By Dr. Denise Renye, Licensed Psychologist (PsyD), Sex Therapist, Life Coach

A Sexologist’s Perspective on Sexuality 

When it comes to sexuality, most people think of, well, sex. This word is both loaded and very limited. However, there are so many other aspects of sexuality that don’t get nearly enough air time.

I’m a certified sexologist with the American College of Sexologists International and a licensed psychologist with a master’s degree in human sexuality. I’ve dedicated years to thinking about, researching, writing, and teaching this topic. I care about this deeply because, even today, there’s a lack of awareness and communication regarding sexual topics in the general public. I know there can be a lot of pressure around sexual activity, but to remove it from its broader context of sexuality does us no favors. 

Sex Is Complex

Having worked in domestic violence shelters and rape crisis centers as a counselor and court advocate, I know sex can be used as a weapon of violence. But I also know through educating individuals and couples on the techniques of erotic massage, eye gazing, and non-violent communication, that sexuality can be an expression of connection and deep love and admiration. Sex can be experienced and used in a myriad of ways across the continuum of pain and pleasure.

A Model for Understanding Human Sexuality

But sex is more than the physical act. When talking about sex, I like to widen the lens and talk about sexuality, which is as deep as it is multifaceted. A holistic model I teach often to couples, individuals, and students is the five circles of sexuality developed by Dr. Dennis Dailey in 1981, which is still relevant. Note: In his original model he listed “biological gender” in the sexual identity circle. We now have a more nuanced and better understanding that gender is a social construct and sex is biological anatomy. Dailey’s work expanded the definition and understanding of sex at the time. No one benefits from a narrow definition – in fact, many are harmed by it – but we can bring our better understanding to his contributions and still see the insight of his work.

In this model, values lie at the center of sexuality, but surrounding it are circles: power and sexualization, sensuality, intimacy, sexual identity, and sexual health and reproduction. All of these aspects of sexuality are important parts of the whole for each individual. 

• Power and sexualization refer to how you use your potency and sexualness. This circle involves not only interactions with other people but also messaging from media and advertising. Positive power exchanges include flirting and giving/receiving pleasure. It’s important to note these exchanges occur between consenting partners. Consent is imperative and sexy. Negative power exchanges are when one person does not (or cannot) gain consent, yet engages in a sexual act. Negative power exchanges are withholding sex as a manipulation tool, sexual harassment, sexual assault, rape, incest, and any other abusive sexual behavior including harassing and trolling online, as well as stalking.

• Sensuality is the awareness, acceptance, and enjoyment of your own body and/or the bodies of others. Included in sensuality are fantasy, body image (how you feel about your body, which influences how and when you allow yourself to experience touch, sexual and otherwise), and skin hunger (the need for physical touch). Everyone has a different level of skin hunger, which is more than fine! Not all bodies crave the same type, duration, and frequency of touch. Sensuality allows for pleasure and includes smell, touch, taste, sight, and sound.

• Intimacy is the degree of emotional closeness between people – not only romantic partners but also friends and family. To establish intimacy with someone, you need to take risks, be vulnerable, communicate well, and establish trust. To do so involves acts of caring/sharing, as well as liking/loving.

• Sexual identity refers to who you are and how you label yourself as a sexual being. It includes how you see yourself as a gendered being (or not), gender role cultural expectations, who you’re attracted to, and the types of sexual practices that excite you/bring pleasure.

• Sexual health and reproduction denote the physical fact of your body and how it functions sexually. This circle includes the components of reproduction, the physical changes that happen from birth to death, and the challenges people may face such as sexually transmitted infections (STIs), sexual dysfunction, and infertility.

How These Circles Interact

As you can see, sexuality is multi-faceted. Furthermore, these circles of sexuality influence one another. For instance, if you have a history of negative power exchanges, that may make it harder for you to build intimacy with others. Or if you are a transgender person, you may be less inclined to seek out sexual-related healthcare because you don’t feel safe disclosing that information to certain healthcare providers.

When someone comes to me with a sexual concern, there are usually several factors at play that require attention and care. I spent 2+ years earning a master’s degree in human sexuality (with various practical application internships) on this topic because sexuality is so complex and cannot be distilled down to a sound bite or a 3-step method to sexual healing. That said, certain exercises come up frequently in my practice; sensate focus is one of them, and I’ll be back to share more about that next week.

Dr. Denise Renye is a licensed clinical psychologist, certified sexologist, and yoga therapist as well as psychedelic integrationist. She has a friendly, down-to-earth and professional approach that will allow space for you to be at ease when talking about sensitive subjects. She has specialized training and works with people in the areas of complex trauma, sexuality, intimacy, states of consciousness, and fringe relationships. Her practice is in Northern California and globally via virtual therapy and coaching.

To find a sex therapist in your area, begin your search here.

Help! My Partner Wants to “Open Up” Our Relationship

You never saw it coming. Your partner said, “We need to talk,” and you immediately began searching your memory banks: What did I do? Did I forget to pay the phone bill? Or take out the trash? Nope. Nothing so benign, something far scarier: they* want to change your monogamous relationship to … what? Something else. Why? What does this mean?

Why an Open Relationship?

First, a little reassurance is in order. There is nothing “wrong” with you, or with them. You are and will be okay. But why is this happening? You will need to conduct a little investigation into the specifics of your situation, but the options are numerous and many of them spring from the idea that one person cannot be another person’s everything. That your partner should meet every single one of your needs is a cultural construct that is often unrealistic and nearly unachievable. The idealized story goes something like this: person meets person, and in a whirlwind of romance the two come together in blissful harmony, they more or less agree on everything, have the same interests, love each other’s friends and family, support each other through work and family stress, agree about financial allocations, and, of course, are entirely sexually compatible. Does this sound like your relationship? Perhaps not.

