Karen Yates interviews Chicago sex therapist Dr. Pia Holec about desire discrepancy—when one person in an intimate relationship has a different level of sexual desire (or a differing type of desire) than the other.
Here, Dr. Pia shares one approach to bring couples together. This interview has been condensed from the live February 2020 show interview, which you can hear in podcast Episode 3, “Sensation Liberation.”
Karen Yates: I’d like to start by having your take on what essentially you see as the main differences between new couples versus established couples. And how are the issues around getting on the same page different?
Dr. Pia Holec: Most people aren’t talking about sex before it’s happening. A lot of what I see is: new couples, they might be more willing to try things because they’re like, “Okay, there might not be this judgment coming in. This person doesn’t have my history. They don’t know all of this information.” So they might be a little bit more open to it. On the other hand, it might be, “I’m too shy, I don’t know what this person might be thinking. They might be more experienced than I am,” et cetera.
And then more established couples, sometimes they get kind of stuck in a rut, stuck in their ways. And if they want to try something new, they might say, “My partner is gonna freak out if I bring something new into the bedroom, or if I express a desire.” Or even, “What might they think about me?” Or it might be, “We’ve been together for 20 years, there’s nothing new to do here.” There’s no desire to even explore more options, or even recognize that more options are available. But the thing is, they’re not talking about it.
KY: When is the best time for people to talk about issues?
PH: Outside of sex! So many people come into my office, and they [tell me that] in the middle of sex, they’re saying, “This isn’t working for me,” or they’re shutting down, or they’re arguing, or they’re trying to explain something right in the middle of the act. And people aren’t going to be receptive to that. There’s not going to be a give and take in those moments. So it’s best to have these conversations before even making it to sex, so that we can talk about sexpectations. We can talk about wants, needs, desires.
We can talk about consent, we can talk about safety, we can talk about all of these different things, right? And it’s also really good to have communication after the act has happened too, to talk about what went well, and maybe what didn’t go so well.
KY: You do something called “sensate focus therapy.” What is that?
PH: Sensate focus therapy is great, because it removes the expectation from sex — the expectation that we’re supposed to have an orgasm, that it’s supposed to happen in a certain amount of minutes, that it’s supposed to happen in a certain way, and that we’re supposed to always receive pleasure. A lot of these things get in the way for people, and it causes a great deal of anxiety. And so what sensate focus therapy does is it causes you to focus solely on the sensation of touch, looking at three things: temperature, texture, and pressure. Temperature: hot or cold. Texture: soft or rough. And then pressure: firm or soft.
And the thing with that is, a lot of people [ask]: “We’re gonna talk about desire, right?” It’s hard to cultivate desire. Like, if you don’t like chocolate, I can’t say, “Here, eat this chocolate and you’re gonna love it.” You have to have a want to even want to do that.
A lot of folks, if they’ve never had a positive experience from sex, then they don’t want to try. They don’t want to explore; they don’t want to masturbate; they don’t want to engage in self-touch. Because it’s kind of like, “What’s the point?”
So with these exercises, you begin to touch your body from head to toe, focusing again on temperature, texture, and pressure. And you allow yourself to only notice the sensations that come up. You’re not going into the exercise with any expectation other than, “What am I experiencing?”
KY: Do you do this by yourself?
PH: It’s a three-step process. In the beginning—and this is the hardest thing for couples—when we’re doing the protocol just as it’s supposed to be, sex is off the table at first. And the person who’s maybe having more of an issue cultivating desire, they’re gonna explore their body on their own, from head to toe.
I tell folks to set aside a designated amount of time, 10 to 20 minutes. Set the mood, get the temperature right in the room, get the lighting good, and just really allow yourself to explore your body. In the first week, you’re gonna have underwear on or a bathing suit, and you’re not going to touch the breasts or the genitals. You’re just going to stroke the body from head to toe. Temperature, texture, pressure.
The following week, you can remove clothes, still avoiding the breasts and genitals. Third week, you can touch breasts and genitals, just no insertion. And then after that, you can begin self-insertion for yourself. Then, you can begin to incorporate a partner. At this point, there’s going to be a toucher and a touchee.
And the thing that’s great about sensate focus is that it teaches us to touch for our own recognition, versus just pleasuring a partner, or getting a partner to experience happiness.
