Sex researcher Dr. Lori A. Brotto speaks with Ray Buckner about her wealth of research on how mindfulness and meditation practice can help women overcome sexual difficulties.
Dr. Lori A. Brotto is a clinical psychologist and sex researcher who has spent over 15 years researching how mindfulness and meditation practice can help women have more fulfilling sex lives. Dr. Brotto spoke with Buddhist practitioner and Lion’s Roar contributor Ray Buckner about her recently released and first book Better Sex Through Mindfulness: How Women Can Cultivate Desire. In their conversation, the two discuss Brotto’s love for Buddhist teacher Thich Nhat Hanh and look at her research on how mindfulness can help women with sexual difficulties better live and thrive in their bodies and minds in both sex and everyday life.
Ray Buckner: I’ve read that your interest in mindfulness practice began with the Buddhist teacher Thich Nhat Hanh.
Lori Brotto: I have a special love for Thich Nhat Hanh. The Miracle of Mindfulness was the first mindfulness book I read. Over the years, I’ve re-read it so many times and I borrow many of Thich Nhat Hanh’s examples — wash the dishes for the sake of washing the dishes, or, walking through the garden, observing the garden, and noticing how anxiety arises when I see a weed. It’s so simple, but so profound. His writing, his thinking, his simplicity and honesty, for me, is really what pulled me into this field.
I’ve recommended many of the people I work with to start with his work. I saw him in Vancouver a few years ago and he just has this incredible presence. He elicits mindfulness when you listen to him.
Yes. His simplicity and the simple acts he speaks of are radical. We get so swept up in all the things that tell us, “I can’t feel this way,” but Thich Nhat Hanh’s message is to say, “Actually, I can.” You talk about really being with your feelings in your book as well — how we can just learn to be with the various sensations that arise during sex, and how that in itself is a compassionate act.
Exactly. There’s a real kindness and compassion woven throughout his writing. Compassion is so key for those with sexual concerns who are plagued with negative self-judgement and feelings of not being good enough and are very hard on themselves. The compassion piece has really been quite critical. It’s important to remember that’s what we’re doing with mindfulness practices. It’s not just about cultivating concentration or attention — that’s obviously part of what we’re doing, but it’s not just concentration training. It’s about how we’re orienting — with compassion and with our arms wrapped around ourselves and our experience.
I’d like to talk about desire. Our early desires seem like something that can have a real impact on how we engage in sexual practices in the future. Young women, especially in a heterosexual context, often place their desires secondary to the needs of boys and men who they’re exploring or engaging with. With queer or trans people, desire can so often be stunted because many simply don’t know who they can have desire for. Could you speak to the resistance to desire that can arise for women and how mindfulness practice can help us explore desire in a clearer way?
There’s some quite sobering data that indicates that young people — young people at the kind of exploratory stage of the initial blossoming of their sexuality — have high rates of sexual difficulty. Looking at the experiences of young women, several studies have found alarmingly high rates of difficulty with desire. Is it because these young girls feel compelled to engage sexually and service the young boys who are asking them, or in some cases forcing them? These girls never really have the opportunity to explore their own sexuality. They never really develop autonomy or agency or know how to ask for what they want or even what that is.
It’s about that notch in the bedpost. We never really cultivate the ability to notice and be aware.
There’s a lot of concern about what kind of lasting impact this has on those individuals over time. Is there a danger in these very narrow experiences of sexuality and desire setting the stage for subsequent encounters later on in life? Although many people might be comfortable having sex, they’re most definitely not comfortable talking about sex. They’re more likely to have it than to talk about it. There’s never opportunities for checking in and saying, “Was that good for you? Because it wasn’t good for me.” And when it wasn’t good for me, asking “Can we unpack that a little and try to understand what that’s about?” We’re just not doing that.
Our research looks at whether mindfulness practice can serve as a way of removing that sense of focus on the outcome. A lot of young people will say that it’s about getting to the end — about getting off. It’s about that notch in the bedpost. We never really cultivate the ability to notice and be aware — noticing that desired feelings come and go and that’s normal, or noticing that arousal comes and goes and that’s also normal. The practice of mindfulness makes a lot of sense for helping them to really develop and cultivate their own sense of sexuality.
One of the things you write about in your book is the tendency to catastrophize our experience. There’s a sense that “If I don’t feel arousal when I’m with my partner, if I can’t have sex, if I can’t feel comfortable, that means something is inherently wrong.” What’s going on within our tendency to catastrophize and how can mindfulness practice help us return back to our body?
There are many larger societal myths and misconceptions that are really unhelpful for sexuality. The idea that if sex is not spontaneous, automatic, or you don’t get totally hot and turned on by a partner, then that means it’s broken, you have a sexual dysfunction, or some other combination of pathological labels is one of those misconceptions. And it’s so not true. The science disproves all of that.
It makes people hypervigilant to their experience. It’s like, “Oh god, I’m not over-the-top turned on right now. What does this mean? Does this mean we’re not compatible? Does this mean it’s not true love? Does this mean I’m broken?”
