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Idea #2: Mindful Sex

Dr. Lori Brotto has a new application for an old idea.

By Danielle Egan, 18 Dec 2007, TheTyee.ca

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Bright ideas for 2008.

[Editor's note: Rather than look back over the year that was, the Tyee is offering its readers a dozen New Ideas for the New Year. We'll publish a new one every weekday from now through Jan. 1. They're textbook cases of thinking outside the box, all of them from people trying to make B.C. a better place to live. Later in January we'll be asking you to suggest your own new ideas for 2008, and publish a selection.]

Close to a third of women report not being turned on by sex. The news has neuroscientists scanning women's brains during masturbation, while pharmacorps scurry to develop drugs, skin patches and potions to notch up libidos.

Vancouver-based sex researcher Dr. Lori Brotto says low sex drive isn't caused by physiological wiring and plumbing problems, but by a psychological mind-body disconnect. In other words, our minds too often have no clue what our vaginas are doing. And Brotto's key weapon to bridge that gap is the ancient Eastern technique called mindfulness.

Buddhists have practiced this type of meditation for thousands of years and Western doctors have recently adapted it as a support treatment for patients with cancer, chronic pain, attention deficit disorders and anxiety but Brotto and her colleague Julia Heiman, director of the famed Kinsey Institute, are the first to use mindfulness for sexual disorders.

Turning off the background chatter

It starts with a raw egg.

In a group therapy session, her patients have to balance the egg on one end on a tabletop. "That's really difficult to do," says Brotto, who opened The UBC Sexual Health Lab in 2005. "But even harder than that, especially for women, is learning to turn off the background chatter and focus on sexuality. They're always multi-tasking, even during sex. The egg exercise introduces the concept of mindfulness: focusing all your attention to one task, being 100 per cent wakeful and attentive, in the present, but also relaxed."

After her patients, ranging in age from 19 to 70, master the egg balance, Brotto moves on to "body scan exercises" done in group therapy and in daily life. "As distracting, annoying or otherwise irrelevant thoughts come up, you put them on a conveyor belt, notice them roll by and bring your senses back to the present moment," she says.

After several weeks of training, Brotto shifts focus below the belt, first as a sort of ice-breaking get-to-know your vagina exercise. "That means looking at and touching her genitals, not creating arousal," reminds Brotto.

"Concentrate on the sensations and simultaneously note any distracting thoughts coming up, so that she stays focused on the present. That's actually a really difficult exercise to do. A lot of women haven't even really looked at their genitals, so we often spend a fair bit of time on that."

Lots of homework

The next stage involves a lot of homework: "reading a fantasy, watching erotica for a few minutes or using a vibrator which should pretty reliably bring about her arousal," says Brotto who was introduced to sex research while studying the sexual lives of rats at UBC.

"Then the goal is to stop after a few minutes and do a mindfulness exercise. By first exciting her body, she can then tune into her sexual sensations even more. Then we talk about how to incorporate that with a partner when all of their relationship factors are at stake: worrying about performance, how your partner is reacting, all the cognitive stuff, like rationalizing the choice to have sex in the first place because he took the trash out, etc. It is a gradual progression towards being more mindful in our sexual lives."

Graduation day

The course actually begins and ends with a test. In the "arousal room" at Brotto's lab, women are hooked up to a vaginal photoplethysmograph that monitors "vaginal pulse amplitude" while they watch erotic videos, interspliced with non-erotic footage to show baseline responses.

Initial tests almost always indicate that women with sexual arousal disorders "will genitally respond to erotic videos even if they report that they didn't feel turned on," according to Brotto. "It's proof of the de-synchronicity between mind and body with many women."

So far, 70 women have graduated from Brotto's mindfulness program. Post-mindfulness training, both the physiological and subjective tests scores -- measured through questionnaires -- improve for a significant majority of her patients.

But competitive types take note: there's no such thing as an ideal or even an average score; the tests are done to track post-therapy changes, so the goal is not to compare one patient with another. "We spend far too much time worrying about whether we're 'normal' or good enough," says Brotto. "Mindfulness is about cutting out that kind of noise and tapping into what your body is doing."

