“If only it would last”

I hear it from men, and I especially hear it from their disappointed partners.  “If only it would last.”

Premature ejaculation (PE) is very, very common. About a third of all men (and their partners, sadly) are plagued by this problem.

The good news is that for most men PE is fixable. It may take some work, but with some effort most can overcome it.

In a moment, I’ll outline some exercises that can help you or your partner.

But in a world of quick pharmaceutical fixes — Viagra, Levitra and Cialis come to mind for men who suffer from erectile dysfunction — there are now medications being developed that will fix most PE. Some men are already using SSRIs, which are principally prescribed as antidepressants, to very effectively slow things down. In the UK there are tests underway of a “new” drug that contains the active ingredient tramadol hydrochloride which has been used for pain relief since the 1970s but has now been redesigned for treatment of PE. Those tests look promising and I’m betting we’ll see it available commercially in Britain and elsewhere soon.

There is now also a brand new topical anesthetic spray, Promescent, which is approved by the FDA. It contains Lidocaine. It works by decreasing penile sensitivity — but doesn’t inhibit the engorgement of the spongy tissue that makes the penis erect — and so prolongs sexual activity and delays ejaculation.  Desensitization may not sound like a good thing but if it helps with staying power many couples are willing to give it a try. This is an over the counter product–no prescription required.

Also, a new medical procedure for PE is in the works, developed by Dr. David Prologo (yes, his name really is Prolong-o) at University Hospitals Case Medical Center in Cleveland.  Recent research has found that many patients with premature ejaculation have a higher than average number of dorsal penile nerve (PDN) branches, accounting for their sensitivity and therefore their getting off too fast.  What Prologo discovered is that by freezing the DPN it can effectively dull the brain’s response to sexual stimulation, giving the patient a longer time before ejaculating without causing erection problems.  He has performed four surgeries to date, three with 100 percent satisfaction and the fourth showing  some significant improvement.

The old ‘tried and true’ treatments for ED come in the form of exercises. There are two types.

I like for guys who have partners to work with both, unless they do not ordinarily masturbate.  In that case, just work with the Squeeze Method.

The Squeeze Method (with a partner, or solo)

[1] This is best done by a couple, but the man can do it alone by masturbation if there is no partner or the partner is not willing to participate.
[2] The couple starts by being as relaxed as they can, and free from distractions.
[3] The couple kiss and caress until the man is aroused, and then the partner takes his penis in hand and begins stroking it.
[4] The man concentrates on his feelings of arousal, to increase his sexual awareness. (He does not try to think of other things in an attempt to distract himself from ejaculation).
[5] When he feels he is about to ejaculate, he signals to his partner.
[6] The partner immediately stops stimulating him and applies firm but gentle pressure around the penis where the glans (head) meets the shaft. The partner keeps applying the pressure for 10-20 seconds.
[7] The partner then lets go, and they wait without doing anything for about 30 seconds.
[8] The procedure is repeated several times before ejaculation is allowed to occur.

The Stop-Start Technique (solo)

[1] The man sets time aside to be private and to masturbate with dry hands.
[2] He slowly strokes almost to the point of ejaculation and then stops before the point where ejaculation is inevitable.
[3] He should do this three times.
[4] On the fourth time, he is permitted to ejaculate.
Learning to be aware of where the ‘point of no return’ is may take some effort. It takes time to build control.  That’s where practice comes in.

Once a man has achieved the measure of control needed to make it through the above four steps successfully it’s time to go through the same process but with a wet hand using lubricant to make the feel slicker and more like ‘the real thing.’

Six likely reasons you’re alone

From day to day I see all sorts of people about a broad range of sex and relationship issues.  I do therapy.  In my practice, because of my eclectic background and training, this includes a wide range of “interventions.”

One thing I generally don’t do is “give advice.” People’s real issues are rarely so simple and easy to answer. But people want them to be simple, so they still ask.

One of the most common questions I get from women is, “Why can’t I seem to find (or find and keep) that special someone?”  The question is usually followed by some words of self-explanation, a common-sense rationalization to explain “why I am alone.”

We humans seem by nature to be compelled to figure things out. We want to understand why things are the way they are and why they aren’t the way we wish they were or hope they might be. It’s hard for us to not have an answer.

I recently read a refreshingly frank and perceptive article by Tracy McMillan. She’s a TV writer, not a therapist.  Taking on the topic “Why You’re Not Married” she has come up with six likely reasons: 1) You’re a bitch; 2) You’re shallow; 3) You’re a slut; 4) You’re a liar; 5) You’re selfish; and/or 6) You’re not good enough.