We know that this process of catastrophizing directly impedes sexual response. A lot of experimental data shows that when one catastrophizes on the outcome, it actually interferes with really important brain-body connections that are necessary for sexual response, arousal, and desire to emerge. Yet it’s so hard to reel that in because it’s so automatic.
We can learn to look at the spaces between those sensations in our body as a way of really feeling what’s happening in the present moment.
This is where mindfulness is an ideal tool because mindfulness is about cultivating that present moment awareness whereby every sensation is observed and noted and we keep coming back to that. We can learn to look at the spaces between those sensations in our body as a way of really feeling what’s happening in the present moment and not jumping to that catastrophic outcome.
People are afraid to say out loud to a partner, “I’m worried that if this sexual encounter doesn’t go well you’re going to be disappointed. You’re going to leave me. You’re going to think I’m a bad partner and you’re going to question my commitment to you.” We have this real fear that if we articulate this out loud, suddenly all those fears are going to come true and the relationship is over. Instead, we hold on to these fears and keep them to ourselves and they wreak havoc, not only on sexual response but on our building sense of anxiety around sexuality. Mindfulness helps with communication. If we can observe that fear of what’s going to happen next as just sensation and as something my body produces then I think it positions us in a way to then open up the dialogue and talk about it.
How can mindfulness help women who are survivors of sexual assault or abuse?
That’s been a very meaningful part of this work — seeing how mindfulness can be a way for people who have experienced sexual violence to feel safe again. The group that we’ve done research with has been women who have a history of child sexual abuse and are now adults. These women are in otherwise happy relationships where they want to be having consensual sex, but during sex they basically fall apart. They either dissociate or have a resurgence of really uncomfortable sensations, anxiety and maybe flashbacks as the sex is unfolding. It’s so upsetting for them because these are women who say, “I thought I got past it. I did my therapy. I’m with someone I really care about. I want to be having sex. Why is this happening?”
For some people arousal can be a trigger that elicits some of those traumatic memories and feelings. So, the instructions of mindfulness can really help. Notice that these sensations are here. Remember you’re right here. You’re here in this moment. Open your eyes and look at your partner. Feel your partner’s skin. It’s been so powerful to see how mindfulness can be a vehicle for helping these women just be in the present moment, seeing sex in a positive way and experiencing arousal in a positive way, not in a way that is inextricably linked to coercion.
As someone who was assigned female at birth (AFAB) but identifies as non-binary, even the methodology by which a lot of your studies have to be conducted — putting a tool through the vagina, for example — would have caused such anxiety for me. I was thinking about the experience of trans women where the anatomy may or may not be a vagina, but there might be similar experiences of anxiety related to the body and how it will be perceived in sex. Were any people included in your research trans or gender non-conforming? Do you plan to conduct research in the future on the benefits of mindfulness practice in the LGBTQ sexual experience?
I love this question. Thank you so much for asking it because we know that sexual concerns are not unilateral to one group. It cuts across all genders, all sexual orientations, and all sexual identities. In our work, we’ve tended to recruit self-identified women, but that didn’t mean cisgender women. We’ve included trans women and we’ve had a handful of trans-identified women participate in our groups as well as non-binary folks. That was regardless of surgery — that has not been part of our inclusion criterion at all. We’ve had quite a sizeable number of different sexual orientations.
Methods and measures is a limitation. If one of our measures requires a certain kind of anatomy, it means we’re only measuring a certain segment of the population who have that particular anatomy. Genital measures are one tiny window into people’s experiences. We’ve never excluded anyone who said, “You know, I really don’t want to put that probe into my vagina.” We have lots of other ways that to measure their experience both quantitatively and qualitatively.
One of the ways that the genital measures have actually been helpful in the study of the practice of mindfulness is that it does allow us to look at what happens with physical arousal in the body and mental arousal in the mind in the moment. Do those two processes unfold together or separately? Many women have described a low degree of concordance — the body is becoming excited but the mind most definitely is not or vice-versa. Some of the genital measures have allowed us to look at the effects of mindfulness on whether there are any changes to that mind-body agreement.
One thing that we’ve looked at across sexual orientation is whether certain groups respond differently or better to mindfulness and we’ve found no difference. Admittedly, our sub-group of trans women is tiny. Our sub-group of lesbian and bisexual women has been much bigger, but still a minority compared to the much more predominant heterosexually-identified group. Overall, we’ve found no difference across these groups in how they respond to mindfulness.
Where would you like to go with your research next?
I’m interested in looking at how is this all working. As a scientist, I’m really trying to understand how mindfulness actually works. Where does it work? Does it work differently for different people? Is it that people are happier through the practice, or are they less stressed and that’s a gateway to everything being better? Much of my work for the past five years has been focused on that. I’d also like to see if we can move this research online. There’s lots of other great models of this with mindfulness apps, but this one would be specifically for sexuality. I’m also conducting studies related to couples, looking at whether we can deliver mindfulness to couples. Do both members of the pair have to practice in order for it to work? That’s something I’m working on now.
Thank you so much for your time, Dr. Brotto. I truly appreciate it.