Many couples work things out between them, perhaps leaning on friends or family for support. Others consider the possibility that adding additional people to the mix could make everyone happier. This is where the idea of “opening up,” or Consensual Non-Monogamy (CNM), comes in. CNM is a blanket term used to describe non-traditional relationships including, but not limited to, open relationships, swinging, and polyamory**. Changing the nature of your twosome could fall into one of these general areas, but what that means to the two of you will be unique.

Things Will Change

Once you have had “the talk,” your relationship will never be quite the same again. That’s okay. You’ll consider what course to chart in this new phase of your relationship. If opening up your relationship is an attempt to fix what is broken, you should consider putting down this article and packing a bag. However, if you and your partner have a respectful, secure, loving relationship to begin with, opening up could be an option for you. Many partners travel this road because the sexual intensity between the two of them has decreased over time. Others hope that the inclusion of additional partners will result in all parties being a little bit happier. Whatever the reasons, you or your partner are ready to give something new a try.

The Path Forward – Talk to Each Other

Once you’ve had “the talk,” what happens next? More talking. Success in any type of CNM relationship depends on sincere, honest, and vulnerable communication. Initially, it is a good idea to explore with your partner what “opening up” means to them. Listen to them with openness and curiosity, and then look inward to see how that sits with you. Ask questions, and do not make assumptions. Be wary of potentially loaded words like “reasonable” without defining what reasonable means. (I may think it is perfectly reasonable to come home at 2 a.m. on a Wednesday morning; you, however, may think it is irresponsible and disrespectful.)

Poor communication and misunderstanding are common challenges and will have to be addressed thoughtfully on an ongoing basis. Another common challenge that partners face during the initial stages of opening up is how they can protect themselves from getting hurt. One way partners opening up for the first time attempt to avoid feeling their feelings is to establish “rules.” Loads and loads of rules. Rules are typically designed in an attempt to mitigate any possible feelings of discomfort in the future. For example, you cannot take a date to our favorite restaurant, or you will not engage in this or that particular sexual position with someone else. In reality, rules limit the exploration and experience in a number of ways, and may have unforeseen consequences. Other, currently unknown, humans will be involved with the two of you at some point, and they have feelings too! Trying to control everyone and everything so that you never have to experience discomfort definitely doesn’t work. So what does work? You may have guessed it: more talking. Direct and clear communication about how you feel when something causes you discomfort is the best way to get your needs met.

Finding Support

As you embark on your journey, consider community. Look online for support groups and other like-minded individuals or couples. Read books about the particular type of consensual non-monogamy you are considering. Improve your communication skills. Consider enlisting a therapist to help you explore the discomforts that arise for you, or a couple’s therapist to help you and your partner navigate the challenges that arise between the two of you (make sure this therapist is familiar with the lifestyle you are pursuing). This is a journey, and it is OK, in fact, it is recommended, to ask for help along the way.

* A quick note about pronoun selection. I adhere to the now widespread use of “they” as an all-inclusive singular pronoun.

** “Open relationships” refer to sexual connections with others outside the primary relationship; “swinging” is a partner activity of a sexual nature; “polyamory” is a bit more complex, but refers to romantic and sexual connections with others outside of the primary relationship in a wide variety of configurations.

To find a therapist, begin your search today.

More than 4 percent of Americans experience bipolar at some point during their lives. During manic episodes, a person with bipolar may have surges in energy, an elevated mood, and sometimes a sense of invincibility. Around 40% of people with bipolar also experience hypersexuality.

When a person’s sex drive is significantly higher than their partner’s, it can cause stress and conflict. In a person with bipolar, difficulties with impulse control can exacerbate these common relationship issues.

Couples in which one partner has bipolar hypersexuality may worry about the effects of bipolar. But bipolar hypersexuality does not have to undermine a relationship. A 2016 study found that when it comes to establishing and maintaining relationships, people with bipolar have similar outcomes to people without mental health issues. Couples may, however, report differences in sexual satisfaction as the person with bipolar experiences mood cycles.

What is Bipolar Hypersexuality?

Most people with bipolar experience cycling moods. This includes times of depression (characterized by low energy, sadness, and hopelessness) and times of mania (characterized by periods of exuberance and high energy). Some people become more interested in sex during mania.

Hypersexuality is not a medical diagnosis. The American Psychiatric Association (APA) rejected its including in the latest version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Other organizations, such as the American Association of Sexuality Educators, Counselors, and Therapists (AASECT) also reject the diagnosis. This is because religion, cultural influences, gender norms, and a couple’s own history all influence their views on what is acceptable sexual behavior. No specific frequency of sex or sexual thoughts is in itself harmful or excessive. What seems very excessive to one couple might be completely normal for another.

Couples concerned about hypersexuality should instead look at changes over time and how those changes affect their life. It is common for couples to differ in their understanding of how frequently they should have sex. Some signs that one partner may be experiencing bipolar-related hypersexuality include:

• A sudden, unexplained increase in sexual feelings.
• Overwhelming sexual urges that cause immense distress. A person might continue thinking about sex even when they don’t want to.
• Feeling intense and painful feelings of rejection if a partner is not interested in sex.

Does Bipolar Hypersexuality Increase the Risk of Infidelity?

Most couples are in monogamous relationships, so an episode of hypersexuality may trigger fears of infidelity. Consensually non-monogamous couples may have other concerns, such as dishonesty about sexual relationships, unsafe sex practices with other partners, and sexual risk-taking.

While there are many studies on bipolar and sex, research on bipolar and infidelity is limited. Estimates of infidelity in bipolar relationships can vary wildly.

There is no right amount of sex to have and no wrong way to feel about sex as long as all involved parties consent. In a 2005 review, 40% of participants with cyclothymia reported “episodic or unexplained promiscuity or extramarital affairs.” However, the study’s definition of sexual excess included “overt bisexuality” and “sexual activity many times per day.” Neither of these factors fall under the category of infidelity, meaning the actual rate of extramarital affairs was likely lower.

A 2016 study compared sexual behavior of people with bipolar to those without bipolar and found very different results. Researchers found no significant difference in sexual risk-taking between bipolar and non-bipolar participants. Sexual risk-taking included items such as “sex with strangers” or “recreational substance use during sex.” The study did not measure infidelity directly though.

