ERP 362: Understanding & Increasing Sexual Desire — An Interview with Dr. Lori Brotto

By Posted in - Podcast March 7th, 2023 0 Comments

Human sexuality is a complex and fascinating topic that has intrigued people for centuries. Sexual desire, in particular, is an essential aspect of our sexuality, yet many people struggle to understand and increase it.
In this episode, we delved into the intricacies of sexual desire, exploring the factors that can impact it and the techniques that can help boost it. From exploring the impact of stress and lifestyle factors to discussing the benefits of mindfulness and communication, we uncovered a wealth of insights that can help individuals enhance their sexual desire and improve their overall sexual experiences. Whether you’re struggling with a low sex drive or simply looking to deepen your connection with your partner, the insights shared in this conversation offer valuable guidance for anyone seeking to understand and increase their sexual desire.

Dr. Lori Brotto is a Professor in the UBC Department of Obstetrics and Gynaecology, a Registered Psychologist in Vancouver, Canada and the Executive Director of the Women’s Health Research Institute of BC. Dr. Brotto holds a Canada Research Chair in Women’s Sexual Health. Her book, Better Sex Through Mindfulness: How Women Can Cultivate Desire (2018) is a knowledge translation product aimed at sharing the science of sexual desire with a broad audience, and the accompanying Workbook will be published by Greystone in October 2022.

In this Episode

7:16 From volunteering with rats to researching female sexual dysfunction: A journey of unexpected discoveries.

12:40 Causes and factors contributing to low desire in women.

18:44 A paradigm shift in cultivating desire for long-term relationships.

24:25 Understanding the impact of low desire on relationships and cultivating arousal.

26:55 Tips for reframing sexual experiences in a more positive light.

33:45 The importance of mindfulness in enhancing sexual response.

Your Check List of Actions to Take

  • Understand your own desires and needs.
  • Communicate openly and honestly with your partner about your desires.
  • Prioritize self-care to reduce stress and increase energy.
  • Experiment with new experiences and activities to increase arousal.
  • Seek professional help if necessary, such as therapy or medical treatment.

Mentioned

The Better Sex Through Mindfulness Workbook: A Guide to Cultivating Desire (*Amazon Affiliate link) (book)

Shifting Criticism For Connected Communication

Connect with Dr. Lori Brotto

Websites: loribrotto.com | brottolab.com

Twitter: twitter.com/DrLoriBrotto | twitter.com/ubcshr

Connect with Dr. Jessica Higgins

Facebook: facebook.com/EmpoweredRelationship 

Instagram: instagram.com/drjessicahiggins 

Podcast: drjessicahiggins.com/podcasts/

Pinterest: pinterest.com/EmpowerRelation 

LinkedIn: linkedin.com/in/drjessicahiggins 

Twitter: @DrJessHiggins 

Website: drjessicahiggins.com  

Email: [email protected]

About Today’s Show

Dr. Lori Brotto, thank you for joining us today.

I’m so happy to be here, thank you. 

I always feel so, so privileged to be talking to people who do research and have something really valuable to share and findings, to convey to people that are interested in negotiating relationship more skillfully. I know we’re going to be talking about low desire, sexual desire as it relates to intimate relationship. For people that are just getting to know you, or maybe do know you but want to hear a little more, what got you interested in looking at this topic?

Yeah, thanks for the opportunity. It’s an interesting question, because I never set out to be a sex researcher or sex therapist. Yet, this is what I do all day long, day in and day out. I do research on sexual health, trying to discover ways of cultivating it, helping patients who are distressed by it, teaching students to understand it better, etc. So I guess my story started when I was a teenager and fell in love with science, I knew that I wanted to be a researcher one day. So I set out, I started my undergraduate degree. I also had a love of the brain and just the brain’s role in controlling behavior. So what I learned within my first few weeks of my undergraduate degree, I was about 18 years old at the time, was the importance of volunteering and getting firsthand experience in the life of a researcher. 

As I was taking my coursework, at the time, I was really interested in depression, and I knew that I wanted to do research on treatments for depression. I had personal friends in my life who struggled with depression and struggled with antidepressant use, and that was the career path that I set out for myself. So started knocking on the door of different professors at the university. I was just looking to volunteer, get any experience at all with helping out in the research lab. It was door closed after door closed after door closed, mostly in response to the fact that I was too young, I had no research experience. How could they let someone so junior into the research lab, dealing with humans? 