McMillan is no misogynist and what she has to say is no self-help column drivel.  She has looked squarely at her own life and observed the lives of women around her. What she means by each of her six reasons is likely not what you think.  Her explanations are, I believe, more perceptive than not.  Perhaps more importantly, they are always thought-provoking.

McMillan’s real purpose seems to be to get women to think in a new, more deeply honest way.  She wants to shake off the easy answers, those rationalizations that make it more or less okay to not be okay with being single.

Treat yourself to a good read. I’d love to hear your feedback. You can post it here for all to read, or send it to me privately and in confidence at drdavidroth@gmail.com .

Here’s Tracy McMillan’s “Why You’re Not Married.”

The Polygamist in the White House… and next door

We may never know if indeed it was a first.

At the White House on Tuesday the president awarded the Presidential Medal of Freedom, the nation’s highest civilian honor, to an esteemed American and de facto polygamist.

His name is Warren Buffett.

In case you didn’t know, for more than a half-century, right up until her death, the celebrated multi-billionaire investor was married to his beloved Susie. And for a quarter-century, at Susie’s behest and with her full approval, he also maintained a committed, intimate relationship and publically shared a home with Astrid.  Holiday cards to friends were signed “Warren, Susie and Astrid.” Upon Susie’s death — which was devastating to Buffett — he and Astrid were able to be formally married.

Warren, Susie and Astrid are a rare exception: most committed, long-term triads are not so public.  Of course, there was no violation of any bigamy statute and no tax fraud. One legal marriage at a time, one spousal tax deduction.

High-profile polygamists — married de facto, if not de jure — may not be running the marriage rights flag up the flagpole, but the Buffetts are not alone.

So respectable a figure as Karl Barth, the twentieth-century Protestant theologian widely held to be the greatest mind in Christendom since Thomas Aquinas, shared the entire second half of his 80-year life in a household with two women.  

When the greatest German composer of the second half of the 20th century, Karlheinz Stockhausen, died in 2007, it was his two common law wives, Suzanne Stephens and Kathinka Pasveer, who jointly announced his passing.

Still, attention in the news media to the subject of polygamy has focused on a single stereotype: fundamentalist Mormons who live on compounds in remote parts of Utah, Arizona and Texas, and on crimes and allegations of crimes by men such as Warren Jeffs against women and children. They are news worthy, sadly real and utterly abhorrent.  But they appear not to be the norm, and according to social scientists who have studied them are not the basis for polygamy.

This is no longer the only image of polygamy in the American media.  The fictional Hendricksons of ‘Big Love’ and the real-life Browns of  ‘Sister Wives’ portray polygamy in a more All American life-in-the-suburbs light. They are for the most part at least approachable and very often endearing. Still, both high-profile TV shows are about families living the Mormon principle of plural marriage as a religious tenet.

The Buffetts’ polygamy is not based on Mormonism. Nor was the Barths’, nor that of the Stockhausen family. And it’s fair to say that none of the women in these three men’s lives was coerced into an underage union against their will by a manipulative prophet or tyrannical patriarch. It was for each of them a life they chose.

As a boy growing up I couldn’t imagine that I knew anyone who was a homosexual.  The thought of meeting one kind of scared me. When I learned that a man I was working with and respected was gay I could barely believe it: he was pretty much like everyone else.  He wasn’t scary. These days, everyone knows someone who is gay. My eldest son is gay. He’s out. No big deal.

I suspect there are polygamists, or would-be ones, in your town, in your neighborhood.  Maybe you know them and maybe you don’t.  And maybe you know or suspect they’re really — de facto — polygamists and maybe you don’t. But chances are they aren’t drawing a lot of attention to themselves and aren’t much like Warren Jeffs — or for that matter Warren Buffett.  Chances are they’re more like you and me.

Perhaps you’re one.

Or perhaps you would be, if you felt you could.

A Bountiful Marriage

So few of us in the United States know much about Canada. 

Mention “Bountiful” and very few think about a town in British Columbia. Fewer still are aware that there is a case, commonly referred to as the Bountiful Case, presently before the BC Supreme Court, that challenges the law that limits a “conjugal union” to the relationship between two persons.

Yes, it’s a polygamy case. And there is a good chance it will ultimately be decided in the Canadian national Supreme Court.