Brotto has 23 sexuality studies currently in the works and just received a five-year provincial grant to beef up her mindfulness program. In 2008, she'll also start an online educational course for women in remote spots and plans to add male students to her programs since up to 34 per cent of men report sexual disorders.

"We're such an eroto-phobic culture and it takes a lot of work to change our internalized attitudes about sexuality," says Brotto, who hopes everyone puts sexual health on the 2008 resolution list.

"Sexuality is a quality of life issue, not this dirty, taboo thing. Why do we have so many hang-ups about something we all value as important? Ultimately we all just want to love and be loved. If people are sexually happier, they'll be happier in general. It's the new anti-depressant."

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16  Comments:

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  • G West

    4 years ago

    Sexuality is a quality of life issue - Really?

    I wonder how 'big' that 5 year provincial grant was?

  • jsinger

    4 years ago

    I have a problem with the

    I have a problem with the word vagina being used to describe women's genitals. Given the importance of the clitoris in sexual arousal it always drives me crazy to hear 'vagina,' which I don't deny is an important part of our anatomy, used when vulva, labia, or clitoris would probably be much more accurate terms for what is being referred to. The vagina is only the inner tube leading from the vulva to the uterus, and unless I am some kind of unusual woman, it is not the place where women feel sexual arousal. The vulva, particularly the clitoris, but also including the labia majora and the labia minora, is where we perceive sexual arousal. I believe the vagina is involved in orgasm in that vaginal contractions take place during orgasm, but if you were to ask any mindful woman where she perceives arousal as it develops, or what area would need the most stimulation for an orgasm to occur, it won't be inside the vagina. For this reason 'The Vagina Monologues' drove me nuts. It would be kind of like referring to men's genitals as 'the scrotum' or something. So...please women - and men, let's call a spade a spade, and a clitoris a clitoris, and the labia the labia, and a vulva (which includes both) a vulva. I think this concept alone will lead to more potential sexual mindfulness for those needing to develop it, which I of course encourage. It will also help men become better lovers by knowing what areas need stimulation, a pretty huge factor in the equation as well. Thanks for the opportunity to express this idea where others might read it, because it is a subject that frequently drives me nuts.

  • shmendrick

    4 years ago

    Vagina

    I think it is well known that 'vagina' is commonly used to describe the whole set inside and out of the female bits.
    And as for 'any mindful woman'... I know at least one for whom where 'most stimulation for an orgasm to occur' is inside, what people call the G-spot. Poor thing spent years wondering what was wrong with her before she got right in there and figured it out.
    and...
    Sexuality is a quality of life issue?
    Um, Yes. Of course. Whatever the grant is, times it by at least a factor of ten. If people were all learning to be mindful enough to have great sex... well, the world would be a better place.

  • woody

    4 years ago

    G West asked,

    G West asked, I wonder how 'big' that 5 year provincial grant was?

    1 inch per yr, for a total of '5' inches.

  • dolphin

    4 years ago

    G spot

    I believe the grafenberg spot is located about a third up the vagina in the front, and certainly important in overall female arousal.

  • G West

    4 years ago

    I think Sex may be a quality of life issue for some

    But 'sexuality'...I don't think so.

    Please consider the word's definition:

    Sexuality - the quality or state of being sexual: a: the condition of having sex b: sexual activity c: expression of sexual receptivity or interest especially when excessive.

    Without some kind of modifier like 'healthy', appropriate, or even (if you must 'mindful') I think promoting simple sexuality is neither sensible nor needed. There's too damn much 'overt' sexuality on television, the internet and in advertising now.

    People should put sex (as good as it can be) back into some kind of appropriate relationship with the rest of their lives.

    We've just spent years investigating, trying and convicting a man for killing 6 women (and perhaps others) who were involved in a business - many of them - that is way too involved with 'sexuality'.

    My view.

  • jsinger

    4 years ago

    Man or woman?

