Let’s Talk About Sex - By Ali Hull
Emma Waring is a sex therapist, and often meets couples, in the course of her work, whose ignorance regarding sex both shocks and saddens her. As a result, she recently published a book, Seasons of Sex & Intimacy (Hullo Creative), which sets out to fill in the holes in our knowledge. For she believes that despite the amount of sex education in schools, nobody really prepares people for sexual intimacy – how our bodies work, and how our partner’s body works as well. And not only is there not enough guidance on sex when it all goes as it should, there is also, she feels, not enough advice on what to do when things go wrong. Nor is school the right place for this information to be handed on to children…
Emma says, “I fundamentally disagree with the idea that children should get their sex education from school. I actually think that children need to get sex education from their parents. As parents, we know our children better than anyone else, and I think we have a responsibility to talk to our children about this from a really young age, to help them understand that sex is a normal and natural part of life. There is nothing to be ashamed of and sex should be celebrated.”
So when should this begin? “Children will often be inquisitive around the age of about three about where babies come from. This is the age we often start taking young children to look at baby animals on a farm. If we can talk about sex without shame or obvious embarrassment, it sets our children on a healthy path to understand sex as a relational thing that two people do when they love one another. We can then build on this story as they get older and have more complex questions. I think the other way to look at it is, if we don’t choose to talk to our children about sex, they will learn about it through pornography and from their friends, probably giving them a very distorted and often incorrect view.”
But surely we live in a highly sexualised society, with plenty of sex scenes on TV and film – what is wrong with the information that can be gleaned from these sources? “I would agree that we live in a sexualised society and we are constantly facing sexualised images – but I don’t think these are very helpful. Sex, when portrayed in films and on television, usually involves young couples, who have perfect bodies. The sexual act will be spontaneous, very arousing for both participants, who will simultaneously orgasm with very little or no foreplay. The message is ‘this is the norm’, but actually it isn’t! It sets up an unrealistic expectation about how sex should be, and is very removed [from] how sex is for most couples. Sex is rarely if ever shown between couples in a committed long-term relationship, or where one person has a disability, or is overcoming breast cancer or prostate cancer.”
In fact, she says, sex changes – even between the same couple, over the course of a lifetime, and that is one reason why her book is called Seasons of Sex and Intimacy.“Spring will [be] passionate, often early in a relationship when sex is new to the couple. Summer is [the] time when a couple get used to how each person responds sexually and this can be deeply satisfying. Autumn may be more predictable and at times perhaps a bit boring and this is OK too. We will move through these seasons at various points and then revisit them. Perhaps a holiday reignites sexual desire and a couple move from autumn back to spring.”
The dangerous season for a couple, of course, is winter. This, Emma says, is “where there is no sexual intimacy and the couple can start to feel distant and unable to tackle the problem. If a couple [are] in the season of winter for a long period of time, it can make it more difficult to tackle sexual problems and get the couple back into having regular sexual intimacy. It’s certainly possible, but often when I’m working with couples who have not had sex for a long period of time, there will be relationship issues to tackle initially, things that need to be addressed before we can consider how to address the sexual problem.”
This can be when things get difficult, she says. “Talking about sex is not easy. In doing so we make ourselves vulnerable. We don’t know what our partner’s response is going to be. We are sharing the most intimate parts of ourselves. And the environment we grew up in can make it harder as well, if people grew up in a family where sex was never mentioned or mentioned disapprovingly. As a sex therapist, I often ask whether my clients ever saw their parents naked, or whether their parents [hid] their bodies and seemed ashamed of them. All these things impact how we think and view sex as we get into adolescence and adulthood, and this can be more challenging if we are in a relationship with somebody who grew up with an opposite parenting style. It may be that one person is very comfortable talking about sex and the other is not. Some of the work that I do with couples can be about discussing this awkward dynamic and working out ways to talk about this subject comfortably.”
Emma believes the information in her book is needed, by those who are already in a relationship and those who want to be in the future. In her work as a sex therapist, she says, “Many couples have said they wish that they had the information I had given them sooner, so they would not have had to live with the problems for so long. I hope the book will give couples quick and easy access to the information they need, and to be able to work out whether they can fix their own problems, or whether they need to consult a professional. If you are a close couple and you don’t feel your sexual difficulties have caused emotional distance, you may be able to implement some of the self-help strategies I discuss in the book and this may be enough. Or you might need to see your GP who can provide you with medication. Maybe you need longer-term sex therapy with a trained therapist, and I have provided information in the book about where to seek this type of professional help. I suggest all couples go and visit their GP first of all. It is frustrating for a couple to invest time and money in seeing a sex therapist only to find six months down the line that actually there is an underlying medical condition that can be treated easily, removing the sexual problem entirely.”
