What Subtracts More than It Adds?

That sounds like a bad riddle, right? Like one I heard on NPR last week: What goes up a hill and down a hill but doesn’t move? The answer to that one is a road. And the answer to what subtracts more than it adds is sex.

Sex after Sixty bookHere’s the disturbing—but not, when I think about it, surprising—statistic I ran across this week, courtesy of colleague Sheryl A. Kingsberg, a PhD and chief of the Division of Behavioral Medicine at the University Hospitals Case Medical Center: “When sex is good, it adds 15 to 20 percent additional value to a relationship. When sex is bad or nonexistent, it plays in inordinately powerful role draining the relationship of positive value—about 50 to 70 percent!” I was so struck by that statistical picture, I’m on the trail of the original research to understand more. But in the meantime, what I know from other studies—and my own experience and conversations with women—suggests that’s about right.

Let me first say that good sex doesn’t automatically make a relationship good. And a good, loving relationship doesn’t automatically mean that the sex will be good. But if I think back to a study done a couple of years ago, “The Components of Optimal Sexuality,” I’m reminded of how many of the characteristics of good sex are also characteristics of good relationships. I won’t revisit the whole list, because you can read the series of detailed blog posts we did on each of the components. But here are just a few that come to mind in this context:

  • Being present. It’s so easy to take our partners (and, of course, others in our lives) for granted. Truly paying attention to one another—today—is a great gift.
  • Connection. When we feel connected to our partners, intimacy comes naturally (especially when we’re overcoming obstacles together). If you’re feeling “together but alone,” there are steps you can take.
  • Authenticity. At this point in our lives, I find that many of us are more willing than ever to own what we think and feel. Whether we’re in longstanding or new relationships, this helps us to be ourselves—and to be open about what we like and need, in the bedroom and the rest of life.
  • Vulnerability. Having sex is perhaps the ultimate act of making yourselves vulnerable to each other. What a reinforcement of the bond that a couple has with each other!
If those parts of your relationship are important to you, too, you’ve got more reason to understand how to stay healthy and be intentional about nurturing this part of your life.

What Is a Happy Marriage?

A couple of weeks ago, I talked about an article I’d seen about how sexual intimacy is linked to marital happiness. The research, by Adena M. Galinsky and Linda J. Waite, found that continued healthy sex-lives help couples dealing with physical illness, especially chronic health problems.

Couples who had sex frequently (and sex was defined broadly—it didn’t need to include vaginal intercourse) were more likely to say they had a good relationship.

"Happiness, not in another place, but this place... this hour."This is, of course, a chicken and egg: More sex doesn’t automatically make a relationship good. It’s more likely—and perfectly reasonable—that an unsatisfying relationship will include less sex. And the women I meet through my practice as well as the rest of life show me that this is often a time when our relationships get some re-evaluation.

Sometimes it’s the empty nest, and the change in schedules and priorities that comes with it. Sometimes it’s retirement, for one or both partners, which means a lot more together time. Sometimes it’s the stress of caring for aging parents along with everything else. Whatever the prompt, when some of us look at our relationships, we say, “Is this really what I want?”

So it was interesting to me to read the details of the Galinsky Waite study, to see how they measured the quality of relationships. These are the questions they asked:

  • How close do you feel your relationship with your partner is?
  • How often can you open up with your partner if you want to talk about worries?
  • How often can you rely on your partner for help with a problem?
  • How often does your partner make too many demands?
  • How often does your partner criticize you?
  • How happy is your relationship with your partner?
  • Do you like to spend your free time together, separately, or some of both?
  • How emotionally satisfying is your relationship?
  • How often does your partner get on your nerves?

If you’re feeling some vague discontent, those questions might help you with a conversation with your partner—or with a couples therapist if you decide some outside perspective and coaching would be helpful. If you’re feeling angry, or resentful, or isolated in your relationship, it’s no surprise that you’re not feeling sexy.

And you deserve to.