So finally, one of the doors did not close. I sat down and had a conversation with a professor, and he agreed to take me on as a volunteer in the lab. Still, I had no idea what his area of research was, other than he was a psychology professor. Then he said, “Let’s head up to the lab, and I’ll show you around, you can get started tomorrow.” So we take the elevator up. I thought it was weird that he had to use a fob to get into the lab. It was behind lock and key, and then there was another fob to get into the backroom of the lab. He was an animal researcher. So he took me up to the animal colony, and what I very quickly discovered is that the volunteer job that I had just signed up for involved watching rats have sex for about 12 hours. So I would be seated in this tiny little room with fiberglass chambers in front of me, and my job was to move the female rats from chamber to chamber while the male rats engaged in sexual activity. Then I would count the number of times that the male rat mounted, and ejaculated, and how long it took, and I was sat there with a stopwatch. So I did that for about six years. I became heavily involved in studying animal models of sexual dysfunction. 

So yes, depression made its way in. Because we looked at the effects of antidepressants and stress and housing conditions, which it turns out to be really stressful for rats to be crowded in cages, on the sexual activity of these rats. I absolutely fell in love with it. I loved that we could manipulate their environment, that we could learn a lot about the impact of environmental stress and antidepressants on sexual activity, and that actually, rats were not a bad model of understanding sexual activity in humans. So that happened for six years. 

Then Viagra was approved. The year Viagra was approved, that same year, a quite a large landmark study was also published on sexual dysfunction prevalence in the United States, published in the Journal of the American Medical Association 1999. It found that 43% of human females reported having sexual problems that lasted at least three months or more in the past year. So it was the combination of: “Wow, 43% of women struggling with sexual problems! We have this incredible blockbuster medication that’s easy, it’s effective, it’s discreet, to treat male sexual dysfunction.” It led me down to starting to do some investigation into, do we have anything comparable for women, like Viagra? 

The timing just happened to be right, it was right before I was starting my PhD. So I switched at that time, left the rat lab, started doing research on human female sexuality, and looking at the impact of similar things: stress environment, hormonal changes, perimenopause, relationship issues, on sexual arousal. So we’d bring the women into the lab, show them erotic films. They would have a small vaginal probe that they inserted into the vagina, and then they used a little handheld lever, and they would move this lever back and forth to correspond to how turned on they were in their mind. It would give me a window into the impact of these different life events and life stages and relationship aspects on their capacity for sexual arousal. So that’s how the story started.

So many questions I want to follow up with. I mean, just bringing us back to those early years and your first day at the lab, I imagine that was an adjustment to what you thought you were going to be doing and what you then were doing, and then growing to love it. I’m curious, as you talk about how much translates from rat sexuality to the human body and human sexuality, as you describe what you were observing, did you feel like it was both the behavior in the female rat as well as the male rat? Or did it correspond more with the male rat?

It corresponded more with the male rat. One of the things that I soon learned is that the effects were opposite in female rats. So for example, chronic stress decreased male rat sexual behavior, but it increased female rat sexual behavior. Now, if you did a one-to-one relationship between the female rat as a model of human sexuality, you would quickly see how ridiculous that was. That for the vast majority of human females, stress does not increase their sexual interest or activity. There’s a small segment that it does, but for the vast majority, it doesn’t. So some of those diametric opposites that we saw in male and female rat models has to do with different parts of the brain that give way to opposite behaviors in response to the same stimulus. 

But it also led me to face this question around: are there limitations in the rat model? That we can even study motivation; we can definitely study motivation and fear and interest, definitely behavior. But when we look at some of the fundamental concepts, like pleasure, interest, emotional parts, it’s just not accessible in the rat model. I’m sure if there’s an animal researcher listening to this episode, I’m going to get a Twitter message that says: “Yes, you can!” But at the time, it was limited for the kinds of things that I was specifically interested in.

For sure. Just out of quick curiosity, I know we’re not here to talk about your experience at the lab. But I am interested, were you able to decipher, in what you were measuring the female rats, responsiveness or their willingness?

