“We now begin to see love as intelligible and malleable.  We will be able to shift from an obsession with the FALL part of love to the MAKE aspect of love, and make this more than sexual connection.  We can develop confidence in our ability to work with and mold our most precious love relationships.  This changes everything!”


Dr. Sue Johnson


Attachment and the Dance of Sex: Integrating Couple and Sex Therapy

NETWORKER SYMPOSIUM: FROM ATTACHMENT TO CREATIVITY / WASHINGTON DC.

– TEXT OF PLENARY BY DR SUE JOHNSON –

Attachment and the Dance of Sex – Integrating Couple and Sex Therapy  

We are just going to chat here a little about a couple of small topics – sex and love – and how to really put them together and make them work – in just 50 minutes or so!

Where to start? Huge topic. So let’s start with my mother!

My little English working class mum, who called sex a “funny five minutes”, did not approve of girls going to university at all. When I came home at the end of my second term, we had a huge fight. She pointed to me accusingly and bellowed – “I know what you do at that university. I know. You have orgies, orgies, wild orgies all the time – that is what you do.” This was very funny, very Monty Python, not just because my mother didn’t know how to pronounce the word ORGY – but because at the university of Hull, on the edge of the North Sea, right beside the fragrant fish docks there was not one orgy to be found anywhere. But that was a while ago – now sex and eroticism are on show and available everywhere. I bet I could even find an orgy in my small Canadian capital city of Ottawa (the city that TV show host John Oliver calls “the city without climax” as compared to NY, “the city without foreplay”). It seems that we are now taking the “shoulds” and shame out of sex, and allowing that sex can be whatever a person wants it to be. So everything has changed. BUT, has it? In many ways, sex seems as separate and as cordoned off from the rest of our human existence – the reality of human relationships– as it ever was.

Our field reflects this. Sex therapy and relationship therapy/couple therapy have traditionally been separate. How Strange!! Sue Carter, the new head of the Kinsey Institute, who studies oxytocin, the bonding hormone, recently suggested to USA Today that it is time for Kinsey to study “human sexuality in the context of relationships”. I agree. One of the first studies I ever read on sex back in 1992, by Hawton, showed that the success of sexual stimulation techniques, like sensate focus, was determined largely by couple’s ratings of their communication prior to treatment.

Of course – Sex is a dance. We can show one partner a technique for how to modify their sexual response, for example by slowing down and squeezing the penis to prevent premature ejaculation, but in the end its the Between – the quality of relationship interactions that powerfully shape partners responses in and out of bed. In focusing on our individual sexuality, perhaps we forget that we are, above all, social bonding animals. Our bodies and our brains are designed to link with and resonate with others in bed and out of bed.

Mae West quipped that “Sex is emotion in motion” and attachment bonds are all about emotion. Emotion is a body sensation – a meaning making machine, and how you express your emotions IS how you send signals to and engage with and attach to others, in and out of bed. Emotion is the music of the dance between lovers – it organizes interactions.

We call sex “making love”, and attachment is a theory of love and loving. Sexual attraction and connection is a key part of falling in love, forming and maintaining a bond. But even though Bowlby, the father of attachment science, told us there were three aspects to adult love – attachment, sex and caregiving, it’s really only very recently that the explicit links between bonding and sexuality have been explored. But – in our bones – we have always known that sex and attachment go together.

In fact, a few months ago there was a huge fair in Las Vegas on robotics. ROXXXY – the sex robot was the big hit. Let’s see her.

true-companion-sex-robot

 

What is really fascinating is that Doug Hines, her creator calls her not “Lady Orgasm” or some such, but the True Companion – he tells buyers “the physical part of your interactions with Roxxxy will be small – you will spend MOST of your time with her “socializing and interacting”. She is programmed to talk only about sex and sports by the way. Even Hines knows in his bones that the people who buy his robot are going to be seeking a lot more than orgasm – they are seeking connection.

The new science of bonding already has some pretty powerful things to say about sex – things that often go against the traditional zeitgeist of what sex is all about and how it works, but first let’s just, in a snapshot, see what the last 20 years of adult bonding theory and research can tell us – this is love in 4 minutes – ready?

 

The adult attachment perspective gives us 5 principles – laws of romantic bonding:

1. Bonding with a trusted other is a compelling drive wired into the mammalian brain by millions of years of evolution. This is all about survival.

 

baby

 

This little girl was born expecting those hands to be there – our nervous system is designed to connect with others. We never outgrow this. We know in our bones – if we call and no one comes we are oh so vulnerable. Love – infant or adult – is an ancient wired-in survival code (not a psychotic mixture of sex and sentiment that we can take or leave). But there are other laws.

