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Addressing a Lack of Arousal

10/19/2017

 
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If you haven’t taken a look at the original post outlining the differences between arousal and desire, be sure to go back and check it out.

Having recently talked about desire, let’s turn our attention to arousal. 
​
Maybe you like having sex (or maybe you used to like having sex) but most of the time your body does not align with that. 
You’re having trouble maintaining an erection or you don’t feel lubricated enough to make penetration pleasurable and it’s starting to kill your desire for sex.

Before you throw in the towel, it could be helpful to check out some contributing factors to a lack of arousal and some things you can do about it:​

Consider an organic cause first

If your body has trouble getting physically ready for sex there are a few organic causes you need to check for first.

Hormonal imbalances, nerve damage, low blood pressure, disease or illness; all of these things can interfere with your ability to get and maintain an erection, lubricate the vaginal walls and get your heart rate going in preparation for physical activity.

if you’re concerned that your body isn’t going through the physiological process of arousal, and you’re not sure why, it’s important to see your doctor and get some things checked out. If something is going on, treatments can include hormone therapy, physical therapy and medications, among other things.

There’s also a reason I put this one first; if you don’t get checked out before pursuing other options, like sex therapy, you could be headed further and further away from the solution to the problem.

So if you think this is the reason, talk to your doctor and/or find a qualified medical professional to help you determine if there is something going on physically.

Maybe it's what you're putting in your body

This is going to be another one that is best addressed with a medical professional, but it’s worth considering that what you’re putting in your body is having an impact on your ability to be physiologically aroused.

Substances like alcohol, marijuana and even prescription medications have varying side effects that can absolutely wreak havoc on your body.

As an example, the use of alcohol and/or antidepressants* can result in inadequate vaginal lubrication and an inability to maintain an erection. Other substances can do this too when used daily or to excess.

If you’re suffering from inadequate arousal during sex, it could be worth looking at your habits.

If you’re on prescription medications, perhaps changes can be made to your regimen to address the issue. If you’re having 3-4 alcoholic drinks a night, perhaps it’s time to figure out how to cut back.

Talking to your doctor about the drugs you’re taking and the substances you’re using is going to be your best bet going forward.

Stress? Anxiety? Fear? Oh my...

I know I said that stress interferes with desire, but it also interferes with your body’s physical responses too.

If you’re afraid of getting an infection, getting pregnant, you have a looming deadline at work, you and your partner have been fighting, whatever, your body is going to be expending precious time and energy on these problems over getting you physically ready for sex.

Some would describe it as an evolutionary mechanism we developed to keep us alive.

Think about it, our ancestors had to prioritize running away from that lion over having sex (in order to keep having more sex…).

We may not have to worry about lions anymore, but chronic stress and anxiety produce the same physical reactions in people. Your adrenaline and cortisol levels go up when you start fighting with your partner or realize that your big project is due at 8am tomorrow morning.

As mentioned in the previous post, if stress is impacting your physiological ability to become aroused you should consider:
  • Exercising, even once a week for 30 minutes is better than nothing!
  • Getting 7-8 hours of sleep
  • Eating fruits, vegetables and other nutritious foods
  • Staying hydrated
  • Doing things that relax you, like meditating, getting a massage or spending time with friends
These things will help balance out your hormones and make it easier to put fears aside when you want to make time for sex.

While addressing these areas might be all you need to feel re-energized around sex, for some there are more complicated issues such as anorgasmia, erectile dysfunction with no physical cause and genito-pelvic pain disorder.

​While these issues are scary and can feel hopeless to try and address, seeing a competent urologist or gynecologist and working with a qualified sex therapist or sexual health provider can be an amazing step in the right direction.

          - Alana

Be sure to check out previous posts on the subject: Arousal & Desire: Defining Our Terms and Addressing a Lack of Desire
*Kennedy, S. & Rizvi, S. (2009) Sexual dysfunction, depression and the impact of antidepressants. Journal of Clinical Psychopharmacology, 29(2), 157-164.

Addressing a Lack of Desire

9/21/2017

 
Wow, I definitely gave everyone some time to think about the differences between arousal and desire (A whole year? Not cool).