There is little evidence to suggest bipolar, or even bipolar hypersexuality, is a significant risk factor for infidelity. Other factors, such as age or gender, seem to play a much larger role. However, hypersexuality may affect couples in other ways, such as creating chronic conflicts over libido.

How Bipolar Hypersexuality Can Affect Couples

Many couples struggle with differences in libido. The effects of these differences depend on each partner’s views about sex, relationships, and intimacy. Some common themes include:

• Issues with attachment and intimacy. When one partner wants sex much more frequently than the other does, the partner who wants sex more often may feel rejected. The partner with the lower libido may feel that their partner ignores other forms of intimacy.
• Sexual coercion and pressure. Hypersexuality may cause some people to frequently make sexual overtures to their partners. This can feel like sexual pressure and may even become coercive.
• Fears of cheating. The partner who has a lower libido may fear infidelity.
• Anger and frustration. Both partners may struggle with anger and frustration about their sexual disagreements, especially if they find those disagreements difficult to discuss.
• Shame. Many cultures and religions promote very specific ideas about what type of sex, at what frequency, is acceptable. A couple who deviates from these norms may feel embarrassment or shame.
• Bipolar-related stress. Cycling moods can be stressful to both partners. This stress may compound the challenges of managing differences in libido.

Coping Strategies for Couples with Bipolar Hypersexuality

Treatment for bipolar can help with feelings of hypersexuality. Couples can also adopt a wide range of coping strategies. Those include:

• Identifying the early warning signs of a manic episode. Some people with bipolar need to change their treatment regimen as a manic episode approaches. Keeping a log of symptoms can help with predicting the next episode.
• Putting the hypersexuality in context. Hypersexuality is a symptom of bipolar, not necessarily a problem with the relationship. Couples may do well to remember that hypersexuality does not define their partnership or who they are as individuals.
• Limiting exposure to triggers. Some people find that certain triggers intensify feelings of hypersexuality. For example, someone who normally uses pornography in a healthy way may find that viewing pornography during a manic episode triggers insatiable sexual desires.
• Relaxation exercises. Bipolar hypersexuality can make both partners feel anxious about their relationships. Doing relaxing activities together, such as meditation, may help. Individual relaxation through yoga or deep breathing can also offer relief.
• Physical activity. Some people find regular physical exercise helps with excessive sexual thoughts. It may also help with other bipolar symptoms.
• Seeking non-pathologizing sex therapy. There is no right amount of sex to have and no wrong way to feel about sex as long as all involved parties consent. Yet shame and humiliation can make both parties feel worse about hypersexuality. It is important to seek treatment from a therapist who will listen without judgment and who is knowledgeable about the continuum of healthy sexual expression.

How Therapy Can Help Bipolar Hypersexuality

Sex often goes hand-in-hand with shame and guilt. Thus, many couples may struggle to talk about bipolar hypersexuality. The person with bipolar may feel simultaneously guilty about their desires and angry about their partner’s inability to match their libido. This can leave them feeling ashamed and unloved. Their partner may feel frustrated or even intimidated by constant sexual overtures. They may worry their partner will leave or be unfaithful, triggering feelings of insecurity and anxiety. Some may judge their partner for their sexual feelings, leading to poor communication and escalating shame.

Couples counseling can offer hope. The right therapist works to help both members of a couple feel safe talking about their emotions and sexual needs. In so doing, therapy can:

• Destigmatize sex, making it easier to talk about differing sexual desires.
• Help couples renegotiate their unspoken understandings about sex.
• Undermine the idea that there is a right or wrong way to feel about or have sex.
• Support couples to move past sexual betrayals.
• Offer each partner coping skills that help them manage anxiety, deepen attachments, and feel less alone.

Individual therapy can help people with bipolar understand their diagnosis and better manage their emotions. It may help the partners of said individuals identify the ways bipolar affects their lives and their relationships.

Many couples find that a combination of individual and couples therapy works best. If you would like get help for bipolar hypersexuality, you can find a therapist here.

References:

1. AASECT Position on Sex Addiction. (n.d.). Retrieved from https://www.aasect.org/position-sex-addiction
2. Auteri, S. (2014). What you need to know about…hypersexuality. Retrieved from https://www.aasect.org/what-you-need-know-about-hypersexuality
3. Bipolar disorder. (2017, November). Retrieved from https://www.nimh.nih.gov/health/statistics/bipolar-disorder.shtml
4. Downey, J., Friedman, R. C., Haase, E., Goldenberg, D., Bell, R., & Edsall, S. (2016). Comparison of sexual experience and behavior between bipolar outpatients and outpatients without mood disorders. Psychiatry Journal, 2016(1). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4852112
5. Kopeykina, I., Kim, H., Khatun, T., Boland, J., Haeri, S., Cohen, L. J., & Galynker, I. I. (2016). Hypersexuality and couple relationships in bipolar disorder: A review. Journal of Affective Disorders, 195(1), 1-14. Retrieved from https://www.sciencedirect.com/science/article/pii/S0165032715306649
6. Toussaint, I., & Pitchot, W. (2013). Hypersexual disorder will not be included in the DSM V: A contextual analysis. The Medical Review of Liege, 68(5-6), 348-353. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/23888588
7. Wang, W. (2018, January 10). Who cheats more? The demographics of infidelity in America. Retrieved from https://ifstudies.org/blog/who-cheats-more-the-demographics-of-cheating-in-america

In the safety of therapy, clients are able to open up about their sexual experiences. This all too often reveals shame lurking beneath the surface. For some people, it’s close to the surface, and for others, it’s buried deep within them.

Shame flourishes when it’s kept in the dark. But shame tends to diminish when it is brought into the open and met with love and compassion. I’m writing this article to highlight some of the common ways shame operates in regards to sexuality. Hopefully, you may learn some ways to leave it behind.

