Needless to say, the research subjects weren't representative of the larger population. In particular, they typically did not include people who had low libido or had other problems getting aroused. This led to models of sexual response that were either vague about the questions of desire and arousal, or which made definite statements about desire and arousal that turned out to be wrong for large parts of the general population.
Meanwhile, therapists were seeing quite a different picture, as the top sexual complaints (not in order) were:
- Premature ejaculation (PE)
- Inability to orgasm (anorgasmia)
- Erection issues for men (ED)
- Loss of libido or mismatched desire, leading to conflict over sexual frequency or complete lack of sex
So that left the number one issue for many long-term couples: problems with desire and arousal, the one thing the lab studies had ignored.
Modern therapy and sexual arousal
The apparent lesson from the early lab studies was that mental and physical stimulation caused arousal, and increased arousal caused orgasms. So most researchers assumed that the primary problem with lack of arousal, and therefore with lack of orgasms, was insufficient stimulation: the subjects weren't being stimulated enough and in the right ways.But Heiman & Lopiccolo took a different approach in Becoming Orgasmic, focusing primarily on the inhibitions that caused their patients to block out or interrupt the normal arousal process. Yes, they included activities for increasing arousal, such as learning to use a vibrator for masturbation and doing what amounts to yoni massage for extended periods. But the first and critical part of the therapy is focused on identifying, working through, and changing long-held assumptions and attitudes that create tension and anxiety and interfere with arousal.
This shift in focus was formalized in the 1990s with the development of the "dual control model" of arousal and desire by Eric Janssen and John Bancroft of the Kinsey Institute for Sex Research. (BTW, that link leads to a great cartoon at the website of one of my favorite sex ed bloggers, so go look at it!)
Janssen & Bancroft observed that most physiological systems in the body have dual control systems. For example, insulin lowers high blood sugar, while glucagon raises low blood sugar. Similarly, sweating lowers high body temperature, while shivering raises low body temperature.
Hitting the Gas, Hitting the Brakes
Their hypothesis, which has been born out by a great deal of experience in the last 20 years, is that sexual arousal is also controlled by two different systems. In effect, one of these is the accelerator pedal and the other is the brake. And this matters, because if the brakes are fully engaged - by stress, anxiety, fear, fatigue, frustration, or any other stressors - pushing down harder on the accelerator will create forward motion only with difficulty, if at all, and it is not likely to be very enjoyable.
Janssen & Bancroft called the accelerator the Sexual Excitation System, or SES, and they called the brake the Sexual Inhibitory System, or SIS. And they found that people differ a great deal in the sensitivity of both of these systems.
It turns out that this is a really good way of figuring out why different people have very different problems related to desire and arousal, and why they need different solutions. To help understand this, picture a very simple 3x3 tic-tac-toe grid, where a person can be either high (+), middle (0), or low (-) in terms of their SES and SIS.
So, for example, we would typically find that people who are high in excitation and low in inhibition (+/-) need very little mental or physical stimulation to become aroused in almost all situations. They get aroused easily and not much distracts them or turns them off. This might sound ideal if you have trouble in either department, but these people may also have problems with impulsivity and tend to have more problems with STIs, unwanted pregnancies, and sustaining exclusive relationships.
People at the opposite extreme (-/+) are slow to warm up under even the best of circumstances, and it doesn't take much to turn them off completely. They are the most likely to identify as asexual, but they can be capable of intense arousal and orgasms if circumstances are just right.
Relatively few people are at those two poles. What about the other two corners of the grid?
The +/+ folks are quick to warm up, but only if everything is going right. Nerves, irritation, worries about being overheard, even minor distractions can interrupt the happy times. They don't need more stimulation when things are blocked for them. In fact, many of them can reach orgasm with high stimulation even when the brakes are on, but it is usually a pleasureless, almost mechanical kind of release.
What they need in order to have great sex is calm, safety, deep relaxation, and trust in their partners. If this is what your partner is like, you'll probably have a lot more success improving your sex life by doing what you can to reduce your partner's stress level than by being more active in bed.
The -/- folks have it easier in some ways. They are slow to arouse, but hard to distract from it. In many ways, they are the ones who best fit the old therapeutic model, because what they need most is a strong, sustained push on the accelerator pedal. Flowers, chocolates, romance, a glass of wine, nibbles on the neck and earlobes, sexy lingerie, some good porn, a long sensual massage, and a lot of good foreplay.
