How to pronounce "nugget"

So having a sex problem is like having a toothache.

By the time you get to the dentist, or to me, a sex therapist,

you just want to get out of pain.

But what we just went through with COVID, that was like a sexual root canal.

I mean, we spent months not changing out of our pajamas.

And sometimes not showering.

No wonder so many of us lost our libidos.

It's not that we're not sexual people.

We want to want sex.

We just don't want it.

In my work with couples,

one of the biggest problems I see

is that sex often stalls out before it even gets started.

There’s a “failure to launch,”

an inability to get going and gain momentum.

For example, one of my patients shuts down

as soon as her partner starts to kiss her.

Turns out, her boyfriend in the eighth grade

told her she had bad breath.

Another patient of mine is terrified of losing his erection,

so much so that he avoids any situation that could possibly lead to sex.

But he tells his partner he has no desire,

and he blames it on work stress.

Meanwhile, he's filled with longing.

He just doesn't dare show it.

And so his partner feels confused and unattractive.

For some of us, there just isn't room in our busy lives

for sexual energy to emerge.

There isn’t what I call the “erotic thread” between sexual events,

those moments when we can express desire or feel desire,

pivot in and out of a quick sexual charge just for the heck of it.

So, you know, it's no surprise

that by the time we actually do get around to finally having sex,

too often it can feel reduced

to a mundane series of predictable behaviors,

stale and drained of erotic life.

So why even bother?

Whenever the issue is a failure to launch,

what we really need is a new way in,

what I call an arousal runway.

And I firmly believe that that runway

needs to be in the form of psychological arousal,

not just physical.

For example, we know that some women can fantasize their way to orgasm

without ever touching themselves.

And men -- well, men can just look at something sexy

or think about something sexy

and start to get a strong physical reaction.

That's the power of psychological arousal.

So why aren't we sharing more of it with each other?

Well, in the beginning of a relationship, we really don't need to.

The newness itself is often its own form of psychological stimuli.

But as we go on,

and as our sexual connection starts to lose its vitality,

that's when we need to be more deliberate about engaging our erotic minds together.

Otherwise, we might start to drift apart.

We might start to fall into a sexless relationship.

Some of us might even start to cheat,

which is the only way that many of us know to get back on that arousal runway.

I have rarely met a couple

that doesn't understand the importance of psychological arousal

and doesn't want more of it in the bedroom,

but they often just don't know where to begin.

So I give homework assignments

that emphasize two types of psychological arousal:

face to face and side by side.

Face to face is things like sharing a fantasy,

role-playing a sexy scenario,

engaging in sexual role-play.

Activities that two people can do just between themselves

with only their imaginations.

Well, that's easier said than done.

With so much shame and inhibition around sex

that takes willingness,

it takes vulnerability, and it takes courage.

So I often suggest starting out with a side by side experience,

something that's a little less pressured.

Reading some literary erotica aloud together,

listening to a sexy podcast, watching ethical porn.

That's the kind where the performers actually want to be there.

Recently, I was working with a heterosexual couple

that needed an arousal boost.

They were trying to get back into sex after having a baby.

And she especially needed help tuning out the stressors

and getting into a sexual mindset.

But as a breastfeeding mom, she felt totally touched out.

So she loved the idea of psychological arousal.

She thought it would be a blast to watch porn together.

She never did anything like that in her life.

But for him, that was something private and off limits,

and he was worried that she was going to judge him based on his tastes.

So I came up with a solution.

I gave them a list of ethical porn sites,

and I asked them, "Hey, how do you feel

about each picking a scene or two that you think would turn on the other?"

Well, not only was he willing to do that,

it led to a fascinating and funny follow-up conversation.

He asked her, "Why exactly did you pick tickle torture for me?"

(Laughter)

So starting side by side,

it helps us get face to face.

But then that face to face arousal,

it needs to be more than just putting on sexy lingerie

or buying handcuffs and a blindfold.

On their own, those things are pretty inert.

What makes them arousing is when they enable us to tap into our fantasies,

or what the late great sex therapist Jack Morin called a “core erotic theme.”

Sexual scenarios that uniquely turn us on more than others,

and they hold on to that erotic charge over time.

Well, a lot of couples say they don't have fantasies

or they don't know what their fantasies are.

But once you start having those side by side experiences,

those erotic themes start to emerge and get talked about.

Like the couple with the new baby.

Why did she end up picking tickle torture for him?

Well, she felt like he needed to lose control,

both in and out of the bedroom,

and he was very ticklish.

Because she was the one who actually had to go through the pain of childbirth,

but then he made such a big deal about being in the delivery room

and having to watch and how hard it was,

he needed to be punished for that.

(Laughter)

And because she loved the idea of just stepping out of her nurturing mom role

and for a little while being a powerful dominatrix.

I can't say they ever got as far as actually engaging in tickle torture,

but I do know that they started to move from side by side to face to face

and started to play with power in ways that they both found really hot.

So what if you are someone who fantasizes during sex

but you keep it to yourself?

Does that count a psychological arousal?

And what if the person you're fantasizing about

isn't the person you're actually having sex with?

That can be confusing.

You might start to wonder, "What's going on here? Am I bored?

Am I not into the sex? Am I cheating in my mind?

Should I push those thoughts out of my head?"

No.

Our fantasies are our allies.

They help distract us away

from the chaotic world outside of our bedroom,

and they lead us and they lull us into our sexual bodies

so that we can tune in and turn on.

Our fantasies are our friends.

You don't fear them. You follow them.

Now does that mean you should take your partner with you

and tell them about that secret fantasy?

Well, that depends.

It could be a great way of going deeper into that face-to-face arousal.

But on the other hand,

if you and your partner are just starting to dip your toes

into the shallow end of the fantasy pool,

well, then you might want to hang out

in the intermediate section a little bit, you know,

like splash around a little bit, get comfortable,

develop some emotional safety,

establish boundaries.

I mean, maybe you got to make it clear to your partner,

"Hey, just so we know, fantasy is fantasy because it's not reality, right?"

There's a line between thought and action.

And just because you happen to have erotic themes that turn you on

and that include others,

that doesn't mean that the sex isn't still just about the two of you.

A bunch of years ago,

I did a study with Dr Kristen Mark on the topic of sexual boredom.

We surveyed nearly 3,500 people in committed relationships

and found that more than 50 percent were either bored or on the brink of boredom.

Women were twice as likely to be bored in the first year of a relationship,

and men got bored in the first three years.

That's a whole lot of boredom on both sides of the bed.

But the good news,

the vast majority of respondents were entirely interested

in trying something new that their partners suggested.

So the antidote to boredom, it could just be a sexy suggestion away.

It could be as simple as waking up one morning,

looking at your partner and just saying,

"Hey, I just had the hottest dream about you."

And then you fill in the blanks.

If it makes you blush, just blame it on your subconscious.

The point is that sexy suggestion,

that little nugget of psychological arousal,

that could be the difference between lying in bed next to someone

and feeling a million miles apart,

or getting on that arousal runway together and taking off.

So what do you think?

After a year and a half of being grounded,

Isn't it time to spread our sexual wings and let ourselves fly?

Thank you.