5 Ways Shame Impacts Sex

Internalized Problems

One marker of shame is that problems are experienced as integral to the person rather than as a natural result of situational factors that can be explained and addressed:

Chantelle looked down as she spoke. “I think there’s something wrong with me. I don’t get aroused anymore, and I barely feel pleasure from sex. I used to really enjoy sex.”

Once we began to unpack her problem and rule out any medical issues, it became clear that there were several very good reasons why Chantelle had low desire and arousal—she felt exhausted from lack of sleep and stress, and she often felt she was running on empty due to having very little time to herself.

Reframing Chantelle’s lack of sexual desire and arousal as a natural response to situational factors in her life rather than something inherently wrong with her was key in helping her let go of the shame and self-blame. Chantelle was then able to address the various factors that were making it difficult for her to enjoy sex. We found creative ways for Chantelle to prioritize her needs for sleep and self-care, which created more energy for her to reconnect with herself and her partner sexually.

Disgust

Disgust and queasiness are signs there is shame lurking within oneself. When babies are born, they have no shame about their bodies. Babies will naturally begin to explore their body, and genitals, with no judgment. It is parents and adults who attach shame to that experience.

It is natural and healthy to explore one’s body, starting in childhood and through all stages of life. It is also natural to experience sexual desire and to act on that desire, when done in a safe and consensual way. If you feel disgust about your body or sexuality, it may mean you are carrying shame or judgments that don’t belong to you.

Many clients I see have some memory of being shamed as a child for exploring their body or playing “doctor” with other children. Other clients have experienced the trauma of sexual abuse as a child or an adult. Sexual abuse or harassment is never the victim’s fault. Please know there is help if you or someone you know has experienced this. In all cases of sexual shame and disgust, please seek help and guidance. Having sexual challenges or problems does not mean you or your body are disgusting or wrong.

Inhibited Desire and Arousal

Shame is like a thick coating of black tar that sits on top of what would be a natural and healthy sexual desire and arousal response. The natural responses are still there, but they are buried beneath the shame, which prevents the natural desire and arousal from surfacing.

Shame is like a thick coating of black tar that sits on top of what would be a natural and healthy sexual desire and arousal response. The natural responses are still there, but they are buried beneath the shame, which prevents the natural desire and arousal from surfacing.

Michael Bader writes in his book Arousal: The Secret Logic of Sexual Fantasies about certain mood states that are incompatible with arousal: anxiety, guilt, and shame. To circumvent these barriers, the subconscious may invent fantasies to remove the source of the anxiety, guilt, or shame to free the person up to experience arousal.

For instance, a shame-bound person may have a sexual fantasy of being shamed or humiliated, which sexualizes the very thing that is blocking their arousal. In many other cases, a person with shame about their body or sexuality will continue to live with a repressed sexuality, unable to overcome their mental blocks or to experience their full sexual expression.

Secrecy and Psychological Splitting

Being overwhelmed with sexual guilt and shame causes people to hide sexual desires or behaviors because they perceive them as bad or unworthy. Hiding and secrecy impede a person’s relationship with others and create isolation. This exacerbates the problem of shame for the person and often disrupts their relationships with their family, friends, and community.

Sexual shame also causes psychological splitting, which happens when a person “splits off” a part of themselves that is deemed to be unacceptable. The disowned part of themselves continues to exist, but only in secret, where it often becomes distorted and intertwined with shame.

Splitting and secrecy cause many problems, including internal disconnect, relational disconnect and conflict, depression, dishonesty, infidelity, and others. Clients with this issue are able to work towards integration of their disowned parts in therapy, which can help reduce the shame.

Communication Breakdown

Couples who have sexual problems accompanied by shame often lash out at each other or shut down during conversations about their issues. The conversation usually starts with an effort to make sense of the problem and try to find a solution. But the conversation becomes frustrating quickly when there is shame involved.

A person with shame is more likely to want to deflect away from their own role in the issue, which can lead to inadvertently blaming the other person rather than owning their part. In other cases, one or both parties are so embarrassed and ashamed that they shut down, and the conversation ends in tears or shutting the other person out:

Alexandra and Neil haven’t had regular sex in years. After what they felt was a debacle on their wedding night, they slowly sank into a cycle of shame and blame. She felt embarrassed at her lack of experience and felt it was her fault the sex was awkward and painful. He felt he had failed in his role as a husband because he couldn’t please his wife. After 2 years of trying and arguing, Alexandra and Neil stopped bringing it up altogether. Now in therapy 10 years later, they have many layers of guilt and shame to process in order to heal and repair their relationship.

Sex-Related Shame: What to Do About It

Remember that many people experience shame about their sexuality and are able to heal from it. If this applies to you, consider engaging the help of a mentor or therapist and use resources such as the books listed below.

Consider meditating on the following phrases:

• “My sexuality is part of who I am.”
• “Sex is good.”
• “I can take responsibility for my sexual desires in a healthy way.”

A therapist can help you work on identifying any sex-negative or shame-based beliefs, exploring where they came from, and reframing them into something that is more positive and affirming of your sexuality. Through this process, you may also work on healing any underlying wounds. Find an understanding therapist here.

Make sure to consult a physician to rule out any physical contributors to your sexual functioning.

Sex-Positive Books on Sexuality

• Come as You Are: The Surprising New Science that Will Transform Your Sex Life by Emily Nagoski
• For Women Only: A Revolutionary Guide to Overcoming Sexual Dysfunction and Reclaiming Your Sex Life by Jennifer Berman, MD and Laura Berman, PhD
• Sex for One: The Joy of Self Loving by Betty Dodson, PhD
• Sexual Intelligence: What We Really Want from Sex–and How to Get It by Marty Klein
• Sexual Awareness: Your Guide to Healthy Couple Sexuality by Barry McCarthy
• Sexual Shame: An Urgent Call to Healing by Karen McClintock

Books for Survivors of Sexual Trauma and Those Who Love Them

• The Courage to Heal: A Guide for Women Survivors of Child Sexual Abuse by Ellen Bass and Laura Davis
• The Sexual Healing Journey: A Guide for Survivors of Sexual Abuse by Wendy Maltz
• Allies in Healing: When the Person You Love Was Sexually Abused as a Child by Laura Davis

Many people see sexuality as key to their identity. But sexuality can change over time. These changes often cause shifts in identity, experiences, and relationships.

