Science of Sex: Mindfulness as a Treatment for Sexual Dysfunction

July 14th, 2018

This month’s Science of Sex post is directly inspired by the book that I reviewed by Dr. Lori Brotto and, in fact, will draw from several of her studies. Mindfulness at first times to be new agey– more hype that hypothesis. But multiple studies have shown that mindfulness can have a positive impact on many facets of life, sex among them. So this month’s Science of Sex post focuses on that.

Check out previous Science of Sex posts here.

Mindfulness as a Treatment for Sexual Dysfunction

Dr. Brotto does a good job of explaining what mindfulness is in her book: it’s an awareness of your thoughts, feelings, and sensations, that allows you to create a distance with them, which can reduce the impact of pain, for example. But mindfulness also helps you remain more in the moment to focus on sensation. We’ll start with Brotto’s work since she’s done so much.

In one study, Brotto and her team found that while mindfulness didn’t necessarily increase arousal, it does increase women’s’ awareness of their physical/genital arousal, in turn increasing arousal concordance (symmetry between observed physical and genital arousal).

Another study by Brotto et al found that a group of 31 endometrial cancer survivors experienced improvements in multiple aspects of sexual functioning — desire, arousal, lubrication, orgasm,  and satisfaction — after participating in three sessions of mindfulness-based cognitive behavior therapy. And the improvements remained six months later.

Yet another study by Brotto found four sessions of a “mindfulness-based therapy significantly improved sexual desire, arousal, lubrication, satisfaction, and overall sexual functioning”. Continued sessions resulted in further improvements in genital and mental excitement. Any immediate improvements continued to a 6-month followup.

Finally, a 2008 study found similar improvements in women’s’ sexual function when exposed to mindfulness training. Furthermore, women who had previously experienced sexual abuse benefited the most from mindfulness compared to all participants.

Clearly, Dr. Brotto has done a lot of research on mindfulness and sexual function and talks about a 60% increase in sexual function after mindfulness in one of her studies. I think we can expect that to continue. But she’s not the only one. Time and again, studies suggest that mindfulness could be key to an improved sex life.

One such study compared how long it took men and women to register their physical arousal, finding that men did it significantly quicker than women. Mindfulness meditation enabled women to require less time to notice bodily responses, putting them on par with men. Additionally, women who practiced mindfulness were less judgmental toward themselves. Others found that mindfulness may be helpful to people who experienced sexual abuse as children.

Yet another study posited that people with more disproportional mindfulness would be less likely to engage in sexually compulsive behaviors or use drugs and found this to be true. Finally, a survey of women who completed mindfulness-based therapy online only found improvements in sexual function.

Studies on mindfulness have focuses on women, perhaps because they’re more likely to experience certain sorts of sexual dysfunction (low desire, difficulty with arousal, impaired pleasure, etc), but it’s reasonable that men could improve their sex lives by learning and practicing mindfulness, too. Some sources even state that mindfulness could help people with ED and at least one study focuses on sensate touch, a type of mindfulness program originally developed by Masters and Johnson, as a possible aid here. I’d like to see mindfulness applied to men. Otherwise, the science is promising.

Further Reading

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Better Sex Through Mindfulness: How Women Can Cultivate Desire

July 12th, 2018

Some of you may not read as many educational books about sex as I do, so you may not realize that this year has been pretty active with releases (this does not actually include my last book review, Becoming Cliterate, which was released last year). It’s why I’ve been reading about sex non-stop for the past several months. It’s been a few years since this has been the case; although, the break from reading about astrophysics certainly was welcome.

Check out all my book reviews before you leave.

Even though Better Sex Through Mindfulness was just published a couple months ago and I was able to get my hands on a digital copy immediately, the author came across my radar last year. You see, Lori Brotto, a psychologist, is one of the women I wrote about in my post about women who study sex.  Let me refresh with the description of her work because it leads us directly to the theme of Brotto’s book:

Lori Brotto has studied the disconnect that women often experience between mental and physical arousal. Brotto’s research suggests that the way that women multitask and tend to be detached from their bodies contributes to this. Brotto suggests mindfulness as one possible solution

So her work and research have led her to write a book directly about how mindfulness can help women overcome their sexual issues. Brotto is one of many who are adamant that the solution to low sexual desire cannot be fixed simply by a little pink pill (Emily Nagoski, who wrote the foreword, shares similar views). And while the tagline of this book focuses on desire. Better Sex Through Mindfulness goes beyond how mindfulness can be helpful with sex drive and focuses on topics such as heightening pleasure and reducing the impact from pain as well.