Now that we’re back in action, let’s start with desire.
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Desire issues are the most common concern I see in my practice and so I wanted to take some time to address it. As a refresher, sexual desire is the psychological process of wanting sex and it can be impacted by many things.
​

If you would define yourself or someone you love as having a lack of desire, it’s useful to consider the following factors.

​I’ll follow each one up with ways you can address that potential pitfall.

Stressed?
There’s your trouble.


How does feeling stressed contribute to a lack of desire?

Let me count the ways…

The most concise answer I can give you is that stress and chronic stress (like looming deadlines at work, drama with family members, or an abrupt change in your life that has many ramifications) cause our bodies to produce adrenaline and cortisol. The simple version is that when our bodies are producing these chemicals (more specifically cortisol) we have less resources to produce testosterone*, which is a contributing hormone (for both men and women) to their desire for sex.

I don’t want to alarm you, but the majority of people in America qualify as having chronic stress.

So consider that if you’re having trouble feeling in the mood, this is the likely culprit.

What can you do to reduce your stress? I bet you can guess what I’m about to say next… that’s right, be sure to exercise, sleep, eat right and do things that relax you. All of these things help to balance out your hormones, reset your body and mind, and they give you the space to even think about engaging in sex.

Challenge your assumptions
​about when desire needs to happen


I continue to be surprised at how many people think “sex needs to happen naturally”.

But according to Rosemary Basson, desire can happen at any time in a sexual experience (because it’s different from being physically prepared for sex).**

Because you can be aroused by but not desirous of sex, it could be helpful to ask some follow-up questions to check your level of desire, “When I find myself in a sexual situation do I still find myself not wanting to have sex? Is sex rarely pleasurable or exciting for me?”

If the answer is no to either of those, it sounds like you’re experiencing desire, just not right out the gate.

Here’s the thing: that’s totally normal!

I’ll talk about that in another post. But it’s worth considering that if you enjoy sex when you get into it, you don’t lack desire. Rather, people are telling you you do because it happens after you get into it.

Give yourself permission to explore
erotic materials, thoughts and fantasies


I’m going to imagine that if you experience attraction to people, you’ve got some ideas about what turns you on. From certain features on a person, to activities, positions, sensations, etc. you’ve got certain sexual cues that are going to rev your engine.

But if you’ve never thought about what turns you on, it’s going to be a lot harder to get what you need from your partner(s) or from a sexual experience.


When you don’t have clear ideas about what’s going to make sex pleasurable, you’re less likely to get those things. Which means sex could feel empty and unfulfilling to you. Which means you’re going to be way less excited to have sex.

Consider this your official permission slip to figure out what turns you on.

Masturbate, experiment with new positions or watch pornography with your partner(s)- who knows it might bring you closer together!

If you take the time to know what you need and you actively express that to your partner, not only is sex going to be hotter and more appealing to you, you might find yourself wanting to have sex more often.

For some, addressing desire in their relationship is as easy as getting the right information. But I know for others, the issue of high-desire/ low-desire has a lot of hurt feelings and painful messages around it. In addition, desire can often be affected by how we feel about ourselves and how safe it is to go to our partners with our concerns.

If you feel it would be harder to address a lack of desire with your partner because of those reasons, I would consider seeing a sex therapist to help you navigate this murky issue.

          - Alana

Be sure to take a look at the previous post, Arousal & Desire: Defining Our Terms

And stay tuned for Addressing a Lack of Arousal
*Cumming D., Quigley M. & Yen S. (1983). Acute suppression of circulating testosterone levels by cortisol in men. Journal of Clinical Endocrinology and Metabolism, 57, 671-673.
**Basson, R. (2001). Human sex-response cycles. Journal of Sex & Marital Therapy, 27, 33-43.

Arousal & Desire: Defining Our Terms

9/16/2016

 
One thing I’ve noticed in conversations about sex is how often people are conflating arousal with desire. Many of us are (mistakenly) under the impression that when you’re aroused, you want sex, or if you want sex then your body is totally ready for it.
​

That’s not always the case.