Sexuality: A Continuum of Experiences

Most people use sexuality to refer to the gender(s) to which they are attracted. However, sexuality means different things to different people. Not everyone experiences sexual feelings. Others have sexual feelings only in certain contexts. Someone who is asexual may have no sexual feelings. Meanwhile, someone who is demisexual may only have sexual feelings in a committed relationship. Even within these identities, there are numerous variations.

Sexuality can change over time. Some of the many reasons a person’s identity might change include:

• Feeling less encumbered by social norms. Some people grow up in repressive families or feel stuck in marriages they did not want or no longer want. When they no longer have these restrictions, they may explore their sexuality. This can cause an identity shift.
• Attraction to a new person. Some people connect strongly with a specific identity. They may then become attracted to a new person who calls that identity into question.
• Political or ideological shifts. Some people change their sexuality for political reasons. Lesbian separatism is the refusal to participate in heterosexual relationships. Some women choose lesbian separatism due to firmly held feminist beliefs.

Understanding Sexual Fluidity

Sexual fluidity is the ability of sexual feelings to change over time. Some people embrace this notion. They may be more open to changes in their sexuality. Others are surprised to experience a shift in sexual feelings.  [fat_widget_right]

Sexologists are people who study human sexuality. They have attempted to understand and quantify human sexuality using scales. For example, the Kinsey Scale ranges from 0-6. It includes identities ranging from exclusively heterosexual to exclusively homosexual. Most people fall somewhere between the two extremes. This is one way to explain sexual fluidity. If most people are not entirely homosexual or heterosexual, then the right experiences or setting may cause a person’s orientation to change.

Other scales that measure sexuality include:

• The Klein Grid. This scale looks at a person’s past, present, and ideal experiences. It includes measures of romantic, sexual, and social attractions. The Klein Grid also makes room for personal sexual identity.
• The Multidimensional Scale of Sexuality. This measure breaks sexuality into nine categories. It was developed primarily as a criticism of other tools that don’t distinguish sexual identity from behavior or treat sexual orientation as something that remains consistent across a person’s lifetime.

Researchers have developed dozens of other scales. Many of these are slight variations on the Kinsey Scale.

Are Sexuality and Gender the Same? The Link Between Sexuality and Gender

Sexuality and gender are distinct. A person’s sexuality includes a wide range of factors, including the gender to which they are attracted. Gender refers to gender identity. Most people are male or female, while others may have a different gender identity or be nonbinary. Some believe that the concept of gender is harmful or problematic.

Gender and sexual identities can change with time, but a change in one does not necessitate a change in the other. When a person’s gender identity changes, they may remain attracted to the same gender(s) of people. For example, a trans woman who once identified as heterosexual may identify as a lesbian following her transition.

The notion that sexuality can change has long been used to oppress sexual minorities. Conversion therapy uses physical and emotional abuse to urge non-heterosexual people to become heterosexual. It hinges on the idea that it’s possible to force someone to change their sexuality.

How Sexuality Affects Identity

Most people see sexuality as a fundamental part of their identity. Relationships often depend on sexual identity. It is common for people to participate in sexuality-based subcultures. For instance, a heterosexual couple may have primarily heterosexual friends.

When sexuality changes or when someone questions their sexuality, their identity may also shift. Sexuality changes may spur fears of rejection. For example, a lesbian who begins to be attracted to men may worry her friends will judge her.

People with non-normative sexual identities—including lesbian, gay, bisexual, queer, pansexual, and asexual identities—can be especially anxious about shifts in their sexuality. The notion that sexuality can change has long been used to oppress sexual minorities. Conversion therapy uses physical and emotional abuse to urge non-heterosexual people to become heterosexual. It hinges on the idea that it’s possible to force someone to change their sexuality.

The Difference Between Change Over Time and Forced Change

Forced change is categorically different from natural shifts in sexuality. People change many preferences or interests over a lifetime. These include changes that are key to their identity. Careers, hobbies, romantic partners, and political ideals figure prominently in identity. And while they often change with new experiences, they are unlikely to change under duress.

Sexuality is similar, though one’s sexual orientation is never a matter of preference. People cannot change who they love or are attracted to. While those feelings may shift with time, attempting to force change for political or religious reasons is unlikely to work. It can also cause lasting harm. Most medical and psychological organizations oppose conversion therapy as a form of psychological abuse. Several states have banned the practice.

When Sexual Practices and Identity Differ

People align with specific sexual orientations for many reasons. Sometimes a person’s sexual practices are not included in their sexual identity. Someone might identify as heterosexual but occasionally have sex with people of the same gender. Many factors, including stigma, may contribute to this behavior.

The philosopher and social theorist Michel Foucault famously argued that sexual identity is a social and historical construct, not an unchangeable identity. He saw sexual identity as linked to power structures and historical shifts. Foucault disputed the idea that sexual orientation is a fundamental part of one’s essence. With this understanding of sexuality, shifts in identity may be inevitable. They may be no different than changes in taste or fashion.

No matter how someone views their sexual identity or how that identity changes over time, sexuality can prompt important questions about relationships, politics, religion, and more. A therapist can help untangle these issues in a respectful and nonjudgmental setting.