2. Loving connection offers us a safe haven to go to where we can maintain our emotional balance, deal optimally with stress, be flexible and move in any direction – and a secure base to go out from to effectively explore and discover our world. Paradoxically, knowing someone has your back, that you are not alone, grows the ability to be independent – and to be curious about your inner and outer world.

3. When we lose this sense of connection with a loved one we experience emotional isolation, loneliness, panic, pain and helplessness. This distress can heighten or it can crowd out other concerns –like sexuality.

4. We now know the key elements that define an attachment bond – the perceived Accessibility, Responsiveness and Engagement we have with loved ones (as in “ARE you there for me?”). Responsiveness shapes bonds.

These 4 laws tell us what is normal in love– they offer us a map for love and loving. Law 5 tells us about differences in how we see and set up bonding relationships.

5. Secure connection with a responsive loved one promotes healthy development and functioning including a positive coherent sense of self and attunement to others, whereas insecure connection – anxious or preoccupied bonding and dismissing or avoidant bonding constrains us – limits our growth. These labels, secure, anxious and avoidant simply describe a partner’s habitual ways of dealing with emotion and responding in intimate situations. Anxiously attached, fired up nervous systems are tuned to cues of rejection and abandonment, these partners seek ongoing intense connection for reassurance, and they also have a hard time trusting and taking in this reassurance. To avoid the pain of expected rejection, avoidant partners tend to numb out, stifle their longings and reject support from others. They shut down and shut their partners out, especially in situations where closeness is called for or vulnerability comes up.

These five principles crack the code of romantic love – a drama of deep in the bone longings, and existential terrors. This framework helps us understand the huge impact of the quality of our love relationships on our lives, our health, our happiness AND – our sexuality. Let’s now take each of the principles of love relationships – and see what they tell us about sex.

Attachment is THE primary need here –even more potent than sex or aggression. SAFETY & SURVIVAL needs come first. Attachment realities define, shape the other two aspects of a love relationship – caretaking and sex. Caretaking and sex can operate separately from attachment, but much of the time they form an interacting system. But some experts focus down on the power of the sex drive and suggest that romantic love is all about sexual desire – just “frustrated desire” in fact- once satiated, the theory goes, love and desire inevitably slip into low-key companionship mode. Acknowledging the primacy of attachment puts much more focus on the fact that sex is a not just about pleasure or procreation – it is a potent bonding activity. To bond with someone means that they become special – irreplaceable – and you want to be special to them. Attachment suggests that there is nothing at all “unnatural’ about serial monogamy – Our need to rely on others has shaped our brain, our nervous system, our hormones. Oxytocin, the so called cuddle hormone or ‘molecule of monogamy’, triggered in your brain at orgasm and even when you simply think of your lover, sets the stage for optimal sexual experience by soothing the fear centers in your brain, fostering trust and helping you read the signals on another’s face accurately.

When bonding scientists prime men and women for sexual arousal with subliminal cues – these folks also suddenly report feeling more willing to be emotionally close and make sacrifices for the sake of a relationship. They automatically access more bonding oriented responses. Arousal seems to naturally prime attachment unless we are numbing out and working at avoiding emotional connection – keeping our sex compartmentalized and impersonal. Sex naturally promotes bonding and more effective bonding promotes great sex.

Oxytocin also blocks the habituation response so the pleasure of sexual intimacy does not diminish with exposure. Indeed in the best survey research, long term lovers report the most satisfying and thrilling sex (so let’s replace the old trite pronouncements on how time and familiarity inevitably kills passion with a contrasting idea – practice makes perfect especially when you are talking about a dance – requiring team work).

Securely attached partners are more likely to have what in my book Hold Me Tight, I call Synchrony Sex– this requires emotional presence, attunement – open sensitive responsiveness, and the total engagement that only comes with emotional safety. Good sex is an astounding act of physical, emotional and mental co-ordination (a little bit like assembling Ikea furniture together but much more fun). Secure attachment fosters “relaxed and confident engagement’ in sex (What is that song? –‘ I want a lover with a slow hand’). If we put bonding into the equation, we arrive at a rich definition of passion that goes way beyond simple lust. Passion is attachment longing – the longing for emotional connection twined with attunement and erotic exploration and play.