Keep the Sex Fires Burning

One of the motivations for my work with women both in my practice and through MiddlesexMD is the difference staying sexy makes for women in their relationships. I’ve heard anecdotes on both sides of the issue: from women who feel the intimacy with their partners drifting away, and from women who’ve reignited their sex lives and feel a burden lifted in their relationships as they and their partners re-engage.

So I was especially interested to see a study announced this month that puts some numbers to those observations. The study was led by Adena M. Galinsky and Linda J. Waite through the University of Chicago’s Center on Demography and Economics of Aging. I’m waiting the full text of the study, but an article in The Washington Post provides some interesting highlights.

A healthy sex life helps couples dealing with physical illness. Illnesses, especially chronic ones, can stress a marriage at any age. The study results showed that couples with more sexual intimacy viewed their marriages more positively in spite of illness.

Assessments of relationship quality are tied to frequency of sex. To put it plainly, couples who had sex more often were more likely to say they had a good relationship. In other studies, good marriages have been shown to prolong life—and certainly quality of life.

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At any age, we can “expand [our] idea of what sex is,” according to Amelia Karraker, postdoctoral fellow at the Population Studies Center at the University of Michigan. I look forward to studying this part of the study in detail, because many of us grew up thinking sex equals vaginal intercourse. When that becomes uncomfortable or less pleasurable, too many of us think we’re done with sex.

This study’s data encourage us to keep sex as a part of our lives for just as long as we’d like to. When sex changes for us, we only need to learn about what’s different and how we can compensate (and engage our partners along the way). When we abandon that part of ourselves, we accept an unnecessary loss—to ourselves and our relationships.

“Wellbeing in older age incorporates both psychological and physical wellbeing as well as sexual wellbeing, which can occur at the intersection of those two,” Karraker said. Or, to put it another way: Sex is part of our physical and emotional health. Our whole lives.

Q: Can my wife and I become intimate again?

This is the kind of question that makes me grateful to have Mary Jo Rapini, who specializes in relationship counseling, as an advisor to MiddlesexMD. When I shared some of your story with her, she said:
It sounds as though your wife may have felt detached from you for a number of years. Recent events have caused her to realize that her concern for you was actually still love, which is a first step: She still loves you, and you still love her.
I often see that couples who lack intimacy actually lack communication. I'd recommend that you focus on communicating better, resolving conflict, and taking every opportunity to be intimate without a focus on physical intimacy or intercourse. It sounds as though your wife has feelings she's uncomfortable talking to you about, which suggests that counseling for her alone would be wise. A therapist can help her understand what she is feeling so the two of you can work together to restore a healthy sex life.
Therapy is also best when you are both healthy physically—including your sexual health. Some women react to perimenopause with depression or anxiety, which it's helpful to address first.
We hope that's helpful, and that you and your wife are able to have a full life together. We're all in favor of healthy, lasting relationships!

Prayer and Sex: Not Such Strange Bedfellows

I had never thought of bringing together these two very personal and powerful actions until I read this post by psychotherapist and MiddlesexMD advisor Mary Jo Rapini. She writes, “One method not as well studied but also valid in bringing a couple closer together and improving sex lives is prayer.”

Well, that got my attention! Prayer, however you express it, has always seemed like something you do alone and in private, although we pray with others in certain contexts, such as liturgies and church rituals.

Sex, on the other hand, is an intimate and private act between two people, who may sometimes struggle with the vulnerability such intimacy demands.

But bringing the two together? Doesn’t that seem, um, odd if not downright sacrilegious? After all, one is sacred and one is, um, fairly creaturely.

Actually, prayer and sex are the most natural intertwining of intimate acts in the world.

If you believe in any sort of Higher Power, bringing that Being consciously (through prayer) into your sex life could open a new level of intimacy between you and your partner. It could also sweep away those musty, Victorian notions that sex is somehow “of the flesh” and therefore opposed to things of the spirit. Which may be where that stubborn scent of guilt that clings to sex originates.