    I'm curious about whether schmendrick is a man or a woman, guessing that the answer is a man, in which case I think he would be wise to defer to what women have to say about their own bodies. I, as a woman, would certainly not presume to know more than any man about what it feels like to live in a male body. Yes, there is something to be said about the G spot as an adjunct of sorts to other kinds of sexual activities that are more likely to lead to orgasm, but I assure you that most women masturbate by stimulating the clitoris, and men who wish to be good lovers would be well advised to be aware of this significant fact. Sexual arousal prior to physical stimulation (i.e. mental stimulation) is felt in the clitoris and vulva much more than it is felt inside the vagina. The G spot requires physical stimulation before it is even perceived, a fact that is simply not true of the clitoris and of the vulva in general. The fact that, as schmendrick said, the word 'vagina' is often used to refer to "the whole set inside and out of the female bits" is exactly what I object to, as I said in my first post. Ultimately both men and women lose by such limited points of view. During fetal development, from the same beginning cells, males develop a penis and females develop a clitoris . The clitoris is therefore the female counterpart of the male penis. The labia and the scrotum similarly develop from the same beginning cells and are the counterparts of each other. Because men certainly distinguish their penises from their scrotums I do not think it unreasonable that women do the same, and have names to match the very significantly different body parts that collectively make up our genitals. I'd love to hear what other women have to say about this.

  • jsinger

    4 years ago

    Sexuality as quality of life issue

    I meant to add that I think sexuality is a quality of life issue. Women have unfortunately had to have our sexuality defined far too much from the male viewpoint, to the ultimate detriment of everyone's quality of life, because women's sexuality as it actually exists has a lot to offer the world. The fact that the word 'vagina' is used so generically is, to me, symbolic of this phallocentric point of view that has limited us. Open your minds, men, at least enough to realize that we women are not necessarily exactly the way you imagine us to be. We are, as John Lennon used to say "the other half of the sky." Let us be free to be who and what we really are and all of us will win.

  • greengreen

    4 years ago

    Hang ups

    "Why do we have so many hangups..." "Why is sex taboo?"
    Gee, let's start with the Catholic Church. Perhaps it could be held accountable for the "provincial grant" rather then the ol' taxpayer.

  • dorothy

    4 years ago

    where it goes no time flat...

    Notice what just happened here? Somebody mentions a problem of sex-organ-brain disconnect, and before we know it, we are into naming all the parts and quarreling over how they 'work'. The CONNECT was the problem, and the other end of that connect was the brain, duh.

    It may not all be in our heads, but it is my considered opinion, that the part that is, is the one that needs to be addressed, and the course of this discourse bears that out in spades.

  • jsinger

    4 years ago

    Dorothy, I'm not exactly

    Dorothy, I'm not exactly sure what you are saying, but.... Please don't think that I am advocating that, during sex or sexual arousal, any woman should be concentrating on any kind of anatomy lesson. That would be the time for her to be "mindful" of the beauty of it all. It's just that, because of the images we are all saturated with, many people have inaccurate images, or so I assume given what pornography etc. apparently conveys about women's bodies and desires. I can't pretend to have a lot of personal awareness of the medium of pornography, but even without seeking it out, some of the ideas it puts out there affect all of us. The little bit I did see recently, on some kind of site that I was led to by a Tyee article some months ago, concerned me in regard to the thought of young people being shaped by what they see represented. I noticed a huge preponderence of photos and films related to anal sex between men and women, which concerned me. I don't object to two adults engaging in any practice that they both feel good about, including anal sex, but I am concerned when the expectation that all women prefer this particular sexual act to all others all the time is perpetuated by being represented almost exclusively, which I came to suspect was the case. Personally I try to connect with the Goddess, who I envision as the giver of love in all its complexity (which isn't always sweetness and light), when I need to eliminate the body mind disconnect. If I had to be involved exclusively in a sex act that didn't stimulate any of my orgasmic tissue (which exists in limited body parts, like the penis and clitoris for example), while pretending to have orgasms for the benefit of a man simply because that's what he expects, it would be difficult to keep that Goddess connection going. It is very important that we and our lovers understand both minds and bodies. In contrast to what I think you are saying, Dorothy, I think that this kind of issue is actually quite relevant to a discussion about mind/body connection/disconnection. I hope the author and the researchers mentioned in the article will see fit to comment on the ensuing discussion.

