Let’s Talk Sex

Written By Dr Vicki Windholz
Life is complicated. Sex is complicated. Sex is influenced by everything that is happening in our lives, and sex influences what is happening in our lives. They are not separable.
Many of the ideas that we develop about sexuality and our bodies begin with what we learn at home, from the society and culture we grow up in, and the sex education we receive at school. Most of us went into sex education classes only to learn boys have erections and ejaculations, and girls have periods and unwanted pregnancy.  Most conversations were usually about how to avoid sexually transmitted infections and getting pregnant. 
The concept of pleasure and balancing a relationship was not mentioned. The skills and tools it takes to talk about sex and pleasure with a partner, to accept a ‘no’, to get enthusiastic consent and have meaningful intimacy were not discussed. 

Myths About Sex

Many things we believe about sex are actually not true, and even those of us who consider ourselves educated about our own bodies continue to believe some of them. For example, sexual desire (libido) was originally believed to be a spontaneous biological drive, the same as thirst and hunger. 
Many people believe that feeling like sex should just happen spontaneously.  You’re doing the dishes, an attractive person appears on the tv, or you have a sexy thought, and suddenly you are thinking “I want to have sex.”
However, research over the last couple of decades has shown that sexual desire and feeling like sex is context dependent. It can feel more spontaneous for some, and more responsive for others, because even though we are made of the same core biology, we all have very different minds.

What Influences Sexual Desire?

Sexual desire is a product of our hormones, our thoughts, and our emotions. 
This complex feeling is very much influenced by our attitudes about sex (e.g. “a real man is always ready to have sex”; “it is dangerous to have sex if you are sick”) and the quality and happiness in a relationship. 
Once you understand how complex sexual desire is, it is easier to understand how it can fluctuate over a day, a week, a month, a year and a lifetime. It is never “just” culture, or “just” biology or “just” anything. It is always the interaction of everything happening in a person’s life at that time.

When Sexual Desire Is Low

People often feel worried if they don’t have a strong sexual desire, or if their level of desire goes down.  In our culture, many people believe that having regular spontaneous desire for sex is normal, and if this isn’t happening, they feel like there is something wrong with them.
Understanding that sex is an incentive motivation system—that responsive desire (only feeling like sex if someone else initiates it) is normal and healthy—is important.  It helps us understand why sex is about ‘thriving’ and not just ‘surviving’. 
It explains why physical and mental stress makes sex less of a priority for most people, and reduces sexual pleasure for everyone. It also explains how our past, including how we are raised, our psychological and sexual history, and our current physical and mental health, directly influences how much we feel like having sex. 
People sometimes feel more comfortable with the idea that sexual desire has everything to do with their chemistry and nothing to do with their life. This false belief holds people back from being open and able to change.

Sexual Desire In Long Term Relationships 

When it comes to sexual desire in long term, monogamous relationships there are two different theories.
One theory, described by Esther Perel talks about desire as ‘wanting.’ The difference between the familiar and the unfamiliar, the stable and the mysterious.  We want love, which is about security and safety and stability, but we also want passion, which is about adventure and risk and novelty. Love is ‘having’. Desire is ‘wanting’. And you can only want what you don’t already have. 
By way of contrast, John Gottman says that reduced desire is due to a lack of intimacy, and not a lack of distance and mystery. From this point of view, intimate conversation, affection, and friendship are central to the erotic life of a long-term relationship.
Both theories are clear that passion doesn’t happen automatically in a long-term, monogamous relationship. They are also both clear that passion can happen—as long as the couple makes an effort to create situations for this to occur.

When A Couple’s Sexual Desire Doesn’t Match Up

A mismatch in sexual desire is a very common relationship problem. It’s not the difference itself that causes the issue - it’s how the couple manages it. 
Problems arise when one person’s level of desire is believed to be ‘better’ than the other person’s. This often leads to unsuccessful attempts to ‘fix’ the other person, rather than learning to manage it constructively. 
For example, one person may often feel like sex spontaneously, and their partner may have a more responsive desire style. In this scenario the spontaneous person may feel rejected and undesired because they do almost all the initiating. 
Their partner with the responsive style of sexual desire may be feeling pushed and pressured, which results in a further lowering of their sexual desire. Rather than seeing one sexual desire style as ‘better’ than the other, the aim is to see sexuality and desire as an intimate interactive process.

Creating A ‘New Sexual Normal’

Sexual intimacy is a way of feeling loved, showing love, and experiencing pleasure. It is a part of living, and it is a part of dying. 
In my clinical practice I see individuals or couples experiencing sexual distress. I explore their sexual distress in the context of their sexual identity, their sexual function and their sexual relationship (actual or desired). We usually experience these three domains as a narrative, a story: it is a story we tell ourselves, a story we tell our partners and a story we may tell others.
I work with people to change the narrative they tell themselves: I encourage them to reframe their narrative from one of powerlessness, decline and distress, to a narrative of explore, experiment and creation of a ‘new sexual normal’. 
Dr Vicki Windholz is a psychosexual medicine specialist, holding public appointments at Monash Health & the Royal Women’s Hospital, and consulting privately at Women’s & Men’s Health Physiotherapy Camberwell Rooms, 549 Burke Rd, Camberwell.