Troubleshooting Orgasm Problems (Part Two)

Recently, I wrote about troubleshooting orgasm problems, and described one strategy for improving orgasmic response by increasing arousal. Today, I’m describing another strategy, which you can use in combination with the increasing arousal: improving the ability to sustain arousal.

Orgasm is a reflex response to a sustained high level of arousal. “Sustained” is the key word here. Anxiety kills arousal; you can’t reach orgasm if your process of building arousal is being constantly deflated by worries like “do I look bad?”, “are the kids about to bust into this room?”, “am I turning my partner off?”, “did I remember to turn off the stove?”,  “do I have enough money in my bank account to pay the rent tomorrow?”, and so on. 

That’s not to say that people who are experiencing stressful things can’t ever have satisfying sex. They can and do, all the time. In fact, sex can be a lovely stress-reducer for some! What I’m getting at is that being able to experience arousal, and sustain that experience for long enough to reach orgasm, takes some anxiety-management chops. 

So, when you’re working with a client who is not reaching orgasm when they would like to, along with considering what kinds of stimulation work for them and how to increase arousal, consider what might be disrupting the sustaining of that arousal. 

If one of the things disrupting arousal and interrupting pleasure is intrusive thoughts, which it often is, you can help your client build the skills to handle that. As a therapist, this is probably squarely within your wheelhouse: they can develop the ability to let emotions come and go, stay in the moment and in their body, and choose connection with their partner over a negative thought-feeling spiral. Developing these skills will help them with every aspect of their relationship, not just sex. 

Another thing to assess any time you’re working with sex issues in the therapy room is sex pain. Pain, like anxiety, can kill arousal in a snap–and more than that, it can be immensely damaging to bodies, minds, and relationships, if left untreated. Sex pain can be caused by all kinds of things, from vaginal atrophy to endiometriosis to undiagnosed STIs to sex positions that just happen to bump the cervix and many other things. The best thing to do if your client reports sex pain is to get them a medical evaluation ASAP so that a team of health care providers can start sorting out exactly what’s causing the problem. Meanwhile, you can help with the relational dynamics and personal thoughts/feelings/meanings that tend to surround the experience of painful sex. 

A combination of those two strategies–helping your client increase pleasure, and thereby arousal, by increasing sensory input and experience; and helping them effectively managing anxiety and other thought/emotion spirals that may disrupt arousal–is a wonderful two-pronged approach to tackling the vast majority of orgasm issues.

The Most Fundamental Sexual Connection

We generally think of sex as something that happens between two or more people. But the most fundamental and important sexual relationship is the one you have with yourself.

When I refer to “the sexual relationship you have with yourself,” I mean the erotic space that exists inside you. That includes the sensuous space of physical pleasure that you experience through your own body, your unique erotic fantasies, and your sense of yourself as a sexual being. All of that belongs to you. It is yours alone, for you to explore in any way you choose.

Self-pleasure has lots of benefits, ranging from increased orgasmic response to better sleep, pain relief, decreased anxiety, improved circulation…I could go on and on. It is unique in that it is private; when you’re having sex with yourself, you don’t have to consider another person’s feelings, reactions, and preferences in the moment, which can allow for a type of exploration that is relaxed and curious.

Often I find that people are impeded in exploring their sexual selves alone by a perception that self-pleasure is in some way gross, lonely, bad, or sad. That’s a real shame, in my opinion. Self-pleasure is completely normal. It’s the most reliable way to experience orgasm, and, for many people, it can be a valuable self-care practice.

If you have that kind of reaction to self-pleasure–if it seems isolating or wrong in some way–ask yourself these questions:

  • Why am I having this reaction?
  • Where did I learn this?
  • Do I still actually believe it?
  • What do I aspire to believe about self-pleasure?
  • How far away from that aspirational belief am I right now?
  • What would be the benefit to me if I were able to shift all the way to the belief I would like to have?
  • What would be the benefit to my relationship(s)?

Then write down the belief you would like to have, and refer to it often. When you notice you are having the old, less helpful thoughts, try deliberately replacing those thoughts with the new ones.

If this is difficult, or progress is slower than you would like, you might benefit from discussing it with a therapist. When you interview a therapist to see if it’s a good fit, be sure to ask them if they are comfortable and competent working with sex issues—this is an issue that will require some explicit discussion about sex and sexuality.

Embracing and exploring your sexual self can allow you to understand yourself better—to know what turns you on and off, what invigorates and excites you, and what gives you pleasure. But it won’t just benefit you alone; you can also bring that knowledge back to your partnered sexual encounters, and your understanding of yourself can make sex that much hotter and more meaningful.

Having a strong connection with your own eroticism can also take some pressure off your partnered intimate interactions. It can be very distressing when one partner wants to have sex and the other does not. If you can stop thinking of self-pleasure as something lonely or lesser than partnered sex, and start thinking of it as an opportunity to explore, experience, and have a lot of fun exploring your eroticism without the pressure of anyone else’s expectations, you may find yourself taking it in stride the next time your partner doesn’t feel like having sex when you do. The reverse is also true. Next time your partner’s in the mood and you aren’t, you could invite them to have some hot self-sexual time.