The case is shrouded in a cloak of prejudice. The town of Bountiful is a fundamentalist LDS one. Those involved do not look like the well-adjusted suburbanites on HBO’s ‘Big Love’ or TLC’s ‘Sister Wives’. There are allegations of child brides and spousal abuse in Bountiful. It’s not the perfect crime-free community. But rights have never been predicated upon engendering everything picture postcard perfect.

What is striking about the Bountiful Case is that it brings to the foreground assumptions we make about the fundamental nature of an institution whose definition we have until recently mostly taken for granted. Marriage is an exclusive union between a single man and a single woman.

But this is a very specific historically and culturally grounded definition.  It is by no means universal.

In G.P. Murdock’s magisterial 1967 Ethnographic Atlas, an overwhelming 85 percent of recorded societies were polygamous. No, that doesn’t mean that 85 percent of marriages throughout the world were multi-partner ones. What it says is that our own society’s refusal to accept polygamy is the “odd man out” in a humanity that has as a species typically encouraged or at least allowed for marriage to be defined as other than simply one man and one woman.

We are an ethnocentric lot. Like gay marriage, the thought of more than two people marrying may be hard for most of us to wrap our minds around.

I will be writing more about this landmark case in the days ahead. I will be writing about polygamy in several contexts – historical, religious, sociological and also clinical. For now, here’s a short but very informative article by attorney Jim Quail called The BC Polygamy Case: Be Careful What You Criminalize.

How do you attach? And are you compatible?

Finally, there is a new, serious, not pop psychology advance in the understanding of how we connect with one another.

I’m not taken with fads. This really is big stuff.

It’s based on attachment theory, that psychoanalytically inspired work of John Bowlby. A couple of folks have broken it down, applied it, and put it into layman’s language in a new book, Attached: The New Science of Adult Attachment and How It Can Help You Find—and Keep—Love, by Amir Levine, MD (a sometime-collaborator with Nobel Prize-winning neuroscientist Eric Kandel) and Rachel S.F. Heller.

You’ll want to read the short excerpt in Scientific American online: http://www.scientificamerican.com/article.cfm?id=quiz-relationship-science-attachment-quiz

And to decipher your attachment style — and if you’re not flying solo that of your partner(s), and also to get a pretty decent attachment theory-based read on your likely compatibility — take the attachment quiz:  http://www.attachedthebook.com/compatibility-quiz/

You can read the stellar reviews, and order the book on Amazonhttp://www.amazon.com/Attached-Science-Attachment-Find%C2%97-Keep%C2%97Love/dp/1585428485/ref=sr_1_1?ie=UTF8&s=books&qid=1294345363&sr=8-1

As an aside, a few of us in sex and relationship therapy have been working with people along these lines for a number of years. It’s exciting to see attachment and intimacy moving into the limelight and coming of age.

The organic obsession

It used to be that “the inability to perform” drove many men to withdraw from — or rendered them unable to enter and successfully sustain — a sexual relationship.

When getting a good erection became less and less likely and over time proved increasingly impossible, that fundamental, pleasurable part of life known as sex was usually gone for good, many times replaced by self-doubt, sadness and even shame.

For many men, and for their partners if they had them, there was a persistent sense of personal failure.  Rarely was the subject ever mentioned let alone discussed.

That was until Viagra and TV ads of smiling couples and men proud of their revived manhood.

Today, the only obstacle for most men to overcome is getting an appointment with someone who can write a prescription.

Well, that’s not entirely true.

Erectile dysfunction (ED) meds are pricey.  They’re patented.  There are no generics. Few medical insurance plans cover them and those that do typically pay for only a few tablets a month for “occasional use.”  For many, this means that getting an erection that will prove itself  may be a luxury. It doesn’t quite come naturally, takes planning and at very least it’s an added expense.

Planning and scheduling sex is a problem for most people.  In fact, it’s one reason so many men who can be helped by ED meds try them but quit using them.  Thirty-six hour Cialis was a big step in the right direction.  Then came Cialis for daily use.  It’s the only prescription medication on the market that makes it possible for most men who suffer from ED to have successful, stress-free, spontaneous sex.  In my opinion it is the best option by far to date.  I have been encouraging the use of Cialis this way since before there was an FDA-approved daily dosage (by breaking the occasional-use tabs into smaller pieces) back when Eil Lilly, the drug’s maker, had just started the daily protocol in trials.