Nothing could be further from the truth. There is no such dichotomy, even though we tend to create one. Male and female become “one flesh”—that’s how we were made, to be sexed creatures. We were made this way by the God whom we would prefer to exclude from the bedroom.

“See, sex in not an afterthought, a way to make more babies. Rather, it is an indispensable quality woven in the fabric of each life on this planet. Sex is not first something we do; it is primarily who we are,” writes Dan Hayes in this post about sex and prayer.

Why not invite God in? Consciously. By praying together. You don’t even have to belong to the same religion—you just have to believe. (God is there anyway; it’s just helpful for us to acknowledge it.)

Sex is a sacred act. That concept is the foundation of many Eastern practices, such as the Tantra. Sex is sacramental—the most intimate physical joining that human creatures can attain. Prayer acknowledges this, and it introduces a different kind of intimacy and perspective between partners.

A few of the effects of bringing prayer into sex, according to Mary Jo, are that by acknowledging a higher power, our own ego and self-righteousness dissolve, unspoken barriers between partners are broken down, and the bond between them is strengthened.

Praying together begets acceptance and forgiveness. It softens the sharp edges that creep into a relationship over time.

So, in the midst of using all the other tips and tricks we’ve discussed so much on this site, why not also pray together? You can do it in any way that’s comfortable for you. You don’t have to use words, but it might be helpful for each of you to hear the prayer of the other.

Join hands. Be still. Quiet yourselves.

Then pray. Together. With or without words.

If you don’t know what to say, here’s a starter:

Father, send your Holy Spirit into our hearts. Place within us love that truly gives, tenderness that truly unites, self-offering that tells the truth and does not deceive, forgiveness that truly receives, loving physical union that welcomes.
Open our hearts to you, to each other and to the goodness of your will. Cover our poverty in the richness of your mercy and forgiveness. Clothe us in our true dignity and take to yourself our shared aspirations, for your glory, forever and ever.
(“A Prayer Before Sex” from Patheos.com)

Music to Make Love By

A young woman I know went to the hospital to have a baby. She packed all the things she thought she needed to keep her comfortable during labor—a big ball to sit on; small balls for back pain, power bars and snacks for energy. She also loaded her iPod with a playlist of her favorite music.

I was expecting Vivaldi, maybe Bach, or some soothing Tchaikovsky. But what filled the room as she puffed her way through contractions was a mélange of rock tunes she had found comforting on the subway when she was nauseated “and everything else I was into at the time.” These included bands like Cat Power and Sun Volt.

Yeah, I’ve never heard of them, either.

We may associate certain music with a happy time of life—French songs we heard in Paris or the Latin beat of Havana. We may like the music we listened to in our youth. Or, we may have cultivated a taste for one genre or another later in life—jazz or opera, for example.

I vividly remember the first time I heard Aaron Copland’s Appalachian Spring in college. That began my love affair with classical music, which continues to this day.

One thing is certain—music is powerful. Just listening to it—and it doesn’t have to be the favs on our playlist—can trigger emotion, such as patriotism, sadness, joy, excitement; it can relieve pain and depression; it causes the release of various chemicals such as testosterone, oxytocin, and those feel-good endorphins, such as dopamine, according to this NCBI article. In fact, music taps into the same neurochemicals as sex, according to a recent study in the journal Nature Neuroscience.

Since we humans seem hard-wired to respond to music, doesn’t it make sense to invite this powerful ally into the bedroom?

As we mentioned in previous posts about engaging all our senses during sex, music can help us “get out of our heads.” This is valuable all by itself. But music can also help us get in the mood. Music that has shared associations can make us feel close to our partner. Or, like Ravel’s Bolero (that quintessential piece to have sex by), it might track the crescendo of the action.

Ideally, your partner likes the same music as you do, but maybe you’ll have to stretch a bit to include his or her favorites. Or maybe you can recall special tunes that are significant to both of you.