Or maybe you would find it sexy to watch, or to participate in some manner? There are many ways you can incorporate self-stimulation into your repertoire for partnered sex. Anxiety and arousal don’t go together; an internal sense that it is your “job” to “give” your partner sexual pleasure and orgasm can really put a damper on enthusiasm and hotness. That knife cuts both ways—worrying that you’re taking too long is decidedly not erotic! Knowing you can take control of your own pleasure (and your partner can do the same) is one of the most empowering and anxiety-reducing shifts I know of.

Tune in next week, when I’ll be sharing some tips for how to explore your self-sexual connection!

When Self-Pleasure Habits Get In The Way of Partnered Sex

If I could give one piece of sex advice to everyone, it would be this: “Switch it up on a regular basis!”

The more ways you can develop for experiencing sexual pleasure, and the more pleasure you can generate, the more likely you are to reach orgasm, whether alone or with a partner. The more different routes you have to orgasm on your own, the more likely you will find a way to reach orgasm with a partner. And the more different routes you have to orgasm with a partner, the more likely you are to experience pleasure even when life throws a wrench into things and certain activities aren’t possible for one reason or another.

Most people who reliably reach orgasm have one primary way of doing so. It is perfectly understandable that people go with what works; why argue with success? Our cultural expectation seems to be that sex isn’t “real sex” unless there is an orgasm, and not only that, an orgasm that someone else “gave” us. So once we figure out how to “give our partner an orgasm”, we tend to stick with that strategy rather than continue to explore and risk not “getting it right”, “being a bad lover” or just missing the orgasm entirely some of the time.

Here’s the problem: the more you focus one just one way of reaching orgasm or experiencing pleasure, the more likely you are to get stuck in a rut. When you bring yourself to orgasm in a specific way, you’re strengthening a neural pathway in your brain. Every time you do the same thing, that pathway gets stronger. Unless you switch it up and cultivate other ways of reaching orgasm, it becomes harder and harder to do so in any other way.

There are lots of ways this might look:

  • I self-pleasure by rubbing myself against something, and I can’t get that same feeling and reach orgasm with a partner
  • I self-pleasure while watching porn, and find it hard to reach orgasm with a partner
  • I can’t reach orgasm without a particular fantasy, and that makes me uncomfortable; I’d rather be able to do it without that particular fantasy
  • I self-pleasure dry (or with a tight hand), and then when I have penis-in-vagina sex with my partner, the sensation just isn’t strong enough to get over the edge

All of these examples point to a particular pathway to orgasm, involving a combination of thoughts, images, novel stimuli, types of touch, amount of slipperiness, amount of pressure, broad versus specific stimulation, etc.

The key to shifting a habitual neural pathway to orgasm is to start to change it up. Let me be clear; this is not always easy, nor is it something most people can accomplish quickly. That’s why an ounce of prevention is worth a pound of cure! If you already have multiple ways you can experience high levels of sexual pleasure, make sure to use all of them to get to orgasm, not just the easiest one.

And if you are in a rut, consider what is different between the way you most easily reach orgasm and the way you and your partner have sex. Think about all the components of the interaction. Then begin experimenting with shifting one or two things more toward a sensation or visual stimulation that partnered sex can match. Here are some specific suggestions:

  • If you watch porn, watch just one video all the way through rather than clicking between many. Get used to arousal ebbing and flowing, and returning, even when the “action” is a little slower and less novel
  • If you touch yourself without lube, try using lube. Partner sex is often slicker than solo sex, although not always. If the opposite is true, try using less lube.
  • If you rub against something, try placing your hand between the object and your body. Gradually shift how much of the sensation is coming from diffuse pressure versus your hand moving, or specific touch.
  • If you have a favorite fantasy, see if you can develop a second-runner-up fantasy. See if you can come up with one that has some things in common with sexy aspects of your partner, or the way you and your partner have sex.

The strategy is to, very gradually, use the new way more and more during any given sexual interaction. Most people like to start this experiment solo, but there is no reason you can’t do it with a partner too if you’re both comfortable with some experimentation.

Start getting turned on the “old” way. But once arousal is building, switch it up. If arousal begins to fall and it is hard to get it to build again, shift back to the tried-and-true, but when possible, shift back again to the new way. Most people starting this experiment need to use the old way to tip over into orgasm at first, but the goal is to become able to get over the orgasmic threshold with the “new way”, which ideally is in some way significantly more similar to partnered sex.

This is necessarily a gradual process, because it takes time to build a new neural pathway. And it generally feels frustrating; neurons have to literally find one another and connect in new ways.

Having a therapist who can support this process can be very helpful. It is important to strike a balance between building the new neural pathway, and experiencing sexual pleasure without too much frustration. You can’t rush this process. Finding ways to stay steady, find patience, make it fun, and keep clear on why you’re doing this in the first place will be crucial.

Whether you are thinking about this from the viewpoint of a therapist helping others, or a person wanting to increase your experience and ease with orgasm, ask yourself what neural pathway issues may be at play, and how you can start building diverse pathways towards more connected, satisfying, and flexible encounters.