As a researcher, Brotto has worked with women to help them solve and alleviate the symptoms of their sexual issues, and she draws heavily from her own research when she makes conclusions in Better Sex Through Mindfulness. When she tells you that women have increased sex drive as well as pleasure from sex due to a something as small as mindfulness, you believe her and wonder if we’ve been treating sexual complications wrong all along. At one point, Brotto mentions how “mood, sense of well-being, body image, self-esteem, and how a woman feels about her partner turned out to be far stronger predictors of her level of sexual desire than a single hormone,” which really drives this point home (later she highlights how opinions about sexuality can also be more significant than hormones). Not only may some treatment options for sexual dysfunction be misguided, but the focus of hormones as cause and treatment for sexual dysfunction after menopause may also overestimate the function of hormones in sexual function.

But let me back up because by calling mindfulness ‘small,’ I am being quite reductionist. Really, mindfulness can be life-changing, and Dr. Brotto takes time to explore the definition and use of mindfulness as well as its history (the word wasn’t using when Masters and Johnson were teaching about sex, for example, but their sensate practices were certainly mindful!). She compares and contrasts mindfulness with cognitive behavioral therapy, with which I was familiar from my own experiences.

Furthermore, mindfulness can be difficult for some people, and Dr. Brotto emphasizes that willingness to try and practice mindfulness as key to its effectiveness. As someone who has struggled with meditation and mindfulness in the past, I think this is especially pertinent. It struck me that getting help to master mindfulness might be the catalyst to success in people who similarly struggle. Indeed, Dr. Brotto points out how trying to force yourself to relax is a misunderstanding of mindfulness and can be counterproductive.

Brotto often points to others’ research as well. In her book, she talks about studies that have highlighted differences in the brains of women who have healthy versus low sexual desire. One difference may be smaller amounts of grey matter in the brains of women who have low sexual desire. Brotto explains how women with low sexual desire spend more time monitoring their sexual performances rather than enjoying sex — and research backs it up!

Better Sex Through Mindfulness isn’t all about the argument that mindfulness can be helpful, however. Scattered through the books are practices that readers can use to (try to) improve their own sex lives. Admittedly, I am not currently struggling with sexual issues, but I found the reminder to be mindful during my everyday life useful. Of course, this book also offered something to sate my appetite for sexual science. Of particular note was how mindfulness can assist women who suffer from pain during sex due to various conditions. While mindfulness does not lessen the pain (and in some instances, medical professionals are not sure how to do this), it does enable women to enjoy sex and intimacy by reducing the intensity of their perception of pain and by encouraging a wider variety of intimacy.

I also highlighted a blurb regarding how sexual concordance differs between men and women. Women experience a lower level of +.26 than men’s level of +.66 (with 1.0 being perfect concordance between mental and physical arousal). This book was full of interesting tidbits like that.

In Better Sex Through Mindfulness, Brotto makes the case for her mindfulness programs by revealing the results of surveys filled out by the participants. She states that “sexual satisfaction increases by 60 percent” from prior to the program. She also illustrates how learning mindfulness can equate to long-term sexual improvement and not just improvement in the present. Even women who were dubious about the effects of mindfulness found it to be helpful. Certain groups of women (those who were the most distresses prior) even benefited the most.

In the end, Dr. Brotto’s book shows that not only is there hope when it comes to sexual dysfunctions such as low desire or pain but that the solution might be easier and more accessible than people realize, all without needing pharmaceutical intervention. Although geared toward women, I can imagine men would benefit from this book, too.

Better Sex Through Mindfulness ends with an appendix full of resources, either for women to get help to improve sexual function. This book is ideal for any woman (or man) who wants to get more out of her sex life, but some professionals might also benefit from reading it and incorporating mindfulness into their treatment and coping strategies.

If you think you might benefit, you can buy it at any number of retailers. A hard copy might be especially useful for partaking in activities, but I usually prefer Kindle versions for highlighting and taking notes. Get the digital version for less than $10. It’s only a couple bucks more for physical!

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Decoding Your Kink: Guide to Explore Share and Enjoy Your Wildest Sexual Desires

June 28th, 2016

Sometime last year — I really need to catch up with reviews! — I was presented with an opportunity to review Decoding Your Kink: Guide to Explore Share and Enjoy Your Wildest Sexual Desires by Galen Fous. The entire theme of the book is something that I think is not only helpful but is necessary for those who are discovering their kinky selves, especially people who are struggling with this fact either because of their upbringing or because their relationships don’t have room for kink.

