# Come As You Are by Emily Nagoski
A revised and updated edition of Emily Nagoski’s game-changing New York Times bestseller Come As You Are, featuring new information and research on mindfulness, desire, and pleasure that will radically transform your sex life. For much of the 20th and 21st centuries, women’s sexuality was an uncharted territory in science, studied far less frequently—and far less seriously—than its male counterpart. That is, until Emily Nagoski’s Come As You Are, which used groundbreaking science and research to prove that the most important factor in creating and sustaining a sex life filled with confidence and joy is not what the parts are or how they’re organized but how you feel about them. In the years since the book’s initial publication, countless women have learned through Nagoski’s accessible and informative guide that things like stress, mood, trust, and body image are not peripheral factors in a woman’s sexual wellbeing; they are central to it—and that even if you don’t always feel like it, you are already sexually whole by just being yourself. This revised and updated edition continues that mission with new information and advanced research, demystifying and decoding the science of sex so that everyone can create a better sex life and discover more pleasure than you ever thought possible.
- correlation does not imply causation
- pudendem means shame
- the stories behind the hymen has nothing to do with biology and everything to do with controlling women
- the hymen affects women's wellbeing due to cultural beliefs
- arousal nonconcordance is normal
- there is a 50% overlap between a man's genital response and his subjective arousal
- there is a 10% overlap between a woman's genital response and her subjective arousal
- arousal nonconcordance
- nonconcordance is about the relationship between the peripheral system and the central system
- nonconcordance is not just a sex thing
- both porn and mainstream culture continue to perpetuate the myth that genital response = desire and pleasure
- men’s sexuality has been the “default” sexuality
- arousal nonconcordance affects men too
- dealing with arousal nonconcordance
- lube can make your sex life better
### The True Story of Sex
> it was just sort of assumed that since men have orgasms during penis-in-vagina sex (intercourse), women should have orgasms with intercourse, too, and if they don’t, it’s because they’re broken.
> In reality, about a quarter of women orgasm reliably with intercourse. The other 75 percent sometimes, rarely, or never orgasm with intercourse, and they’re all healthy and normal. A woman might orgasm lots of other ways—manual sex, oral sex, vibrators, breast stimulation, toe sucking, pretty much any way you can imagine—and still not orgasm during intercourse. That’s normal.
### [[arousal nonconcordance is normal]]
> A woman can be perfectly normal and healthy and experience “arousal nonconcordance,” where the behavior of her genitals (being wet or dry) may not match her mental experience (feeling turned on or not). ^-bzez
> A woman can be perfectly normal and healthy and never experience spontaneous sexual desire. Instead, she may experience “responsive” desire, in which her desire emerges only in a highly erotic context.
## Chapter One: Anatomy: No Two Alike
### [[pudendem means shame]]
> Medieval anatomists called women’s external genitals the “pudendum,” a word derived from the Latin pudere, meaning “to make ashamed.” Our genitalia were thus named “from the shamefacedness that is in women to have them seen.”2 ^midvf
### The Beginning
> About six weeks after the fertilized egg implants in the uterus, there is a wash of masculinizing hormones. The male embryo responds to this by developing its “prefab” universal genital hardware into the male configuration of penis, testicles, and scrotum. The female embryo does not respond to the hormone wash at all, and instead develops its prefab universal genital hardware into the female configuration of clitoris, ovaries, and labia.
> All the same parts, organized in different ways. Every body’s genitals are the same until six weeks into gestation, when the universal genital hardware begins to organize itself into either the female configuration or the male configuration.
> Welcome to the wonderful world of biological homology.
> Homologues are traits that have the same biological origins, though they may have different functions. Each part of the external genitalia has a homologue in the other sex
> Both male and female genitals have a round-ended, highly sensitive, multichambered organ to which blood flows during sexual arousal. On female bodies, it’s the clitoris; on male bodies, it’s the penis. And each has an organ that is soft, stretchy, and grows coarse hair after puberty. On female bodies, it’s the outer lips (labia majora); on male bodies, it’s the scrotum. These parts don’t just look superficially alike; they are developed from the equivalent fetal tissue. If you look closely at a scrotum, you’ll notice a seam running up the center—the scrotal raphe. That’s where the scrotum would have split into labia if the chemistry or chromosomes had been a little bit different.
> Nipples on females are vital to the survival of almost all mammal species, including humans (though a handful of old mammals, such as the platypus, don’t have nipples, and instead just leak milk from their abdomens), so evolution built nipples in right at the very beginning of our fetal development. It takes less energy to just leave them there than to actively suppress them—and evolution is as lazy as it can get away with—so both males and females have nipples. Same biological origins—different functions.
### The Clit, the Whole Clit, and Nothing but the Clit
> Averaging just one-eighth the size of a penis yet loaded with nearly double the nerve endings, it can range in size from a barely visible pea to a fair-sized gherkin, or anywhere in between, and it’s all normal, all beautiful.
> Unlike the penis, the clitoris’s only job is sensation. The penis has four jobs: sensation, penetration, ejaculation, and urination.
> Two different ways of functioning, one shared biological origin.
### Hymen Truths
### [[the stories behind the hymen has nothing to do with biology and everything to do with controlling women]]
> The hymen is a profound example of the way humans metaphorize anatomy. Here is an organ that has no biological function, and yet Western culture made up a powerful story about the hymen a long time ago. This story has nothing to do with biology and everything to do with controlling women. ^3vie8
### [[the hymen affects women's wellbeing due to cultural beliefs]]
> In a sense, the hymen can be relevant to women’s health: Some women are beaten or even killed for not having a hymen. Some women are told they “couldn’t have been raped” because their hymen is intact. For them, the hymen has real impact on their physical wellbeing, not because of their anatomy but because of what their culture believes about that anatomy. ^d3n07
### The Sticky Bits
> Why do we talk about penises “getting hard” and vaginas “getting wet,” when from a biological perspective both male and female genitals get both hard and wet? It’s a cultural thing again. Male “hardness” (erection) is a necessary prerequisite for intercourse, and “wetness” is taken to be an indication that a body is “ready” for intercourse (though in chapter 6, we’ll see how wrong this can be).
### Why It Matters
> Some authors argue that the differences between men and women are more important than the similarities. Others say that the similarities are more important than the differences. My view is that the basic fact of homology—all the same parts, organized in different ways—is more important than either.
### What It ‘Is’, Not What It ‘Means’
> Everyone’s genitals are made of the same parts, organized in different ways. No two alike.
> Are you experiencing pain? If so, talk to a medical provider. If not, then your genitals are normal and healthy and beautiful and perfect just as they are.
> The genitals you see in soft-core porn images may have been digitally altered to appear more “tucked in”; don’t let that fool you into believing that all vulvas look that way.
> Find a mirror (or use the self-portrait camera on your phone) and actually look at your clitoris. Knowing where the clitoris is is important, but knowing where your clitoris is is power.
### Turn On the Ons, Turn Off the Offs
> Developed in the late 1990s by Erick Janssen and John Bancroft at the Kinsey Institute, the dual control model of sexual response goes far beyond earlier models of human sexuality, by describing not just “what happens” during arousal—erection, lubrication, etc.—but also the central mechanism that governs sexual arousal, which controls how and when you respond to sex-related sights, sounds, sensations, and ideas.3
> Your central nervous system (your brain and spinal cord) is made up of a series of partnerships of accelerator and brakes—like the pairing of your sympathetic nervous system (“accelerator”) and your parasympathetic nervous system (“brakes”). A core insight of the dual control model is that what’s true for other aspects of the nervous system must also be true for the brain system that coordinates sex: a sexual accelerator and sexual brakes.
> So the dual control model of sexual response, as the name implies, consists of two parts: Sexual Excitation System (SE). The accelerator of your sexual response. It receives information about sex-related stimuli in the environment—things you see, hear, smell, touch, taste, or imagine—and sends signals from the brain to the genitals to tell them, “Turn on!” SE is constantly scanning your context (including your own thoughts and feelings) for things that are sex-related. It is always at work, far below the level of consciousness. You aren’t aware that it’s there until you find yourself turned on and pursuing sexual pleasure.
