard means they’re fully aroused. But that’s just wrong. If you’re a young, healthy man, you can be plenty hard during sex and still be focused on lots of other things and not be that into it.
Sure, if your orgasm threshold is a 30, you could probably still ejaculate under those circumstances. But your orgasm threshold is up around an 80 (i.e. most guys who have difficulty ejaculaing), then just going through the motions isn’t going work.
To get better results, the first thing you need to do is start paying attention to how genuinely aroused you really are.
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2. Don’t Penetrate Unless You’re Fully Aroused.
Most straight couples put a lot of emphasis on penetrative sex. There are of course lots of other ways to make love besides penis-in-vagina intercourse. But most heterosexual couples don’t feel quite right unless intercourse is somewhere on the menu.
Accordingly, the most common clinical situation in sex therapy with men who have difficulty ejaculating is that they can’t ejaculate during intercourse. One important reason men with high orgasm thresholds have difficulty ejaculating during intercourse is that they hurry to penetrate before they’re really ready.
Remember, it only takes an arousal level of 20 or so for most young, healthy men to get hard. But if you start intercourse at an arousal level of 20, you’ve got a big climb ahead to get to 80.
Sure, intercourse can be exciting. But if you’re like most men, the most exciting part is right at the moment of penetration. Like most things in life, intercourse just doesn’t deliver the same thrill on the hundredth thrust as it did on the first.
So don’t penetrate the minute you get hard. Instead, see if you can get to a 60 or more of arousal before penetration. That way, it won’t be such a big jump to get to 80 before intercourse gets boring.
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3. Be a Bit More Selfish in Bed
Having a high orgasm threshold has certain advantages. If you’re a man who has difficulty ejaculating, chances are you can have sex for hours. You can be a perfect gentleman, and make sure your partner lots of orgasms. But after being a perfect gentlemen, most men with this condition have difficulty ejaculating.
To reach orgasm yourself with a partner, you need a different approach — one that maximizes your own arousal.
Let’s say you’ve followed my advice above and waited to get to an arousal level of 60 before penetration. Good. But now that you’re fully hot and bothered, this is not the time to act like a gentleman. Now is the time to be a bit of a beast.
Assuming you have a good, trusting relationship with your partner, chances are they won’t mind if you focus entirely on your own arousal for a bit. If you’re like most men I see who have difficulty ejaculating, your partner will probably be thrilled that you trusted them enough to “really let go.”
Most partners enjoy being treated a bit ruthlessly in bed — assuming you’ve properly relished them first.
If in doubt, check with your partner of course — since people’s tastes do vary. But I’ve treated many men who had difficulty ejaculating where it turned out the main thing they needed was to know it’s okay to be a bit rougher in bed.
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4. Have a Back-Up Plan
If your orgasm threshold is an 80 and you’ve been thrusting away for a half hour or more and you’re nowhere close to being able to come, then for God’s sake please do something else!
The truth is, you can’t always reliably reach an arousal level of 80 with a partner. Some days, for whatever reason, it’s just not going to happen. A modern man with a high orgasm threshold should expect the same consideration most modern women get under the same circumstances.
Most modern couples don’t automatically expect a woman with a high orgasm threshold to climax every time. And if she wants an orgasm, most modern couples find it perfectly acceptable for a woman to give herself one in bed with a partner.
In my sex therapy office, I encourage couples to give a man who has difficulty ejaculating the same consideration. Don’t assume he has to have an orgasm every time. And if he wants one after you both feel intercourse has gone on long enough, for heaven’s sake let him pull out and give himself one.
Sure, it’s nice to ejaculate during intercourse. But make sure you have a back-up plan, just in case.
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Further Reading for Men with Difficulty Ejaculating — and for Their Partners
Lots of other factors can be involved when a man has difficulty ejaculating. In sex therapy, it can be important to consider his masturbation habits, his age, his neuro-psychological wiring, and any medications he might be taking.
But the four rules above are a good place to start.
If you’d like more advice on how to nurture your own genuine arousal — and how to enjoy it for life with someone you love — check out my book, Love Worth Making: How to Have Ridiculously Great Sex in a Long-Lasting Relationship (St Martin’s Press, 2018).
Love Worth Making is available online at any of the following retailers, and wherever books are sold.
The post Difficulty Ejaculating: How to Manage Delayed Ejaculation appeared first on Stephen Snyder MD.
