A primer on sexual arousal.

Arousal (a-ROUS- al): The normal change from a non-sexual to a sexual state of body and mind.

The secrets of good sexual arousal are hidden in plain sight. They’re obvious, once you know what you’re looking for. But so many couples end up losing their bearings in this area, that a good general introduction to the subject seems overdue.

Physical sexual arousal — the sexually aroused body — has been endlessly studied, most famously by Masters and Johnson in the 1960’s. And less rigorously but no less intensely by every sexual couple since the dawn of human self-awareness. Most heterosexual couples study the male partner’s erections and the female partner’s state of lubrication carefully for reassurance about their respective states of sexual arousal. Urban legends rise and fall over the decades concerning other putative guides to one’s partner’s level of sexual arousal (see “nipple erection,” “pupil dilation”). But through all of this, we’re in the realm of the sexually aroused body.

The sexually aroused mind has proved harder to study. Research on mental sexual arousal continues to await its Masters and Johnson; no one has yet shown up for the job. A particularly thorny problem with the study of mental sexual arousal is the overwhelming diversity in people’s experience of arousal. But I’m going to be brave here and offer some practical generalizations. Here is what I tell my patients to look for, as the hallmarks of mental sexual arousal:

Attention to sex (to the exclusion of practically everything else). When we’re aroused, sex grabs our attention. We think about sex, and we stop thinking about bills, problems, responsibilities, image, reputation . . . our entire portfolio of ordinary concerns. Sexual arousal focuses us. It focuses us on sex. Our time sense typically becomes impaired. (Sexually aroused people tend to arrive late to meetings). If someone gave us an IQ test during peak sexual arousal, we wouldn’t do very well on it. The tester might have a difficult time getting us to pay attention to the questions. Good sex makes us definitely dumber. And great sex can make us downright stupid.

Regression to infantile thinking and behavior. There is an essential selfishness about sexual arousal. When we’re aroused, we don’t tolerate frustration very well. We’re likely to get upset when the phone rings. We don’t care who’s calling, or what they want. When we’re aroused, we don’t want to be bothered by anything except our sexual needs. We may be deeply absorbed in passionate feelings towards our sexual partner, but we might at that moment not want to hear all about their day. We just want to be treated very nicely, and told we’re wonderful and that everything is fine.

A sense of specialness. This is the hardest part to put into words — but it’s readily obvious to anyone who’s ever had good sex: Sex feels special. When most of us recall the greatest sex we ever had, what we remember is an experience of sustained, intense, and therefore intensely meaningful sexual arousal. Deep, sustained sexual arousal stirs something ancient in us, and is intensely validating. It feels special, and makes us feel special. When I ask couples about their recent sexual experiences, I often ask, “Did it take you someplace special?”

It should be clear from the above description that we’re talking about a kind of mental state that is complex, contradictory, and volatile. And that has the capacity for great good as well as great harm and grief. But wouldn’t that just about fit our ordinary experience of what sex is like? Perhaps it’s not so surprising that so many long-term couples largely avoid the heights of sexual arousal.

Many times people come to see me complaining of a sexual symptom, such as lack of sexual desire, or sexual boredom, or some other dysfunction. And within the first several minutes, it’s clear that the person or couple has been attempting to have sex despite neither of them being mentally sexually aroused.

Sometimes a couple simply never knew to pay attention to the mental aspects of sexual arousal. But more often, at some point early in their sexual relationship, with all the vulnerable feelings that can get stirred up during sexual arousal, something just didn’t feel right. And no amount of talking or fighting or lovemaking seems to be able to make it feel right.

Sometimes in therapy a couple can find a way to finally express in words what it is that hasn’t felt right in bed. Often the lack of good sexual arousal will turn out to have been a sign that something needed attention. And sometimes, with a bit of luck and enough careful attention, a couple that lost their way can find it again.

© Stephen Snyder, MD 2010

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