> Sexual Inhibition System (SI). Your sexual brakes. “Inhibition” here doesn’t mean “shyness” but rather neurological “off” signals. Research has found that there are actually two brakes, reflecting the different functions of an inhibitory system. One brake works in much the same way as the accelerator. It notices all the potential threats in the environment—everything you see, hear, smell, touch, taste, or imagine—and sends signals saying, “Turn off!”
> This brake is responsible for preventing us from getting inappropriately aroused in the middle of a business meeting or at dinner with our family. It’s also the system that throws the off switch if, say, in the middle of some nookie, your grandmother walks in the room.
> The second brake is a little different. It’s more like the hand brake in a car, a chronic, low-level “No thank you” signal. If you try to drive with the hand brake on, you might be able to get where you want to go, but it’ll take longer and use a lot more gas. Where the foot brake is associated with “fear of performance consequences,” the hand brake is associated with “fear of performance failure,” like worry about not having an orgasm.
> If you’re having trouble with any phase of sexual response, is it because there’s not enough stimulation to the accelerator? Or is there too much stimulation to the brakes? Indeed, a common mistake made by people who are struggling with orgasm or desire is assuming that the problem is a lack of accelerator; it’s more likely that the problem is too much brakes (more on that in chapters 7 and 8). And once you know whether it’s a problem with the accelerator or the brakes, you can figure out how to create change.
### Your Sexual Temperament
> The brakes and accelerator are traits. We all have them and they’re more or less stable over time, but, like introversion/extroversion, they vary from individual to individual.5 Just as we all have phalluses and urethras, as we saw in chapter 1, we all have a sexual accelerator and sexual brakes in our central nervous systems (we’re all the same!). But we all have different sensitivities of brakes and accelerator (we’re all different!), which leads to different sexual temperaments or personalities.
> Some people are high on both brakes and accelerator, others are low on both, some have high brakes but low accelerator, and some have high accelerator but low brakes. And most of us are average.
> Suppose you’re high on SE and low on SI—sensitive accelerator and hardly any brakes. What kind of sexual response do you have?
> You respond readily to sex-related stimuli but not to potential threats, so you’re easily turned on and have a difficult time turning off. Which isn’t always as fun as it might sound, and it can, under some circumstances, be related to inconsistent condom use, more partners, more one-night stands, and feeling “out of control” of your sexuality, which are higher risk for unwanted consequences.6 The sensitive accelerator plus not-so-sensitive brakes combination describes between roughly 2 and 6 percent of women, and it’s associated with sexual risk-taking and compulsivity.7
> What if you have the opposite combination—sensitive brakes plus not-so-sensitive accelerator? This describes about 1 to 4 percent of women and is associated with problems with getting aroused, lack of interest or desire, and difficulty with orgasm. If you have sensitive brakes, you’re very responsive to all the reasons not to be aroused, and if you have a relatively insensitive accelerator, it takes a lot of concentration and deliberate attention to tune in to sex.
> Sensitive brakes, regardless of the accelerator, is the strongest predictor of sexual problems of all kinds. In a 2008 survey of 226 women age eighteen to eighty-one, low interest in sex, arousal difficulties, and orgasm difficulty were significantly correlated with inhibition factors, especially “arousal contingency” (“Unless things are ‘just right’ it is difficult for me to become sexually aroused”) and concerns about sexual function (“If I am worried about taking too long to become aroused or to orgasm, this can interfere with my arousal”).8
### Different for Girls… Sometimes
> For example, about 10 to 20 percent of both men and women report an increase in their sexual interest when they’re anxious or depressed.11 But a guy who wants sex more when he’s anxious or depressed may have less sensitive brakes. A woman who wants sex more when she’s anxious or depressed may have a more sensitive accelerator.
### Can You Change Your Brain?
> So can we change it?
> The answer has two parts, both equally important.
> First, accelerator and brakes are traits you’re born with that remain more or less stable over time, and so far the only variable that seems to impact either is partner characteristics (see chapter 3).15 In general, though, it seems there’s very little we can do to deliberately change the mechanism in your brain.
> then there’s the second part of the answer: You may not be able to change the mechanism itself, but you probably can change what the mechanism responds to. You can often change what your brakes consider a potential threat, and you can reduce those threats, like unwanted pregnancy, STIs, stress, etc.
> Your brain has a sexual “accelerator” that responds to “sex-related” stimulation—anything you see, hear, smell, touch, taste, or imagine that your brain has learned to associate with sexual arousal.
> Your brain also has sexual “brakes” that respond to “potential threats”—anything you see, hear, smell, touch, taste, or imagine that your brain interprets as a good reason not to be turned on right now. These can be anything from STIs and unwanted pregnancy to relationship issues or social reputation.
> There’s virtually no “innate” sex-related stimulus or threat; our accelerators and brakes learn when to respond through experience.
> People vary in how sensitive their brakes and accelerator are. Take the little quiz on page 54 to find out how sensitive yours are—and remember that most people score in the medium range, and all scores are normal.
### Chapter Three: Context: And the “One Ring” (to Rule Them All) in Your Emotional Brain
> Context is made of two things: the circumstances of the present moment—whom you’re with, where you are, whether the situation is novel or familiar, risky or safe, etc.—and your brain state in the present moment—whether you’re relaxed or stressed, trusting or not, loving or not, right now, in this moment. The evidence is mounting that women’s sexual response is more sensitive than men’s to context, including mood and relationship factors, and women vary more from each other in how much such factors influence their sexual response.6
### Sensation in Context
> Suppose you’re flirting with a certain special someone, and they start tickling you. You can imagine some situations where that’s fun, right? Flirtatious. Potentially leading to some nookie.
> Now imagine that you are feeling annoyed with that same special someone and they try to tickle you.
> It feels irritating, right? Like maybe you’d want to punch that person in the face.
> It’s the same sensation, but because the context is different, your perception of that sensation is different.
> chronoception (sense of time): Time does indeed seem to fly when you’re having fun—or rather, when you’re in a state of “flow.”10
> People who are given a drug that will relax them and are told, “This is a drug that will relax you,” not only feel more relaxed compared to those who got the drug but not the information, they also have more of the drug in their blood plasma.11 Context changes more than how you feel; it can change your blood chemistry.
> Painful or Erotic?
> If your partner spanks your butt while you’re in the middle of tying your toddler’s shoes, it’s annoying. But if your partner spanks your butt in the middle of sex, it can feel very, very sexy indeed. Context can cause sensations that are typically perceived as painful, like spanking or whipping, to be erotic. Sexual “submission” requires relaxing into trust—turning off the offs—and allowing your partner to take control. In this explicitly erotic, highly trusting, and consensual context, your brain is open and receptive, ready to interpret any and all sensations as erotic. And in a culture where women have to spend so much time with the brakes on, saying no, it’s no wonder we have fantasies about abandoning all control, relaxing into absolute trust (turning off the brakes), and allowing ourselves to experience sensation.
### Sex, Rats, and Rock ’n’ Roll
> “Context changes how your brain responds to sex” doesn’t just mean “Set the mood,” like with candles, corsets, and a locked bedroom door. It also means that when you’re in a great sex-positive context, almost everything can activate your curious “What’s this?” desirous approach to sex. And when you’re in a not-so-great context—either external circumstances or internal brain state—it doesn’t matter how sexy your partner is, how much you love them, or how fancy your underwear is, almost nothing will activate that curious, appreciative, desirous experience.
> It’s completely normal that context changes how you perceive sensations. It’s just how brains work.
### “Is Something Wrong with Me?” (Answer: Nope)
> Your brain’s perception of a sensation is context dependent. Like tickling: If your partner tickles you when you’re already feeling turned on, it can be fun. But if they tickle you when you’re angry, it’s just irritating. Same sensation, different context—therefore different perception.
> When you’re stressed out, your brain interprets just about everything as a potential threat. When you’re turned on, your brain could interpret just about anything as sex-related. Because: context!
> Wanting, liking, and learning are separate functions in your brain. You can want without liking (craving), anticipate without wanting (dread), or any other combination.