References:

1. Berkey, B. R., Perelman-Hall, T., & Kurdek, L. A. (1990). The multidimensional scale of sexuality. Journal of Homosexuality,19(4), 67-88. doi: 10.1300/j082v19n04_05
2. Overview of sexual orientations. (n.d.). Retrieved from http://www.soc.ucsb.edu/sexinfo/article/overview-sexual-orientations
3. Sexual fluidity. (n.d.). Retrieved from https://vaden.stanford.edu/health-resources/lgbtqia-health/sexual-fluidity
4. The emergence of sexuality: Foucault, sexual identities, and the modern self. (n.d.). Retrieved from http://www.thinkolio.org/olios/emergence-sexuality-foucault-sexual-identities-and-modern-self
5. The Klein Sexual Orientation Grid. (n.d.). Retrieved from http://www.americaninstituteofbisexuality.org/thekleingrid

Sexuality is often a sensitive issue. In recent months, many people have come forward, speaking out about inappropriate, harmful, and abusive sexual behaviors and actions taken by people of positions in greater power. These abuses of power and their effects have too long been in the shadows of silence. The topic of sexuality deserves greater awareness from all of us. By taking the time for honest and open self-reflection, we can all help prevent the misuse of power.

What is inappropriate and harmful sexual activity? For the purposes of clarification, let’s say this includes any physical or verbal behavior that is suggestive, seductive, harassing, demeaning, or exploitative. When a person in therapy is attracted to their therapist, this can often be discussed in therapy without harm—as long as the therapist is not excessively affected by attraction or countertransference. The therapist must be able to focus on the sexual issues of the person in therapy only to the extent such discussion is based on their therapeutic process. It is also essential to establish and uphold boundaries, including an explicit agreement that there is no possibility of sexual relationship at the time or in the future.

Issues related to sexuality present enough challenges in ordinary relationships. When it comes to the therapeutic relationship, sexuality can be even more of a challenging and complex consideration.  Here are some things to consider when examining sexual feelings toward or from people in therapy.

Coping with Sexual Feelings Toward a Person in Therapy

It can first help to explore why you may be attracted to a particular person. Is there something about them that meets one of your needs? Perhaps it is a natural need, but it is one that must be met elsewhere.

1. Talk to a colleague who can help you sort out what you are experiencing and take appropriate steps to keep the therapeutic relationship ethical. [fat_widget_right]
2. Seek personal counseling. Working with your own counselor can help you resolve your feelings and uncover any issues in your life you may be struggling to deal with effectively.
3. If you are unable to resolve your feelings, terminate the professional relationship and refer the person to another therapist.

Coping with Sexual Feelings from a Person in Therapy

A good first step here is to acknowledge the person’s feelings as normal. Appreciate their courage and vulnerability around bringing them up or having them named. Explain that although the intimacy that often develops within the therapeutic relationship is powerful, it is best described as a kind of contextual love that is specific to the power differential relationship. Sexualizing this kind of love is detrimental to your work in therapy.

1. Make it very clear, with both words and body language, that a sexual relationship is outside the bounds of the therapeutic relationship. (Ethical codes vary in their statements of how long after termination it is considered ethical to begin a sexual relationship, if ever.)
2. Make every effort not to shame or reject the person you are working with. Track for and attend to any signs of shame or rejection.
3. If appropriate, look for therapeutic ways in which issue of sexuality can be addressed and explored.
4. When sexual feelings are unspoken or unconfirmed, use your best professional judgment to determine what would best serve the person you are working with: naming the feelings yourself or waiting for them to make the choice to do so.
5. Be prepared in advance. Consider how you might handle this kind of situation or how you might handle it with greater skill. Seek the support of supervision.

How Can We Deepen Our Understanding?

The issue of sexuality goes much deeper than simply understanding feelings and setting boundaries. These several questions, brought up by students, can help you explore this topic further in order to deepen your understanding.

• “When a client tells me they are attracted to me, I feel flattered and awkward. How can I express myself so the attention doesn’t end up on me and my response, or so my client doesn’t get the wrong impression?”
• “How do I work with clients who automatically associate intimacy with sexuality?”
• “Do I need to shut down my sexuality altogether to be an ethical therapist or body worker?”
• “How can I help a client understand the difference between therapeutic or transpersonal love and personal love?”
• “What are right and wrong uses of sexual current?”
• “Can sexual current itself be separated out from therapeutic love and intimacy? Or is it just to be “managed,” understood and accepted?”
• “Should the experience of sexual current in a session always be named?”
• “How can I tell if a client is misunderstanding my intentions?”
• “What range of control do I personally and realistically have over my sexual feelings?”
• “How can I effectively and appropriately use this control?”
• “Is there a way this client’s attraction could be used therapeutically?”

Here are a few stories for further consideration:

• “A male counselor was attracted to a female client. He knew she was in crisis and offered to meet her in a restaurant to provide professional support. Having just gone through a nasty divorce where her ex-husband had numerous affairs, she was in a vulnerable position. She talked about feeling unlovable and unattractive. The counselor placed his arm around her shoulder to comfort her and offered to follow her home to check on her safety. He offered nurture and support, and from there they slipped into a sexual situation.” This counselor, who took advantage of his client’s vulnerability, has likely been led more by unmet personal needs and poor boundaries and judgment than malicious intent to harm. Sexuality is a strong motivator, and it can warp a person’s ability to make good judgments. As a friend says, “Please stay away. My hands grow larger and my head smaller when love is before me.”
• A caregiver writes: “My point of view is that what we need most of in this world is love. Love motivates my work, and I believe it is the most fundamental of all healing energies. When I sign a note to a client, “love,” I am not worried about people personalizing it with me since everyone knows or senses that I am not being romantic or suggestive. I think we are all adults here. And I still call my clients, “darling” sometimes. No one gets the wrong idea.” These words may be compelling, but people everywhere, especially people in a lesser power role, do get the wrong idea, do misinterpret, do make words mean something they want them to mean, and do confuse personal and transpersonal love, particularly when vulnerable and longing for love and acceptance.
• As part of a process of relationship repair between a student and a teacher, the student explained her experience. “I was confused by how you related to me in terms of your body language and energy when we met at a restaurant to talk about some theoretical questions I had. Your words and lack of help in focusing me and our conversation on the question created more and more confusion and insecurity within me. I felt ashamed of these feelings. Then when you sat down next to me at the table, instead of across from me, I felt invaded and manipulated. I felt uncomfortable and expressed my discomfort and vulnerability with the “newness” of being with a man, in particular a single man in this type of context. It felt more like a date than a teacher-student meeting. I felt ignored and disregarded when you failed to respond to my concern and discomfort. I began to feel that your needs were more important. I feel angry now as I see that I was subtly forced to push my needs aside in order to maintain the relationship with you and get my question answered. I needed you to maintain the boundary of teacher and student because I couldn’t do it myself. I trusted you, and this trust was violated. My shame prevented me from resourcing myself and correcting the situation, but I hold you responsible for seeing this and doing something about it in order to care for me and protect my spirit as a vulnerable student and single woman.” The courage and clarity of both the student and the teacher in facing this situation enabled clarity and resolution. The teacher understood, apologized, and did some therapeutic work to better understand his boundary issues and lack of sensitivity and responsiveness to his impact.