Yeah, absolutely. So rats show both receptivity, as do humans, so the extent to which the female rat accepted the male rats’ advances. They also show proceptivity, which is sort of a solicitous behavior if you will, which is a term we use in animal behavior. So when they do darting and hopping or ear wiggling, those are invitational behaviors the female rat shows. Whereas lordosis, which is a curvature of the back to allow easy penetration of the vagina, that’s more of a receptive behavior. So yeah, proceptive behaviors are more akin to motivation; flirting, initiating, winking. Similarly, solicitous things that we would see in human females, you can look at some of those differences in the rat as well.

Okay, thank you. So given your research and all that you’ve done in identifying what contributes to the experience of arousal and desire, it sounds like particularly for women? 

Yeah. 

Okay. Help us with what you would like to share around low desire as it manifests. Sounds like there’s lots of contributing factors, which you just named. But where would you like to start?

Yeah. So that 43% figure that was published in the 1999 JAMA article, it’s been replicated now numerous times, using different study methodologies, looking at different countries of the world, whether you ask people on a self-report questionnaire or an interview. So what we pretty consistently find is, probably somewhere between 30% to 40% of women will say: “Over the last year, I’ve struggled significantly with some domain of my sexuality.” When you dig a bit deeper and ask the more specific questions: “Is it desire? Is it arousals or orgasms? Is it pain? Is it discrepant desire from your partner?” 

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“Low desire is the most common complaint, and interestingly, it’s also the most common sexual concern in men as well. Although, in the media, and maybe even in healthcare, we tend to focus much more on erectile functioning. Like, what’s the penis doing, as opposed to what’s the brain doing? But low desire is the most common of the sexual difficulties in both men and women.”

We have relatively less data on gender diverse people, on trans people. But among the data that we do have, it also seems like that’s probably the most common of the sexual concerns as well. 

So when you asked about what are the causes, we could run down a list. Of course you want to rule out some of the common medical causes. So is the low desire because of depression? We know that depression, first of all, 20% of people have depression, more than that are using an antidepressant, and both depression and antidepressants can be associated with low desire or sexual problems. So we want to make sure that we’re looking at what other kind of diagnoses or issues is the person experiencing? Have they had surgery? Are they going through the perimenopause, where there’s hormonal fluctuations and sex hurts, and painful sex is the reason for their low desire? Do they have another endocrine issue that’s contributing? Then once you run down that list, then we get to the far more common causes. So, stress, interpersonal issues, the chronic to-do list distractibility, negative judgments, body image. I could go on and on and on about those contributors.

Yeah, no kidding. So sounds like one of the first ruling out is the physiological, whether or not it’s a medication, or depression, or some medical thing that might be interfering with their physiological arousal and a sense of desire. Also then, the environmental or interpersonal, the more relationship stuff as well. Even as you mentioned the brain, as far as I remember coming across some of the research or how it works is, for the female brain, a lot of the arousal pathway goes through the brain. It’s a little bit longer of a route for that actual genitalia responsiveness. Is there anything you want to say about that?

Yeah, thanks for that opportunity. Because it is a place where I think we have a lot of stereotypes and myths around desire, one being that you either have desire or you don’t. That desire is fixed, and once it’s gone, you can’t get it back, and that desire declines with age. All three of those are myths that don’t stand up to the science. In fact, what the research tells us quite clearly is that desire acts like many other emotions do. So we feel happy when good things happen to us: when someone says something nice, when we see something that is pleasant, when we do something we enjoy, we feel good, we feel happy. Same thing works with sadness, and desire works the same way. In that, desire is responsive, it is experienced in response to arousal. So very often, when there is a desire problem and the person says I have no desire, we have to look at, well, is arousal happening? Are you getting the right stimulation? Are you feeling sexual pleasure? Beyond just feeling it, is your brain registering that that is happening? Because desire is a brain mechanism. 

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“Desire happens in response to arousal, not the other way around. It’s not that first you’re in the mood for sex, and then you find it, and then you get aroused. That has been the historic model of desire that’s been completely turned on its side, for women and for men, for the most part.”

Especially people in long-term relationships, where you do have that natural decline in desire that happens as you are with your partner longer, and there’s less to be surprised about, and there’s less mystery, and there’s less novelty, and there’s less desire. However, if we can focus on novel methods of cultivating arousal, then that can be the pathway towards cultivating desire. 