> For most people, the best context for sex is low stress + highly affectionate + explicitly erotic. Think through your contexts with the worksheets that follow.
### Chapter Four: Emotional Context: Sex in a Monkey Brain
> This chapter is about stress and love and how they affect sexual pleasure.
> Trust your body. Listen to it—not to the specific circumstances of the moment but to the deep, primal messages of your evolutionary heritage:
> I am at risk/I am safe.
> I am broken/I am whole.
> I am lost/I am home.
> Because it’s not just the sexual aspects of a context that influence whether you get turned on. It’s all the other emotional aspects, including your preexisting emotional state.
> Stress is the physiological and neurological process that helps you deal with threats. Love is the physiological and neurological process that draws you to your tribe.
> Stress underlies worry, anxiety, fear, terror, all the variants of “Run away!” But it also underlies anger—irritation, annoyance, frustration, rage. And to a great extent it underlies the shutdown that characterizes depression
> The key to managing stress (so that it doesn’t mess with your sex life) is not simply “relaxing” or “calming down.” It’s allowing the stress response cycle to complete. Allow it to discharge fully. Let your body move all the way from “I am at risk” to “I am safe.”
> Love, for our purposes, is attachment, the innate biological mechanism that bonds humans together. It underlies passion, romance, and the joy of finding a partner you can connect with. But it also underlies grief, jealousy, and heartbreak. Sometimes it’s joyful, like when you’re falling in love. Sometimes it’s agonizing, like when you’re breaking up. But always attachment pushes us from “I am broken” to “I am whole.”
> We can understand women’s sexual wellbeing only if we take context into account—and most of that context has nothing to do with sex itself. Which means we can improve our sexual wellbeing and expand our sexual pleasure without directly changing anything about our sex lives
### The Stress Response Cycle: Fight, Flight, and Freeze
> Let’s first separate your stressors from your stress. Your stressors are the things that activate the stress response—bills, family, work, fretting about your sex life, all of that.
> Your stress is the system of changes activated in your brain and body in response to those stressors. It’s an evolutionarily adaptive mechanism that allows you to respond to perceived threats. Or it was evolutionarily adaptive, back when our stressors had claws and teeth and could run thirty miles per hour. These days we are almost never chased by lions, and yet our body’s response to, say, an incompetent boss is largely the same as it would be to a lion. Your physiology doesn’t differentiate much
> When your brain perceives a threat in the environment, you experience a massive biochemical change, characterized by floods of adrenaline and cortisol to your bloodstream and a cascade of physiological events, such as increased heart rate, respiration rate, and blood pressure; suppressed immune and digestive functioning; dilation of the pupils and shifting of attention to a vigilant state, focused on the here and now. All these changes are like revving your engine before a race, or taking a deep breath before you duck underwater—preparation for the action to come.
> What action that will be depends on the nature of the perceived threat—that is, it’s context dependent.
> Suppose the threat is a lion—the kind of threat we were dealing with in the environment where the mechanism evolved in our early ancestors. The stress response cycle notices the lion and shouts, “I’m at risk! What do I do?” A lion, your brain informs you in much less than a second, is the kind of threat that you are most likely to survive by trying to escape.
> So what do you do when you see a lion coming after you?
> You feel fear, and you run.
> And then what happens?
> There are only two possible outcomes, right? Either you get killed by the lion, in which case none of the rest of this matters, or you escape and live. So imagine that you successfully run back to your village and scream for help, and everyone helps you slaughter the lion, and then you all eat it for dinner, and in the morning you have a respectful burial service for the parts of the carcass you won’t be using, giving reverent thanks for the lion’s sacrifice.
> And how do you feel now?
> Relieved! Grateful to be alive! You love your friends and family!
> And that is the complete stress response cycle, with beginning (“I’m at risk!”), middle (action), and end (“I’m safe!”).
> Fight emerges when your emotional One Ring determines that a stressor should be conquered. Flight emerges when your One Ring determines a stressor should be escaped.
> But suppose the stressor is one that your brain determines you can’t survive by escaping and you can’t survive by conquering—you feel the teeth of the lion bite into you from behind. This is when you get the brakes stress response—the parasympathetic nervous system, the “STOP!” activated by the most extreme distress. Your body shuts down; you may even experience “tonic immobility,” where you can’t move, or can move only sluggishly. Animals in the wild freeze and fall to the ground as a last-ditch effort to convince a predator they’re already dead; Stephen Porges has speculated that freeze facilitates a painless death.1
> If an animal survives such an intense threat to its life, then it does an extraordinary thing: It shakes. It trembles, paws vibrating in the air. It heaves a great big sigh. And then it gets up, shakes itself off, and trots away.
> What’s happening here is that freeze has interrupted the GO! stress response of fight or flight, leaving all that adrenaline-mediated stress to go stale inside the animal’s body. When the animal shakes and shudders and sighs, its body is releasing the brakes and completing the activation process triggered by fight/flight, and purging the residue. Completing the cycle. It’s called “self-paced termination.”2
### Stress and Sex
> In fact, more than half of women report that stress, depression, and anxiety decrease their interest in sex; they also reduce sexual arousal and can interfere with orgasm.3 Chronic stress also disrupts or suppresses the menstrual cycle, decreases fertility and lactation, and increases miscarriage, as well as reducing genital response and increasing both distractibility and pain with sex.4
> We also know that the brain can handle only a limited amount of information at a time; at its simplest, we can think of stress as information overload, so when there’s too much happening, the brain starts to triage, prioritizing, simplifying, and even plain old ignoring some things.
> And we know that the brain prioritizes based on survival needs: breathing, escaping from predators, maintaining the right temperature, staying hydrated and nourished, and remaining with your social group are all first-order-of-business priorities—and of course these priorities sort themselves based on context
> Stress is about survival. And while sex serves a lot of purposes, personal survival is not one of them
> My technical description of Olivia’s out-of-control experience is “maladaptive behavior to manage negative affect”—which just means trying to cope with uncomfortable emotions (stress, depression, anxiety, loneliness, rage) by doing things that carry a high risk of unwanted consequences. Compulsive sexual behavior is one example. Other examples include:
> using alcohol or other drugs in a risky way dysfunctional relationships—for instance, trying to deal with your own feelings by dealing with someone else’s escaping into distractions, like movie binge-watching when you have other things you need to be doing disordered eating—restricting, bingeing, or purging
### Broken Culture → Broken Stress Response Cycles
> First, in modern life, we are, as I mentioned, almost never chased by lions. Our stressors are lower intensity and longer duration—“chronic stressors,” they’re called, in contrast to “acute stressors,” like straightforward predation. Acute stressors have a clear beginning, middle, and end; completing the cycle—running, surviving, celebrating—is inherently built in. Not so with chronic stressors. If our stress is chronic and we don’t take deliberate steps to complete the cycle, all that activated stress just hangs out inside us, making us sick, tired, and unable to experience pleasure with sex (or with much of anything else).
> Second, our emotion-dismissing culture is uncomfortable with Feels. Our culture says that if the stressor isn’t right in front of us, then we have no reason to feel stressed and so we should just cut it out already. As a result, most people’s idea of “stress management” is either to eliminate all stressors or to “just relax,” as if stress can be turned off like a light switch. Our culture is so uncomfortable with Feels that we may even sedate people who’ve just been in a car accident, preventing their bodies from moving through this natural process; this well-intentioned medical intervention has the unwanted consequence of holding survivors of traumatic injury in freeze, which is how PTSD gets a foothold in a survivor’s brain.5
> But third, even without medication and an emotion-dismissing culture, our ultrasocial human brains are really good at self-inhibition, stopping the stress response midcycle because, “Now is not an appropriate time for Feels.” We use this self-inhibition in order to facilitate social cooperation—i.e., not freak anybody out. But unfortunately, our culture has eliminated all appropriate times for Feels. We’ve locked ourselves, culturally, into our own fear, rage, and despair. We must build time, space, and strategies for discharging our stress response cycles.
### Complete the Cycle!
> Think about what your body recognizes as the behaviors that save you from lions. When you’re being chased by a lion, what do you do?
> You run.
> So when you’re stressed out by your job (or by your sex life), what do you do?
