Sexual psychologist Lori Brotto talks gender equality, mindfulness, and the science of desire.
#MeToo. #ItWasMe. #TimesUp. 2017 was a year when women across ages, demographics, cultures, geographies, and abilities stood up and refused to be silenced any longer. The recent World Economic Forum in Davos declared 2018 to be a year when women would thrive. Tolerance for previously permissible harassing behaviour and speech has decreased, and the conversation around equality and equity is in razor sharp view.
As a feminist, women’s health researcher, clinician, and mother, I am proud to be part of this discourse and the movement to prevent injustices against women. And while I aspire to empower women in all aspects of life, I am particularly concerned with their sexual satisfaction—a subject that is often overlooked in these discussions, but is incredibly important for their health and happiness. The science of female desire—how it works, why it sometimes fails, and what can be done to improve it—has become the driving force behind my work as both a therapist and researcher, as well as the inspiration for my new book Better Sex through Mindfulness.
For centuries, women’s sexuality has been the focus of a failure discourse. In the late 1800s, their misbehaving sexual desires (whether those desires were too high or too low) were dismissed as a case of hysteria or “wandering womb”. This paved the way for the use of vibrator technology (yes, of the clitoris) to relieve women of their suffering. Although hysteria could, conceivably, be diagnosed in men, it rarely was. Instead, hysteria remained a common diagnosis for nearly all women’s ailments for decades, setting the stage for a legacy of misunderstanding, medicalizing, and pathologizing women’s health that has persisted for centuries.
Although our understanding of anatomy and physiology has advanced light years since that time, there is still much about women’s sexuality that remains unknown or misunderstood. Study after study finds rates of low sexual desire in women to be 10-20% higher than those in men, with as many as 40% of women reporting low—or altogether absent—sexual desire at some point in their lives. Yet, whereas men in North America can choose from a cadre of approved medications for improving their low libidos, women have just one option: Addyi. Available only in the United States, Addyi provides lackluster benefits amidst a sea of negative side effects.
Why are libido issues so much more common in women than in men? And why is the only female medication available so risky and ineffective?
Perhaps we are thinking about female desire in entirely the wrong way. A recent study by researchers Sara Chadwick and Sari van Anders certainly seems to suggest so. In it, Chadwick and van Anders explored the cultural symbolism of female pleasure using an online sexual simulation game. They found that women’s orgasms—so often championed as indicators of female sexual liberation and satisfaction—were viewed by the men in their study as symbols of their own sexual confidence and accomplishments. Men, it turned out, felt personally “responsible” their female partner’s sexual experience, and their “ability” to elicit a woman’s orgasm was directly tied to their own sense of achievement.
How, I wonder, did women’s sexual satisfaction become a men’s issue?
In my own work, I’ve learned that there are fundamental differences between men’s and women’s sexual desire, and many uniquely female factors that can contribute to problems with low or nonexistent libido. For example, women are more likely to experience distractions, negative self-talk, anxiety, performance failures, and catastrophic beliefs than men are—and each of these factors can wreak havoc on her sexual response and well-being. Other common contributors can include feeling fatigued or stressed, having judgemental thoughts, and being worried about pleasing a partner. Indeed, with so many potential challenges to overcome, it’s no surprise that a growing percentage of women feel frustrated in their sex lives.
But it doesn’t have to be that way. Over the past several years, I’ve investigated how mindfulness meditation can serve as a tool for addressing women’s sexual concerns—a topic I explore in greater depth in Better Sex through Mindfulness. By practicing simple exercises daily for at least 4-8 weeks, I’ve found that women from all walks of life can improve their sexual desire, as well as reduce sex-related distress, boost mood, and increase overall sexual satisfaction. Mindfulness, I truly believe, is transformational.
In the spirit of 2018, our year to thrive, I’d like to share one of these exercises with you. I hope that this exercise empowers you to experience sex in a way you never have before—one deep, mindful breath at a time.
Pleasurable Touch Exercise
[Adapted from Better Sex through Mindfulness]
Allow yourself approximately fifteen minutes for this exercise. You may also want to select a time when you feel better about yourself, when there are few distractions, and when you are unlikely to be interrupted. You may choose to have a water-based lubricant on hand for the genital touching parts of this exercise.
