Posts Tagged ‘arousal’

The year in clinical sexuality, 2011

Thursday, December 29th, 2011 by Stephen Snyder, MD

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

As we get ready to leave 2011 behind, I would like as always to express my gratitude to family, friends and colleagues for your support and encouragement over the past year; and to my patients for your trust and confidence.   May we all merit much happiness in 2012.

Here’s my list of 2011′s most interesting happenings in clinical sexuality and related disciplines.


Vampire love

This year, in Twilight:  Breaking Dawn Part 1, Bella finally consummated her relationship with Edward, after three years of cinematic foreplay — and immediately ended up pregnant.  By the end of the movie, she’d become both a mom and a vampire.    Shows what can happen.

In SexualityToday at the Movies:  Breaking Dawn, we continued the discussion of the “integrative” aspect of ordinary female desire that we began in Twilight and the Art of Foreplay and in The Nine Rooms of Happiness:  What Does a Woman Want?

Elsewhere on the paranormal sexuality front, The NY Times Magazine featured a cover story on the new MTV series Teen Wolf —  “We Are All Teenage Werewolves.”  In Wolf Love in the New York Times, I discussed how the human-to-werewolf transformation works as a metaphor for sexual arousal — especially its primal, selfish aspect.

Australian writer Katherine Feeney picked up on the idea in Unleashing the Animal Within.  And Cosmo ended up interviewing me for an article in the December issue entitled “The Fierce Sex Every Couple Should Try.”    Shows what can happen.

 

What can we learn from Google about sexual motivation?

This year saw the publication of A Billion Wicked Thoughts, an interesting report on what must be the world’s largest sex experiment — an analysis of 55 million sex-related Google searches.   The book has a new and rather interesting theory of human sexual motivation, but the theory gets lost in its popular book format.

As I wrote in The Simple, the Complex, and the Still-ForbiddenA Billion Wicked Thoughts hasn’t had an easy time in print so far.  The New York Times Book Review assigned the book not to a sex researcher but to a cultural critic, Wesley Yang, who called it a “farrago.”   And most sex therapists I’ve spoken to so far have been unwilling to read it.

I’ve argued that  it would be foolish to ignore the book’s’ ambitious theory of sexual motivation, or the huge and unique set of data that supports it.    I’ve attempted, in a series of articles loosely based on A Billion Wicked Thoughts, to place the work in cultural and scientific context and to show its applicability to the practice of sex therapy.

It’s turned out to be a larger project than anticipated, and one I still haven’t completed.   But for anyone with the time and interest, Lessons from the World’s Largest Sex Experiment contains the links to the series of eleven articles I’ve written so far on the subject.

It’s still politically tricky to discuss the ordinary differences in sexual psychology between men and women.   Yes, I know, there’s lots of intra-gender diversity as well.   But that doesn’t make the inter-gender differences less important.

So I was pleased recently to find that Dr Meredith Chivers’  Sexuality and Gender Laboratory (Sagelab) at Queens University in Kingston, Ontario, a leading center for research into gender differences, has also taken up the challenge of communicating the results of this new research to the public – both on the web and on twitter.    That’s good company, and good news for the rest of us working in this politically slippery area.

 

The male of the species

Even now, 13+ years since Viagra was introduced, few people understand the physical/psychological complexities of male sexual arousal.   In Diary of a Manhattan Sex Therapist:  The Other Side of Saturday Night we discussed some of the psychological issues in younger men with erectile dysfunction (ED.)

The past year saw publication of two important professional articles highlighting the risk of sexual side effects from the chemical finasteride, used in the hair-loss medication Propecia and the prostatism medication Proscar.   In Diary of a Manhattan Sex Therapist:  Propecia, and Another Look at Sex and Propecia we discussed the common and often devastating side effects that can occur in men who take finasteride.

Premature Ejaculation (PE),  the most common sexual problem in young men, still gets surprisingly little publicity despite the significant impact it has on men and their partners.   Johnson&Johnson’s PE drug Priligy (dapoxetine) was rejected by the FDA in 2006, but has been approved in many other countries now worldwide.

Will the FDA be considering Priligy again?    It doesn’t seem imminent.    In the meantime, men seeking medication  for PE can be treated off-label with any of the Prozac family of so-called SSRI’s (Priligy is just a short-acting SSRI).   But until a medication is specifically approved for PE here, few MD’s in the US will be motivated to become skilled in doing this kind of treatment.

Take a look at 2010′s  The Latest News About Premature Ejaculation.   Not much has changed since then.

 

More on monogamy and near-monogamy

Problems with monogamy continue to fascinate modern readers.  In the wake of the Anthony Weiner episode, The Search for Sexual Sanity Continues  discussed the controversy over how to evaluate and treat what one might call ”Impulsive/Compulsive Courtship Behavior.”