> You run… or walk, or get on the elliptical machine or go out dancing or even just dance around your bedroom. Physical activity is the most efficient strategy for completing the stress response cycle and recalibrating your central nervous system into a calm state. When people say, “Exercise is good for stress,” that is for realsie real.7
> Here are some other things that science says can genuinely help us not only “feel better” but actually facilitate the completion of the stress response cycle: sleep; affection (more on that later in the chapter); any form of meditation, including mindfulness, yoga, tai chi, body scans, etc.; and allowing yourself a good old cry or primal scream—though you have to be careful with this one. Sometimes people just wallow in their stress when they cry, rather than allowing the tears to wash away the stress. If you’ve ever locked yourself in your room and sobbed for ten minutes, and then at the end heaved a great big sigh and felt tremendously relieved, you’ve felt how it can move you from “I am at risk” to “I am safe.”
> Art, used in the same way, can help. When mental health professionals suggest journaling or other expressive self-care, they don’t mean that the construction of sentences or the task of drawing is inherently therapeutic; rather, they’re encouraging you to find positive contexts to discharge your stress, through the creative process.
> I’m inclined to add grooming and other body self-care to the list. Though I’m not familiar with any specific research on it, I’ve talked with lots of women for whom showering and the rituals, part social, part meditative, of painting their nails or doing their hair or putting on makeup—generally “getting ready” to go out (or stay in)—fully transition them from a stressed-out state of mind to a warm, social state of mind. These anecdotes aren’t data, but I’m inclined to call them evidence and say: yeah. Spend time treating yourself with affection
> Emotions are tunnels: You have to walk all the way through the darkness to get to the light at the end. I say this so often my students sometimes roll their eyes: “Not the tunnel again.” Yes, the tunnel again. Because it’s true.
### Attachment and Sex: The Dark Side
> Attachment is about survival; relationships are about survival. When they are threatened, we do whatever it takes to hold on to them, because there are no higher stakes than our connection with our attachment objects.
> I’ll illustrate this idea with some of the darkest and most disturbing science I’ve ever read—it’s disturbing precisely because it shows us how powerfully attachment affects the emotional wellbeing of mammals like us. In Harry Harlow’s series of “monster mother” studies, conducted in the middle of the twentieth century, his research team invented mechanical “mothers,” to which infant rhesus monkeys attached. Once the infants were emotionally attached to the monster mothers, the mechanical devices shook the infants, spiked them, or jetted cold air onto them, to force the babies away.
> And what did the infant monkeys do when their “mothers” treated them badly, shook them off, rejected them?
> They ran back to their mothers.
> In an episode of the radio show This American Life, Deborah Blum, author of a biography of Harlow, Love at Goon Park, puts it this way:
> The [rhesus monkey] babies came back and they did everything they could to make those mothers love them again. And they cooed, and they stroked, and they’d groom, and they’d flirt, and exactly what human babies do with their moms. And they would abandon their friends. They had to fix this relationship. It was so important to them.19
> And just as the baby rhesus monkeys used attachment behaviors to repair their relationships with their monster mothers, women in unstable relationships may use sex as an attachment behavior to build or repair the attachment
### Survival of the Social
> Which brings me to an additional stress response known as “tend and befriend,” which we can think of as the marriage of stress and attachment.29 As an ultrasocial species, our survival depends not just on our individual ability to fight, run, or shut down, but also on our ability to collaborate with our tribe, so that we can protect them and they can protect us. Women may be more likely than men to access this “affiliative” stress response, dealing with potential threats by connecting affectionately with people. As always, to what extent this difference is inborn and to what extent it’s learned isn’t clear, but the differences start early, with girls as young as eighteen months being more likely than boys to approach, rather than avoid, a parent doing scary things.30
> Where stress and attachment overlap, the message of your emotional One Ring is, “I am lost!” and when you escape the lion and run to your attachment object, the message is, “I am home.” If you’ve ever found yourself checking your email obsessively when you’re stressed, or scrolling endlessly through social media, or texting your partner just to say, “Hey,” or calling all your friends one after the next, or, like Elle in Legally Blonde, running for an emergency manicure, you may have experienced the tend and befriend stress response. Both feeling taken care of and taking care of others register in your stress response as “completing the cycle.”
> I blame Charles Dickens. Take Mrs. Cratchit from A Christmas Carol. Her son, Tiny Tim, dies, and she tells her other children that she’s crying because the color of her sewing hurts her eyes, and she “wouldn’t want to show weak eyes” to her husband. When I was little, I used to think, as Dickens wanted me to, Mrs. Cratchit is so brave. But now that I know about the stress response cycle, I want to yell, “Lady, your child died! It’s not ‘weak’ to cry! And your other kids deserve to know that it’s normal to grieve!”
> Being with the tribe doesn’t replace the Feels built into completing the cycle. We need to discharge the stress response, complete the cycle, before our bodies can move on. “Home” is the place—physical and emotional—where we can discharge stress without being judged or shamed or told we just need to relax or forget about it. “Home” is where we receive our partner’s “loving presence.”
### The Water of Life
> Stress reduces sexual interest in 80–90 percent of people and reduces sexual pleasure in everyone—even the 10–20 percent of people for whom it increases interest. The way to deal with stress is to allow your body to complete the stress response cycle.
> Trauma survivors’ brains sometimes learn to treat “sex-related” stimuli as threats, so that whenever the accelerator is activated, the brakes are hit, too. Practicing mindfulness is an evidence-based strategy for decoupling the brakes and accelerator.
> In the right context, sex can attach us emotionally to new partners or reinforce emotional bonds in unstable relationships. In other words, sex and love are closely linked in our brains—but only in the right context.
> Sex that brings you closer to your partner “advances the plot,” as opposed to gratuitous sex, for no reason other than that you can. To have more and better sex, give yourself a compelling reason to have sex, something important to move toward.
### Chapter Five: Cultural Context: A Sex-Positive Life in a Sex-Negative World
> I was chatting about this one October evening, over poutine and beer, with Canadian sex researcher Robin Milhausen, and she said this brilliant thing: “We’re raising women to be sexually dysfunctional, with all the ‘no’ messages we’re giving them about diseases and shame and fear. And then as soon as they’re eighteen they’re supposed to be sexual rock stars, multiorgasmic and totally uninhibited. It doesn’t make any sense. None of the things we do in our society prepares women for that.”
> We’ll start with three core cultural messages about women’s sexuality that my students grapple with as their established ideas about sex are challenged by the science: the Moral Message (you are evil), the Medical Message (you are diseased), and the Media Message (you are inadequate).
### Three Messages
> I was puzzled by the false beliefs my students brought with them into the classroom, until I began reading antique sex advice manuals. And there they were in black and white, written a hundred years ago or more—the same false ideas my students believed. Students have absorbed these ideas from their families and their cultures, without any of them ever having read those books.
> One day in class, I read aloud a couple of definitions of “sex.” First I read from Ideal Marriage: Its Physiology and Technique by T. H. van de Velde, from 1926. He wrote that “normal sexual intercourse” is
> that intercourse which takes place between two sexually mature individuals of opposite sexes; which excludes cruelty and the use of artificial means for producing voluptuous sensations; which aims directly or indirectly at the consummation of sexual satisfaction, and which, having achieved a certain degree of stimulation, concludes with the ejaculation—or emission—of the semen into the vagina, at the nearly simultaneous culmination of sensation—or orgasm—of both partners.1
> Then I read from The Hite Report, published in 1976, from the chapter titled “Redefining Sex”:
> Sex is intimate physical contact for pleasure, to share pleasure with another person (or just alone). You can have sex to orgasm, or not to orgasm, genital sex, or just physical intimacy—whatever seems right to you. There is never any reason to think the “goal” must be intercourse, and to try to make what you feel fit into that context. There is no standard of sexual performance “out there,” against which you must measure yourself; you aren’t ruled by “hormones” or “biology.” You are free to explore and discover your own sexuality, to learn or unlearn anything you want, and to make physical relations with other people, of either sex, anything you like.2
> And I asked my students, “Which of these is more like what you learned growing up?”
> No contest. Ideal Marriage.
