When an individual or couple initiates sex therapy, they're often quick to identify what they think the problem is. “I can't get an erection.” “Sex is painful.” “My partner has no desire.” These, on the surface, might seem like the problem. But what is often the unmentioned, but more significant, underlying concern is the impact this has on the individual’s or couple’s sex life. So while these might look like the problem, these are really just a symptom of the problem. The real problem is that sex is not enjoyable, workable, or value congruent. But we can actually get even more nuanced in describing the problem. It's not just that sex isn't working, more specifically, it's that intercourse isn't working. Why make this distinction? Let’s do a little exercise together.
I’d like you to sit down with a blank piece of paper and write two words: Intercourse and Sex. I’d like you to write down a definition for both of those words. Most people define intercourse as the act of penetration between a penis and vagina. It’s a pretty uniform definition that most people would agree on. Sex, however, might have some more variation in the definition. Some would say that sex and intercourse are the same things. Some might say that other kinds of sexual activity, like oral sex or manual stimulation, are also included in sex. Some might say that foreplay, like hugging and kissing, might be included in sex. Some might say sex begins even before there is any physical contact through verbal or non-verbal communication. For many, sex is a much broader concept, which also serves a broader function. So let’s talk about function.
Using this same piece of paper, write down what you believe the function of intercourse to be. I’d like you to also write down what you believe the function of sex to be. Put differently, why do people have intercourse? And why do people have sex? Are there differences between these two lists? The two most common answers I hear for intercourse are: procreation and pleasure. But when asking about the function of sex, many people list more answer. These may include: closeness, warmth, pleasure, a way to express love, exploration, experimentation, connection, making up after a fight, playfulness, feeling safe, self-esteem, and more. Intercourse, it would seem, has functions that are more closely tied to an outcome while sex seems to have many functions that are tied to a process. Why does that make a difference? I’ll clarify this point with a brief metaphor.
Imagine there are two kids sitting in the back of a car traveling from New York to Florida for a trip to Disneyworld. One kid is sitting in the back counting down the seconds till they get there. But all that waiting is accompanied by some whining. “Mom, I'm hungry”. “I'm bored.” “Are we there yet?” “I have to go to the baaaaathrooooom”. For this kid, the 20 plus hour drive to Florida is absolute agony. Every second he is not at his desired destination is another second that he is uncomfortable, anxious, or frustrated. His sibling, sitting right beside him, is listening to music on her iPod. She's playing the license plate game. She's trying to get truckers driving alongside to honk their horn. She's enjoying the scenery. For her, she's focusing on enjoying the trip, not just focusing on the destination. So while you have two kids in the same car, on the same drive, going to the same destination, for one, the journey is an enjoyable process, for the other, it's torturous.
How does this relate to sex? Well, for many, intercourse may be seen to be the goal of a sexual encounter. Foreplay is just the “appetizer” you’re trying to “get through” to get to the “main course” of intercourse. Moreover, since intercourse has a more narrow definition and function, there are more clearly discernible metrics to define the “success” or “failure” of that encounter. For example, if one were to define the function of intercourse to be procreation or pleasure, erectile dysfunction or vaginismus (the involuntary spasming of the pelvic floor muscles making penetration impossible or painful) would render that encounter of intercourse to be a failure. However, if the function of sex is about the “journey”, not the “destination”, can a couple have a meaningful sex even if they have erectile dysfunction or vaginismus? If the function of sex is pleasure, connection, and closeness, are those things still possible? Of course! This is precisely why Ian Kerner, a sex therapist in NYC, emphasizes transitioning from “foreplay” to “coreplay”. It is, in fact, during this “play” that one can connect to all of the values that make sex meaningful. It's not just what comes before the "real" play, i.e. intercourse.
So how can intercourse interfere with great sex? With an emphasis on getting to the “destination” and decreased mindfulness on the “journey” an individual or couple can lose contact with the things that make sex fulfilling and rewarding. I am certainly not suggesting that couples stop having intercourse, especially if this is a meaningful part of sex for a couple, but focusing on the process can enhance the outcome rather than the outcome being the sole focus of attention. Dr. Stephen Snyder, a psychiatrist and sex therapist in NYC, uses the metaphor of a meal to highlight this point. If you sit down for a three course meal at a nice restaurant, you want to enjoy the whole meal, even if what you’re most excited about is dessert. Moreover, if you rush through the appetizer and entrée to get to dessert, and dessert isn’t as wonderful as you hoped, you’ve also lost out on the opportunity to savor the meal that preceded it. Excessive focus on getting to intercourse can detract from the broader experience of sex. To maximize your experience during sex, engage the journey, not just the destination.
In my next post I will discuss some of the emotional and physiological consequences of placing pressure on the outcome of intercourse.
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