The "L" word, Sex

Those of you who read this blog regularly know that I rarely use the "S" word.

That John Lennon Song, Mind Games

And yet, here we are, associating it with the "L" word, Love. Is that even politically correct?

Sex in some relationships has been described as marital glue. It is what keeps many couples together when all else fails. Sometimes, it shouldn't, keep them together. Sometimes we're glad it did.

It sells.  Boy, does sex sell. It would seem that without it, nothing sells.

Twenty-five percent of divorced couples blame sex.

People like me are called upon to treat it, to treat problems with it, problems about it (cheating, sexual assault).  You would think everybody wants it, sex, but that's certainly not true at all.

Some merely want to express love in a physical way, and that it can be, an expression.

We've discussed how to use code to signal one's willingness for it, how that can be romantic.

"Honey, come into the bedroom, I have something I want you to look at."  

Or perhaps better,

"Kids, we're taking a nap.  Keep the fighting down."  

Other posts about it have suggested that problems with the mechanics, especially, are usually problems with communication. It is also difficult to communicate about because what we want feels so . . . private. To communicate about private things we have to feel safe, we have to trust. We all have numerous reasons not to do that, not to trust. Yet trust in a relationship that is sexual is everything.

Ironically, many singles assume sex to be a natural, safe part of their relationship. They trust too much and sometimes get burned, come to therapy to talk about it. That lovely piece of themselves, the part that trusted others in relationships erodes, changes. That is something to mourn.

But it is a coming of age thing, too. We really shouldn't trust just anyone. And trust, guess what-- has to be earned-- usually over time.  Lots of time.

A sex therapy is a type of relationship therapy. Meaning it is about both, trust and communication, that old faithful of any therapy, really.  If a couple can't communicate about how to load a dishwasher, then communicating about their most sensitive desires is going to be difficult, too.

"This way!"
"NO! This way!"

Not loving, not at all.

Oh, let me segue, it's my blog. 

I am always amazed at how the Old Mighty determined the male and female anatomy to be so different. (The Old Mighty is the way my grandfather referred to the Creator of the Universe). She worked it so that we have no intuitive knowledge about how the apparatus (fine, anatomy) of the opposite sex operates, even feels.*  Here we are, so alike, and yet in this difference, and those differences in our brains, we're only able to empathize with one another if we talk pointedly about ourselves. Leave the code at home.

My hunch is that we're made differently because where there is pleasure, cheap, clean, unadulterated pleasure, we are motivated to communicate to share it.

And the beat goes on.

I want to blame television, the movies.  In the media it seems to be all about intercourse, nothing else.  Someone doing someone. Even this language, seriously.  Doing? Think of the scenes you've seen on Madmen or another show. Doesn't the emphasis seem to be on penis-vagina sex, except for an occasional on-your-knees job, a sacrifice to make someone happy.

As a young trainee at Loyola University Medical School's Sexual Dysfunction Clinic in the 80's, I almost fell off my chair when Domeena Renshaw, a pioneer in the field, pronounced,

"Only one in five couples have successful intercourse." (Meaning both partners experience orgasm.)  "We just aren't made that way." (Meaning that we will both be satisfied during intercourse.)

Then she proceeded to show us slides that clearly indicate that the clitoris isn't in a physiological position to be especially excited by the penis. Location, location, location.  During intercourse the clitoris, the female center of arousal, isn't stimulated directly by the penis. The male's sex organ is sexy, certainly unto himself, but not to the clitoris.

Now of course you will argue this, because Mr. P is sexy, and beautiful, and can be involved in the pleasuring process as a willing, delightful participant. And the more compliments he gets, the happier he is, as is his wearer, who enjoys an improved body ego. And that's an important thing, I think, for both partners, loving their bodies and communicating admiration and love for what are probably the strangest parts.

That alone is a pick me up for Mr. P, encourages him to stand up and be counted. (Fine, I'll stop).

Mr. P's self-esteem (I couldn't stop, sorry) falls quickly if he feels the success of the party depends upon him, that the responsibility is all his. Ms. C. feels the same way when the circumstances are reversed.

So sex therapists will discuss this, the importance of relating lovingly, admiringly, giving as well as taking,  participating in a mutual process of pleasuring.  We suggest, too, that because of complementary anatomies, the way we are made, it is foreplay that matters most, not intercourse, no matter how it is demonstrated on television. The director of the show has no need to show the foreplay; the sponsors are waiting.

