Pressure or Pleasure?

Reprinted from PN/Paraplegia News May 2014

Although sexual activity for many people is fun and satisfying, that isn’t always the case. For some people, sexual activity after spinal-cord injury (SCI) can feel pressured, stressful and demanding.

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In these cases, sex has lost its playfulness and sense of enjoyment. It has become an obligation or a job to be accomplished.

When sexual activity takes on such negative emotions, it’s often because performance has become overly important at the expense of enjoying the intimacy and sexual pleasure.

Instead of sharing one’s self with a partner, the focus has shifted to achieving a satisfying erection or in ensuring that one’s partner reaches orgasm.

Expectations need to change away from a traditional individual performance model to a realistic shared experience model.

A better approach to sex after injury might be to try new ways of being sexual and find new ways of receiving and giving pleasure.

Shared Experience Model

Unfortunately, before SCI, many people have had little experience with a model of sex that focuses on promoting pleasure and intimacy rather than focusing on erections and functioning. This is the “shared experience model.”

As we age, develop disabilities and change relationships, our sexual interest, expectations and arousal evolve, as well. What was once arousing in our sexual life may no longer be possible.

For example, as an older adult, the challenge is to promote sexual desire, satisfaction and eroticism in the face of declining health and function. The same is true for SCI. In the face of SCI, the challenge is to find methods of arousal, pleasure and intimacy in spite of the injury.

At any given time, either member of a couple with SCI may experience some form of sexual dysfunction. These could range from erection problems, low desire or even pain during sexual contact. While the awareness of these problems has increased in recent years, these difficulties are rarely simple performance problems with a simple cure.

Unfortunately, there isn’t a pill or quick fix for most sexual difficulties.

Emotional Distress

When an individual experiences a sexual dysfunction there’s often emotional distress or frustration, as well.

If the couple can’t communicate about the problem, it can quickly grow into an even bigger issue. Sex then becomes something that is avoided or a source of conflict.

The timing of sexual activity is another important consideration. One of the biggest recipes for disaster is having sex when one is not in the mood.

Trying to perform under such conditions inevitably leads to a negative experience and disappointment. Sexual arousal can’t be forced and needs to evolve naturally.

For all of us, the quality of sex varies from day to day. Some days, sex may be very good. Other days, it may be mediocre or even poor. That’s just the way it is for all of us.

What’s important, however, is that we not view sex as a pass/fail experience. For two consenting adults, there should never be a time when sexual activity is seen as a failure. Sex isn’t a win-lose situation.

Explore & Discover

After SCI, relaxation, sensual touch and emotional pleasure are probably more important than sexual performance.

In the months after injury, the goal is to explore and discover a satisfying experience that promotes sexual enjoyment in spite of age, disability, gender or other barriers.

Here are a few tips:

-Be creative and try something new and playful. Bring a sex toy, a new position, food or something unique into the bedroom.

-Be honest about your level of arousal. If you’re not in the mood, tell your partner and wait until the time is better for the both of you. Don’t force sex at times that you may be feeling stressed, upset or tired.

-Try being intimate in a way that ignores erections, lubrication and orgasm. Enjoy touching, holding, massage and oral stimulation.

-If you typically use Viagra, Cialis or penile injections, try enjoying sex without them. Make a decision that sometimes sexual activity doesn’t always have to depend on your physical performance and the quality of an erection.

-As much as possible, let go of your pre-injury sexual behaviors and experiences. Instead, look at your disability in an honest way and focus on what you can do to give and receive pleasure.

-Try enhancing the emotional connection by keeping your eyes open during sex. Make an effort to look at each other in the eye and describing what you’re doing or feeling.

-Clear your mind. Being intimate isn’t the time to be thinking. Get rid of cognitive thoughts and let your mind indulge in sexual fantasy, pleasurable sensations and feelings of closeness.

A Different Focus

The key to a positive sexual experience after SCI is to move beyond the attention to physical functioning.

All too often, we become obsessed with our own sexual performance at the sake of mutual pleasure. Make sexual activity fun and enjoyable by ignoring the quality of erections and focusing on the pleasures you can receive and give to your partner.


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