> The Moral Message: “You are Damaged Goods.” If you want or like sex, you’re a slut. Your virginity is your most valuable asset. If you’ve had too many partners (“too many” = more than your male partner has had), you should be ashamed.
> The Medical Message: “You Are Diseased.” Sex causes disease and pregnancy, which makes it dangerous. But if you’re ready to take that risk, sexual functioning should happen in a particular way—desire, then arousal, then orgasm, preferably during intercourse, simultaneously with your partner—and when it doesn’t, there is a medical issue that you must address. Medically. With medication. Or possibly surgery. To the extent that a woman’s sexual response differs from a man’s, she is diseased—except for pregnancy, which is what sex is for.
> The Media Message: “You Are Inadequate.” Spanking, food play, ménages à trois… you’ve done all these things, right? Well, you’ve at least had clitoral orgasms, vaginal orgasms, uterine orgasms, energy orgasms, extended orgasms, and multiple orgasms? And you’ve mastered at least thirty-five different positions for intercourse? If you don’t try all these things, you’re frigid. If you’ve had too few partners, don’t watch porn, and don’t have a collection of vibrators in your bedside table, you’re a prude. Also: You’re too fat and too thin; your breasts are too big and too small. Your body is wrong. If you’re not trying to change it, you’re lazy. If you’re satisfied with yourself as you are, you’re settling. And if you dare to actively like yourself, you’re a conceited bitch. In short, you are doing it wrong. Do it differently. No, that’s wrong, too, try something else. Forever.
### Criticizing Yourself = Stress = Reduced Sexual Pleasure
> When you get right down to it, self-criticism is yet another form of stress.10 I described stress in chapter 4 as an evolutionarily adaptive mechanism to help us escape threats—“I am at risk.” When we think, “I am an inadequate person!” that’s like saying, “I am the lion!” Literally, our stress hormone levels increase.11 Your body reacts to negative self-evaluations as if you’re under attack.
> The solution is to practice replacing self-criticism with self-kindness.
> Women tend to have a two-layered response to this idea. First, they instinctively love the idea of being more accepting of themselves and not blaming themselves when life isn’t perfect. The research tells women what they already know intuitively: Self-criticism is associated with worse health outcomes, both mental and physical, and more loneliness.12 That’s right: Self-criticism is one of the best predictors of loneliness—so it’s not just “I am at risk,” it’s also “I am lost.”
### You Do You
> We all grew up hearing contradictory messages about sex, and so now many of us experience ambivalence about it. That’s normal. The more aware you are of those contradictory messages, the more choice you have about whether to believe them.
> Sometimes people resist letting go of self-criticism—“I suck!”—because it can feel like giving up hope that you could become a better person, but that’s the opposite of how it works. How it really works is that when you stop beating yourself up, you begin to heal, and then you grow like never before.
> For real: Your health is not predicted by your weight. You can be healthy—and beautiful—no matter your size. And when you enjoy living in your body today, and treat yourself with kindness and compassion, your sex life gets better.
> Sexual disgust hits the brakes. And sexual disgust is learned, not innate, and can be unlearned. Begin to notice your “yuck” responses and ask yourself if those responses are making your sex life better or worse. Consider letting go of the yucks that are interfering with your sexual pleasure—see chapter 9 to learn how.
### Chapter Six: Arousal: Lubrication Is Not Causation
> The idea that genital response doesn’t necessarily match a person’s experience of arousal runs contrary to the “standard narrative” about sex. As far as most porn, romance novels, and even sex education texts are concerned, genital response and sexual arousal are one and the same.
## Measuring and Defining Nonconcordance
### [[there is a 50% overlap between a man's genital response and his subjective arousal]]
> Put on your sex researcher hat again and imagine conducting an experiment like this:1 A guy comes to the lab. You lead him into a quiet room, sit him down in a comfortable chair, and leave him alone in front of a television. He straps a “strain gauge” (which is exactly what it sounds like) to his penis, puts a tray over his lap, and takes hold of a dial that he can tune up and down to register his arousal (“I feel a little aroused,” “I feel a lot aroused,” etc.). Then he starts watching a variety of porn segments. Some of it is romantic, some is violent, some matches his sexual orientation, some doesn’t. Some of it isn’t even humans, it’s bonobos copulating. He rates his level of arousal on the dial as he watches, and the device on his penis measures his erection. Then you look at the data to see how much of a match there is between how aroused he felt—his “subjective arousal”—and how erect he got—his “genital response.”
> Result: There will be about a 50 percent overlap between his genital response and his subjective arousal. It’s far from a perfect one-to-one correlation, but in behavioral science it’s exciting to find a relationship that strong. It’s highly statistically significant. ^-6rll
### [[there is a 10% overlap between a woman's genital response and her subjective arousal]]
> Now let’s run the same experiment with a woman. Put her in that quiet room, in that comfortable chair, and let her insert a vaginal photoplethysmograph (essentially a tiny flashlight about the size of a tampon that measures genital blood flow), and give her the tray and the dial and the variety of porn. ^z6ixg
> Result: There will be about a 10 percent overlap between what her genitals are doing and what she dials in as her arousal.
> 10 percent.
> It turns out that there is no predictive relationship between how aroused she feels and how much her genitals respond—statistically insignificant. Her genital response will be about the same no matter what kind of porn she’s shown, and her genital response might match her sexual preferences… or it might not.2 It’s called “arousal nonconcordance.”3
> What the media coverage has failed to make clear is that women’s genital response is actually very discriminating, compared to other automatic physiological responses. For example, your Achilles tendon reflex, heart rate, and skin conductance (sweating) will all increase after watching a scary segment of the movie Cujo and after watching porn. But your genitals have no interest in Cujo.6
### [[nonconcordance is about the relationship between the peripheral system and the central system]]
> Nonconcordance is about the relationship between the peripheral system—the genitals—and the central system—the brain: two separate but interconnected systems. And the relationship between these systems varies from person to person and from context to context ^pmaip
### [[nonconcordance is not just a sex thing]]
> Nonconcordance is not just a sex thing. It shows up in all kinds of emotional experiences and is a puzzle to all kinds of emotion researchers.12 For example, in a study of the “chills” we feel when we hear moving music, research subjects were played “My Heart Will Go On.” Half of them reported experiencing chills—subjective experience—and 14 percent exhibited piloerection (their hair stood on end)—physiological response. Among those who listened to “Bittersweet Symphony,” by The Verve, 60 percent experienced chills—subjective experience—and none exhibited piloerection—physiological response.13 ^7d6-s
### Lubrication Error #1: Genital Response = Desire
### [[both porn and mainstream culture continue to perpetuate the myth that genital response = desire and pleasure]]
> Nonconcordance isn’t news—or it shouldn’t be. Sex researchers have had an increasingly clear idea that nonconcordance is a thing for a decade or two now. It’s been in the news, it’s been described in mainstream sex books… and yet my students and blog readers are routinely surprised to learn about it, and both porn and mainstream culture continue to perpetuate the myth that genital response = desire and pleasure. Now that you know about nonconcordance, you’ll see people getting it wrong all over the place. ^y3a2r
### [[men’s sexuality has been the “default” sexuality]]
> For centuries, men’s sexuality has been the “default” sexuality, so that where women differ from men, women get labeled “broken.” Even men who differ from the standard narrative get labeled “broken.” Men have, on average, a 50 percent overlap between their genital response and their subjective arousal, and therefore, the patriarchal myth goes, everyone should have a 50 percent overlap.
> But women aren’t broken versions of men; they’re women.
> If it weren’t about men-as-default, then we’d all be just as likely to wonder, “What’s up with men, that they have so much overlap?” as we are to wonder, “What’s up with women, that they have so little overlap?” But no one asks about men. No student, no blog reader, no fellow sex educator, no one anywhere has ever asked me, “Why are men so concordant? Isn’t that kind of…?” The only people who ask that question are the sex researchers.
> When we’ve overcome this myth of men-as-default, we’ll stop mistaking “varied” for “broken.” We’ll remember that, like height, as I described in chapter 1, people within a particular group may vary more from each other than they do from a different group. ^az7w8
### [[arousal nonconcordance affects men too]]
> But in the meantime, I’m going to fight patriarchy with patriarchy. Let’s make nonconcordance universally acknowledged, by understanding how it affects men.