Oh my goodness, Lori, this seems game-changing! Even as we’re thinking about it, I’m like, what a paradigm shift! Because so often we think, we see something attractive, we feel desired, thus, we then respond with arousal. Or even in relationship, if I love my partner, I find them attractive, or they look sexually attractive or desirable, then I will feel aroused. But what you’re saying, in long-term relationship, actually, if we can be conscientious, intentional about cultivating arousal, then we will feel desire. That seems like a very different mindset.

Yeah. But it’s a very positive one, a reassuring one, and optimistic one, that gets away from this idea that once desire is gone, you can’t get it back. So what I often say to couples is, what are you doing to cultivate your arousal? They’ll say, I don’t know, what do you mean? Have you ever touched yourself? Have you incorporated sexual tools, like fantasy, and a good lubricant, and a vibrator? Are you paying attention to arousal as it’s unfolding? Or are you lost in judgments, or even just basic benign distractions?

Disconnected, not even noticing the arousal.

Yeah, exactly. So it is a game-changer, because it suggests that there is actually a lot we can do to cultivate desire. 

I feel such compassion for many of us that have been in relationship with the paradigm of expecting our partners to turn us on or activate that desire, that then we feel arousal. The way I’m hearing you talk about right now is that we are having some agency in our own arousal, and then that we bring that into relationship and share that with another. But it’s not as though it’s this passive thing that we’re not engaged with. 

Yeah, there’s all sorts of myths and stereotypes that come up, even just in your story. One myth being, the longer I’m with my partner, the more they should know how to turn me on, and I shouldn’t have to tell them. If I have to tell them or show them, that’s a sign they don’t care, we’re not compatible, they don’t love me. Again, the list goes on and on. 

“Whether you’re in a mixed gender or same gender relationship, your partner has no idea what things feel like for you. Their frame of reference is what things feel like for them, which have almost no correlation to how good things feel for you.”

That’s assuming that we’re static beings and we’re not going through changes, and that our needs might differ depending on where we’re at.

Yeah, our physiology differs or what have you. So if we can look at the opportunity to share with a partner, information about what feels good, show them what feels good, discover what feels good together, it can actually be very pro-sexual. It can be very, very sexy, in fact, that discovery pathway.

I remember I watched a Netflix series, it’s by The Goop Lab, and it was the Sex, Love, and I can’t remember what it is. I think it was Jaiya, she has the Erotic Blueprint. I feel like some of these models have some value, but also, I think there’s a wider perspective, with the research and evidence-based that you’re bringing in. But I remember just the education around the clitoris and how big it is, like how it goes around the mound. I was like, I did not know that! Like, that makes so much more sense. Just even that piece of education was so helpful of even knowing. I guess what I’m sharing right here is, even as open-minded as I might believe I am, there’s still so much that I don’t know about my own body or maybe my own arousal.

Yeah, and it’s not your fault. I mean, we are facing a centuries old, long-standing, shame-cultivating legacy around women’s sexual pleasure. Thank you, Freud, who said that if you only have orgasms from clitoral stimulation, that was a sign of immature psychosexual development. So you’re right, most people have no idea. Even clitoris owners have no idea that the clitoris is so much more than what meets the eye, that most of the erectile tissue of the clitoris is below the surface. So you can stimulate the clitoris by touching either side of the vagina on the outsides, or even further down stimulating the vestibular bulbs. It’s this beautiful, very elaborate object, full of erectile tissue, that responds very much to touch, fills with blood, gets engorged. Most people assume it’s just the little button that you see on the outside. 

Yes! Well, before we go into it, I would love to get your input on how people can cultivate more arousal. Before we do that, I know you also have something to say around how low desire impacts relationship. I’m sure this is a thing that people have a pretty good sense of, but is there anything you want to say about that?

For sure. I mean, we talk about that as being discrepant desire. So we’re just going to assume that there are two people in the relationship, it just makes this a lot easier, and one person has lower desire than the other person. So what often presents to the therapy room or to my office is, “Help me, Doc, with my low desire.” Then you start to investigate further. It’s not this person’s low desire, it’s only their low desire in relation to their partner’s higher desire. So of course, the question is, maybe their partner’s desire is too high. 

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“Often, doing sex therapy is best done by doing couples therapy, where you can ask both people around what their expectations and norms are around desire and sexual frequency. So when you frame it from a couple’s-based discrepancy point of view, it takes the finger-pointing away from any individual.”