The largest organ of the body is the skin, and it needs attention in all kinds of places, not just those naughty bits that Monty Python used to tease about. Foreplay is all about that, the rest of the body.

But we can't assume that even this, touching other parts, other areas of skin, will be a good thing. We need permission, an invitation really, to touch someone, even if we're partners. It may be covert permission. We may already have it. After years, some of us merely know. Permission granted. Without permission, some people get very anxious at the very idea, being touched.

So let's say that permission is granted.  There are potential problems, however, permissions aside. In many cases Mr. P will be to blame for not cooperating. We'll talk about that case right now.

A young man, could be you, could be your brother, your son, your friend, calls a therapist for help.  Hopefully, he thinks, this is a sex therapist. The therapist, who has marketed herself with all the right Google key words, might hear that he wants sex therapy but might hedge her advice.

 If you are not in a committed relationship it is likely to be an evaluation, not sex therapy, not from me, anyway. 

Why? What's this?! It doesn't seem fair at all!  How is someone supposed to get into a committed relationship while being a failure at sex?

Excellent point, which is why we schedule the visit, not wanting to be unfair, and evaluate, maybe even suggest a treatment plan. But these recommendations are likely to have little or nothing to do with the mechanics of sex. They are relationship recommendations.

Our young man has never had real relationship problems, or problems with sex. He has had partners before his current relationship. He does not use drugs or drink. His parents are together and seem happy and he has never heard sex as a dirty word.  In his current relationship he is losing his erection because he is suddenly very anxious while putting on a condom.  He has an anxiety problem, he says, but only about performing in the sack and only in this relationship.

This is pretty common, losing an erection, or in the case of females, losing focus. Men often lose theirs in the process of putting on a condom. Getting back to the party feels like starting over.

So start over, we say. 

Whenever this happens, erections, arousal, drifting away, a couple is instructed to start over.

"And is she helping you at this point, when you both notice what you're labeling as a problem?" asks the therapist.

"What do you mean, helping?" He is lost.

"Well, either emotionally or physically. Either by loving you with words or actions.  Are you telling her what she could do to get you back into this?"

No, of course not.  She is expecting him to get it up.   After all, this is his job. Her pleasure is supposedly within his agency.

It is so backward, I feel. We used to have this expression, not popular, apparently today, not in the age of Fifty Shades of Gray, that you have to be responsible for your own orgasm.

Taking responsibility for one's own climax means many things, among them wanting to feel in the mood when we know our partner is in the mood or certainly will be, preparing mentally and physically for time together. But it is also telling a partner what we want, exactly, when we're actually making love (there's that word). We're the only ones who know the answer to that, to what makes us feel good. It is a nice process, too, a learning experience when we don't know what makes us feel good, when there are two eager learners, working with trial and error.**

The dysfunctional cycle or homeostatic feedback loop of the case:

Two partners, A and B are involved in the love making process, except that only A feels responsible for the success of a "date".  Suddenly:

A has trouble with his erection while putting on a condom, or at any other time.

B waits for A who is having trouble with Mr. P., who seems to be taking a nap.

A begins to get anxious, fiddling with the condom or worrying that this will never happen. Mr. P isn't waking up.  Wake up, damn it!  Mr. P doesn't cooperate under pressure.

B is becoming impatient, is considering what is on television.

A worries that B is going to abandon him, drop him. The two aren't committed after all. Meanwhile, Mr. P is not looking his best, is nowhere to be found, has disappeared altogether.

B looks at A, accusingly. Well?  When are we going to get back to it? (Note, not What can I do to help?)

A's anxiety rises with every passing second. Mr. P is hardly breathing.

B to A:  Call me when you've fixed this problem.

A's fears are realized. Our young man has learned that he had better fix this or he'll never have a normal relationship. He calls a sex therapist.

What do you mean, Is she helping me with this?  No! Why would she?  

The Beatles liked to sing in the song Mind Games, which I'm pretty sure is about sex, but in code,

Love is the answer.  

Work on that, we say. The rest is commentary.

therapydoc

*Our DNA is approximately 95%  alike, yet we still use the language, the opposite sex..  I think that is because that five percent weigh in when we interact in this way, in a potentially procreative, sexual way.

**This is why some of us recommend sex in the format of a committed relationship. If you assume you have until you are a hundred years old, give or take a few years, to figure it out, there is less stress. Trial and error, lots of words and audible breathing, and this falls into place rather quickly. Oh, and deserved trust, lets not forget.

P. S. John Lennon died December 8, 1980. A fan killed him, I think.  We could comment on that all day long, I suppose.