It’s not the first time I’ve reviewed a book about discovering your kinky self, so I was curious how Galen Fous would handle it differently than other authors, especially with his history as a mental health professional.

Very shortly into the book, Galen name drops a survey on his website, and he does this multiple times thereafter. He also links to his Fetlife account, lecture series, personal website, and his professional website. While I commend Galen for actually utilizing hyperlinks in his digital book, the significance of the survey is unclear.

At first, it almost seems as if it will reveal something about the user. It is simply a way got Galen to glean information about sexuality from readers and visitors. Don’t get me wrong. I think this is important, and what better place to encourage users to vocalize than in Galen’s own book?

However, the numerous mentions imply there’s a greater usefulness to the reader. This is especially true in the chapter that discusses personal erotic myths at length. At the end, Galen tells the reader to find their own PEM and directs them to the survey, but it’s never clear how the survey will be helpful in doing so. Fous never says “Imagine the story that is so erotic to you that it never fails to get you off. Imagine the role you play in your fantasies and how power and kink play into it.” Although there is a small section in the survey that asks the reader to consider this, the book itself leaves the reader wondering.

At times, Decoding Your Kink almost seems like a vehicle manufactured entirely as a vehicle to get more responses (and clicks to his site). At best, readers deserve better and it’s mildly annoying. But I can see this turning off a reader enough for them to put down the book.

My second major concern is Fous’ use of the term “fetishsexuality,” which he has coined and introduces as a sexual orientation alongside straight, gay, bisexual, so on and so forth. It rubs me wrong for several reasons. There’s no doubt that living in a society that fails to be sex positive is difficult for any kinkster, myself included, but it does a disservice to those who have fought to marry and have been murdered to simply invent a sexual orientation like this. Furthermore, one can be a kinkster combined with any of those sexual orientations, and many people are fetish-inclined without it being a necessity in the bedroom.

Finally, I think someone who is really struggling with accepting this part of their identity might find this new term to be confusing. Baby steps, you know? Let’s open up their eyes to fetishes and how they can be awesome and positive without adding new definitions that are not (yet) wildly accepted.

But let me sing some praise for Decoding Your Kink. I think it’s important that a mental health professional is sex positive and kink positive. I think it’s important for those with kinks and fetishes to recognize that those sexual interests are not necessarily unhealthy. They can be enjoyed, and they may not be shamed for having those fetishes.

Anyone who encourages kinksters to be honest to themselves is doing important work. Galen goes one further by collecting data and trying to develop a treatment model for those clients who seek help but don’t need their kinks treated as problematic or symptomatic of an issue.

Galen’s own kinks might make the reader feel more comfortable. He speaks honestly about topics such as physical (not sexual) touch with his clients, especially men who might be disconnected with their bodies and who may not experience positive physical interaction other than sex.

I did find the chapter on Erotic Mythos to be interesting and potentially useful, too. A personal erotic myth is essentially a sexual personality, and Galen outlines a few archetypes: King/Queen, Tyrant, Lord, Daddy, daughter, etc. In this section, the reader becomes familiar with stories of a few clients whose “personal erotic myths” followed a specific erotic myth fairly closely. Galen also talks about how important it can be to find a partner whose erotic myth complements our own.

Fous also treads carefully on the subject of bringing up your kinks to your partners, negotiating and potentially finding satisfaction of your fetishes outside of your relationship. Similarly, he explains the difference between D/s and BDSM and the interplay between kink and romance in a way that can help to

Yet all these positives don’t manage to make me forget about the strengths. There are places where Fous lacks clarity and flexibility. As I finished the last page, I felt somewhat let down. I think because the title “Decoding Your Kink” implies a book that will be hands-on and provide the reader a way to deal with their own struggle in regards to sexual identity. But at the end of the day, the words within these pages serve more as a general insight into Fous’ research and work with clients while providing a way for him to glean more data.

Again, I find this all interesting but it’s not what I expected to get from this book. I am mildly annoyed at this fact because I am not in the middle of a struggle myself, but someone who is, someone who picks up this book looking for answers, is unlikely to find them in a clear way that encourages action. For them, I would suggest As Kinky As You Wanna Be instead of Decoding Your Kink: Guide to Explore Share and Enjoy Your Wildest Sexual Desires/

 

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Erectile Dysfunction and Extramarital Sex

January 5th, 2009

A friend of a friend was looking for advice on her current situation. Her husband had been having troubles with erectile dysfunction for a while and while prescription medicine solved the problem, it was no longer working. Add to it that his doctor had just confirmed it would be a permanent issue, and my friend was feeling disgruntled. Her husband suggested that she go out and find someone else with whom to have sex and she was wondering whether or not this is a good idea. She certainly wished for sexual intimacy and was considering sex outside her marriage but wasn’t sure.