Don’t use this as an opportunity to broaden your taste in music, however—this might not be the time to sample that heavy metal band your son told you about. What you want is music that’s familiar, whether it’s soothing, romantic, or energizing. What you don’t want is an unexpected clash of cymbals at an inopportune moment. You want to avoid jarring changes in tempo or volume. The music should either sound similar or transition gradually. You might also consider keeping the remote close at hand to click to the next song or turn the music off altogether if it gets too distracting.

The Internet is full of lists of sexy music. Amazon also sells downloadable and unadorned Music for Sex. (A little more nuance might be nice.) But in this sphere, the best music is your own, drawn from shared memories and personal taste. Whether it’s Aaron Copland or Buena Vista Social Club, country, R&B, or classic rock, make it yours.

So maybe sit down together tonight and compile your playlist of music to make love by. Let us know how it goes—and be sure to share with us what works for you.

Making the Most of Time

I once knew a crusty old farmer who refused to acknowledge the existence of daylight savings time. Ask him the time during spring or summer, and he’d respond, “Do you want the real time?” To Robert, daylight savings time was just some misguided newfangled invention.

This weekend, we return to “real” time.

While we gain an hour of sleep early on Sunday morning, we give up an hour of evening sunlight for a whole season. There’s something primeval about these fall and winter twilights. Something that makes you want to draw near the fire. Huddle together for warmth and protection. Share tall tales and drink something bracing.

We can ignore this ancient urge. We can fill the evening hours with activity. We can turn on lights, and stay up late.

But we may be ignoring something important in this seasonal cycle. Perhaps the shortening days and waning light are also reminders. I know they are for me. Our own time is becoming short as well. It’s a bittersweet truth that can’t be altered no matter how busy we keep ourselves.

Rather than avoiding this natural cycle, wouldn’t it be better to savor these twilit evenings, this waning light, with awareness and gratitude—in the same way we ought to experience this season of our lives? Wouldn’t this time be the richer for living it with greater compassion and attention? And doesn’t it make sense to begin with those closest to us?

This year, why not celebrate the return of real time? Why not set aside that hour or two of fading light to reaffirm love and life with the person you share it with now? This can be a quiet thing—the spirit of this season isn’t bombastic or overblown. Its colors are muted—ochre rather than fuchsia; the tone is subdued—Bach rather than Wagner.

Maybe walk together as evening falls. Crunch the leaves; smell the musty crispness. Hold hands.

Maybe sit together in the twilight. Drink mulled wine. Light candles.

Watch a special movie that moves you both. Read aloud—poetry or a book you love.

Mostly, experience this transition with your spiritual senses. Life is moving on. You are acknowledging the passing of time with someone you love. That’s something to be done with care and attention.

When he was 81, my friend Robert moved out of the farmhouse he had shared for his entire life with his bachelor-farmer brother. He moved out to marry Paula, who had outlived three husbands. This was his first marriage. I was the “flower girl” for the marriage of two octogenarians.

Robert wept as he said his vows. When he kissed the bride, it may have been for the first time. You can bet he rejoices in every moment of real time he has with his love.

We should do no less.

Sex Talk Begins with What We Say to Ourselves

One of the advantages of having an advisory board is the different perspectives we bring to the same set of problems. In our last conversation with Mary Jo Rapini, the issue of body image came up: the fact that we women are sometimes our own worst enemies when it comes to nurturing our sexuality. The topic clearly hit a chord with Mary Jo--she'd also been coming across examples of it--and she offered to write this blog post.  

I was recently at a meeting that explored the literature and dealt with issues of sexuality, dysfunction, and relationships. The most popular theme in each educator’s presentation, no matter what their field of study, was the importance of body image in influencing women’s libido. Although many of the diagrams and graphs were complicated, the message was not. How women feel about their bodies influences their libido.

