This Woman Knows the Secret to Better Sex
(And why it matters for you)
When psychologist Dr. Lori Brotto published Better Sex Through Mindfulness in 2018, she was deluged with requests from readers who wanted to be treated by her or to participate in sessions at her Sexual Health Research Lab at the University of British Columbia. Unable to meet all of these requests, Brotto instead published a companion book, The Better Sex Through Mindfulness Workbook: A Guide to Cultivating Desire. It includes exercises to help women understand their emotional and physical connection to their sexual selves. Here, Brotto talks about why, contrary to popular belief, hot sex might require a little bit of work.
What is the connection between mindfulness and better sex?
The connection is strong. In order to understand why it works, we need to take a step back and understand what the main contributors are to sexual problems. We know that distraction, judgment, irrational thoughts, preoccupations, catastrophizing, spectatoring, all of these concepts have been shown to contribute to sexual difficulties, especially low desire. And mindfulness, which really boils down to present-moment, non-judgmental awareness, is quite a simple set of skills that addresses every single one of those potential barriers that impede sexual desire. In our science, we’ve evaluated that. We’ve been able to demonstrate not only that mindfulness works, but that the improvements people see are lasting. A year later, people are still practicing the skills and still benefiting from them.
There is this pervasive myth that sex needs to be spontaneous and thrilling and, like, “rip your clothes off” all the time. But your research shows that good sex takes effort. How do we let people know that effort is sexy as well?
I often say, “Think about anything that’s meaningful and important to you, that was not planned. There are probably very few wonderful events that were totally spontaneous.” People can easily relate to that. They’re like, “Yeah, I planned that dinner party, I planned that vacation.” You can also plan foreplay, you can plan the fantasies that you’re having while leading up to the sexual encounter, so that you’re not kind of jumping into the cold water fully dressed. You’re slowly kindling the fire by eliciting some erotic scenes in your mind. We really want to normalize planning, but also talk about it in a very pro-sexy way as well.
You acknowledge that some people may be skeptical about the concept of mindfulness, and that’s quite all right. How do you allay those concerns?
I’ll give you an example. We started running our mindfulness groups for women with vulvo-vaginal pain—one in five women have chronic burning, stinging sensations with any kind of vaginal penetration. When we first started introducing mindfulness to that group—because there’s a whole literature on mindfulness for pain—the women were really skeptical. It’s because they had been led to believe that there was some injury, there was some irritation or infection at the vulva and vagina that was causing their pain. It makes sense that they would think this, because their doctors would dismiss them. We presented them with actual scientific studies that showed that, number one, all chronic pains are maintained in the brain, and, number two, that mindfulness changes the brain. If we can change the brain and change the pain centres of the brain, it should have this downstream effect of improving vulvar pain as well. The way we address the skepticism is science.
We live in such an incredibly stressful world right now. How do you convince women that it’s okay for them to take time every day to do their mindfulness practice?
I’m going to sound like a broken record, but it really comes back to the science. Originally, when mindfulness was being evaluated back in the late 1970s and early 1980s, it was always in the context of these comprehensive, eight-week practices, at least an hour a day, or seven hours of walking mindfully through a forest. There’s been a lot more research since then, showing that even 10 minutes a day can produce structural and functional changes in the brain that allow us to really benefit from mindfulness. We know that multitasking actually leads us to be less efficient. It leads us to take less pleasure in the things that we’re doing and make more mistakes. By investing a short amount of time in mindfulness, we’re actually saving time in other areas of our day.
We’ve all just come through two years of Zoom fatigue and trying to get our kids through school. What effect has the pandemic had on people’s libidos?
Some of the early speculation in April 2020 was that we’d see a baby boom. Because, of course, no one had anything else to do but stay home and have sex with their partners. We had all this extra time on our hands. When we studied it, and we followed people over time, we found the opposite. Every other study found the opposite as well. Desire went down, sexual activity went down. The only thing that went up was masturbation. Probably it was a coping mechanism, a way to feel some brief moments of pleasure in an otherwise dismal life stage.
Do you get the sense that everybody feels like other people are having more and better sex than they are?
It’s more than a sense, because I have patients tell me that constantly. They think they’re the only one that struggles with this. I’ll say, “Have you really asked other people?” And they’ll say, “No, I haven’t asked. But I can tell by looking at them, the way they hold hands, they’re having tons of sex.”
We tend to think that desire must come first, and arousal will follow. But you challenge that thinking. How are arousal and desire related?
We know from scientific studies that the direction of arousal first and then desire is far more common than we previously thought. It’s far more common in longer-term relationships, where we might agree to sexual activity for non-sexual reasons. It’s our anniversary, or I want to feel close, I want to say thank you, I want to get rid of my headache, what have you. In the encounters, as long as the kinds of stimulation and exchanges are right for her, and right in a way that elicits her arousal if she continues to focus and stay present, that can give way to a wanting. She probably feels the wanting well into the encounter, even if she doesn’t feel it at the outset. That message, that kind of normalization of feeling neutral at the outset, is really important because so many women feel broken when they don’t feel horny.
You write that one-third of women struggle with low or declining desire. Is this low desire a problem for everyone who experiences it?
No, it’s not. That’s a really important question. If you’re going through a stressful period you might say, I’m not interested in sex. I’m recovering from surgery, or I’m tending to an ill partner, or I have a major stressful life event happening. It’s a smaller proportion of those with low desire who experience distress. And even in distress, we need to be careful because sometimes it’s the partner’s distress. To qualify for a disorder, one needs to have the symptom of low desire, combined with clinically significant personal distress.
Part of mindfulness is an acceptance of all emotions, whether positive or negative. Tell us about the metaphor of the guest house, which you use to explain this process.
Women have a really hard time admitting that they feel anger—like there’s something really wrong with us if we if we feel angry or irritable or irritated. The mindfulness approach shows that our effort to get rid of anger and emotions like that creates a lot of suffering that then harms us. “The Guest House” is a translated poem by the Persian poet Rumi. It talks about inviting all the guests, because some of them might be clearing you out for some future delight. It’s in the acceptance of emotions that suffering starts to fade.
There are lots of myths out there regarding menopause and sex. What are some of those myths?
That sex ends with menopause. That menopause depletes you of all your hormones, which it doesn’t—during the up to 10 years of perimenopause, there are actually fluctuating levels of estrogen. That aging women can’t initiate sex. That if you don’t have a partner, you’re asexual. That young people are sexually promiscuous and have no sexual problems. I could go on and on.
Why is good sex important for mental and physical health?
The World Health Organization has declared that sexual health is a component of quality of life. Now, if you’re an asexual person, this is not going to be relevant, because asexual people just don’t have sexual interest at all and are totally fine with it. Removing asexuals from that group, sexual health can directly contribute to self esteem, to physical health, to relationship satisfaction. All of that has been supported by a lot of science. When sexual health is not going well, it can also directly contribute to relationship conflict, depression, anxiety, and stress. Sexual health and general health and quality of life are tightly intertwined.