Since the patent on Viagra doesn’t run out until March 27, 2012, cheap sildenafil — Viagra without its stage name — won’t be on the market for another 15 months.  The Levitra patent is good until 2018 and Cialis patents will remain in effect until 2017 and 2020. So will next year’s generic sildenafil drive down prices on vardenafil (Viagra) and tadalifil (Cialis)?  Only time will tell.

This much is clear: men do want erections and their partners (or those they may aspire to have as partners) generally want erections too.

But at what price? It’s not simply a matter of the dollar amount.

Many health conscious people wonder: Are these medications safe in the long run?  Do I or my partner really need to be taking pills every day? Is this the trade-off I have to make for the sake of sex going to have long-term adverse effects on my life and longevity?

I don’t know how to answer those questions. People ask me my opinion and tell them that I am very comfortable with the ED meds.  But I’m also one who always tries find a natural, healthy “diet and exercise” answer before turning to a pharmaceutical one.

But is there such an option?  When it comes to ED, there is.

It’s commonly referred to as Horny Goat Weed. Okay, let’s roll our eyes and shake our heads at the name. (I do every time I say the words.) Also referred to as Rowdy Lamb Herb, Barren Wort, Bishop’s Hat and Fairy Wings, Horny Goat Weed, or Yin Yang Huo as it is called in Chinese medicine, works on the same basic principle as the three ED medications. It acts as a vasodilator.  Its primary active ingredient, icariin, works by increasing levels of nitric oxide to relax smooth muscle cells lining the blood vessels supplying the spongy tissue of the penis. That’s what takes a flaccid penis and firms it up.

Horny Goat Weed is often referred to as an aphrodisiac, but in my view that’s a misnomer. It doesn’t stimulate desire. What it does is foster genital engorgement. That’s a very important distinction because with ED you can have all the desire and no or very little “sign of arousal” in the form of a hard-on.   (However, in a classic feedback loop, desire can increase when one is feels the physical effects of stimulation.)

So where does one get Horny Goat Weed? How much is needed? And how does one take it? These are the questions I’m asked. Unfortunately, they’re not as easy to answer as “Doc, can you give me a prescription?” followed by a trip to CVS or Walgreen’s.

Where do you get it? If you Google Horny Goat Weed you’ll find lots and lots of folks who sell it. The problem, of course, is that marketing trumps quality. I’m betting there is a lot of junk Horny Goat Weed out there. Like any herb (I nearly typed “weed”) the best place to get it is from a source you respect and trust. My most trusted online herbalist doesn’t carry it at all.  You’re not likely to find it in the local Whole Foods or herbal section of the drugstore. Wherever you get it — online or locally — look for the words wild-crafted and/or organic. The last thing you want is bad Horny Goat Weed.

What form is best? It comes in capsules, tinctures and in bulk to make a tea. My recommendation is to make the tea. Swallowed capsules don’t seem to metabolize well. I don’t have much experience with tinctures. Besides, there is something wonderful about the ritual of making and savoring tea.

How much and how often? I have heard different things from different Chinese herbalists regarding dosing.  I recommend a pot a day, consistently, 2-4 hours before the time when you might be likely to have sex. If you buy whole leaves, chop them first before brewing in a tea ball.  Steep the tea, make it stronger or weaker as you like, and see how it goes.  After a couple of weeks, adjust the amount of Horny Goat Weed in the mix, stronger or weaker, to increase or reduce the dosing.  Aim for consistency over time. Horny Goat Weed seems to be most effective in the way that daily use Cialis is, as a regular part of your life. And it’s helpful if you can get it from a consistent, reliable source.

An added bonus: very good quality Horny Goat Weed costs only a small fraction of what the medications do, at least until the day of generics comes.

But just as the prescription meds don’t work for everybody — because most but not all ED is tied to vascular issues — not everyone will be helped by Horny Goat Weed.  Still, for those who stick to it, it’s very good and my first intervention of choice.

One more thing. For those who are going to go the prescription meds route, the Cialis folks have a smart way of getting people to believe in their product and I think it’s fair. They offer a free 30-day trial of their daily-use medication (with a doctor’s prescription, of course).  When asked, I usually recommend that doctors write for the higher dosage (5 mg) and start patients off with half-tablets (2.5 mg), breaking them in half. If the dose works well, the patient gets two months free and establishes a solid habit and a regular sex life.  Assuming the 2.5 mg dose works, by continuing that way you get daily Cialis for a cut-rate price.  Here’s the link: http://voucher.cialis.com/index.cfm

The end of Love for the Holidays… as seen on Facebook

We tend to see — or, more often, “feel” — the world around us from the vantage point of individual experience, through our own narrow-focus lens of pain and pleasure.