My first reaction was that there may be other activities husband and wife can do together. Oral sex and mutual masturbation both popped into my mind. Use of toys is also something I would advocate. A hollow dildo may work for some while others just might use vibrators and regular dildos. Use with her husband or alone, this friend might not feel as much of a need to seek sexual gratification after all. Furthermore, I encouraged her to research alternative treatments for ED such as acupuncture or herbal remedies. I’m no doctor but it certainly seemed like all involved parties gave up on finding a solution, not just for his ED but for achieving sexual intimacy together, rather quickly.

I next wondered if their relaitonship was stable and whether extramarital sex, even if condoned by her husband, would cause further strain. As I inquired further, it became obvious that everything wasn’t peachy keen. She and her husband were no longer sharing the same bed, resulting in an even further loss of intimacy. While she felt willing to look into other ways they could be intimate together, he had already written off the subject. It was clear, not being able to perform in bed had done a number on his ego and confidence, thus it was affecting their relationship.

As this information came to light, my opinion quickly changed from “this might be a plausible solution” to “This couple needs therapy, not extramarital sex.” What they had both perceived as problem in the bedroom was really a larger problem with their relationship, of which sexual frustration was only a symptom. It seemed to me, that by considering she have an outside sexual encounter, this couple was only putting the cart before the horse. By working on meeting each others’ emotional needs, I have a feeling the wife will feel less of a desire to have sex with others and they might be able to substitute other activities for vaginal sex, instead.

Now, in their specific situation I would strongly encourage therapy and, if he was not willing, she should go alone. I would not recommend that she continue with the idea of sleeping with others, at all. Still, were their relationship strong and healthy, it may have worked out as long as they were both sure about what they want and made sure to vocalize it.

While what he was suggesting might be a completely selfless sign of love, it could also mean a test. If she had sex with another man, he might judge her as failing or not loving him enough despite his flaws. Or perhaps he really isn’t comfortable with the idea at all but feels he must do something so that she does not leave him for something better. Either way, even a stable relationship would suffer. This is why it’s important to be honest not only to our partners but to ourselves.

It may take a little soul searching in order to really know whether or not he is okay with his wife having sex with another man and it even may be difficult for her to come to terms with the idea. Feelings like jealousy, resentment and poor self worth may surface here but they are all surmountable. If you’re Is it absolutely possible to put aside human traits of jealousy and possessiveness? Sure. Do we all have the will to do so? Not usually. If either partner is uncomfortable at all, it’s not something which should be acted upon, at least yet.

Furthermore, it doesn’t hurt to analyze the desire to seek out sexual fulfillment elsewhere. If this woman had done so, she would have discovered that she was not looking for sexual gratification alone; rather, she was looking to fill the emotional loss she was experiencing due to her husband pulling away. While he might be okay with her being in a sexual relationship with someone else, would he feel the same about her being emotionally intimate with another?

Which leads me to my last point: it’s vital to discuss (and agree upon) expectations and guidelines. The more she talked, the more it sounded like she was looking for a full time boyfriend but I could not help but wonder if this is what her husband had in mind. Perhaps he expected her to only have no-strings-attached one night stands. Perhaps he expected they would only have vaginal intercourse or not engage in activities which he felt we special to them (whether sexual or otherwise). Does he expect them to use protection? If so, what kind? Will she tell her new beau that she is married? Discussing when, where and how these trysts can occur not only helps to make sure all parties are on the same page but can help to shed light on whether or not everyone really is comfortable with the situation.

While I think this arrangement can work for some people, I think it doesn’t work for more people. I think certain conditions must be “met” before a couple should consider this. Other activities should be considered first, the relationship must be stable and healthy, both partners must be accepting of the idea and completely honest about their feelings and it’s a good idea to discuss guidelines and expectations beforehand.

If you have been successfully involved in a similar arrangement, it’s extremely likely it’s because you gave it some thought and followed these guidelines. Many of these considerations are those which belong in any relationship (honesty and communication) and others can be effective in negotiating open relationships or threesomes as well.

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