> Every guy, at some point in his life, has the experience of wanting sex, wanting an erection, and the erection just isn’t there. In that moment, the erection (or lack of erection) isn’t a measure of his interest—he might even wake up the very next morning with an erection, when it’s nothing but an inconvenience.
> Guys sometimes wake up with erections, not because they’re turned on but because they’re waking up out of rapid eye movement (REM) sleep, and one of the things that happens during REM is “nocturnal penile tumescence.” Erections come and go throughout the sleep cycle, whether or not you’re dreaming about sex. It doesn’t mean anything, it’s just an erection. It’s nonconcordant.
> Most boys, around adolescence, experienced unwanted genital response—sitting at the back of the bus, noticing a teacher’s body, his own ill-fitting pants, or even just general excitement about nonsexual things (driving a car, eating a donut, really anything) can activate the relevant pathways and generate the physiological response in a teenage boy.
> But genital response is not desire; response isn’t even pleasure. It is simply response. For everyone, regardless of their genitals. Just because a penis responds to a particular idea or sight or story doesn’t mean the person with the penis necessarily likes it or wants it. It just means it activated the relevant pathways—learning. “This is a restaurant.” (Remember: Men’s 50 percent overlap between genital response and arousal is highly statistically significant… but it’s still just 50 percent, and people vary.) ^ilfb4
### [[dealing with arousal nonconcordance]]
> If you’ve got a body that doesn’t always match your mind, then you’ve got a body that defies conventional (and wrong) wisdom, and so you might find yourself in the position of having to correct your partner’s understanding. There are three things to remember, which can resolve any problem your nonconcordance may generate.
> First, remember that you are healthy and functional and whole. Your body is not broken and you are not crazy. Your body is doing what bodies do, and that’s a beautiful thing. Hooray! So know that you are normal. Tell your partner you are normal. Tell them calmly, joyfully, and confidently. No need to be defensive or aggressive—it’s not their fault they don’t know about nonconcordance.
> Second, offer your partner other ways to know that you’re turned on.
> Third and finally, deal with any lack of lube-on-demand by supplementing with the fluid of your choice: your saliva or your partner’s (when there’s no risk of infection transmission), your partner’s genital fluids (ditto), store-bought lube, whatever. ^sa83-
### [[lube can make your sex life better]]
> What is lube for? Reducing friction, which can increase pleasure, and it always decreases the risk of tearing and pain. And always use lube if you’re using protective barriers like condoms or dams. Lube increases their efficacy and makes them more pleasurable. Lube is your friend. Lube will make your sex life better.27 ^posn7
### Chapter Seven: Desire: Spontaneous, Responsive, and Magnificent
> Where spontaneous desire appears in anticipation of pleasure, responsive desire emerges in response to pleasure.
> And it’s normal. People with responsive desire don’t have “low” desire, they don’t suffer from any ailment, they don’t even long to initiate but feel like they’re not allowed to. Their bodies just need some more compelling reason than, “Sex is generally fun,” or “That’s an attractive person right there,” to crave sex. They can be sexually satisfied and in healthy relationships, and yet never crave sex out of the blue. That’s Camilla. Lack of spontaneous desire for sex is not, in itself, dysfunctional or problematic! Let me repeat: Responsive desire is normal and healthy.
> But actually? It turns out everyone’s sexual desire is responsive. It just feels more spontaneous for some and more responsive for others, because even though we’re all made of the same parts, the different organizations of those parts result in different experiences.
### Desire = Pleasure in Context
> desire = pleasure in context
> Though details vary from person to person, we can experience desire in a variety of ways, depending on the context and the sensitivity of our brakes and accelerators.
> To illustrate, let’s think through three different scenarios, each with the same stimulation, same brakes and accelerator, but different contexts.
> Scenario 1. You’re feeling very calm and happy and trusting, not doing anything in particular, and your partner comes over and touches your arm affectionately. The touch travels from your arm, up your spine, to your brain. In this state of mind, your central nervous system is very quiet, there’s very little other traffic, and the sensation of your partner’s touch says, “Hey, so, this is happening. What do you think?” And your brain says, “Affection feels nice.” The stimulation continues, your beloved partner touching your arm affectionately, and the sensation travels up to your brain and says, “This is happening some more. What do you think?” And your brain says, “Affection feels really nice,” and tunes its attention more to that sensation. Then your partner starts kissing your throat, and that sensation makes its way to your emotional brain and says, “Now this is happening, too. What do you think?” And by then the brain says, “That is fantastic! Go get more of that!” In that context, sexual desire feels responsive.
> Scenario 2. You’re stressed, exhausted, or overwhelmed, it’s very noisy in your brain, there’s heavy traffic, lots of yelling and horns honking about all the stuff that’s stressing you out. Your partner’s affectionate touch travels from your arm, up your spine, to your brain, and it says, “This is happening. What do you think?” And your brain says, “WHAT? I CAN’T HEAR YOU OVER ALL THIS NOISE!” And by then the sensation is over. (Sensations are a little bit like Snapchat.) If your partner keeps touching you, the sensation keeps asking your brain, “This is still happening. What do you think?” And eventually it might get your brain’s attention, and your brain might say, “ARE YOU KIDDING ME? I’VE GOT ALL THIS OTHER NOISE TO CONTEND WITH!” And if the sensation ever gets noticed enough to expand out of your brain’s emotional One Ring, it comes out in the form of, “Not now, honey.”
> Scenario 3. Your sexy, sexy partner has been away for two weeks, but you’ve been sending each other frequent texts, which started out flirty but have been gradually escalating in explicitness and intensity as you get more and more into teasing and tormenting each other. By the end of the two weeks, just the sound of your phone receiving a text makes you gasp and tremble. There’s noise in your brain, but all of it is chanting, “Sexy, sexy partner!” By the time your partner gets home and touches your arm affectionately, you’re set to go off like a rocket. In that context, sexual desire feels spontaneous.3 In all three scenarios, stimulation comes first, whether it’s your partner’s touch or just the idea of your partner’s touch. If the context is right, the stimulation feels good and leads to desire. All three scenarios are normal, healthy sexuality.
> What all of this means is that if you want to expand your access to spontaneous desire, all you have to do is look for the contexts that facilitate it
### Good News! It’s Probably Not Your Hormones
> But if you’re experiencing low desire, hormones are the least likely culprits.5 Lori Brotto and her colleagues tested six hormonal factors to determine which predicted more or less dysfunction in women with low desire, and not one of them was significantly predictive of low desire.6
> So if it’s not your hormones, what has the research found to be predictive of low desire? According to Brotto, “developmental history, psychiatric history, and psychosexual history.” In other words, all that stuff from chapters 4 and 5—stress, depression, anxiety, trauma, attachment, etc.
> It’s Not a Drive
> Most of us are used to thinking about sexual desire as a drive, like hunger. A drive is an uncomfortable internal experience that pushes you to go fix a problem. And what’s the consequence if you don’t solve the problem? Ultimately, you will die. Hunger is a drive. So is thirst. Thermoregulation. Sleep—you can literally die of sleep deprivation.
> For centuries, scientists thought sex was a drive. It’s probably how you think about it, too. It’s how I thought about it for a long time.
> Turns out, no.
> It’s easy to prove that sex is not a drive: As animal behaviorist Frank Beach put it in 1956, “No one has ever suffered tissue damage for lack of sex.”7 Put more colloquially, nobody ever died because they couldn’t get laid. Maybe they wanted to, but that’s frustration, and people don’t literally die of frustration.8 If it’s not a drive, what is it? It’s an “incentive motivation system.”9
> Most people associate the word “incentive” with the idea of a prize, something worth working for. The biological meaning is similar. Where drives are about being pushed by an uncomfortable internal sensation, incentive motivation systems are all about being pulled by an attractive external stimulus. Curiosity is the quintessential example of an incentive motivation system, as natural to us as hunger, but without the threat of actual death.10
> But there’s a more important reason that it matters that sex is like curiosity and not like hunger: If someone steals a loaf of bread because they’re starving, on some level we can have sympathy and mercy; even when stealing is wrong, we acknowledge that people do what they have to do to survive. But if someone steals a loaf of bread simply because they’re curious what someone else’s bread tastes like… do we have the same sympathy, the same mercy?