These stories illustrate how important it is to both think proactively about how you will respond to sexual issues when they arise and to learn how to attend to and repair relationships when needed. When personal sexual desires get involved, thinking can become very warped.

It is especially important to seek out and use resources such as colleagues and supervision when faced with ethical dilemmas, things about which you feel ashamed, or mistakes you have already made or believe you may make. If you are unsure how to begin this process on your own, the support of a compassionate counselor can help.

Cultural issues can heavily affect women’s sexuality, according to a study published in Sexuality & Culture. They are particularly salient for women who are lesbian and bisexual.

Prior Research

Previous research focused on the way individual factors affect sexuality. For instance, a 2016 study showed women who endorse benevolent sexism are less likely to assert their sexual needs. They are also more likely to tolerate sexual selfishness from their partners.

A 2017 study found relationship issues often prompt women to feign orgasms. They may be prioritizing their partner’s ego or avoiding an argument. Sometimes women fake orgasms to end sex sooner.

Despite the breadth of research on female sexuality, the Sexuality & Culture study is one of the first to compare desire in heterosexual and non-heterosexual women.

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Cultural Factors in Women’s Sexuality

This study involved interviews with 31 women ages 20-69. The researchers interviewed women identifying as bisexual, heterosexual, and lesbian. Questions focused on the relationships between women’s sexual desire, their identity, and their experiences.

Cultural themes played a key role in women’s sexual experiences. The most prominent themes included:

1. Gender roles: The gender binary, relationship dynamics, and body image concerns
2. Religion: Spiritual beliefs regarding sex and gender
3. Cultural shifts: Changes in sexual taboos and expectations
4. Minority stress: Heteronormativity, stigma, and coming out

These cultural themes affected a diverse group of women. However, their role was most prominent among women who identified as non-heterosexual. The researchers suggest this disparity occurs because non-heterosexual women must face challenges related to both sexism and heteronormativity. Compounded stigmas seem to increase their sensitivity to cultural expectations.

To empower women’s sexual expression, advocates should be mindful of how systems of privilege affect sexual desire. Individuals experiencing distress or difficulty relating to these issues may find it beneficial to discuss them with a counselor or therapist.

References:

1. LGBQ* women’s sexual desire particularly impacted by social and cultural pressures. (2017, December 06). University of Kentucky News. Retrieved from https://uknow.uky.edu/research/lgbq-women-s-sexual-desire-particularly-impacted-social-and-cultural-pressures
2. Rosenkrantz, D. E., & Mark, K. P. (2017). The sociocultural context of sexually diverse women’s sexual desire. Sexuality & Culture. doi:10.1007/s12119-017-9462-6

In Western cultures, we tend to see romantic relationships as monogamous by default and any other relationship dynamic as a failure, especially if these relationships involve sexual or romantic activity outside of the relationship. However, monogamy is not the only relationship style that is functional, and there is an ever-increasing social awareness about consensually and ethically nonmonogamous relationships. Some of these are referred to as “polyamorous,” “open,” or “swinging” relationships, and are generally relationships in which more than two people are romantically and/or sexually involved.

Despite an increase in public awareness of nonmonogamy, there continues to be a stigma around it that is grounded in myths about the risks of including more than two people in a relationship. If you have ever considered a nonmonogamous relationship, read on to learn about some of the myths and facts about nonmonogamy, and why monogamy might not be the only way to have a healthy, fulfilling relationship.

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It is important to note that not all people want to engage in nonmonogamy, and not all people may stand to benefit from a nonmonogamous relationship style. This article aims to break down some of the stigma around nonmonogamy and provide a first step for those who might consider creating a nonmonogamous relationship for themselves.

Myth: Sexual behavior outside of a monogamous relationship is inherently damaging to a relationship.

Infidelity is a painful issue that affects many relationships. The outcomes range from the breakdown of trust, to the dissolution of an otherwise happy relationship, to an increase in the risk of sexually transmitted infections (Conley, et al., 2012). But what if infidelity was not a failing of the person who strayed or of the person who was cheated on, but rather a symptom of not being able to meet the standards set by monogamy?

Specifically, some people cheat on their partners because their sexual and emotional needs are not fully met by one partner, but they are still generally happy with the relationship and do not want it to end. In the course of a longer-term relationship, it may be impossible for two people to meet each other’s needs all of the time. In this case, nonmonogamy may be an opportunity for committed partners to explore how each person’s needs can be met and to create a relationship style that works for them. When outside partners are discussed and agreed upon and open communication is a priority for all involved, there is less room for infidelity.

Myth: Nonmonogamous relationships are less functional than monogamous relationships.

Given that most of us were raised to enter into monogamous relationships, breaking those barriers down and living in a different way can feel very uncomfortable. Nonmonogamous couples do tend to experience jealousy, fear of abandonment, and conflict as they establish boundaries and negotiate new relationship dynamics without role models to turn to (Weitzman, Davidson, & Phillips, 2009). These issues can arise in monogamous relationships as well, and working through them can build a healthier relationship overall.