Then you can talk about things like negotiation, and you can talk about capitalizing on the times where the lower desire person feels much better and feels in the mood, you can talk about other ways that the higher desire person might find other sexual outlets; maybe they masturbate more, maybe they watch erotica more, maybe they go for a run and work off that energy. So that’s often really important, because so often, it’s the low desire person that feels like they’re broken, and then they take that expectation with them into the therapy room. That the therapist is going to fix them, raise their desire, send them back into the relationship, and everything will be perfect. Again, I think everything I’ve been saying so far is, that’s not the way desire works.

Well, I love that you’re speaking to the couples’ system and having both people in the room to participate in the dynamic that’s created between the two individuals, and also looking at the high desire. Well, obviously, my work with couples. Not obviously, you don’t know this. But I tend to do more of the relational dynamics and the emotional component, and so often, the person who has high desire feels somewhat, not controlled, but limited by person that has a low desire. So to be able to have access and support them to feel some of their own agency or their own sexuality, and then also how they participate together.

Yeah, 100%. I mean, I hear that all the time, that the higher desire person says it’s the low desire partner who is the deciding factor. They decide when and where, because anytime I initiate, I’m told no. It leads to me feeling rejected. It leads to me feeling bad. So I’ve learned to just wait for the low desire person. Well, guess what kind of pressure that puts on the low desire person, to be the person who always instigates, when they don’t want to; they don’t want to instigate. So in addition to the higher desire person gaining some agency of their own, it’s also about what role can they play in helping the other person discover their arousal, in learning how to cultivate desire. In looking at, are their ebbs and flows, during the day, during the week, during the month, where desire is a little sharper than other times. So there’s actually quite a bit that the other partner can do.

Yes. As we even look at the sequence of what comes first, desire and arousal, even the question of: “Would you like to make love? Or do you want to be intimate?” If the person that might typically in the past had more low desire, is confronted with that question, they might just check in around, do I feel desire or do I not feel desire? 

Right, they don’t feel it. They don’t feel desire.

Rather than, “Are you open to engaging with me and explore arousal?” That then can give a lot more space and fluidity to the experience.

100%. So just reframing that question in a different way. “Are you open to going on an exploration with me? Are you open to receiving touch? Are you open to spending some time together and connecting physically?” Not “Are you feeling in the mood for sex right now?” Ask me in an hour, once well into it. Ask me that question again.

Exactly. As I reopen to being together in ways that feel pleasurable and maybe experience arousal, and then can we explore the question around do we want to be intimate, and share that together. It seems like such a different setup. Just a personal share on that, I remember. I mean, look, my husband and I have been together for almost 17 years. I think literally, just in the last year or two years, I become more aware that the anticipation is really helpful for me, and I didn’t even know that. So sometimes just getting into this field of just really noticing and paying attention, it’s just so much more revealing. 

So before we go, I know we’re going to get to arousal and what you would recommend around that. I just want to ask, as far as the brain and any gender differences, I’ve always interpreted that the pathway for women going through the brain had something to do with safety. But I don’t know if that’s actually true. Do you know what I’m asking?

For sure, yeah. So when we look at what actually happens, from neutral towards engaging in sexual activity, that’s not a light switch. There’s a series of decisions at every time point that happen. At the outset, the first decision one needs to make is, do I have good reasons to engage in this or not? So we talk about those as being approach reason. So what’s in it for me, what’s in it for my relationship that’s important to me? So is it to gain intimacy? Is it to celebrate a birthday? Is it because I want to have an orgasm on the other side? Is it because it helps me manage my anxiety? Is it because I feel powerful? So really contemplating what the approach reasons are. If the reasons are only to avoid something bad, so I’m going to agree to sex because if I don’t, you’re really difficult to live with, we fight all day, you’re belligerent towards the kids. We call those avoidance-related reasons, and those are a direct line to resentment. So we need to be really mindful of what are the reasons that a person has. For some people, when I ask them what their reasons for sex are, they kind of look at me like, “Ah, I’ve never thought of that before.” So we start there. We start by helping them come up with what’s a good reason, that would take you out of what you’re doing right now, towards being open, towards engaging?

Then the next step after that, that we look at, is the range of stimuli. So what are the things? What are the touches, the exchanges, the smells, the sounds? What do you need to see? What are the things that elicit arousal for you now? Not the things that worked 20 years ago, but now? Is it nipple stimulation? Is it a foot rub? Is it seeing a clean bedroom? What are the things that are happening right now that elicit arousal? Then the third part of that is context, and that’s where safety comes in. Do I feel safe with this partner right now? What’s our emotional tone between us? Did we just have a fight that is still dimming the context of this? Am I worried about kids walking in? Am I worried about getting a sexually transmitted infection? So all of those fit within context. 