Passion is about so much more than responding to novel stimuli or ramped up lust. Secure connection is a constant process of tuning in, connecting, missing each other, disconnection, repair and falling in love again. In this dance, passion can be constantly renewed, not simply by finding more exotic sexual positions (although who can resist being intrigued by the positions in the new Joy of Sex such as Wailing Monkey Climbing Tree) but by changing the level of our engagement in the moment and with our lover.

If we really understand love, we can also understand how to shape lasting passion.

We are discovering this right at a time when we are surrounded by impersonal sex –to the point where young men are routinely seeking help because, having conditioned their brains every day since the age of 12 to respond to porn sex images, they cannot get an erection with their girlfriends. We are also regularly told that sex in long term relationships is almost always “vanilla” –BLAND. So to be spicy at all – it just has to be ramped up with constant novel stimuli, new lovers, rougher sex, new toys. So let’s look at the difference between impersonal – what I call avoidantly attached sex – and sex that is infused with emotion and attachment.

What is the relevance of the Safe Haven concept for sexuality? Secure bond sex is more likely to be RELAXED and confident. Higher anxiety is linked to lower levels of arousal, intimacy and satisfaction in sex – and lower rates of orgasm in women. Attachment anxiety also takes every less than satisfying sexual experience and amplifies its impact on the relationship as a whole. Danny tells me – “If Lyn doesn’t want sex with me every day then this proves she doesn’t really want me – love me – and I have always felt this way.” He protests his wife’s “distance’ by demanding sex and every time she hesitates, it confirms his catastrophic fears. She wants sex less and less of course. For Danny, sexual frequency totally defines his relationship. A more secure lover can tolerate differences in desire, & communicate more clearly about sexual issues. Those of us who experience moments of safe haven connection also tend to have a more positive and articulated sense of self – and this includes self as a sexual being.

This focus on emotional safety may be a particularly crucial defining element in sex for women. If you expose men and women lying in brain scan machines to explicit or subliminal sexy pictures – everybody’s brain lights up. But only in women does the cortex – the judgement/control center of the brain light up. Women’s brains naturally pair up desire and safety concerns. Makes sense – sexual intercourse is literally much riskier for women. So women most often need to check out the relationship context – to talk as part of foreplay before allowing themselves to descend into conscious, active desire. Women, in particular, may be physically aroused (their body registers a cue as sexually relevant) but may not necessarily translate this into explicit desire – wanting to have sex.

All the new evidence is that women are more sensitive to relational context – safety – and so for them desire often follows arousal (versus the classic model of sexuality where desire comes first). Desire is in response to interactions with their partner. Note – this means that a woman can be totally healthy and normal and never experience spontaneous sexual desire. (this is Chivers research – Rosemary Basson-) This research helps me explain to Danny that the fact that his wife does not come on to him or instantly respond to any sexual signal isn’t a sign that she does not desire him – and that the emotional context he creates is key in moving her into a sexual space. The way he demands sex actually activates her sexual brakes –pushes her out of sexual and into safety/survival mode. He needs to get curious about what context cues activate her sexual accelerator.

Bonding science also says that a loving relationship also offers us a Secure Base to go out from. What this says to me is that great sex is a ‘safe adventure’. Thousands of studies show that safe emotional connection fosters curiosity and confident exploration (Feeney’s study). Think of a zip line – the freedom –exhilaration you feel comes precisely from knowing you are on a line – you are held. Would you be screaming ‘WEEEE’ if you were not sure that the line would hold? )

I love this picture on a 4th century AD Etruscan vase –

 

s&a vase

 

I love the look on this ladies face – she is inviting – curious – present – she is willing to experiment. She is coming from a secure base – and you get no sense that she has worries about her performance or sexual self image. Hundreds of attachment studies, show that safe emotional connection is the opposite of deadening – in or out of bed. Security increases risk-taking and spontaneity. A secure base allows us to play – to learn- to explore each other’s bodies and minds. Thrilling sex is about being secure enough to surrender to the moment – to let go and see what happens.

What are the implications of the attachment concept of Separation Distress – the impact of this sense of emotional disconnection and the pain it triggers for sexuality? We know that rejection registers in the adult brain in the same way and same local as physical pain – it is a danger signal. It primes panic – fight and flight and freeze. These responses put a brake on sexuality. Both an obsession with possible loss and separateness, or fearful numbing out of this ‘danger’ tends to distract a wee bit from erotic play! Loss of desire or lack of engagement in sexuality is most often not about familiarity putting us to sleep but about emotional disengagement and the physical lack of attunement that goes along with it.