Holiday times are especially hard for many people.  We all know this. But when they’re hard for you, it seems all you can see is your own life from your point-of-view.

Many of us feel very alone at this time of year. This is never more true than when a relationships comes to an end and you’re suddenly… alone.

Becoming suddenly single seems to be a relationship status that loves company at this time of year.

That’s what some interesting data visualization research drawn from Facebook member profiles shows.  And seeing it puts it into a whole new perspective.

David McCandless and Lee Byron, tech researcher-journalists, scanned 10,000 Facebook records over the course of a year to see when people’s statuses used terms about relationship breakups.  What they learned is that right now during the two weeks leading up to Christmas is peak season for the relationship valley known as The Break-Up.

Shift in focus. Here’s how to visualize it:

Seeing you’re not alone may be not be the consolation you desperately want if you’re going through a breakup or right on the brink.  But if knowledge is power then perhaps you can use the visual shift to your advantage: to work together without acting rashly until this season has passed, or to commit to being more compassionate and mindful with your partner through this time, or to get outside help, or to put what you know to be an inevitable end into a more grounded, potentially fruitful perspective.

By the way, in case you didn’t notice, there are other times too when a relationship is very likely to end:  Spring Break and the days leading up to it, April Fools Day, just about any Monday.

The good news is if you and your significant other stay together up until Christmas it’s likely to turn out all right. People rarely break up on Christmas Day.

Here’s a presentation by David McCandless at the TED conference last summer in Oxford via YouTube.  The Facebook breakup data starts about 6’30″ in.

Our true selves

“And so, like runaway slaves, we either flee our own reality or manufacture a false self which is mostly admirable, mildly prepossessing, and superficially happy.

“We hide what we know or feel ourselves to be (which we assume to be unacceptable and unlovable) behind some kind of appearance which we hope will be more pleasing.

“We hide behind pretty faces which we put on for the benefit of our public.

“And in time we may even come to forget that we are hiding, and think that our assumed pretty face is what we really look like.”

– Simon Tugwell

“If only I had a hot lover”

“If only I had a hot lover,” she said to me.

If only everyone had a hot lover, I thought.  But that wouldn’t solve this woman’s problem, or most people’s problems.  It sounded good though.

When people come to me they nearly always identify a “problem” that is rarely the real problem. Most often it’s a symptom of a problem they themselves cannot see. Very often it’s one that is part of what I refer to as ‘core material.’ Core material is not just stuff that’s in our heads. It’s psychological, emotional, spiritual, physical, interpersonal, social. It is tied to our very identity, which is why it’s too risky to look at directly.  Sometimes it is entirely inaccessible to us, and for good reason. It would be too painful or hard to make sense of to face head on. Sometimes, we’re deeply invested in not knowing what’s really going on there.

And so without intentionally doing so we fashion for ourselves rationalizations, and rationalizations about our rationalizations, to make sense of things that are messy, contradictory or simply beyond our ken.  That’s why we come up with solutions such as, “If only I had a hot lover.” It gives us imaginary control over the otherwise uncontrollable.

This young woman wanted to see me because, as she put it, even though she met and dated men she was attracted to, she lacked a desire for sex and when she had it she felt unsatisfied.  Especially if one has had clumsy, incompetent, selfish or boring  lovers, seeking and finding a “hot” one makes a very defensible commonsense solution.  And, depending on the person, it might even offer some hope for better sex and more fulfilling intimacy.

But in my experience it is rarely the answer.

A fresh look at great sex

If you want to know what a great sex life is like, you should ask the real experts – people who believe they are having really great sex.

That’s the revolutionary but commonsense assumption behind research conducted by Peggy Kleinplatz, PhD, and her colleagues at Ottawa University. They interviewed 64 people over a five-year period, mostly from the US, all of whom said they had great sex lives.

Their findings paint a radically different picture of optimal sexuality from what is commonly portrayed in the media.

Truly great sex had little to do with the sorts of things popular men’s and women’s magazines typically focus on – things like multiple orgasms and “lasting all night.”

Popular culture promotes “achieving great sex through ‘secret’ techniques, novelty and variety, suggesting that one is to look outside of oneself to find great sex. In contrast with these sources and mechanistic models … the participants in this study found techniques and sex ‘acts’ mostly irrelevant,” says Kleinplatz.