August 5, 2018
Women’s Sexual Desire, and Why Men Often Don’t Recognize It
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We’ve learned a lot about women’s sexual desire in the last few decades.
Back when sexologists were mostly male, sexual desire—or “libido” —used to be thought of as like some kind of hydraulic pressure in the body. Like the pressure most young men feel when they need to ejaculate.
But the hydraulic model doesn’t fit the facts of most women’s sexual desire. Most women need a reason to have sex. Otherwise, they might go for a long time without feeling desire.
Men need a reason to have sex, too. But for most men, the reason can be as simple as your partner taking off their shirt.
Most men’s minds tend readily to say “yes” to sex. Whereas most women’s minds tend to say “maybe,” or “that depends.”
As a sex therapist, when a straight couple comes to see me because they aren’t having sex, the male partner is almost always still regularly masturbating. Often the women has stopped masturbating, or does it only rarely.
In the absence of satisfying sex, it’s as if the woman’s sexual desire has just gone to sleep. Like the screen-saver program on an old-fashioned desktop computer, a woman’s sexual desire system will often stay in “sleep mode” until someone moves the mouse.
As I discuss in the video below, the most important way to move the mouse is simply to have good sex:
Women’s Sexual Desire and the Definition of Good Sex.
Of course that leaves open the question of just what constitutes good sex, right? People have widely different opinions, of course.
But having discussed the subject with many hundreds of people over the years, I think most people’s notions of good sex would involve getting authentically aroused– not just hard or wet.
As I discuss in my article, Sex Tips for Married Lovers, authentic arousal requires more than hardness or wetness. By my definition, you’re not really aroused unless you’ve lost a lot of IQ points.
Real authentic arousal should also make you feel good about yourself. And good about your partner too—in a primal way that just says “YES, that’s the stuff I like!” Otherwise your mind can easily go into screen-saver mode, and sexual desire can turn off completely.
But many couples don’t know how to recognize authentic sexual arousal. They think if they’re hard or wet, they’re ready to have sex. That leads to a lot of bad sex, since hardness and wetness just aren’t sufficient to move the mouse.
You can’t nourish desire with bad sex. Only good sex can nourish desire in a committed relationship.
Obvious, huh? You’d be surprised. Many couples I see in my office have never bothered to reflect on those simple facts.
How Women’s Sexual Desire Confuses Men
As a sex therapist, I’ve noticed that heterosexual women’s sexual desire sometimes confuses men. They miss it completely.
Here’s why: Many women don’t just want sex. They want to feel desired first — as I discussed in an earlier article.
If a woman doesn’t feel desired first, then the sex itself may not seem so appealing.
Wait, you say. Doesn’t everyone know how important it is for most women to feel desired?
You’d be surprised. I see many men in my office who have no clue how important this is for women’s sexual desire.
Now here’s something that I find baffles most men: In order to feel desired, a woman may sometimes actually move away from her partner — in the hopes he’ll come running after her.
That’s so foreign to the average male mind that few men understand it at all.
When talking with men in my office, I’ll often cross species lines and illustrate with the following example:
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What Men Can Learn from the Sexual Behavior of Female Rats
I once attended a sex therapy convention where researcher Jim Pfaus showed videos of rats having sex. The most interesting part turned out to be the foreplay.
By human standards, male rats are all premature ejaculators — so rat sex is typically very short-lived. But rat foreplay can go on for a long time.
Here’s typical rat foreplay:
The female rat runs in front of the male rat, gets his attention, then darts away. With any luck, he’ll be interested enough to chase after her. He might chase her around the cage for a long time, before she finally lets him have her.
The female rats tend to like to prolong all this running around. And more than one sex researcher has wondered whether the female rats enjoy this strange kind of foreplay more than the actual sex.
Many people have noted that the whole thing looks suspiciously like what sometimes during heterosexual human mating: how women’s sexual desire often seems to be as much for the pleasure of being chased as for what happens afterwards.
“Juego” and Women’s Sexual Desire
Now of course there are exceptions. Just as there are exceptions to every generalization you might make about sex and gender. There’s a tremendous amount of diversity in human mating. In an article in PsychologyToday, I discussed the fact that some men have an unusually strong yearning to be desired too.
But the fact that many women’s sexual desire can manifest by a wish to run away ordinarily causes a lot of mischief in heterosexual couples. So it’s a crucial thing for a man to understand.
In an earlier article, I quoted from an article my colleague Esther Perel who described one of her Spanish-speaking clients playing a game she called “Juego.”