All this is interesting but, perhaps the most important law of attachment for sexuality is that- A.R.E.- Accessiblity Responsiveness and Engagement are the defining features of secure bonds and also I would argue – optimal sexuality. Emotional and physical attunement, responsiveness and focused mutual engagement –full presence – epitomizes great sex. We can see these qualities in the sexiest dance of all – Argentine Tango. The open, yet safe embrace helps each person keep their balance – recover from missteps – Partners tune into and mirror one another’s moves – in synchrony – moving from body memory –responding to a thousand cues instantly. It is not the STEPS – the external performance technique that makes the dance. It is about feeling – it is the flow of the partners’ attunement that makes the dance beautiful and mesmerizing – it is the intensity of Engagement between the partners. You don’t believe me?- let me show it to you in just three minutes:

 

 

This all fits with the recent brain scan study from our lab where, after therapy focused on bonding conversations, all a male partner had to do to completely calm the brain of his lady when she in lying in an MRI machine waiting to be shocked on her ankles – is to hold her hand. The couples in this study increased the security of their attachment bond, AND they reported increased sexual satisfaction after therapy and at two year follow-up, even though for many of them, sexuality was not a specific focus in therapy sessions. I tend to think of this result in these terms:

 

knight

 

Attachment science says that your attachment style or habitual connection strategy plays a big part in orchestrating your sex life. Attachment offers us a map that tells us about differences in how we experience sex, what motivates us as sexual beings and how we communicate around sex.

The key ingredient in the better sex experienced by secure lovers seems to be attuned emotional presence. As we connect emotionally, so we connect sexually. When the emotional music has more range and depth, this makes for a more multi-dimensional experience where lovers have sex for erotic pleasure, to feel close, please their partner, express love and find physical release. Secure lovers report more joy and positive emotions during sex. Security fosters splendid Synchrony sex and splendid sex fosters secure bonds – and that is quite a clever little feedback loop.

In Anxious Attachment, a partner turns to sex mostly for proof of love and to gain affection. Chronically anxious folks tend to have Solace Sex where the main goal is comfort and to feel DESIRED, the erotic is a sidebar. They want to please their partner, but their own anxiety consumes most of their attention. Danny tells his wife – “If I can give you an orgasm – then, then, just for a moment, I get to believe you really chose me – want me.” When I ask him if he finds his orgasms fulfilling, he simply looks at me and says, “I want to know she loves me.”

Numbed out, avoidantly attached lovers focus mostly on their own sensation and performance in bed. In the typical chronically distressed relationship – where Demand/Withdraw dances predominate, there is always at least one person who is moving into avoidant attachment. With THIS focus, sex tends to be a lonely, one-dimensional experience, and indeed these partners report less sexual satisfaction. Sex without emotional engagement is like dancing without music. FLAT. This kind of Sealed-off Sex seems to particularly fit with the old punchline “Having a great time. Wish I was here.” Chronically avoidant lovers have more one night stands, report less enjoyment of kissing and cuddling and are more likely to endorse coercive sex (if you are numbed out –you need more extreme sensations to get turned on). The image of avoidant casual sex here is that it is very much the booby prize – not, as it is sometimes cast – a mature acceptance of idea that novelty is the essential ingredient of passion and desire.

A secure couple can have all three kinds of sex, Synchrony Sex, Solace Sex which is focused on reassurance, and Sealed off Sex focused on sensation only, at different times, but it seems that the ability to have Synchrony sex – at least some of the time – to integrate sexuality and bonding makes a huge difference in a couple relationship.

Sex is a dance – anxious and avoidant music limits the dance – Insecure attachment constrains sexuality.

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What does all this mean for intervention? –there have been more and more calls for a movement away from medical mechanistic interventions for sexual issues towards the integration of sex and couple therapy. If we really want to be effective couple and sex therapists, indeed it seems to me that this separation MUST end. Sex – unless it is simply recreational – happens in the context of a relationship and that context is Everything. The essence of the EFT approach to treatment in a nutshell is to put sexual blocks and problems –negative sexual cycles of interaction – into the context of relationship patterns of connection and disconnection.

In my book Hold Me Tight, I write about Frank and Sylvie – and how they deal brilliantly with his erectile problems. They deal with them together. At first Frank’s shame and fear of failure in bed was very much part of his withdrawal in the relationship in general. Loss of erection cued Frank’s shame and fear – his hiding – this upset Sylvie and made her hurt and angry. Her anger and Frank’s defensiveness cued further loss of erection – Sylvia felt unloved, and on and on. In bed the tense and careful music blocked out arousal and engagement. In Stage 1 of EFT, this couple’s sexual dance – their repetitive negative cycle in the bedroom was integrated into therapist’s outline of their general pattern of disconnection – which they called Thin Ice – hard to dance on Thin Ice- one wrong step! The dance of attachment protest by Sylvie and stonewalling by Frank was framed as the Enemy that left them both afraid and alone. The therapist also included some sexual education elements normalizing the softening and hardening of the penis in a love making session and expanding sexuality to include much more than penetration. These partners began to become less triggered and help each other out of this Demon Dialogue and to become more open in terms of sharing emotions, affectionate touch and sexual interactions.