Read through the following instructions in their entirety before beginning the exercise. The goal of this exercise is to deliberately elicit and experience pleasurable body and genital sensations using touch. You will “try on” a sexual identity as you use touch, imagining that you are a sexual, sensual woman who enjoys her sexuality and is fully capable of a healthy sexual response. There is an important feedback loop from your genitals to your brain: as you notice sexual arousal in your body, your mind may interpret these sensations as being sexual, which then further increases the body’s arousal.
- Get into a comfortable position, perhaps lying down. Begin by closing your eyes and briefly checking in with how you feel in this moment. You might consider taking three minutes to first notice how your body feels overall, whether there are any particular emotions present, and whether your mind is particularly busy or not.
- Next, focus your attention on the sense of touch or contact, starting with your feet. Notice the point at which your feet touch the surface beneath you, whether it is the bed or the floor. Focus attention on any sensations in your feet. Wiggle your toes and take note of what that feels like.
- Move the focus of your attention up to your ankles, calves, and knees, noticing any sensations, tension, tingling, or feelings of warmth or cold there. Spend a few moments on each of these body parts as you move up your body.
- Next, focus attention on your genitals. Imagine that you are sexy and fully capable of sexual response as you focus on this part of your body. Are you aware of any sensations in your labia, clitoris, or vagina? Notice if these sensations feel sexual. Contract your vaginal muscles and notice if that gives you a heightened sense of pleasure. Focus on the sensations produced in your genitals and take note of any thoughts or emotions that emerge. Remind yourself that these are the important parts when it comes to sexual pleasure and activity. They are yours.
- Whenever you notice that you have forgotten about paying attention to the sensations in your genitals because your attention was focused on the content of a thought or story, congratulate yourself on becoming aware of that. Notice what your attention had been engaged with and then gently and kindly return your attention to the sensations in your genitals in this moment.
- Next, move your hands to your genitals. While imagining to yourself that you are a sexual, sensual woman, lightly press your fingers on the area of your clitoris. Press on the area of your clitoral shaft and hood and then down each side of your outer labia. Lightly touch your inner labia. Feel the sensations produced by different amounts of pressure. Describe the sensations to yourself. Remind yourself that the goal of this exercise is to enhance your awareness of pleasurable sexual sensations. That is all.
- Move your fingers down to touch the outer entrance of your vagina and then, when you are ready, guide one or more fingers inside (use a water-based lubricant if you prefer). Describe the sensations to yourself. Contract the vaginal muscles and notice how it feels with your finger(s) inside. If you notice that you are caught up in thinking about the sensations or lack of sensations rather than experiencing the sensations themselves, gently and kindly redirect your attention to the sensations. Do not get caught up in the content of your thoughts but rather observe them as blips on a movie screen.
- Next, move the focus of your attention as well as your hands to the rest of your upper body, including your breasts. Describe the sensations to yourself as you touch these parts of your body. Try on a positive sexual identity as you notice signs of vitality in these parts of your body. For the next few minutes, allow your attention to move fluidly to all of the different things that you are feeling in your body while maintaining the image of yourself, in your mind’s eye, as a sexual and sensual woman. Do not worry if this image seems hard to believe in this moment.
- Continue to do this for a few more minutes. Then gradually make the intention to move your hands and feet and slowly open your eyes. Take a moment to pay attention to how you feel as the exercise comes to an end. If you notice negative thoughts arise at any point during this exercise, just take note of them (“Ah, judgmental thoughts are here”), and when they have faded away, redirect your attention back to your bodily sensations. Do not be hard on yourself if you find this difficult. Many women do, and it often takes some practice to feel comfortable with this exercise. I recommend that you try this exercise twice in the first week.
Lori A. Brotto, PhD, is a clinical psychologist, a sex researcher, and the author of Better Sex through Mindfulness: How Women Can Cultivate Desire (coming April 2018 from Greystone Books). A member of various sexuality organizations, she is also Canada Research Chair in Women’s Sexual Health and an associate editor for Archives of Sexual Behaviour.