This is not to say that we don’t want to explore or add variety to our sex lives. Many of us do. It simply means that when all is said and done, those aren’t the keys to what we consider truly “great sex.”

What this research shows is something those of us who work with clients from day-to-day have long known: ultimately a great sex life has less to do with ideal physiological functioning such as rock-hard erections, ultra-slick spontaneous vaginal lubrication, or even successful intercourse and orgasm, than how people connect emotionally and, in a broad sense, spiritually.

The portrait Kleinplatz and colleagues paint of great sex includes eight major characteristics:

  • 1. being present, focused, embodied
  • 2. connection, alignment, merger, being in sync
  • 3. deep sexual and erotic intimacy
  • 4. extraordinary communication and heightened empathy
  • 5. authenticity, being genuine, uninhibited and transparent
  • 6. transcendence, bliss, peace, transformation and healing
  • 7. exploration, interpersonal risk-taking, and fun; and
  • 8. vulnerability and surrender.

They identified two additional components of great sex but characterized them as “minor” because only a minority of participants touched on them and they were not emphasized to the same degree: 1) intense physical sensation and orgasm, and 2) lust, desire, chemistry and attraction.

Although a few believed these two were necessary components, they stated that they were not sufficient in and of themselves to constitute great sex.

The study focused on optimal sex in general, not single, isolated “peak” sexual experiences.

“The actual sexual behaviors and acts performed are far less important than the mind-set and intent of the person or couple engaged in these acts,” Kleinplatz observes.

By focusing on the individual’s subjective experience, the definition of sex may be broadened to include times even when no physical contact is involved.

Those interviewed included members of different racial and ethnic groups, people of different ages and relationship statuses representing a various sexual orientations and levels of physical ability and sexual functioning.

What is perhaps most striking about this qualitative research is that the otherwise dissimilar participants’ conceptualizations of great sex were consistently very much alike.

Kleinplatz writes, “The major components of optimal sexuality seemed to be almost universal among participants of different backgrounds, sexual proclivities and relationship histories.”

What that tells is this: there are undoubtedly various routes to great sex, but when we have it and get around to describing what it is, the essential experience tends to be quite similar among us all.

More about the 8 Components of ‘Great Sex’

  1. Being present, focused and embodied This was the first and most frequently mentioned factor contributing to great sex. As one woman described, “It’s being fully alive in one’s skin, engaged with the partner — emotionally, intellectually, physically, spiritually — in the moment.”
  2. Connection, alignment, merger, being in sync Depth of the connection between partners was one of the most critical elements of the experience regardless of duration of the relationship.
  3. Deep sexual and erotic intimacy This is the foundation of a relationship in which optimal sexuality becomes a possibility. It involves deep mutual respect, caring, genuine acceptance and admiration, but this is easier said than done. As Kleinplatz notes, “you can’t trust just anyone.”
  4. Extraordinary communication, heightened empathy Kleinplatz describes the study’s participants as having ‘black belts’ in communication.These weren’t people who learned all about the other sex’s genitalia and then just applied the technique,” she says. “These were people who were so engaged in and with their partners’ bodies that they could read their partners’ responses, not only touching them, but feeling them.”
  5. Authenticity, being genuine, being uninhibited, transparent “This is pretty much the opposite of self-consciousness,” says Kleinplatz. “It’s allowing oneself to be emotionally naked while being seen by a partner.”
  6. Transcendence, bliss, peace, transformation, healing Participants in the study often reported a sense of timelessness or the infinite during great sex. “Their experience often really was exalted, and they would use language borrowed from religion to describe it,” says Kleinplatz.
  7. Exploration, interpersonal risk-taking, fun Participants described great sex as an adventure, an opportunity to discover things about themselves and their partners and a chance to pursue ever greater depths. “Interpersonal risk-taking and exploration emerged as important components of great sex… undertaken in the context of play and fun,” says Kleinplatz.
  8. Vulnerability and surrender  “Giving oneself,” letting oneself be vulnerable and surrendering to a partner were exquisite aspects of great sex, participants in the study said. Kleinplatz describes great sex as a leap of faith. “It’s saying ‘I’m going to jump off this cliff, be naked and be vulnerable and give myself to somebody else and take them in’ and I hope I feel good after I do that.”

“The Components of Optimal Sexuality: A Portrait of ‘Great Sex’”, was published in 2009 in The Canadian Journal of Human Sexuality

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