As Frank and Sylvie began to create an emotional and sexual secure base together, they moved into Stage 2 of EFT – restructuring their bond. They were able to own their softer emotions and move into a more positive dance. A focus on sexuality here resulted in Frank being able to express his fear of rejection in bed and tell Sylvie what he needed from her. Sharing fears, and the need for reassurance that they were indeed desirable and desired, even at times when sex did not “work”, made their relationship a safe haven where they could explore – play and learn –in bed and out of bed.

They could then deal with the issue of Charlie (Franks name for his penis) “taking a nap” as an attuned team. Problems and differences were now simply that – something to be solved together – not panic buttons – thin ice. This couple describe a scenario that would have triggered catastrophic disconnection before therapy, where they started a lovemaking “date’ with Sylvie making a joke about Frank’s weight and Frank withdrawing. But then she was able to as Frank said, “hug me back into feeling okay”. A series of interruptions then set them up for failure – their adolescent daughter came home early and knocked on their bedroom door – the candle they lit fell over – the curtain caught on fire – etc etc – Needless to say, Charlie became discouraged and retreated a number of times. So they went downstairs – drank coco and then were able to change the music – dash upstairs and do their version of Wailing Monkey Clasping Tree!!

In general, as an EFT therapist, I work with sexuality and sexual issues in the same manner as I work with any other issue. Interventions in each session follow the same sequence. First I focus down on moments of stuckness – disconnection – in bed and out of it. Then I reflect the negative pattern of a couples’ dance and the insecurity and lack of eroticism it shapes –the pattern is framed as the problem. 2. I explore and deepen emotional awareness – Help Danny talk about his terror that he is not “good enough” for his partner, rather than how cold Lyn is. 3. Guide sharing between the couple – turning newly discovered emotions into new music –signals to shape a new dance with the partner. Only when the therapist invites Danny to share his vulnerability can he begin to ‘move’ her and ‘touch’ his lady– and to invite her onto a pathway of safe connection and eroticism with him. 4. Reflect the new connection that has just happened in the room – I ask Lyn what it is like to hear Danny risk sharing the vulnerability that is behind all his pressuring for sex and attention. She reaches for him and in a soft voice offers to hold him – her body is open and soft when she does this – in contrast to her usual closed stance. 5. To create closure, I then consolidate the shift that they have made– showing them how in charge they can be – how they can change their bond and their sexual dance – they just did it. Lyn agrees, she says to Danny – “This is better. I can see YOU, not just this guy pressuring me for sex. When I can see You then wanting to make love comes easy. I can let my wall down.”

James Taylor reminds us “Thin thin the moment is thin – ever so narrow the now”. If we know where to focus, we can lean into critical moments of disconnection and guide clients into a new physical, sensuous and emotion bonding connection. Then eroticism can flower. It is fascinating to watch this kind of couple –how their bodies change in this process- just like birds in ritual mating dances, they begin to open their bodies to each other – mirror each other’s moves – create physical synchrony- and this is a part of successful bonding and mating. It is not enough to just make partners a little less conflictual and hope the sex gets better – and it’s not enough to teach sexual techniques and ignore the context in which they happen. We must recast a couples bond – and use this safety to ignite exploration and erotic connection and reawaken passion.

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The actor, Peter Ustinov said –“Sex is a conversation carried out by other means”. We are learning how to shape loving conversations, conversations that lead to physical synchrony and erotic play that can last a lifetime. We are learning how to put sex and attachment together. We certainly don’t have to choose between secure bonding and passion – one is a constantly opening doorway into the other. We can take more and more people into this:

 

end

 

And who will show couples how to, with delicious deliberation, make and keep love – in bed and out of it? All this science won’t make a difference unless YOU take this science – the growing science of sex and bonding out into the world – You are the beacons – the ones people bring their needs and fears to. We can give people hope in a world that is giving up on relationships – a version of the erotic that is stunningly personal rather than impersonal –   How can you possibly turn that down ? Come – light this fire with me. We can bring science and sex, safe connection – love and lust, the erotic and the emotional together. Let’s just do it.