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​
Let’s start by defining our terms:

Arousal is the physiological process by which the body prepares for sexual activity. This includes increased blood flow to the genitals, which produces erections for men and results in the swelling of the labia and clitoris for women; your heart rate increases, your pupils dilate, your skin gets flushed, etc.


Desire is a psychological process of strongly wanting or wishing for sex or sexual contact. It’s when you find yourself so attracted to your partner that you want them to stop making dinner and get down there on the kitchen floor with you. Or you make eye contact with an attractive stranger and you get those little tingles all over.

The primary difference here is that one process is physiological (it’s automatic, your body starts the process when it gets the right cues that it’s “business time”) and the other is psychological (it starts in the brain as a thought process and it’s totally subjective).

Don’t get me wrong, they are absolutely related. But because arousal and desire can happen separately and operate independently of one another we have a couple of options when sex gets put on the table.
​​

First Option?

​You’re good to go! Why are you still reading this article?
​

Second Option?

​Maybe you’re getting a bunch of cues that sex is about to happen. Your body naturally starts the process to give you an erection or lubricate the vaginal canal, but that doesn’t necessarily mean you’re going to feel turned on by those cues and want to bang whoever or whatever is sending you those cues.
​

​​Third Option?

​You’re in the right head space, but maybe your body isn’t on the same page. You want to have a sexual interaction, but your body isn’t ready or prepared for it.

If you find that there have been times when the second and third options are wreaking havoc in your sex life it’s helpful to check in with yourself and your partner on which one it is.

See, when these two processes get mixed up or molded together it means we have a harder time seeing the forest through the trees. You won’t know how to address the problem because you haven’t taken it apart to see what, specifically, is out of whack.


Is it your desire or is it your arousal?

I’ll be talking about how to address both in future posts so stay tuned! In the meantime, start becoming aware of the differences between the two and how each process plays out for you and your partner.


​- Alana

When Sex Becomes a "Between-Problem"

7/12/2016

 
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Couples Therapy is actually a very recent development in the field of mental health. Marriage and Family Therapy, my field of study, got its start in the 1940’s and 50's when psychotherapists and psychologists began to notice that the ways in which a family interacted affected an individual’s treatment outcome.
 
It started with many prominent figures in the field working with schizophrenic patients and their families. In every clinic addressing this very serious mental health concern, there was a common theme of patients regressing when visited by family members or after returning home.*
 
Why would being with your family have such a strong effect on your ability to do better?
 
I think the answer lies in the understanding that we are social creatures; we form attachments to our caregivers, we find solace in our friends, we generally seek out the people who get us.
 
We learn how to be functional, or not-so-functional, people from the ones who raised us, who gave us messages about how we could develop and who we could be. It would stand to reason that this also sets us up for finding the people who reinforce our view of the world and our view of ourselves.

This is why I need your partner to come with you if we’re talking about a sexual problem in therapy.


Let me clarify by saying that sexual intercourse is an interaction between people. Notice I said, 
between. Any dysfunction that happens during sex with your partner(s) is a relationship problem, or maybe a “between-problem.”

Obviously, I will want to be sure that biological causes are ruled out by a medical professional. But even when there is a biological issue, there are still relational factors that could increase your stress level, your anxiety and these will negatively affect your condition. The mind and the body are not as separate as we have been led to believe!

If you can masturbate when you're alone but find that you lose your erection with your partner, it's a between-problem.

If you're experiencing little to no desire for sex and you feel guilty for how it's affecting your partner, it's a between-problem.


Basically, (at least) two people need to be accountable for changing the interactions that got them into this situation in the first place.
 
In the end only one thing is certain for me if I see one partner for individual treatment: they’re going to regress when they go home, because their partner isn’t going to be on the same page with what I’m asking and progress will either be slow or not at all. 
 
When the above situations, or any number of common sexual dysfunctions are impairing your life and your ability to be intimate you could benefit from seeing a sex therapist who also has training in couple’s therapy. Consider including your partner in counseling, at least in the first session. It could have a huge and lasting impact on your ability to do better!
​

          - Alana

*Nichols, M. (2013). Family therapy: Concepts and methods (10th ed.). Upper Saddle River, NJ: Pearson Education, Inc.