To play “Juego,” the first thing is to make yourself not a bit unattainable. If your partner responds by pursuing you, you’ve won the game.
For many men, the hardest thing about playing “Juego” is to realize there’s a game going on in the first place.
A lot of men will just greet their partner’s unavailability with a shrug of the shoulders and go do something else — which of course defeats the whole purpose. Then they’re surprised that she’s angry or frustrated.
Take home message: If you’re in a committed relationship, notice when she might be pulling away from you. If that happens, keep in mind the possibility this is a manifestation of her desire — and that like the female rat, she may be hoping to begin a chase.
Just keep that in mind. You can thank me later..
You’ll find more actionable advice on how to make sense of men’s and women’s sexual desire in my book, Love Worth Making.
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Available wherever books are sold — as well as online from the following booksellers . . .
The post Women’s Sexual Desire, and Why Men Often Don’t Recognize It appeared first on Stephen Snyder MD.
July 22, 2018
Sexual Desire: Why It Goes Missing, and How to Get it Back
Why It’s Normal to Lose Sexual Desire
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Sexual desire, and how to keep it going in a relationship, can be a bit of a mystery.
But don’t feel bad. It’s a mystery to most sex experts as well. In this article, I’ll show you how sexual desire really works, and why it doesn’t always behave the way you want it to.
I’ll also introduce you to a new way of looking at desire problems—not in terms of what causes them, but in terms of what perpetuates them.
When we’re done, you’ll have a better sense of what to do—and what not to do—when desire goes missing.
There’s been a lot written about loss of sexual desire in committed relationships. Which of course makes sense, since loss of sexual desire typically only becomes a problem when you’re in a relationship.
But as a sex therapist, when I looked around for something good to recommend to my patients about sexual desire, I couldn’t find anything adequate on the subject. So after many years, I ended up writing my own book, Love Worth Making—from which much of what you’ll read here is taken.
I hope you come away from reading this article with some fresh ideas on the subject—and with some new ideas for how to keep sexual inspiration alive in your own relationship. First though, some background:
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Sexual Desire Isn’t Simple
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For a long time, sex researchers never attempted to study sexual desire.
That may have been good judgment on their part, since it’s a confusing subject. In the 1950’s and ‘60’s, Masters and Johnson limited their field of study to what they called the “sex response cycle,” which was all about getting more blood flow to the genitals and preparing for orgasm.
Desire never really figured into it.
Later, in the 1970’s, Helen Kaplan understood there was something missing from the Masters and Johnson model. Her solution was to tack on something called “desire” at the beginning of Masters and Johnson’s “sex response cycle”.
The idea had a kind of intuitive appeal. After all, you obviously need something to get sex going. But there never was really much science behind it.
Now many years later, sexual desire is still a murky subject. Sex researchers these days even debate whether sexual desire and sexual arousal are really two separate things at all. .
Why A Woman’s Sexual Desire is A Bit Different
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Back when sexologists were mostly male, sexual desire—or “libido” —used to be thought of as some kind of hydraulic pressure in the body. Like the pressure most young men feel when they need to ejaculate.
Most people in the world still think of desire this way—as some kind of hydraulic force seeking an outlet. But the hydraulic model doesn’t fit the facts of most women’s sexual desire.
Most women need a reason to have sex. Otherwise, they might go for a long time without feeling desire.
Men need a reason to have sex, too. But for most men, the reason can be as simple as your partner taking off their shirt.
Most men’s minds tend readily to say “yes” to sex. Whereas most women’s minds tend to say “maybe,” or “that depends.”
As a sex therapist, when a couple comes to see me because they aren’t having sex, the male partner is almost always still regularly masturbating. Often the women has stopped masturbating, or does it only rarely.
In the absence of satisfying sex, it’s as if her sexual desire or “libido” has just gone to sleep. Like the screen-saver program on an old-fashioned desktop computer, a woman’s system will often stay in “sleep mode” until someone moves the mouse.
As I discuss in the video below, the most important way to move the mouse is simply to have good sex:
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Is the Sex You’re Having Worth Desiring?
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Of course that leaves open the question of just what constitutes good sex. People have widely different opinions, of course.
But having discussed the subject with many hundreds of people over the years, I think most people’s notions of good sex would involve getting authentically aroused– not just hard or wet.
As I discuss in my article, Sex Tips for Married Lovers, authentic arousal requires more than hardness or wetness. By my definition, you’re not really aroused unless you’ve lost a lot of IQ points.