It is commonly assumed that nonmonogamous relationships are not as happy or healthy as monogamous relationships. Several decades of academic research have found that nonmonogamous relationships, on average, are just as functional as monogamous relationships (Knapp, 1976; Rubin, 1982; Watson, 1981) and that nonmonogamous marriages are as stable and content as monogamous marriages (Rubin & Adams, 1986). What makes or breaks a relationship is not exclusivity, but rather the ability of the partners involved to be honest, communicative, and self-aware of their needs and boundaries.

A good therapist can help you and you partners explore what kind of relationship dynamic will work best for everyone involved, how to navigate jealousy and fear of abandonment, how to negotiate boundaries and ensure all parties are treated fairly, and how to disclose to the important people in your life.

Myth: People who do not want to make monogamous commitments are abnormal.

With monogamy so pervasive, it may seem as though those who are nonmonogamous are somehow abnormal or unhealthy (Conley, et al., 2012). This myth seems to be tied to beliefs about infidelity and culturally developed ideas of how romantic and sexual needs should be fulfilled. The difference between infidelity and consensual nonmonogamy is the communication and awareness of all people involved. Many monogamous marriages experience infidelity, and the lies and betrayal associated with that infidelity can shake the foundations of trust in the relationship. For the partner who strayed, it can shake their sense of self-worth and leave them feeling as if they have failed at something that society suggests is a natural ability. For the partner who was cheated on, it can feel as if they have failed at meeting the needs of their partner, that they are undesirable, or abandoned.

The pressure of a culture that pushes monogamy as the ideal, healthy, or only relationship option excludes those who feel most comfortable with nonmonogamous relationships or whose needs are not exactly in line with their partners. The result is often infidelity, serial monogamy, and internalized shame.

Myth: Nonmonogamous relationships are more complicated than monogamous relationships.

As you might have guessed, inviting additional people into your relationship in any way can lead to some challenges, including jealousy, communication issues, fear of abandonment, guilt, and negotiating acceptable sexual or romantic behavior with multiple partners (Weitzman, Davidson, & Phillips, 2009). Some polyamorous people find that the public stigma around nonmonogamy creates issues within their relationships, and they may struggle with disclosing to family members; having to hide their multiple partners due to perception, stigma, and concerns about discrimination; and a lack of legal protection regarding the custody of children (Cohen & Fevrier, 2017).

Despite these unique challenges, research shows that nonmonogamous people have highly secure bonds with their partners (Jenks, 1985), that female partners feel more free and unhindered by patriarchal expectations (Stelboum, 1999), and relationship satisfaction actually improves (Weitzman, Davidson, & Phillips, 2009). When nonmonogamous couples live with multiple partners, they report that their relationships benefit from shared household responsibility, parenting tasks, and financial contributions (Weitzman, Davidson, & Phillips, 2009).

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What If I Think I Might Want to Explore Nonmonogamy?

As nonmonogamy becomes increasingly common, there are growing numbers of resources available to people who may want to explore this as a relationship option. If you think nonmonogamy might be right for you, you can explore blogs and forums for polyamorous or nonmonogamous people. There are a few published book options as well, including The Ethical Slut by Dossie Easton and Janet Hardy, and Opening Up: A Guide to Creating and Sustaining Open Relationships by Tristan Taormino. These books outline many of the skills you may need to cultivate to have strong, loving, nonmonogamous relationships.

Finally, look for a therapist who is open to, and affirmative of, nonmonogamous relationships. A good therapist can help you and you partners explore what kind of relationship dynamic will work best for everyone involved, how to navigate jealousy and fear of abandonment, how to negotiate boundaries and ensure all parties are treated fairly, and how to disclose to the important people in your life.

References:

1. Cohen, M. T., & Fevrier, S. S. (2017). Historical, biological, social, cultural, and psychological aspects of non-traditional arrangements: Understanding consensual non-monogamy. In N. Silton (Ed.), Family Dynamics and Romantic Relationships in a Changing Society (pp. 28-46). Hershey, PA: IGI Global.
2. Conley, T. D., Moors, A. C., Matsick, J. L., & Ziegler, A. (2012). The fewer the merrier?: Assessing stigma surrounding consensually non-monogamous romantic relationships. Analyses of Social Issues and Public Policy, 13, 1-30.
3. Conley, T. D., Moors, A. C., Ziegler, A., Karathanasis, C. (2012). Unfaithful individuals are less likely to practice safer sex than openly nonmonogamous individuals. The Journal of Sexual Medicine, 9(6), 1559-1565.
4. Easton, D., & Hardy, J. (2009). The ethical slut: A practical guide to polyamory, open relationships & other adventures. Berkley, CA: Celestial Arts.
5. Knapp, J. J. (1976). An exploratory study of seventeen sexually open marriages. Journal of Sex Research, 12, 206-219.
6. Jenks, R. J. (1985). A comparative study of swingers and nonswingers: Attitudes and beliefs. Lifestyles: A Journal of Changing Patterns, 8(1), 5-20.
7. Rubin, A. M. (1982). Sexually open versus sexually exclusive marriage: A comparison of dyadic adjustment. Alternative Lifestyles, 5(2), 101-106.
8. Rubin, A. M., & Adams, J. R. (1986). Outcomes of sexually open marriages. The Journal of Sex Research, 22(3), 311-319.
9. Shelboum, J. P. (1999). Patriarchal monogamy. In Munson, Marcia, and Stelboum (Eds.). The lesbian polyamory reader: open relationships, non-monogamy, and casual sex. New York: Haworth Press.
10. Tamar Cohen, M., & Fevrier, S. S. (2017). Historical, biological, social, cultural, and psychological aspects of non-traditional arrangements: Understanding consensual nonmonogamy. Family Dynamics and Romantic Relationships in a Changing Society.
11. Watson, M. A. (1981). Sexually open marriage: Three perspectives. Alternative Lifestyles, 4(1), 3-21.
12. Weitzman, G., Davidson, J., & Phillips, R. A. (2009). What psychology professionals should know about polyamory. Baltimore, MD: National Coalition for Sexual Freedom Inc.