It makes sense, especially if you are a woman yourself or are close to one. You know how it feels when you feel bloated or fat and your partner wants to get naked. There is a sense of dread and duty; either you acquiesce or you find an excuse. It doesn’t matter how beautiful your partner tells you they believe you are, or what you’re wearing; if you don’t feel good about your body you don’t look forward to being vulnerable or wanting pleasure. Both of these are important when making love.MiddlesexMD_Rumi

When I see women who are struggling with their body image I find myself reciting things I have heard or read that help. For example, experts tell women to focus on an area they like and to appreciate and dress in to flatter that feature. For many women, this may be helpful, but my practice is full of women who can only admit to liking a very small limited area. Let’s face it; if you tell me your favorite area is your eyebrows, I'm going to struggle with how to help you build a better body image using your eyebrows--any expert would.

Body image can include areas that aren’t exactly body related. For example, many professional women boast a high body image and self esteem due to their careers. They may not like their body or parts of it, but they don’t let it hold them back sexually.

What we say to ourselves is much more important than what others say. A recent report I read said that women routinely say over twenty derogatory things about their bodies each day. These same women suffer from how they view their body emotionally, physically, and sexually. It doesn’t matter if their husbands love their bodies, comment on the beauty of their bodies, or tell them how attractive they are: These women are destroying their concept of themselves from within. Media is an easy target to blame, but media is not the entire problem. What we say to ourselves is the problem. What we think to ourselves is the problem. What we say to our friends about our inadequacies is a problem. All sex talk begins with what we say to ourselves. No sex talk will make women feel sexier, hotter, or more desired if they have destroyed their sense of sexiness from within. Hormone therapy can make you feel more like having sex, but if you don’t feel good about your body, you will be reluctant to act on your feelings.

Since this is an inside job we do to ourselves, the work to stop perpetuating a poor body image is also up to us. It means you have to take a stance and begin by advocating for yourself, for your intimacy/sex life with your partner. That means sitting down with your partner and directly addressing what happens to you when you talk to yourself. Usually loving men will do anything to help their partner if they understand the mission.

  1. If you are highly suggestive and seeing a photo of a taut, scantily dressed woman with sex appeal makes you feel and talk badly about yourself, then rid your home of these types of magazines, TV shows, or whatever you are currently seeing.
  2. Movement is linked to many sensory areas of our brains. Movement makes our mood better, our affect more animated, and our sense of sexuality healthier. You don’t need to run marathons to feel and be sexy, but you do need to exercise each day. Ten minutes is better than no minutes. An hour a day split up any way you want is best!
  3. Begin a journal to yourself listing derogatory comments you remember being said to you prior to the age of eight. These comments may have been made as "jokes" by warped people, but they weren’t jokes. They are wired into your brain, and you may be repeating these to yourself as part of your negative mantra.
  4. Catch yourself. Whenever you make a derogatory comment about some part of your body, picture a stop sign and say aloud, “No.” Ask yourself, “What right do you have to abuse anyone including yourself?” Then think of who in your life made you think this was okay. Sometimes you will remember things your dad said, but more likely your mom used to insult herself as well.
  5. If anyone in your life right now insults your body, that is a huge red flag. Tell them they are waving a red flag, and abusing you with negative comments is not okay. If your kids hear this message, they will begin early protecting their body image.
  6. Women are much more critical of their bodies than men are. Part of this is due to the fact that women are more sensitive and do not abuse men’s bodies with negative comments to the degree men do with women. One way men will learn how to treat women is if a woman stands up to them when they make a derogatory comment instead of joining them in their taunts.
Couples will spend money to enhance their sex life with products, medications, and exotic vacations. However, the least expensive and perhaps most effective is to begin changing how we talk to ourselves. The first sex talk you get is not the one you get from mom or dad during a formal birds and bees lecture. It’s the mini body image lectures we give ourselves when we are children. These mini body image insults we say each day to our bodies are more potent than any sex product, medication, or exotic vacation we could ever afford.

Romance Awareness Month? Still Time to Seize the Day

The editor of the MiddlesexMD newsletter, who somehow knows these things, tells me that August is Romance Awareness Month.