Real authentic arousal should also make you feel good about yourself. And good about your partner too—in a primal way that just says “YES, that’s the stuff I like!” Otherwise your mind can easily go into screen-saver mode, and sexual desire can turn off completely.
But many couples don’t know how to recognize authentic sexual arousal. They think if they’re hard or wet, they’re ready to have sex. That leads to a lot of bad sex, since hardness and wetness just aren’t sufficient to move the mouse.
You can’t nourish desire with bad sex. Only good sex can nourish desire in a committed relationship.
Obvious, huh? You’d be surprised. Many couples I see in my office have never bothered to reflect on those simple facts.
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The Accelerator and the Brake
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Another thing wrong with the old “hydraulic model” of libido is that sexual desire has both positive and negative inputs. It has an accelerator and a brake.
Your sexual mind takes account of everything in the moment that might make you want to have sex, and everything that might make you not want to have sex. Then your sexual mind turns desire on or off, depending on the outcome.
That’s true of both women’s and men’s desire. But ordinarily men’s brakes aren’t as sensitive. For many women, the fact that there are unwashed dishes in the sink can seriously interfere with desire.
For a man, that would be rare.
There are many other reasons a woman’s sexual mind might keep its foot on the sexual brakes. Stress and exhaustion would certainly top most modern women’s list. Then there’s hating your body; feeling angry, depressed, or worried; painful intercourse; too much pressure to have an orgasm; bad sex in general; or any combination of the above.
Trauma from your past can make you not want to have sex—sometimes years or decades later, when you least expect it. So can being abused or mistreated by your partner. Or knowing there’s no future in the relationship, but not being quite ready to leave.
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A New Category of Things That Ruin Sexual Desire
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In my book, Love Worth Making, I discuss a new category of things that can be relevant to sexual desire.
Things in this category don’t necessarily cause low sexual desire. Instead, they tend to perpetuate it.
These things tend to be just ordinary negative reactions to sexual disappointment. But negativity tends to be un-erotic, which obviously creates further impediments to desire.
In my book, I call these phenomena “sex-knots.” A sex-knot is when your natural reaction to a sex problem ends up making that problem worse. Let me show you some examples: .
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Sex-Knot #1
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You have no desire for sex.
You think, “There must be something wrong with me.”
…..Now you definitely have no desire for sex. .
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Now obviously you don’t even need a partner to get caught in the above sex-knot. It’s one you can tie all by yourself. But the majority of sex-knots require two people.
As in the following example:
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Sex-Knot #2
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. You lose desire.
……Sex begins to feel like an obligation.
……That makes you really lose desire.
“Obligation sex” can be a real desire-killer. It doesn’t take long for most low-desire people to figure that obligation sex isn’t the answer. But then there’s still the problem of what to do with a partner who’s still interested.
Under the circumstances, many women start avoiding anything that might turn their partner on. No sexy underwear. No lingering kisses. Nothing that might put them in the uncomfortable position of having to say no. It’s easy to see where this might lead: .
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Sex-Knot #3
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You have no desire.
….You worry that if your partner gets turned on, they’ll get frustrated and angry. ….So you shut yourself down sexually.
….Now you totally have no desire.
You might even start staying up later and later at night, hoping your partner will be asleep by the time you get to bed. Some couples’ bedtime rituals become an intricate dance around the question of whether they’re going to wind up in bed awake together or not.
Loss of sexual desire can start out quite innocently and understandably, and then turn into something bigger that involves your whole attitude towards lovemaking.
It’s crucially important to identify sex-knots. Unless you accurately identify and correct them, they’re likely to keep perpetuating states of low sexual desire.
The sex-knots above are all from Chapter 10 of my book, which is a chapter entirely devoted to women’s sexual desire issues. Chapter 11, which addresses men’s desire issues, features a whole different set of sex-knots.
Sex-knots are so important for sex therapy that I added a whole separate section at the end of Love Worth Making, with descriptions of the most common ones – and instructions for how to untie them. .
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Taking Action
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Loss of sexual desire can have major repercussions on your relationship with your partner. It doesn’t necessarily mean there’s anything wrong with your relationship. Desire comes and goes in any relationship. Sometimes you feel it, and sometimes you don’t—as I explain in the following video:
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But loss of desire can be an indicator that you need to take stock of your sexual state of mind.
