If I had to estimate, about a third of my clients wish they wanted or enjoyed sex more, about 10% would prefer less sex, something like 20% worry that they’re too into sex, and about a third of my clients are content with their libido and current sex lives.
I generally have really smart clients who a) are invested in therapy and b) will research anything and everything in a methodical way — how to negotiate a raise, install a ceiling fan, sleep train a child, etc. But some of these same folks will neither raise the issue of sex in sessions nor do much intentional research beyond talking to friends, Google/Buzzfeed/Reddit-ing it, or querying porn.
All of those options can offer some guidance and inspiration. However, if you’re among the majority of people who are not thrilled about how sex is going, I encourage you to bring it up in therapy and/or read some of the following scholarly yet accessible books for a deeper take. Because your experience might be different than your friend, or that of Reddit user “perfectstubble”. And because porn has many virtues but illuminating the emotional, psychological, and biological underpinnings of sex isn’t one.
Headlines to consider:
Many people don’t know that much about sex.
Many of my clients tend toward overcontrol/inhibition and may have felt that “good” or “normal” people don’t do fun things in bed. Both men and women may have been shamed for having sexual desires, taught to think that interest in sex is shallow or anti-intellectual. I will admit, I once had a brooding artist boyfriend in my early 20s say he always thought sex was “sad” before me. On the contrary, sex is a prime place for adults to be playful and imaginative, states of mind that can be hard to access for grownups — which makes it all the more satisfying when we do have great sex and all the more difficult at times to get there.
Even people who have had lots of partners may have only scratched the surface with sex — often it takes a longer-term relationship to facilitate wider exploration. Men might be relying on the same old move that melted their high school girlfriend’s face off and feel confused when it doesn’t do much for you. Women may not realize it can take extra time to orgasm with a new partner and be unnecessarily discouraged.
If any of this resonates with you, I recommend starting with sex therapist Ian Kerner’s books, such as Passionista for women and She Comes First for men. Or for a quick overview of sex topics, try the Swiss nonprofit Lilli — https://www.lilli.ch/en/sexuality_understand. Their vision is that “when [people] have sexual problems, they…invest in overcoming the limitations of their sexual learning process.” What an empowering growth mindset to have about sex! Think of it as a skill you can learn, like anything else — survival skills, organizational skills, social skills, sexual skills.
Spontaneous vs. responsive desire
A game-changer is knowing the difference between spontaneous desire (thinking of or being reminded of sex and spontaneously feeling turned on and ready/desire precedes action) vs. responsive desire (you start foreplay or sexual acts and then feel in the mood/action precedes desire). Some people are simply wired for responsive desire. Others may have felt spontaneous desire in the honeymoon phase of a relationship (approximately 18 months to three years) but over time desire can shift toward responsive. This is particularly true of women in long-term monogamy. Don’t misinterpret this to mean that you are uninterested in sex altogether. The process may simply need to evolve.
When, where, and how matters.
Sexologist Emily Nagasaki’s book Come As You Are includes a great exercise for helping identify the contexts that can make or break sex. For my clients, feel free to ask me about it in session, or pick up the book for help identifying the internal and external factors that help you, personally, have a good time. From setting, to partner characteristics, life circumstances, mood, body image, worry about sexual functioning — getting in touch with what shows up, especially at this moment in life, can make a big difference in enhancing satisfaction.
It can be hard to talk about sex, but it’s harder to go your whole life missing out on good sex.
Don’t feel bad if it’s awkward. Therapists are professionally trained and ethically bound to tolerate awkwardness. And I’m sure you come by that reticence honestly, meaning there are so many reasons we can feel weird about discussing sex. We were not all raised in sex-positive environments. Religious trauma, sexism, exploitative porn, porn abuse, lots of stuff can be confusing and boner-killing. Take a step toward reclaiming your birthright of physical and emotional pleasure. If you need more inspiration, check out the Netflix series Sex Education for healthy depictions of frank and practical sex talk. Or just do what Esther Perel does and say “erotic” instead of “sexual.” You too will sound effortlessly sophisticated on the topic instead of faintly embarrassed and intimidated. ;)
The pros and cons skill is one of my favorites from DBT because of its practicality and versatility. When clients are struggling with a decision -- anything from whether to leave a job to end a relationship to drink alcohol -- I enthusiastically screen-share my virtual whiteboard and create a four-square grid for us to fill in. The benefit of this format is that it's comprehensive -- you see gaps and add details that you may not consider if simply freestyling out loud. It is also incredibly validating, because we see in black and white how complex many decisions are, how there are significant consequences in every direction rather than one clear, "right" answer. (No wonder we're struggling.) Despite the complexity, having things spelled out has a tendency to nudge us forward. We glimpse that ultimately, we're going to pick a square and live with the consequences, because even "not" choosing is a choice -- it's choosing inaction/"no"... which has consequences.
The example above is a relic from pre-pandemic in-office days that explores a client's habit of isolating when depressed ("TB" means target behavior in DBT-speak). As you would expect, enumerating the pros of not isolating can be motivating. Less intuitive is that listing out the cons of not isolating can be validating rather than shaming -- we see and appreciate how hard it can be to make that choice when in the thick of things. Identifying specific cons further allows us to brainstorm what can help reduce the feared consequences, such as emotion regulation and distress tolerance skills. We also note which elements are short-term (S here) and which are long-term (L) to get a better sense of how to weight the decision and make a plan to cope. Lastly, clients can screen-shot the finished pros and cons matrix for continued reflection outside of session.
Which dilemma in your life could use a fancy pros and cons?
Rebecca Robinson, LMFT provides expert online, evidence-based therapy to deep-thinking/deep-feeling adults in California and Pennsylvania.