Who knew?

According to an online poll by Zoosk, which calls itself a “romantic social network,” couples enjoy more romance than single people. Without getting too fussy about the details, according to the Zoosk survey, 79 percent of people in couples say that their partner is romantic while only 41 percent of single people say the same (presumably of their current interest?).

And even though the vast majority (78 percent) of those polled consider romance important in a relationship, only 20 percent of single people are happy with the romance in their lives compared to 59 percent of the coupled folks.

(Just to be clear, neither single people nor couples considered taking out the garbage romantic—so don’t try to make that count.)

In honor of Romance Awareness Month, maybe it’s time to take stock of the romance in your life. Are you stuck in a rut? A little rusty when it comes to new ways to woo your honey? Or maybe you haven’t thought about romance in a long, long time.

Romance might be considered a nuisance and a bother by some long-term couples. Romance is for newlyweds. What’s the point? He (or she) knows I love him (or her).

Maybe. But we frail human creatures still need reassurance from time to time. And saying the words out loud keeps our own emotional machinery in good working order, too. I’m betting that couples who manage to stay sexy and in love over the years are very good at romance. You know the couples I’m talking about. They hold hands; they enjoy being together; they touch; they make eye contact.

Romance can be as simple as a little squeeze or an “I love you” before bed. In fact, couples in the Zoosk survey actually preferred a hug and a kiss to dinner by candlelight (41 to 39 percent), while the singles prefer the dinner to the kiss (44 to 32 percent).

The tricky thing about romance is that it requires you to really know your partner in order to anticipate the unique things that will please him or her. Roses and chocolate might completely miss the mark while fresh coffee in the morning might be the most sensitive, loving and, yes, romantic, gesture imaginable. There’s no one-size-fits-all when it comes to romance.

Romance is all about acts of thoughtfulness and caring that is uniquely targeted toward the person you love. It’s about going a little out of your way for no reason at all, except that you care.

Done right, romance communicates to your partner that he or she is uniquely loved, and that leads to a sense of intimacy and caring in return. (And maybe to sex.)

This is the stuff that keeps a relationship tender and vital. While romance can be sexy, it isn’t about sex; it’s about expressing your love without ulterior motive or expectation of return in a manner that that only your partner will appreciate.

August may be Romance Awareness Month, but there are eleven more months to practice in.

Let’s get started!    

Q: How can I feel intimate with an emotionally remote partner?

I posed this question to Mary Jo Rapini, an advisor to MiddlesexMD and a therapist, writer, and speaker. Here’s her advice:

You’re not alone in your feelings of being married to a man who cannot express his love. I am happy that you are healthy enough to advocate for yourself and your own sexual and emotional needs. There are several things I can suggest that may really help you feel more connected to your husband—and will help you feel better as well.

The SmartMarriages website has good information that can help you and your husband. They are very pro marriage, but more than that, they are pro relationship. Anyone who wants to improve her relationship could benefit from their resources.

Buy a book called The Five Love Languages, by Gary Chapman. Many couples have found it helpful; men like it, too, and reading it together will lead to better understanding of each other and how you each feel most loved. The author also offers weekend classes throughout the U.S.; you might find him in your area.

You and your husband would benefit from attending a marital retreat. If he doesn’t like groups, or if you don’t, I would suggest a private therapist. I think your husband would feel less threatened if you sought out a male therapist.

One of the most beneficial experiences to help couples become more emotional in their loving and more connected is attending Tantric classes, offered in many cities. They are a bit unusual, and some guys (especially older) are reluctant to attend, but if you can persuade him to go to just one, he will enjoy it.

Remember that men are raised to be competitive. They usually open up to their wives, but fear being “too vulnerable.” This may generalize to their sexuality. Try more touching with him and less talking or trying to “process emotions.”

Make sure you’re taking care of yourself, including having someone you can talk to! You need emotional support so you can regain your strength and confidence.