You’ll want to ask yourself, “Is the sex we’ve been having really worth desiring? If not, what’s missing? Am I in some way “stepping on the brake”? If so, why?
Knowing a bit about “sex-knots” (above), you might also want to ask yourself, “Is my reaction to my own lack of desire perpetuating the problem?”
It can be useful to ask such questions. But just knowing the answers won’t always fix the problem. As every sex therapist knows, you can’t resolve a sex problem just by thinking about it, or even by talking about it.
If you’re like most couples I work with, you also need an action plan. Fortunately, there are things a couple can do to have good sex—even in the absence of sexual desire. In my article, Sexless Marriage, and What To Do If It Happens to You, I’ll show you some simple methods for “tuning up” together as an erotic couple—even if one or both of you aren’t feeling much sexual desire at all.
Desire problems are among the most common reasons couples come to sex therapy. Happily, these days there’s a lot we can do to help.
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My book, Love Worth Making, goes into much more detail about what we sex therapists actually do in the office. About how sex therapy really works. And about making sure the sex you’re having is really worth desiring in the first place.
Love Worth Making is available online from the following booksellers . . .
The post Sexual Desire: Why It Goes Missing, and How to Get it Back appeared first on Stephen Snyder MD.
June 17, 2018
Sexless Marriage, and What To Do If It Happens to You
and “Nearly-Sexless” Marriage
There’s sexless marriage. And then there’s “nearly sexless marriage” — where a couple might only have sex a few times a year. Or as one patient of mine, an insurance executive, described it — “on a quarterly basis.”
If sex on a quarterly basis feels like enough for you, that’s fine. But in my experience, most couples with sexless or nearly sexless marriages consider it a problem and wish things were otherwise.
Sexless marriage is one of the commonest reasons couples come in for sex therapy. It’s been said that sex is 20% of a marriage when it’s going well, but 90% when it’s not. Feelings of inadequacy are common. So are feelings of shame — especially if you assume all the other couples you know are having awesome sex lives.
But the truth is that sexless or nearly-sexless marriage is very common. Conservative estimates put the prevalence at 15% of American couples (1). So chances are, at least some of your friends and neighbors are in the same boat.
Check out the following video for a quick overview:
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What Causes Sexless Marriage?
There are as many different stories as there are couples.
But here are a few common plot lines:
1. Bad Sex
If for whatever reason one or both of you aren’t enjoying the sex you’re having, then it’s not surprising you wouldn’t want to do it. As I discussed in my article, The One Sex Tip You Need For a Long-Lasting Relationship, some couples lack basic knowledge of how sexual feelings work.
Any of the so-called “sexual dysfunctions” (vaginismus, pain on penetration, erectile dysfunction, premature ejaculation, etc) can make you feel bad about yourselves as a couple. And feeling bad about yourselves is not exactly an aphrodisiac for most people.
2. Bad Feelings
Sometimes the reason has nothing to do with sex. If you’re like most people, how you feel about yourself as a person has a direct connection to how much you’re able to enjoy yourself in bed. To quote one of my favorite sex writers, Julia Heiman, “Often sex is a nonverbal expression for what is avoided or inaccessible verbally, such as marital unhappiness, a power struggle, emotional emptiness, or existential anxieties or losses (2).”
You’d be surprised how many couples expect themselves to have sex despite the fact that they hate each other. And many other couples suffer from unresolved grief or trauma, or the other life difficulties that sap their sexual connection. To add another twist, sexless marriage itself can be a potent source of emotional unhappiness.
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3. Loss of Desire
Sometimes one or both partners may lose their libido entirely, even when the sex has been reasonably good. This appears to be more common in women. The causes of loss of desire are endless. Biological, psychological, and social factors commonly come into play.
Loss of desire can be global — where nothing makes you feel sexually interested anymore. But sometimes it’s just loss of desire for your mate. Some wives in sexless marriages continue to masturbate, and some don’t. But almost all husbands in sexless marriages are masturbating in private.
The Westermarck Effect
Regardless of whether your sexless marriage is the result of bad sex, emotional unhappiness, or loss of desire, there’s something specific that eventually happens in almost every case of sexless or near-sexless marriage that makes the condition much more likely to remain permanent. Psychologists call it The Westermarck Effect — for Finnish sociologist Edvard Westermarck, who noted that people raised together as siblings don’t ordinarily regard each other as potential sex partners.