> Because sex is not a drive, it is not a biological “need,” and no one is entitled to it, and no one ever has permission to steal it from anyone, under any circumstances.
Compare with maslows hierarchy of needs
### “Why Can’t I Just Take a Pill?”
> If you want to experience more spontaneous desire, just for the fun of it, you don’t need to change you, you can just change your context,
### “Sex Worth Wanting”
> Optimal” sex is remarkably similar to the “good sex” described by survivors of child sexual violence, including qualities researchers identified as “communication,” “openness, vulnerability,” being “present in the moment,” and being an “active, assertive participant.”23 In another study that asked twenty women to describe “good sex,” only three participants mentioned being “in the mood” or “wanting it” as hallmarks of “happy and joyful” sex.24 More common in these women’s narratives of good, happy sex were comfort and naturalness, basic pleasure, and, above all, emotional connection.
> But magnificent sex goes further and deeper. As Kleinplatz and Ménard put it, “Magnificent sex requires growing beyond the conventional scripts most people learn in their youth. Disappointing sex lives can change. The goal here is not merely to discard sex guilt, shame, and inhibition. Rather it is to jettison the entire aspirational package of paint-by-numbers sex.”25 People who have magnificent sex don’t just show up and put their bodies in the bed—e.g., good sex. They deliberately cultivate a context that’s “just safe enough” to dare the leaps of faith they take into the wild places in their souls. That’s magnificent sex. And out-of-the-blue desire has almost nothing to do with it. When people who have magnificent sex want sex, they don’t just want the sex we see performed in the mainstream media or porn. They want to know themselves and their partners more fully, and they want to be seen and known more fully, felt more deeply, held more closely. This is what I call “magnificent desire.”
> As Gottman and his colleagues found, couples who sustain a strong sexual connection over the long term prioritize sex—but. It’s also normal for there to be times when sex drops off the list of priorities. When you have a new baby, when you’re caring for a dying parent, when you’re both overwhelmed with work, sometimes there truly isn’t time or energy to pause and turn toward each other with erotic intention. You can allow that to be true, knowing that it’s a phase of life you’ll pass through together, and you’ll find your way back to each other on the other side.
> And it’s worth considering what you will each find there, on the other side of your shared dry spell. Is it play or connection or exploration or peace? Or is it more like a chore or an obligation or drudgery? If you dread the idea of showing up and putting your body in the bed, lack of desire is not the problem. Lack of pleasure is the problem.
This happens through the menstrual cycle too. Spring play. Summer? Autumn connection. Menstruation love?
### Sharing Your Garden
> Some people have a spontaneous desire style—they want sex out of the blue. Some have a responsive desire style—they want sex only when something pretty pleasurable is already happening. The rest, about half of women, experience some combination of the two, depending on context.
> If partners have different levels of sexual desire, the higher desire partner doesn’t have the “right” amount of desire and the lower desire partner doesn’t have the “wrong” amount of desire, and vice versa. People vary.
> If spontaneous desire goes away, it’s because the context changed, not because someone is “broken.” To bring spontaneous desire back, change the context.
> The most important thing to know about desire is that it’s not what matters. Pleasure is what matters. If you create a context that allows your brain to interpret the world as a safe, fun, sexy, pleasurable place, you’ll create sex worth wanting.
### Chapter Eight: Orgasm: Pleasure Is the Measure
> I told her that orgasms feel different to everyone and that orgasms can vary from each other, depending on the mode of stimulation, whether you have a partner with you, maybe even where you are on your menstrual cycle—any number of factors. Sometimes you feel a rhythmic pulsing of the muscle around your vagina, sometimes not. The main thing most women describe most of the time is a sense of “doneness,” a sense that you’ve crossed a threshold and something has completed. There’s often a peak of tension where your muscles tighten and your heart pounds. Orgasms are like art, I told her. You know it when you see it. It may not be what you expect, but it will be different from everything else.
> This great variety and variability makes orgasm almost impossible to define—though scientists spend thousands of words puzzling over it. But when you strip it down to the universal essentials, here’s what you get: Orgasm is the sudden, involuntary release of sexual tension.1
> Notice how much is missing from that definition: genitals, muscle contractions, sexual behavior, pleasure, or indeed anything that specifies what it feels like or how it happened. Orgasms vary—from person to person, and from context to context. They happen while you’re making love—and sometimes they don’t. They happen while you’re masturbating—and sometimes they don’t. They can happen from clitoral stimulation, vaginal stimulation, thigh stimulation, anal stimulation, breast stimulation, earlobe stimulation, or mental stimulation with no physical contact at all—or not during any of these. They can happen while you’re asleep, while you’re exercising, or while you’re in a variety of other completely nonsexual situations. They can be delightful, humdrum, spiritual, annoying, ecstatic, fun, or frustrating. Sometimes they’re awesome. Sometimes they’re not. Sometimes you want them. Sometimes you don’t.
> To begin, I’ll tell you what orgasm is not: It is not a genital response, “pleasure,” or hierarchical
### Nonconcordance—Now with Orgasms!
> nonconcordance—now with orgasms!
> The first thing orgasm isn’t is a “genital response.”
> Remember nonconcordance from chapter 6—what your genitals are doing doesn’t necessarily match what you’re experiencing? There’s evidence that this is true for orgasm as well—at least among women who are able to orgasm in a laboratory while their genital response is being measured.
> For example, in one study, research participants were asked to masturbate to orgasm in the lab and then “grade” their orgasm on a scale of 1 (“weak or poor”) to 5 (“most powerful or excellent”).2 Result? There was no relationship between the grades women gave their orgasms and the genital responses traditionally treated as “markers” of orgasm, such as number of contractions of the pelvic floor muscle.
> Those rhythmic, involuntary contractions are perhaps the most nearly universal physiological marker of orgasm—but even that can’t be relied on all the time. In one study, two out of eleven women exhibited no vaginal muscle contractions at orgasm.3 And in another study, some women exhibited the muscle contractions without orgasm.4
> In other words, genital physiological markers of orgasm are not always predictive of a woman’s subjective experience of orgasm. Which makes perfect sense if you recognize that orgasm—like pleasure—isn’t about what happens in your genitals, it’s about what happens in your brain.5
### No Two Alike
> Orgasm is a lot like being tickled. Sometimes it can be fun, other times it’s annoying, and sometimes it feels like almost nothing. Pleasure is a perception of a sensation, and perception is context dependent. That’s just as true for orgasm as it is for tickling. But no one ever asks me, “Why is it that a lot of the time when my partner tickles me it feels fun and pleasurable, but then other times it really doesn’t?” We all know intuitively that the perception of tickling sensations is context dependent. There’s a time and a place for tickling.
Again…link to menstrual cycle phases
> All orgasms are the sudden release of sexual tension. How that release feels depends on context. Which is why some orgasms feel amazing and others… really, really don’t. A handful of examples:
> A woman told me, red faced, that she had an orgasm during her exercise class. She was too embarrassed to feel any pleasure, and she was confused both by the orgasm and the lack of pleasure.6 A friend with major depression said she could have orgasms but she didn’t experience pleasure with them. I told her that was normal, that pleasure comes from context, and her context was gray and flat. Normal for a person with depression.
> An undergrad was turning paler and paler during my guest lecture about sexual assault. I had mentioned in passing that sometimes women have orgasms during rape and that that’s basically just a reflex, it doesn’t mean pleasure or consent. She came up to me afterward and said I’d changed her life with that one sentence.7 A woman periodically orgasmed in her sleep and would wake up midorgasm, sometimes from a dream, sometimes not, but always puzzled by the warmth and pulsing that were not necessarily accompanied by any particular enjoyment.8
### All the Same Parts…
> The third thing orgasm isn’t: hierarchical. All orgasms are different, and there is no “right” kind or “better” kind of orgasm. It’s even hard to say that there are different kinds of orgasm—because they’re all made of the same basic parts (sudden release of sexual tension) organized in different ways.