So when we’re touching to explore for our own desire and for our own exploration, we’re able to provide a different experience for both ourselves and our partner.
KY: The thing that I like about what you’re saying is, you’re working through these phases of clothing-on, clothing-off. Because I think we are so genitally obsessed in society. And also, a lot of trauma comes up around the super-sensitive areas of our body that have been sexualized. To begin the exploration with some clothing on really allows the mind to open, to go to a new place that maybe you’ve never had to go before. Maybe it hasn’t even occurred to you that, “Wow, if I touch my face and my hair, I might find some sort of pleasure there.”
PH: Absolutely. And I’m glad that you brought that up, because this really works great with people who’ve experienced trauma—because they’ve been conditioned to think any type of sexual touch leads to flashbacks or negative experiences. And so, like you said, when we’re avoiding those areas first, we’re able to cultivate pleasure on our own, without that conditioning that we’ve previously experienced, that schema that we’ve experienced.
KY: So basically the partner that has the desire issue is the one that does this?
PH: It could be both. There could be a mismatch in desire as well. But if there’s one person in particular, they’re going to start this exercise on their own first. And that gives them the sense of control—they feel like they have a sense of agency—then they can incorporate their partner into the exercise, and then they will swap touching one another.
KY: I was just wondering, because one of the things we were talking about is how some people think they know what they’re in to, but in some regards, describing what they’re in to is pretty elusive. You don’t even have the vocabulary, right?
PH: Exactly. So, when you’re incorporating the partner, this is done non-verbally. Because, to your point, we don’t often have the verbiage to say what we like, where we like it, how we like it. So what we teach couples to do, or individuals as well, is to engage in what’s called handwriting. Placing your hand over top or underneath your partner. And if they’re in an area that you’re enjoying, allow the hand to stay there, give a physical indication that ‘I’m enjoying this, I like what’s happening.’ If it’s touching an area that’s too sensitive, or that you’re not enjoying, you can move the hand away. That can help to take away some of this sense of awkwardness. And again, like we said, we’re not going to be talking during the sexual act and giving feedback in that way. So that’s a really nice physical way to get feedback.
KY: So when it comes down to temperature, what is a person doing?
PH: I say get creative. Think of different ways to incorporate hot or warm, and cool or cold. Whether that’s getting some ice cubes and rubbing that around your body, getting a really hot washcloth, or using some warming lotions. Or, you know, if you’re playing with fire, or candles, or wax —just different things like that. Just get creative.
KY: What do you see happen with folks that have begun trying this?
PH: It’s super hard! People don’t want to say, you know, “I’m coming in here because I’m having an issue with sex, and now you want me to take sex off the table? How is this supposed to work?” This sounds counterproductive, right? When we take that away, you’re able to crave it more, right? Oftentimes that one person’s like, “Alright, I’m down to do these exercises, I’m on board,” and the other person is pressuring them. They’re saying, “Are you doing the exercises? Are you spending the amount of time? Is it working yet? How much longer do we have to go?” So sometimes that can take a bit of time to process together and get everyone on board.
And afterwards, when people are agreeing to this and they’re really doing the exercises, it is just beautiful how much people can change over time and explore themselves, and create sexual experiences that they never thought possible. So it takes a lot of time. It takes a lot of patience, but it can end up being a really rewarding experience.
KY: You’ve just taken us through this pretty large idea of sensate focus therapy. Is there a cool exercise you can give the audience to try at home? Something that’s doable as a first step?
PH: Yeah! I say, folks, you do not have to take sex off the table, but just go home and touch your body, head to toe. Behind your knees, behind your elbows. Like when’s the last time someone explored the back of their knee? Oftentimes people say they’ve never done that. And think about temperature, texture, pressure. Try something different in terms of temperature—whether that’s getting, like I said getting something warm [or] getting an ice cube. In terms of texture, try something different: a feather, the back of a hairbrush, the back of your fingernails. And then in terms of pressure, vacillate between something soft or something firm.
I think it’s just important that we’re talking about sex. Because, like I said, it’s not happening enough, and that is what is causing the conflict between desire and expectations. When we have the ability to be honest and transparent, that’s where beautiful sex happens.