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“So we’ve got these three pieces: the reasons, the stimuli, and the context. When those fit together and they’re all positive, that paves the way for the brain to process the information and create arousal in the body.”

So you start to see physiological signs. In females, nipple erection, vaginal blood flow, fullness, etc. Then, really, really importantly, and this is where all of my research is focused on, what does the mind do? If we pay attention using mindfulness skills, and we really notice the arousal, that paves the way for wanting, or desire in other words. Then of course, if the outcome is positive, emotionally positive, physically positive, or both, or however the person defines positive, then this reinforces the likelihood the next time. So that’s kind of the sexual response cycle. So you can see at every turn of that cycle, there’s actually quite a bit that the person can do. They can think about their reasons. They can know what are the range of stimuli that elicit arousal for them. They can have a really good sense of things like context and safety. They can use mindfulness skills to pay attention. They can have a broad definition of rewards, so that it’s not just orgasm on the other side; most women don’t orgasm through vaginal penetration. So thinking about what would make the encounter rewarding, and then really registering when it is rewarding so that it reinforces behavior the next time.

Thank you so much, this just gives such empowerment to people that are maybe grappling with what’s happening, and giving them a lot to work with that gives them that sense of agency. I’m also like, in partnership, most partners want to assist in creating those things to be positive.

100%, they just don’t know how.

They don’t know how, yes. So before we lose you, I know your time is super-valuable, I am interested in hearing a little bit more about the mindfulness and your research and what you would like people to know around that.

Yeah. So I’ve already planted the seed, that the brain, the mind, same thing, that it’s really important for that brain-body connection that happens, that is essential for sexual response to happen. So what’s interesting is the number of times during a day that people get distracted. Like, we’re chronically distracted; we’re pulled left, right, and center, we multitask constantly, we get pulled by notifications on all the different devices that are around us. It doesn’t stop during sexual activity, so those same distractions happen during sex. So very often, what people will say is, I can easily start asking myself, “Did I turn off the stove? Then I start thinking, did I lock the front door? I wonder who’s coming up the front door? Should I stop now and go and lock it? Or should I just hang on because it’s going to be five more minutes? They sort of go down this rabbit hole of seemingly benign distractions, but not benign in the sense that they do disrupt that brain-body connection that’s critical for sexual response. 

Then on top of these benign distractions, there’s a whole laundry list of judgments that people have. “Do I smell okay? Will I orgasm? Will my partner notice that I’ve gained 10 pounds? What if sex hurts, should I stop?” Again, the list can go on and on here, and as a sex therapist, I hear these all the time, the specific kinds of sex-related judgments that people have. 

So that combination of the benign plus the judgments means that you have to work really hard to keep the brain-body connected during sex. Thankfully, there is a tool to do it, it’s mindfulness. Mindfulness is not new. It has historic roots in Buddhist meditation. But it’s been gifted to us in the western world about 40 years ago in a very secular form, where it involves a set of practices and skills that teach a person to exercise the muscle of the brain, to pay attention non-judgmentally. 

So I was introduced to mindfulness, not as it pertains to sexuality, but as it pertains to managing extreme emotions. This was when I was a postdoctoral fellow at the University of Washington, and learned at the time that mindfulness can be such a powerful way of writing out negative emotions, withstanding distractions, staying present, staying anchored, and even discovering parts of yourself that you never knew were there. It just struck me at the time that “Oh my gosh, this is exactly what we need for people who are complaining about sexual problems.” At the time, I was doing research with cancer survivors with sexual problems, who really mourned the loss of their sexual arousal after cancer. 

So I immersed myself. I started practicing mindfulness, I started going to retreats, reading books, going to a teaching session with people who were new to mindfulness. As I was learning, I gathered together a group of cancer survivors who had sexual problems who wanted to learn about it as well. So I was learning, I was teaching them, I was gathering data at the same time, and that set the wheels in motion for my initial research on applying mindfulness to sexual problems. Yeah, that was 21 years ago. 

So fast-forward two decades, and we and many others around the world have taught mindfulness groups, we’ve done it online, we’ve done it with couples. Essentially, the outcomes are pretty consistent. 