Following Westermarck, most researchers today assume there’s a basic biological mechanism at work here. If you live with someone for a long period of time and don’t have sex together, you begin to feel like siblings to each other.
That’s exactly what happens to people in sexless marriages. They eventually begin to feel like siblings. The incest taboo accidentally kicks in, and once this happens sex can start to feel pretty awkward.
For this reason, as a sex therapist I advise couples in sexless marriages to take action as soon as possible, and not wait months or years to do something about it. And when a couple in a sexless marriage starts taking steps to reverse the process, I tell them to expect that the first few times are going to feel awkward. That’s normal — The Westermarck Effect in action.
So What’s A Sexless Couple To Do?
For most couples, The Westermarck Effect dictates that you can’t just jump in bed together and expect good sex right off the bat. In addition to knowing beforehand that things might feel awkward at first, I usually recommend couples start by first spending some time getting in tune again.
We sex therapists have a long tradition of recommending “warm-ups” for couples — from Masters and Johnsons’s “sensate focus” to this decade’s “mindfulness.” My new book Love Worth Making: How to Have Ridiculously Great Sex in a Long-Lasting Relationship shows you both of these techniques.
What I usually recommend for sexless marriage couples in my office is something a little different — a technique I developed myself, that I discuss in Chapters 6 and 15 of Love Worth Making. I call it “The 2-Step.” Here’s how it works:
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Step One
Step One is basically a mindfulness practice. Spend some time in bed doing nothing together. Most couples prefer to be naked, but do whatever makes you feel most comfortable.
If you like, you can talk about whatever is on your mind—good, bad, or indifferent. Anything at all. It doesn’t have to be erotic. But keep it simple. No big discussions.
When you feel you’ve talked as much as you need or want to, see if you can give yourselves permission to just be together quietly, doing nothing.
This might not feel erotic at all at first. That’s fine. Sometimes you may just need time to quiet down a little. But in time that quiet can be the soil from which arousal grows.
The key to Step One is that your only goal at first is to do nothing at all. So often we get so wrapped up in our emotions that we lose sight of the simple elements of experience — our breathing, the sensation of our bodies against the mattress, the temperature in the room.
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Step Two
At some point during Step One, you may notice feelings of arousal. If that happens, just enjoy it for its own sake. Arousal isn’t all-or-none. Sometimes it can be rather subtle – a private, inward thing.
Take your time. Just focus on your moment-to-moment experience of arousal.
If you’re like most people in sexless couples, this will feel awkard at first.
Just notice the awkward feeling, without getting too involved with it.
Sometimes awkward feelings like this will pass, if you don’t get too emotionally involved.
The key to Step Two is to experience arousal for its own sake, without feeling like you have to do anything about it. Too many couples assume that every time they get aroused, they have to extinguish it with an orgasm — as if arousal was something irritating or unpleasant.
Instead, think of arousal as something warm and nourishing. If you’re like most people in sexless marriages, you’ll want to let that warm feeling sustain a bit, before acting on it fully.
If you both want to have sex, then sure — go ahead.
But here’s the thing:
What ultimately heals a relationship is usually not the sex. More often, it’s the time you spend in bed just being in the moment together, doing nothing at all.
Copyright 2018 Stephen Snyder MD
Parker-Pope, T: When Sex Leaves the Marriage. New York Times “Well” June 3, 2009.
Heiman JR, Epps PH, Ellis B: Treating Sexual Desire Disorders in Couples. In Clinical Handbook of Couple Therapy, Ed. Jacobson NS and Gurman AS. NY: The Guilford Press, 1995
Westermarck, E: History of Human Marriage. Johnson Reprint. 1975 (original 1921). ISBN 0384669549
Love Worth Making launched Feb 2018 from St Martin’s Press.
It’s been hailed by New York Times bestelling author Dr Christiane Northrup as “Hands down, the most practical, fun, and empowering book I’ve ever read on how to have a fabulous sex life in a committed relationship.”
ABC News Chief Women’s Medical Correspondent Dr Jennifer Ashton said, “Love Worth Making does for sex therapy what Hamilton did for the Broadway musical. This playful yet profound book reminds us that sex should be easy―and can be, once we learn how to get out of our own way.”
Order your copy today!
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How Do I Find A Sex Therapist?
What Makes A Sex Therapist Different?
Finding a good sex therapist isn’t easy. If you’re suffering from a sexual problem, it’s crucially important that you see someone who understands the difference between a sex therapist and a “regular therapist.”