Is strict monogamy often not worth the emotional cost?  That’s the opinion of Dan Savage, quoted in Mark Oppenheimer’s Married, with Infidelities in The New York Times.  In What’s So New About the New Non-monogamy? and Still Further Along the Road Less Traveled, we responded to the Oppenheimer piece, as did Ross DouthatRabbi Shmuley Boteach, and many others.  

Sex at Dawn, whose lead author Christopher Ryan has claimed that monogamy for humans is about as natural as a Big Mac and fries (and about as healthy), continues to be the decade’s most interesting and talked-about sex book, and clinched the Society for Sex Therapy and Research‘s Consumer Book Award for 2011.

Will Sex at Dawn influence sex therapy? Well, at least it might increase our empathy for people who find monogamy particularly difficult.

We reviewed the related book Bonobo Handshake by Vanessa Woods in Sex in the Wild, discussed some of its implications for our era in Empathy’s Magic, and ventured a bit into the evolutionary psychology debates with Eros, Thanatos, and Sunday Afternoon.

 

On loving your Blackberry

The most interesting sex article of the year, in my opinion, was Jonathan Franzen’s New York Times article about the sensual charms of his new Blackberry device.

As Franzen notes, electronic machines can now supply some of the self-affirmation that humans have traditionally only been able to obtain though intimate relationships.   He writes, “our technology has become extremely adept at creating products that correspond to our fantasy ideal of an erotic relationship, in which the beloved object asks for nothing and gives everything, instantly, and makes us feel all powerful . . . a world so responsive to our wishes as to be, effectively, a mere extension of the self.”

In the past, one of the few ways an adult could experience this kind of automatic, effortless self-affirmation was through the magic of really good sex.   But that’s no longer entirely the case.  As I discussed in Eros and Technology, Franzen’s essay alerts us to the still-difficult “problems of actual love” – including the challenge of relating long-term to someone who, unlike a piece of electronic equipment, was not designed specifically to meet our needs.

 

What’s ahead in 2012?

Well, obviously, I don’t know.   I’m hoping to finish the long series of articles loosely based on A Billion Wicked Thoughts that I began this year in Lessons from the World’s Largest Sex Experiment.

For the sake of my many patients with adult ADHD who keep asking me for reading materials (OK, it’s usually their spouses who ask for the reading materials), I’d like to continue the series on adult ADHD that began with ADHD, Marriage, and the New York Times, Alvin?  Alvin?  Alviiin!!!!,  and  Dr Laura Muggli on ADHD in Women — plus deliver my long-promised reviews of The ADHD Effect on Marriage,  and Is It You, Me, or Adult ADHD?

Plus we’ll continue the series on sex therapy fundamentals that began with Some Open Secrets About Sexual Arousal,  Sexuality, Simmering, and the B Train Back From the Beach, and Sexual Arousal for its Own Sake.

That’s assuming nothing else comes along in 2012 to distract us.   A dubious assumption, I know.

 

Human Sexual Response

Tuesday, April 19th, 2011 by Barbara Gross, LMSW

Masters and Johnson (1970), the pioneering sex researchers, described a woman’s cycles of sexual arousal as having several phases. They believed that women moved through each phase in a linear fashion. They called this cycle the “human sexual response cycle.”

The phases are described as

1) the excitement phase: this phase is marked by an elevated heart rate, faster breathing, increased blood pressure, blood flow to the genitals and vaginal lubrication.

2) the plateau phase: this is essentially just a higher level of arousal.

3) the orgasm or climax phase

4) the resolution phase: during this phase the body will return to the pre-aroused state.

The delineation of this cycle was helpful in assisting some individuals in understanding their sexual responses, however, a lot more has been uncovered in the last 40 years. Many women do not go through all these phases and most do not necessarily go through them in a linear fashion. Some women never have orgasms yet have desire and arousal. It is possible that that progression from desire, through arousal to orgasm may be more characteristic of men than women. Another researcher, named Basson, states, “There is an unfounded assumption that desire always proceeds arousal, which precedes orgasm… It is often the case that arousal precedes desire. The physical aspect of sexual activity can lead to feelings of arousal, which can facilitate desire and a wish to continue sexual activity”. So a new model now exists where arousal and desire co-exist and reinforce each other.

This is important in the treatment of female sexual dysfunction because we may need to assist women with low desire or lack of arousal from a multitude of angles. The mythology around sexual response can be very damaging. Many women feel they should experience sex or their sexuality in a certain way. Every woman is unique. And ultimately sexuality is multi-faceted. Desire, arousal, and orgasms are all overlapping parts of a sexual whole.

Dr. Stephen Snyder writes on “simmering.”