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“I’m convinced mindfulness is the most powerful tool for cultivating sexual pleasure. I’m absolutely convinced of that. I wasn’t convinced of that 10 years ago, but I’ve just seen enough of the data and heard enough of the stories from people to convince me that this is really the missing element in sexual pleasure.”

Wow, how beautiful! What a gift that you have the research to support the findings, but you’re also a clinician and being able to see the transformation in applying this treatment to sexual, or low desire in this case, or just dissatisfaction or what might be called dysfunction. Even as you talk, it’s almost like, with the distraction or even all the judgments that might interfere, it’s like the mindfulness gives focus to allow for some deepening and to have connection to the desire or the arousal that gives it life and move air debris and sustain. Is there anything else you want to say about just the power of it?

Yeah, just that it’s accessible. It’s a simple practice. It’s not an easy practice, because it does involve training the brain, how to stay present non-judgmentally. So both of those are tall orders: staying present, and being non-judgmental. But in our research over the many years, we’ve also looked at the question: What if a person has never engaged in yoga or anything remotely close to mindfulness or meditation, can they really still benefit? The answer is, yeah. It worked just as well for the veteran meditators as it did for the people who were brand new to it. Over the years, we’ve looked mostly at low desire. But we’ve also looked at it in populations of women with genital pain, prostate cancer survivors with erectile dysfunction. We’ve looked at it in survivors of sexual abuse, lots of different samples of cancer survivors, men with situational erectile dysfunction. Yeah, as I said, the story is pretty consistent.

Wow, it sounds incredibly powerful. Also, just the applications, it sounds far and wide around who can benefit and really engage in the practice. I appreciate you underscoring that it’s both the focus and the non-judgement. That it’s a discipline, that it takes a level of practice and a learning curve. I know we’re winding down our time here. What would you like to invite people to engage with as they perhaps want to try to practice mindfulness and apply it to their sexuality?

Yeah, I think maybe three things. One is, practice mindfulness in your life somewhere. So maybe while you’re standing in line at the grocery store, or you’re eating part of your meal tonight, is take each bite slowly, pay attention, notice the colors, the flavors, what it feels like in your mouth, and eat slowly and deliberately. So you could do that totally on your own. 

The second thing is, next time you engage in sexual activity, whether on your own or with your partner, try and apply that same skill of really feeling every sensation, and catching yourself when you jump ahead to, “Am I reaching orgasm? Are we at the end?” So catch yourself and bring yourself back. 

Then third, and this is a bit self-serving. But I did write a book on the topic. So definitely, have our skills training manual that we’ve used in our research over the years. Because I was approached by so many people to get into our groups, I finally said, why don’t I just write a book on it? So Better Sex Through Mindfulness describes the science of mindfulness.

Tell us more about your book. 

Yeah. I mean, I’ve never thought I was an author. I’m a researcher, and I do a lot of writing for scientific articles, but those don’t make their way out to the general public. So Better Sex Through Mindfulness, which came out in 2018, is really a synthesis of the science as it’s been applied to sexual concerns. Then 2022, so just a few months ago, I publish the workbook to accompany Better Sex Through Mindfulness. Again, it just walks people through all the exercises that we’ve delivered in our programs. People can do this at home on their own, with a partner, and have access to the very same exercises that we’ve been studying for the last few decades.

This sounds like a must-have for any relationship. You’ve been able to provide right from the research to the application and really deliver this, so that people can work with it in their own way. I’ll make sure to have the link to both books on today’s show notes. We are definitely gifted by your presence here today. So anything else you want to say before we wrap up, or anything else you want to invite people into or direct them towards? 

Yeah. It’s not just for folks who struggle in their sexuality, there are plenty of couples in relationships that actually enjoy quite happy and satisfying sexuality. There’s an invitation there, to how do we infuse some mindfulness to make it even better, be even more present?

Yes. Well, I know I will be getting the book, and will definitely appreciate just the wisdom and what you’re bringing to really help. I mean, you’re saying really, in a lot of ways, it’s not our fault, that we don’t have the guidance around this. So it’s really important. Thank you for your contribution.

Thank you. I’ve really enjoyed the conversation, thanks for the opportunity.

Signing Off

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Dr. Jessica Higgins ~ Relationship and Transformational Coaching