You may have read my last blog on risk factors for orgasm problems in women. I promised to share some clinical examples. I hope they speak to you and offer some perspective on the complexities of sexual response.
“Amy,” a happily married mother of three, sought treatment for the inability to achieve orgasm. “I can sing in front of my kids,” she said. “But I could never sing in front of my husband. What if I sing off key? What if I look stupid?”
My response to her: “When you can sing in front of your husband, you will be able to have an orgasm in front of him, too.” So how can Amy allow herself to “let go” during sex when she can’t tolerate intimacy and vulnerability in non-sexual situations?
Shame and eroticism are commonly paired during sexual development. “Annemarie” was sexually abused by her older brother from age seven to nine. To avoid acknowledging the abuse, Annemarie feigned sleep when her abuser brother entered her room at night. “It was easier to pretend I was asleep than to attempt to deal with all of the confusing feelings.” Annemarie invariably associates sexual response with shame. She can’t allow herself to achieve orgasm because she can’t bear to recall that profound shame from her past. She has not had an orgasm in 28 years.
Problems experienced between couples outside the bedroom are often played out inside the bedroom as well. “Joan,” a 42-year old, married mother of two, reported intense contempt and anger toward her husband during a recent session in my office. When I question her as to why she is unreceptive to an orgasm, she tells me “I don’t want him to think he has any affect on me.”
And what about the woman whose husband threatens her? “You better be fun in bed,” he says. “Or else! If you don’t loosen up and enjoy yourself, I’m going to divorce you.” “Laney,” who suffers from Generalized Anxiety Disorder, is already distracted by intrusive thoughts during sex. Now she has the added pressure to “be fun.” Imagine trying to achieve orgasm under these conditions. And what of the many women who were taught that sex is dirty?
The good news is a little education goes a long way. Simply sharing statistics or debunking myths can have significant therapeutic value. They are comforted to hear that less than 20 percent of women can reliably achieve orgasm from intercourse alone. Providing women an opportunity to explore their shame, anger, fear, or other negative emotions can be extremely liberating. Most women appreciate the chance to gain insight into their sexuality. Centuries of stigma around female sexuality will not disappear overnight, but we are starting to see subtle shifts in the pendulum toward a healthier outlook.
Kimberly Resnick Anderson, LISW, MSSA
Director, Summa Center for Sexual Health