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Key points
- Being trained to be the object of desire rather than the “experiencer” of it takes a toll on women's mental health.
- For many women, sex becomes a chore. A solution is to prioritize well-being and pleasure, and be exquisite in one's self-care.
- Women need to ask for what they need to feel safe. This is key and essential for exploration.
Some of the more recent topics I have covered include the healing power of pleasure and the sexual brain-body connection. But what I haven’t yet addressed is that a big obstacle for those attempting to navigate the path to pleasure and sexual well-being stems, in part, from a lack of training on the part of their healthcare providers.
Psychologists are not required to take courses in sexuality in graduate school. Doctors aren’t taught about sexuality in the vast majority of medical schools. Contributing to this are the serious gaps in the literature regarding female sexuality. The New York Times recently highlighted this with an article titled, "Half the world has a clitoris. Why don’t doctors study it?”
How are healthcare providers expected to help their patients without adequate training? Given the powerful role that pleasure plays in our well-being, and to advance the cause of making the study of sex and pleasure a priority in medicine, I had a conversation with one of the movers and shakers of the sexual medicine revolution, Dr. Kelly Casperson, a board-certified urologist and author of You Are Not Broken: Stop Should-ing All Over Your Sex Life.
Where did I find Dr. Casperson? Where many women search for current information about reproductive health, sex, pleasure, and related matters: good old Instagram. Here is a link to our conversation on her podcast.
Dr. Casperson says that as a urology student, she was taught that women are different, they're complicated, and that we (doctors) will never figure them out. As a practicing urologist, she saw patterns in her patients and started asking questions, realizing that these issues could not be solved in a 10-minute doctor's office visit.
She started wondering: Who is helping the people sleeping with the men to whom their (also male) urologist is giving Viagra? The answer was often no one.
Our ambivalence toward female sexuality
Women are rarely encouraged to learn how to enjoy themselves sexually. Instead, they’re trained from an early age to be more interested in how their bodies look rather than how they feel in them. My colleagues believe the process of being trained to be the object of desire rather than the “experiencer” of it significantly contributes to the orgasm gap and takes a toll on women’s mental health.
Is it any wonder that 90 percent of the calls I get are about the loss of desire, mostly in women? In these cases, the women feel broken, and the men feel inadequate or angry. Many women get shamed either way.
Western medicine focuses on the doctor fixing the patient
According to Dr. Casperson, Western medicine asks, "How can I fix you?"
On my end, I've learned as a psychotherapist that it's not my job to fix them. It's my job to stay present and listen deeply so that clients can tolerate their feelings and learn from them.
We must be taught how to attend to our bodies and core emotions. If we are not working with the body, we cannot listen to the emotions and begin to work with them.
The trauma epidemic and what to know about it
Dr. Casperson continues, “In the medical profession, identifying your feelings is thought of as 'soft.' But let’s be honest; doctors are traumatized. Their training is traumatizing, and they see the worst of the worst every day. We need to teach all medical professionals how to better process trauma. I encourage my colleagues to read the work of Gabor Mate, a Canadian physician who addresses the effect of trauma suffered by persons with substance abuse issues and how trauma can impact decision-making.
"A Holocaust survivor who treats trauma, Edith Eger, author of The Gift, offers this healing question: How can you be the best loving, unconditional, no-nonsense caregiver to yourself? In other words, we need to be our own best caregivers and let go of the rigid thinking that keeps us trapped in post-traumatic pain.
"My own observation is that the clients who benefit the most from therapy are those who learn to become their own good parent."
Having pleasure is good medicine
Dr. Casperson adds, “Patients say to me, 'I don't want to date my spouse.' I say, 'Well, how about just having more fun?' If you are primarily childcare and home maintenance to each other, a relationship gets very dull very quickly. Unfortunately, for many women, sex becomes a chore. We feel entitled to good sex, but we often live unhealthy lifestyles. This is where change needs to take place. For it to happen, we need to prioritize our well-being and pleasure."
The role of core emotions in our well-being and pleasure
My book, Why Good Sex Matters, explores the groundbreaking work of Jaak Panksepp, the neuroscientist who mapped out seven wired-in “core emotions” that we share with all mammals. These emotional systems are the source of our “embodied” emotional experiences and profoundly influence our emotional and physical states. For a brief introduction to the core emotions, click here.
The "core states"
I coach clients on how to have more pleasure by teaching them about the "core states": fear (anxiety), rage/anger, lust (sexual excitement), panic/grief (sadness), seeking (expectancy), care (nurturance), and play (social joy), and how they function.
The future of therapy, according to Panksepp, will focus on increasing pleasure. He coined the term "affective neuroscience" and posited that our emotions are innate and are also adaptive learning and memory systems. Pleasure is part of learning to access play, care, and lust, and heal our traumas.
Tips on prioritizing pleasure
Dr. Casperson concludes, “The bottom line is, how can we begin to prioritize pleasure? The good news is that it's within you to figure it out. Take pleasure into your own hands."
For me, attention is everything. With our bodies, our breath, and our attention, we can change the structure and function of the brain by what we focus on. We must resist being hijacked by our own attention-grabbing lifestyle. So, my advice is:
Be exquisite in your self-care. Be your own best caregiver at all times.
Create a safe space; feeling safe is essential for exploration. Play turns off when we don't feel safe.
Women need to ask for what they need to feel that safety. Ask over and over without making it a big deal. If we don't ask, we've committed a relationship offense.
Look to what's good about the now. Harness your attention on what you want to learn and whom you get to be while playfully exploring ways to create the outcomes you want for yourself and your partners.
References
Wise, N. (2020). Why Good Sex Matters: Understanding the Neuroscience of Pleasure for a Smarter, Happier, and More Purpose-filled Life. Houghton Mifflin.