  • Canis Latrans

    4 years ago

    With all due respect...

    But it does seem odd to me that women seem to have such a great need for counsellors, gurus, therapists of sundry sorts and such. Save for my Mrs, at least insofar as I know. :-)

    Even for all my suffer and muddling through ways, I always knew where my dick was, where to put it and how to make sure I got my own out of the sexual deal-, and the Mrs likewise with her anatomy. (Still always hot to trot she is, the sleaze. :-)

    This counsellor thing being one of the oddities of life I have never quite figured out about "some", at least, of the fair sex. And I say "some" advisedly, for I do know a great many others, on the other hand, have no trouble getting it on like gang busters either. Welll, one or two in my limited experience. B-D

    Go for it ladies-, be mindful now. :-)

    ______________

    It's a wonder, I suppose, we shagged ourselves to the point we are so multiplied we have filled the earth over-full with our progeny. Us guys musta done it single handed, ya think? No pun intended. :-) It's only the boomer generation on, it seems to me, as liberated as they are :-), can't even produce enough to replace themselves.

    Maybe a good thing for future generations though, eh. :-) Long as we don't go too far with it, that is.

  • jsinger

    4 years ago

    hahaha

    Thanks for the humour Canis Latrans. The whole topic is, of course, on the hilarious side.

  • dorothy

    4 years ago

    I'll try

    This is kind of difficult, because it moves into a very personal area, where 'opinions' really don't stretch.

    I would say, that if you remember assumptions and agendas etc, while supposedly carrying out the effectuation of a meaningful relationship, you still labor under that 'disconnect'. The connect would be recognizable by there not being an awareness of such things as individual body parts. I don't know that I have ever been aware of separate 'orgasmic tissues' beyond explorative activities in my pre-teens. That is not 'how you do it' as an adult, at least not where I came from. Integration of the whole person in a unified experience, where thought (what there is of it), feeling, and all the physical stuff are not 'findable' as separate entities is the hallmark of the disconnect having been eliminated. Again this is a very persoanl thing, and I can see where the guru-thing comes in, simply to make people (not just women) forget their separate and separated agenda-items and anxieties. In my day, we would put Ravel's Bolero, or Wagner's Ride of the Valkyries on the grammo. I don't know what they do today, but some kind of shamanic input works for many people, who would otherwise have difficulty.

  • reality_check

    4 years ago

    Too many ultra-feminists, I say!

    Notice that I use the word "ultra"! Nothing wrong with women wanting equality and a fair deal. However, there is a segment of the population of the that are too extreme to be seen as healthy and helpful in advancing the cause of women!

    Quote:
    Close to a third of women report not being turned on by sex. The news has neuroscientists scanning women's brains during masturbation, while pharmacorps scurry to develop drugs, skin patches and potions to notch up libidos.

    Vancouver-based sex researcher Dr. Lori Brotto says low sex drive isn't caused by physiological wiring and plumbing problems, but by a psychological mind-body disconnect. In other words, our minds too often have no clue what our vaginas are doing. And Brotto's key weapon to bridge that gap is the ancient Eastern technique called mindfulness.

    Notice how some women seem to want to minimize the usefulness of the penis. At least that is my take on this. Oh! We cannot talk about the vagina because most women cannot have orgasm there. Perhaps, it might be useful for some women to ask the question of why they end up in the sack with a guy who does not take care of her clitoris and vilva and vagina! If it is so useless, why do sales of dildos,... are ... always up (pun not intended), hey? Why most women-centric sex shops sell them? Why do women get wet down there?

    BTW, my Asian GF has no problem in reaching orgasm, but I do take care of her clitoris and her vagina,... and she likes it that way! She has not been brainwashed to think that all men (and by extensiuon their penises) are useless, yet!

    A very good article!

    PS: If you find this comment offensive and feel like censoring it, I will draw my own conclusion on why it was taken down. There is nothing offensive about this comment as I am talking about extremists, not women at alrge!

  • macsasquatch

    4 years ago

    What a relief...

    All these years I figured the criticisms of my performances were warranted. Now I find that it might not have been me; she's been multi-tasking.

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