Often a “regular therapist” will advertise themselves as a sex therapist, when they’re really not — which can lead to a lot of wasted time and money.
If you have a sex problem, don’t assume just any therapist will be able to help you. As a sex therapist, I see many individuals and couples who’ve spent years in conventional psychotherapy and not gotten any help at all with sex.
Here’s how to tell the difference:
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1. A Sex Therapist Wants to Know All the Details
It’s not enough to just hear someone describe their sexual problem. If you’re a woman who has pain during intercourse, it’s crucially important to know whether the pain is on initial penetration, or on deep thrusting. And whether it’s all the time, or only some of the time. If you’re a man with difficulty ejaculating, a sex therapist will want to know the details of how you masturbate.
A sex therapist wants to know everything that goes on in bed – and in your head. Who does what to whom? And how does that feel? Then what happens next, and why?
As a great architect once said, “God is in the details.” The tiniest details can sometimes contain the solutions to a couple’s sexual problem.
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2. A Sex Therapist Is Interested in NOW
Your sexuality is clearly influenced by your experience in life – not just your sexual experience, but also your experience of being loved, appreciated, and listened to, going all the way back to childhood. Those experiences carry a lot of weight.
Unfortunately, most therapists, on hearing that you were abandoned as a child, will want to spend weeks talking with you about it. Sometimes that can be helpful, but often it’s not. And it can be particularly un-helpful if in the meantime you’re struggling with a sexual problem that’s not getting any better as the weeks go by.
A sex therapist appreciates full well the importance of the fact that you were, say, emotionally abandoned as a child. But a sex therapist also knows that if you don’t get help for your sex problem, you’ll soon feel emotionally abandoned in therapy as well.
The solution, as every sex therapist knows, is to deal first with the immediate causes of the sexual problem – then deal with other more “remote” causes later on.
Your sexual mind is very simple. It just wants to feel good. You can’t resolve a sexual problem if you keep having discouraging experiences in bed. The only way to heal a sexual problem is by having good experiences in bed. For most people, that has to come first.
Much of regular therapy, typically, is about pain. The therapy itself is often very hard work. But a couple can stay in pain for years in therapy, and still not resolve their sex problem.
As every sex therapist knows, sex therapy is not about pain. It’s about feeling good. Unless the therapy helps you feel good, nothing productive is going to happen.
Which brings me to the final way a sex therapist differs from a regular therapist . . .
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3. A Sex Therapist Wants You to Take Action
Talking with someone in therapy, or with your partner in therapy, can be very important. But talking will only get you so far. If you’re not taking action in the bedroom, then chances are nothing much is going to happen.
After a first consultation session, a sex therapist will typically recommend that an individual or couple do something specific at home – both to get experience doing it a better way, and to gather more data.
After seeing a sex therapist for the first time, you’ll want to come away with a specific action plan – of things you can do right away, to get you on the road to feeling good again.
Sex problems tend to make people feel terrible about themselves. As a sex therapist, I feel it’s crucially important that someone feel better when they leave my office, than when they walked in.
If you’re struggling with a sex problem, there’s never been a better time to get help. Just make sure you see someone who has lots of experience helping people with sex problems.
Make sure you see someone who can give you a sense of hope – and an actionable plan for turning that hope into reality.
OK . . So How Do I Find Someone Like That?
Simple: Both the Society for Sex Therapy and Research (SSTAR) and the American Assocation of Sex Educators, Counselors, and Therapists (AASECT) have search directories where you can search for someone in your area. They hyper-links above will take you there directly.
One you have some names, call each one up and talk with them about the 3 issues I mentioned above. Some therapists will have this information on their websites already, as I do on my Frequently Asked Questions page. And with some, you’ll need to specifically ask.
Don’t be afraid to ask a potential therapist whether they have particular experience with the specific sex problem you have — including how many patients they’ve seen with this issue.
And if you want to be a really informed consumer, check out my book, Love Worth Making. It’s not a substitute for seeing a sex therapist, but it will give you a fair idea of what goes on behind the office door.
Copyright 2018 Stephen Snyder MD
Love Worth Making launched February 13, 2018, from St Martin’s Press, and was immediately hailed by New York Times bestelling author Dr Christiane Northrup as “Hands down, the most practical, fun, and empowering book I’ve ever read on how to have a fabulous sex life in a committed relationship.”
Order your copy today!
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The post How Do I Find A Sex Therapist? appeared first on Stephen Snyder MD.
