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Two Roads to Orgasm

There's a reason couples therapy often doesn't work for sexual problems.

It's astonishing how many people have wasted years of time (not to mention thousands of dollars) on couples therapy without talking about what really goes on in the bedroom.

I know several women who sat diligently in therapy for months with their husbands, listening to theories about why the sex in their marriage was boring them to death. And who finally arrived at my door very discouraged (I tend to specialize in people who've just about given up on therapy) but still unable to put into words what the real problem was.

What's often called for is some fearless questioning about really goes on during lovemaking. The actual who-does-what-to-whom, and how-does-it-really-make-you-feel.

The reason all these couples found sex boring because it WAS boring. And in each case, the most boring part by far was his dutiful attempt to give her an orgasm, despite the fact that neither of them was very turned on.

Have a couple stop doing that, and things tend to get better.

One might say there's a high road and a low road to orgasm.

The intensity of orgasm is more or less dependent on the intensity of arousal that precedes it. Great arousal leads to great orgasms. High arousal—the high road—doesn’t have orgasm as a goal at all. Approached from the high road, orgasm is just an afterthought, like dessert at the end of a memorable meal.

But most of us are also perfectly capable of having orgasms without much arousal at all. Even at a relatively low level of sexual excitement, the right kind of friction in the exact right spot can be sufficient. The low road leads directly to orgasm, which is its goal. But the quality of the orgasm is usually rather disappointing. Poor quality arousal leads to poor quality orgasms.

Sometimes orgasm can be a sort of giving up—“Well, I’m not going to get much more excited than I am right now, so let’s have an orgasm and get to sleep.” Most bad sex leads to low-road orgasms.

Low-road orgasms can serve to relieve anxiety or get you to sleep, or momentarily quell unwanted sexual thoughts. But I encourage people not to take the low road too much.

If it feels like you’re not even close to orgasm, then don’t push it. If it’s going to feel like work to get dessert, then don’t do it. Sex should never feel like work. Better just to skip dessert.

If you’re not really feeling excited, then don’t just hang around waiting for your partner to get you to climax. That’s not fair to either of you. OK, If you’ve just GOT to have dessert or you’ll be all cranky later, then go ahead and give yourself dessert.

But don’t make such a big thing about it. Next time, keep it on the high road if you can.

And if you're in couples therapy and it's not helping, just do a quick check to make sure you're on the right road.

Copyright © Stephen Snyder, MD 2014 New York City

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