3 Reasons Why Scheduling is Sexy!

6/9/2016

 
Put it on the calendar, so you can put it on me later
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In the last couple of weeks the idea of putting sex "on the calendar" has come up with multiple people, clients and friends alike. “Spontaneous sex is way better” they say, “scheduling sex makes it feel like a chore” or “we shouldn’t have to schedule sex, it should be spontaneous!”
 
I can totally understand why putting your weekly romp in your Google calendar like it was a root canal doesn’t get you hot and bothered. But why do we expend so much energy maintaining this idea that sex needs to “happen naturally”?
We schedule dentist appointments, doctor’s appointments, our kid’s recitals; even when we hate going to these things we will still ensure that it gets written down, because there is no way I am getting another cavity.
 
So why don’t we view sex the same way?
 
If we don’t ensure that we’re maintaining that part of our relationship, our desire for our partner wanes. Isn’t that important enough to schedule? Isn’t that a big enough consequence to consider penciling your partner in for an afternoon quickie?
 
Maybe you’re interested in the idea but aren’t sure how to broach the topic with your partner. Perhaps you need more convincing that making the time is the best way to stay connected.
 
Lucky for you, I have a few great ideas about why it’s better for you to listen to me on this one. Here are the three reasons why scheduling sex is some of my go-to professional advice:
​

​When you schedule, you up the anticipation

When’s the last time you weren’t excited for that big event you got tickets 3 months in advance for? My point exactly.
 
Once you knew it was going to happen you started anticipating and planning and spending a great deal of mental energy on what you were going to wear, who you were going with, etc. All the while, you’re building a sense of suspense, a perpetual excitement that heightens the experience before you even get to it!
 
Building that sense of anticipation works the same for sex- you agree you’re going to get frisky when you get home, he sends you a flirty text, she tells you she bought a new toy, before you know it your desire for the hot sex you’re going to have with your partner is almost unbearable and you’re rushing home to enjoy the time you’ve planned out together.
 
That sounds way better to me than being unsure as to whether your partner is going to want it after work or not.
​

When you plan, you’re working on communicating

Which brings me to my next point: spontaneity is great and I have nothing against it, but it’s foolish to leave all your sexual experiences up to chance. There’s too many opportunities for hurt feelings, miscommunication and eventually there’s a huge emotional barrier between you that feels insurmountable.
 
When you’re planning, you’re actively negotiating what works best for both of you and this strengthens your communication.
 
When you plan on having coffee with a friend it doesn’t just happen- it takes figuring out when a good time for both of you is, where you’re going to go, ensuring that the kids are taken care of (if that’s a consideration) and being flexible enough to adjust the plan as necessary.
 
In the act of planning you are required to communicate about your wants, your needs and what works best for you. The same goes for scheduling sex.
 
The side benefit here is that the good communication habits you’re practicing get applied to other, less sexy areas too!

​When you make the commitment, you make it a priority

​Like everything in life, relationships take work. If you’re not actively making your partnership a priority then it will fall by the wayside.
 
The sad truth is, if your intimacy with your partner takes a backseat to work, family events and catching up with friends, then, eventually, so does the rest of your relationship.
 
Putting time to be intimate (and possibly sexy) with your partner on your calendar is like making a promise- you know when and where it’s going to happen and you’ve committed to, not just the activity, but to your partner.
 
It promotes a sense of accountability; maintaining that part of your relationship ensures that you are building a sustainable, overall connection with this person.

-

Building your desire, working on good communication skills and promoting accountability in your relationship are some pretty killer side-effects for this one activity.

​If you’re ready to build a better relationship, try asking your partner if they would like to have their clothes ripped off when they get home from work that night.
 
You never know, it could be the start of a new era in your relationship.

          - Alana

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    Alana R. Ogilvie

    Relationship Counselor
    Certified Sex Therapist
    Aspiring Yogi


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  • Home
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  • Work with Me
    • Therapy Services >
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    • Premarital & Commitment Counseling
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