> Instead of thinking about “kinds” of orgasm, we can think about different ways to have an orgasm. Here’s a small sample of the highly pleasurable orgasms women have described to me:
> Orgasm from clitoral stimulation.
> Orgasm from vaginal stimulation.
> Orgasm just from breast stimulation.
> Orgasm from having her toes sucked.
> Orgasm when her partner penetrated her (well-lubricated) anus with a finger, while pinning her to the bed by her hair. The most erotic sensation, she specified, was his warm palm resting gently on her butt cheeks.
> Orgasm when her partner slowly and gently stroked fingertips upward along her outer labia… again… and again… and again. She said, “What started out as an appetizer turned into the main course.”
> Orgasm without any genital stimulation, while she was giving her partner oral sex. She was so closely tuned to his arousal that when he came, she did, too.
> Are these clitoral orgasms, vaginal orgasms, breast orgasms, toe orgasms, butt cheek orgasms, labia orgasms, and oral orgasms?
> Nope. Despite the painstaking efforts of women’s magazines and even researchers to identify and label the various kinds of orgasms we could be having—G-spot orgasms, blended orgasms, uterine orgasms, vulval, and all the rest9—there can be only one. (Like The Highlander.) There’s just the sudden release of sexual tension, generated in different ways. Anatomically, physiologically, even evolutionarily, it doesn’t make much sense to talk about kinds of orgasms based on what body parts are stimulated.10
Makes me think about the research about difft kinds of orgasms…volcanic?!?
> Just as all vulvas are normal and healthy just as they are, so all orgasms are normal and healthy, regardless of what kind of stimulation generated them or how they feel. An orgasm’s value comes not from how it came to be or whether it meets some arbitrary criteria but from whether you liked it and wanted it.
> It comes to this: Pleasure is the measure. Pleasure is the measure of your orgasm—not what kind of stimulation created it, not how long it takes to get there, not how long it lasts or how strongly your pelvic floor muscle contracts. The only measure of your orgasm is how much you enjoy it.
### Your Vagina’s Okay, Either Way
> Yet women ask me all the time, “Why can’t I have an orgasm during intercourse?” The reason they can’t is very likely the same reason most women can’t: Intercourse is not a very effective way to stimulate the clitoris, and clitoral stimulation is the most common way to make an orgasm happen. In fact, research has found that one reason why women vary in how reliably they orgasm with penetration is the distance between the clitoris and the urethra.13 It’s essentially a matter of anatomical engineering.
> So the question is not so much why some women aren’t orgasmic from vaginal penetration as it is why are some women? There are several hypotheses, but probably the two best contenders are: (a) stimulation through the front wall of the vagina of the urethral sponge (the female homologue of the prostate and the original hypothesized source of the “G-spot”); or (b) the vestibular bulbs, extending down to the mouth of the vagina from the head of the clitoris. But in the end, the answer is: People vary.14 People vary in the layout of their genitals and the sensitivity of the tissue. My guess is that both of these hypotheses have merit, but you can imagine how challenging it is to get funding to do research on women’s orgasm, so it may be a while before we know for sure.
> Now, if penetrative orgasms are comparatively uncommon, why do women ask about it so often? Why is it so often viewed as “the right way to orgasm”?
> And the answer is, of course, “Ugh, patriarchy.” Men-as-default again. Centuries of male doctors and scientists—Freud is often pointed to as a key offender here, and rightly so—claimed that orgasms from vaginal stimulation are the right, good, normal kind, and clitoral orgasms are “immature.”
> But it’s men-as-default in a different way from how it worked with arousal and desire. Culture sanctions spontaneous desire as the “expected” kind of desire because that’s how men experience desire (though not all of them do, of course), and culture sanctions concordant arousal as the expected kind of arousal because that’s how men experience arousal (though, again, not all of them do)… but if women’s expected kind of orgasm is whatever men experience, then that should be orgasms from clitoral stimulation, since anatomically the clitoris is the homologue of the penis. To say that women should have orgasms from vaginal penetration is anatomically equivalent to saying that men should have orgasms from prostate or perineal stimulation. Certainly many men can orgasm from that kind of stimulation, but we don’t judge them if they don’t, and they don’t usually wonder if they’re broken if they don’t.
> So apparently, according to cultural myth, women should be just like men—with concordant arousal and spontaneous desire—right up until we actually start having intercourse, and then we’re supposed to function in an exclusively female way, orgasming from a behavior that also happens to get men off very reliably. Men’s pleasure is the default pleasure.
### Difficulty with Orgasm
> Distress about orgasm is the second most common reason people seek treatment for sexual problems (after desire), occurring in about 5 to 15 percent of women.15 Difficulty with or absence of orgasm in certain contexts is very common.
> For example, only 11 percent of college women report having an orgasm the first time they “hook up” with a new partner, compared with 67 percent of college women having sex in the context of a relationship of more than six months’ duration.16
> Around 12 percent of women have not had an orgasm, or are unsure whether they’ve had an orgasm, by age twenty-eight.17 And there probably are some women who never experience orgasm—the research indicates something like 5–10 percent.18
> Most problems with orgasm are due to too much stimulation to the brakes—too many worries, too much stress, anxiety, shame, or depression, including stress, anxiety, shame, or depression about orgasm.19 If you’re interested enough to want to have an orgasm, chances are you can, given the right stimulation and a context that lets you turn off the offs. And if you can orgasm now in an ideal context, chances are you can orgasm in a new and different positive context—like with your partner.
> Never Had an Orgasm… as Far as She Knows Students laugh when I add “as far as she knows,” but several times I’ve talked about what childhood masturbation to orgasm is like—squeezing your legs around a swing set pole or rocking your vulva against a stuffed animal, as well as touching your genitals with your hands or pressing your pelvis into the mattress—and people have said, “Oh! So that’s what I was doing!” Memories of childhood orgasm are often more like sleep orgasms or exercise orgasms; they’re not particularly erotic. You’re not having sexual fantasies to fuel your accelerator, but nor do you have a decade or more of cultural shaming to hit your brakes.
### Impatient Little Monitors
> So change the goal, change the effort, change the criterion velocity. Pleasure, not orgasm, is the goal. If it takes five minutes, that’s five minutes of pleasure. Hooray! If it takes thirty minutes, that’s thirty minutes of pleasure! Also hooray!
### Flying Toward Ecstasy
> Orgasms happen in your brain, not your genitals.
> Less than a third of women are reliably orgasmic from vaginal penetration alone. The remaining 70+ percent are sometimes, rarely, or never orgasmic from penetration alone. The most common way for women to orgasm is from clitoral stimulation. And we are all normal.
> All orgasms are created equal. It doesn’t matter what stimulation generates them, the quality of an orgasm can only be determined by how much you enjoy it.
> To have bigger, better orgasms, turn off more of the offs, and turn on the ons more gradually.
### “To Feel Normal”
> The most important thing you can do to have a great sex life is to welcome your sexuality as it is, right now—even if it’s not what you wanted or expected it to be.
> Letting go of old, bogus cultural standards requires a grieving process, going through the little monitor’s pit of despair.
> To facilitate that letting go, develop the skill of “nonjudging.”
> When you give yourself permission to be and feel whatever you are and feel, your body can complete the cycle, move through the tunnel, and come out to the light at the end.
### [[correlation does not imply causation]]
> Which brings me to a sentence every undergraduate who takes a research methods class will memorize: “Correlation does not imply causation.” It refers to the _cum hoc ergo propter hoc_ fallacy—“with this, therefore because of this”—which means that just because two things happen together doesn’t mean that one thing caused the other thing. The quintessential example in the twenty-first century is the relationship between pirates and global warming. This is a joke made by Bobby Henderson, as part of the belief system of the Church of the Flying Spaghetti Monster. Henderson wanted to make a point about the difference between causation and correlation, so he drew a graph that apparently plotted increase in global temperature with the precipitous drop in the number of seafaring pirates. Did the loss of pirates cause global climate change? Of course not. It’s absurd, right? That’s the point. ^mwa-i