Most people, of course, are more toward the middle on one or the other or both of these two dimensions, but in the very large majority of cases where people perceive that their sexual interest or arousal or desire has declined, or is in some ways inadequate, it's usually the brakes that are messing things up.
A lot of us live high stress lives, and for most of us it doesn't take much tension to put on the brakes. If that's the case for you or your partner, then getting in the mood for sex isn't primarily about more romance and better foreplay. It's about reducing the stress and blocking out the distractions that are slamming on the brakes. As Dr. Nagoski says,
The difficulty for many couples is simply not being able to make enough time with no distractions or demands. But if your life is so overscheduled that you can't find time to strengthen and maintain your relationship, you may want to re-examine your priorities. After all, every form of sex therapy and couples therapy requires a great deal of time. Making enough time for real intimacy and good sex every week might be your best way to prevent the need for that.
It turns out that this is a really good way of figuring out why different people have very different problems related to desire and arousal, and why they need different solutions. To help understand this, picture a very simple 3x3 tic-tac-toe grid, where a person can be either high (+), middle (0), or low (-) in terms of their SES and SIS.
So, for example, we would typically find that people who are high in excitation and low in inhibition (+/-) need very little mental or physical stimulation to become aroused in almost all situations. They get aroused easily and not much distracts them or turns them off. This might sound ideal if you have trouble in either department, but these people may also have problems with impulsivity and tend to have more problems with STIs, unwanted pregnancies, and sustaining exclusive relationships.
People at the opposite extreme (-/+) are slow to warm up under even the best of circumstances, and it doesn't take much to turn them off completely. They are the most likely to identify as asexual, but they can be capable of intense arousal and orgasms if circumstances are just right.
Relatively few people are at those two poles. What about the other two corners of the grid?
The +/+ folks are quick to warm up, but only if everything is going right. Nerves, irritation, worries about being overheard, even minor distractions can interrupt the happy times. They don't need more stimulation when things are blocked for them. In fact, many of them can reach orgasm with high stimulation even when the brakes are on, but it is usually a pleasureless, almost mechanical kind of release.
What they need in order to have great sex is calm, safety, deep relaxation, and trust in their partners. If this is what your partner is like, you'll probably have a lot more success improving your sex life by doing what you can to reduce your partner's stress level than by being more active in bed.
The -/- folks have it easier in some ways. They are slow to arouse, but hard to distract from it. In many ways, they are the ones who best fit the old therapeutic model, because what they need most is a strong, sustained push on the accelerator pedal. Flowers, chocolates, romance, a glass of wine, nibbles on the neck and earlobes, sexy lingerie, some good porn, a long sensual massage, and a lot of good foreplay.
Most people, of course, are more toward the middle on one or the other or both of these two dimensions, but in the very large majority of cases where people perceive that their sexual interest or arousal or desire has declined, or is in some ways inadequate, it's usually the brakes that are messing things up.
Where Do You and Your Partner Fit In?
Want to know where you fit in? This is the short version of the Sexual Temperament Questionnaire that Dr. Emily Nagoski uses to help people identify where they fit in terms of SIS and SES. It's quick and simple. (I scored 8 on SIS and 12 on SES, putting me in the middle of both scales, just in case you were curious! :)A lot of us live high stress lives, and for most of us it doesn't take much tension to put on the brakes. If that's the case for you or your partner, then getting in the mood for sex isn't primarily about more romance and better foreplay. It's about reducing the stress and blocking out the distractions that are slamming on the brakes. As Dr. Nagoski says,
If you’re the partner and want to generate desire, use your knowledge of her as an individual both to turn on the “ons” and turn off the “offs”: what makes her feel cared for, safe, affectionate, stress-free, sexy, and beautiful?And of course, that's one reason tantric sex is so successful for many couples. We start with some of the most effective relaxation techniques known: a safe refuge, an uninterrupted block of time, a warm bath or shower, some quiet meditation, a trusted partner, and a long, loving massage. And only then, when you're completely de-stressed and relaxed, do we add the arousal in ways that deliberately take away all time pressure and all responsibility to perform. There's no need to do anything but lie back, relax, and enjoy all those lovely sensations.
The difficulty for many couples is simply not being able to make enough time with no distractions or demands. But if your life is so overscheduled that you can't find time to strengthen and maintain your relationship, you may want to re-examine your priorities. After all, every form of sex therapy and couples therapy requires a great deal of time. Making enough time for real intimacy and good sex every week might be your best way to prevent the need for that.
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