Monday, December 6th, 2010 by Stephen Snyder, MD

Here is a wonderful introduction to the idea of “simmering,” slowly meandering around the periphery of arousal as a path to “just desserts” at a different time.  Enjoy this beautifully rendered piece by Dr. Snyder:

A train in motion

On the B train, one hot summer Sunday afternoon. I’m bringing my children and a few of their friends back to Manhattan, after a long day at the beach in Brooklyn.

There’s a young couple standing near the exit door, sharing an ipod headset. Each with an earpiece in one ear — the two of them tethered together by the cords of the headset.

She’s leaning against the wall, sweat-soaked in a T-shirt and shorts. He’s a few inches shorter, wearing sandals, beach clothes, and long hair. His hands are resting lightly on her hips. Her arms are draped over his shoulders.

They seem entirely absorbed in the music, the motion of the subway car, and each other. Their eyes, half-shut, are out-of-focus, dreamy. They’re both wearing goofy, crooked smiles – as if sharing some silly secret. They look as if they might easily miss their stop.

Amidst the noise of the children, and the rocking and bouncing of the subway car, it would be easy for this couple to pass unnoticed. But there is something about them that holds my attention. A certain aura.

It’s sex, of course. Their goofy smiles, their dreamy manner. Definitely sex. They’re fully clothed, standing up and doing nothing obviously improper, but definitely enjoying a long moment of sexual arousal on the trip home from the beach.

Turning away self-consciously, I realize I’m not the only one watching this couple. The young children are oblivious, of course. But all the adults in the car are clearly aware of what’s going on. Everyone is stealing glances at them, transfixed by the same sexual vibration. Their sexual aura is now general throughout the subway car. I fear we will all miss our stops.

Sexual arousal is more than just sex

As I wrote in an earlier article, the secrets of sexual arousal are hidden in plain sight – and completely obvious once we know to look for them. Sexual arousal, if all goes according to nature’s plan, makes us dumb and happy, absorbed and distracted. We miss our subway stops, and arrive somewhere far uptown wondering what happened to us.

Most of us learn that to succeed in a fast-paced world we need to make all our subway stops. We learn that we don’t really have time for arousal. Many modern couples hurry through sex, without letting themselves get very aroused — then wonder where their sexual magic has gone.

In my sex therapy practice, I teach couples a technique for cultivating arousal even when they don’t have the time or energy for sex. The technique, which in sex therapy circles is called “simmering,” is a foundation technique for preserving a couple’s sexual bond. Good simmering can be nearly as important in this regard as good lovemaking.

What the couple I’ve described on the subway was doing — enjoying arousal for its own sake — is something every couple can do in the morning together, getting ready to leave for work; or while clearing the dishes after dinner.  All that’s necessary is to recognize that there’s more to sexual arousal than just sex.

For 21st Century couples in the age of the Blackberry, it’s likely to be the simmering that holds us together. In the next blog article, we’ll discuss simmering in more detail.

Stay tuned.

Copyright © Stephen Snyder, MD 2010, New York City
www.sexualityresource.com

Follow Dr Snyder on twitter:  www.twitter.com/SexualityToday

www.centerforfemalesexuality.com


MCFS Clinical Director responds to the New York Times

Tuesday, December 1st, 2009 by Bat Sheva Marcus LMSW MPH PhD

New York Times

Sunday Magazine

November 29, 2009

 

Dear Editor:

Daniel Bergner’s article in the Times magazine section, Women Who Want to Want, once again poignantly expresses both the deep distress felt by women with the loss of their libido as well as the complexity of understanding and treating the condition. Women’s loss of desire, while experienced sharply and distinctly, can be extraordinarily varied in both its primary cause,  its contributing factors and in the range of treatment options. 

Women’s sexual problems, of necessity, must be assessed by integrating the emotional, physical, chemical and  psychosocial perspectives in order for us to be successful in treating them.  Most often, as your article states, recommended treatment protocols are unilateral; the underlying assumption being that one “magic bullet,” should alleviate the problem. Often we find that this leaves women who have tried a single approach feeling as though they have failed;  and more hopeless, resigned and unhappy.   

Only with an integrated approach to diagnosing and treating women with female sexual dysfunction, more will have a better chance at achieving what they are looking for, a full and satisfying sex life.  While critics may believe this is yet another “luxury” health problem, we’re certain none of them would want to settle for a tepid sex life.  And if what we see in our practice is any indication, they’re in good company. 

Bat Sheva Marcus LMSW, MPH, PhD

Clinical Director

Medical Center for Female Sexuality

2975 Westchester Avenue

Purchase, New York 10577

(914) 328-3700

260 East 66th Street

New York, New York 10065

(646) 839-0700

www.centerforfemalesexuality.com