So, what can a sex therapist offer that a book can’t? “There are occasions when a couple will really benefit from seeing a sex therapist. If they are having difficulty communicating, bringing in an impartial third person can be very helpful. Sometimes we are not aware of how our partner perceives us. They may feel, for example, that we are angry when we speak to them, and yet we are not necessarily feeling this ourselves. Sometimes a therapist will be able to validate that by reflecting their own perception of a patient. This kind of feedback can be helpful if it is done in a constructive way. Sometimes I work with couples where one person talks over the other or gives their partner no space to voice their needs or desires, and this is what is happening in their home. Or I might work with a couple where they almost have a parent-child dynamic – one person takes a very nurturing role and the other slips into being compliant, and so loses their sense of autonomy. Often my role is to simply walk alongside these couples as they find ways to help themselves, and it will be the couple and the work they do away from the sessions that will make the difference. Having regular sessions with a therapist, however, will help them stay on track. If a couple agree to go away, for example, and do some homework-style exercises, and they know this is going to be reviewed soon with the therapist, they are much more likely to do the exercises than if they had no sense of accountability.”
What are some of the key issues she feels men need to know about regarding how sexual desire works for their wives? “Couples often say to me that this information is absolutely key – the different ways men and women experience sexual desire and arousal. Often men and women are not aware that there are differences. But academics William Masters and Virginia Johnson pioneered research into the nature of human sexual response (and the diagnosis and treatment of sexual disorders) in the twentieth century, and this revealed the differences. They wrote Human Sexual Response, which was published in 1966 [by Little, Brown and Company], and much of my training as a psychosexual therapist was based on their work.”
Masters and Johnson identified four distinct phases of human sexual response:
Excitement phase, including desire and arousal.
Plateau phase, at full arousal, but not orgasm.
Resolution where the body returns to it normal state.
“Masters and Johnson suggest that one moves through the four linear stages from desire to resolution,” Emma says, but other researchers disagree: “Rosemary Basson has looked more recently at the female response cycle and she suggests men and women do not necessary follow the linear model. She argues that unlike men, women have less spontaneous sexual desire and are often in sexual ‘neutral’. This does not mean that they do not want sex, but it is not necessarily at the forefront of their minds. Instead, women need two important factors to be present for sexual desire to happen: she has to feel positive about the relationship and connected to her partner, and she has to be sexually aroused.”
Looking at the first of these issues, Emma points out that a problem somewhere else in the relationship will – for most women – impact their sexual relationship as well. “If a woman is unhappy, feels unheard or is dissatisfied with the marriage, this can directly affect her willingness to engage in sex. And of course, that means effective communication is vital. A big problem in the relationship will simply get in the way of sexual desire, and if it is not addressed, then the woman may well not be interested in sex at all, even though it is not sex in itself that is the problem. If there is a fundamental dissatisfaction within the relationship, then both parties need to address this before the sexually difficulties can be adequately addressed. And the need for arousal is, of course, why foreplay is so important – one of the things that is often left out of sex scenes on TV or in film, not least because of the time it takes up.”
Emma sees men and women in her clinic – so is there a marked difference in their questions, their attitudes to sex, or their willingness to engage and take her advice on board? “I don’t feel that there are any obvious marked differences in the questions or attitude to sex, or indeed willingness to engage in the advice or treatment discussed. I have noticed over the years that we can have stereotypical views about how men and women behave and there is not always a basis for this. I try not to hold any stereotypes but take each individual as I find them. For example, we can make the assumption that men are always willing and ready for sex and women are more reluctant or not interested, but in fact I see as many men who are struggling with low sexual desire as women. And I very rarely meet anyone who is looking to have ‘casual’ sex. This could simply be that those who are open to therapy are more likely to have a different attitude to sex than those who wouldn’t consider therapy, but what surprises me is that almost everyone I work with is looking for sex to be a meaningful experience. It seems that most people instinctively feel sex is better in the context of connection and love. When I work with single patients, I always ask them what their hopes are for the future and almost without exception they are looking for a lifelong committed partner and to be able to enjoy sex within that relationship.”