You’re stressed so you clench. When you clench, it cramps. It’s a cycle that starts in the mind and finds its way down into the body. And I’m not talking about your jaw, I’m talking about your genitals.
Anxiety presents itself in many ways, but one of its more clandestine manifestations takes place below the belt. For men, that can lead to erectile dysfunction, an ailment we’re all familiar with thanks to late-night ads. Far fewer of us can list the effects anxiety has on the female sexual response cycle.
After researching 5,865 adolescents and adults ages 14 to 94, researchers at the National Survey of Sexual Health and Behavior (NSSHB) found that upwards of 30 percent of women report pain during vaginal intercourse. The most common approach to the problem was to “do nothing.”
As Andrew Heartman, a certified sex surrogate based in California, has reminded us,“[Women] can engage in sexual activity, but not really be present, and not really enjoy it… they can perform sufficiently to have their partner be satisfied.”
Sometimes, it’s worse than just a lack of enjoyment.
“I would say one of the main reasons women come in to see a sex therapist is because they have painful sex,” says Houston-based sex therapist Mary Jo Rapini. “When you talk to them further, you start understanding it’s their anxiety.”
She explained that some women are so hard hit with anxiety during sex that their vaginal muscles tighten up to the point that penetration becomes impossible. “When they do try to have intercourse, they can’t,” she says.
Rapini treated one woman who had gone 12 years without having sex because it was too painful. Even on her wedding night, she was unable to consummate the marriage. In other extreme cases she’s seen women unable to undergo a procedure as simple as a pap smear. “They can’t get the speculum in,” she says. “It’s so tight.”
Unfortunately, stigmas surrounding sex, specifically sexual dysfunction, run deep, and most people shy away from addressing the issues head on. “There’s an element of shame, with anxiety and depression. We’re used to seeing it as a weakness or proof there’s something wrong with you,” says Rapini.
As opposed to the platter of pills available to help enhance male sexual performance, the FDA has approved just one pill to treat sexual dysfunction in women. It’s called flibanerin, and it was originally marketed as an antidepressant.
But just because it’s an uncomfortable topic to bring up doesn’t mean it’s uncommon. As Rapini explains, “Anxiety is growing in the population and it’s incredible… Our brains have trouble just throwing stuff out.” According to Rapini, it’s not uncommon for this kind of anxiety-induced vaginal tightening to occur in women the week before their periods. Many women are also affected during the pre-menopausal period. “Your hormones are all over the place,” she says.
But not all instances fit neatly into a timetable. Rapini explains that women can be especially sensitive to situational factors relating to sex. Women who aren’t comfortable with their partners, women in bad relationships, even women turned off by something said during sex can find themselves closing up at a moment’s notice. “As a sex therapist, my job is more finding tools for them to help them relax,” says Rapini.
Within clinical circles, the condition is known as vaginismus, which the American Congress of Obstetricians and Gynecologists defines as a “reflex contraction (tightening) of the muscles at the opening of the vagina.” Because the condition has been linked to stress and anxiety, therapy is recommended. Often, vaginal dilators are also employed. As WebMD notes, “The approach is called progressive desensitization, and the idea is to get comfortable with insertion.” For women who experience more mild symptoms, other approaches may apply such as antidepressants, warm baths, breathing exercises, and heating pads.
Of course, when it comes to arousal issues with women, you’ve also got to give a nod to lubrication. Vaginal dryness is a big issue, and according to Rapini, it often works alongside anxiety to sabotage women’s pleasure. “For an orgasm to happen, first of all, the woman has to create the scene or the excitement in her mind. You can’t do that if your mind is focused or taken over by anxiety… and especially if you’re not using lubricant,” she says.
Experiencing pain during sex may not be the easiest thing to admit to, but Rapini says it’s not as unusual as one would think. “First of all, this is not abnormal. It affects a large part of the population.” Reports hold that women are twice as likely to experience anxiety as men. But the first step to securing sexual satisfaction in women takes place in the mind. “There’s a rhythm to recovery,” says Rapini. “That rhythm starts by slowing down.”
I get a dozen or so messages a month on this topic. I’ve written about it in numerous postings and spoken about it in several podcasts, but still the email comes.
One of the real bugaboos for anyone, regardless of gender, is living up to our own expectations of sexual performance. So many things can get in the way, literally and figuratively, of fully enjoying ourselves and/or pleasuring our partners.
The arousal stage of our sexual response cycle is particularly vulnerable to a disruption. And when there’s trouble there, there’s no hiding it. A limp dick or a dry pussy can put the kibosh on all festivities that we may have hoped would follow.
However, performance anxiety can strike any of us, regardless of age, and at just about any point in our sexual response cycle. This is a particularly galling when it seems to come out of the blue. And regaining our composure can be more far more difficult than we imagine.
Today we will be focusing on male performance anxiety. I’ll address female performance anxiety at a later date.
Here’s Bob, he’s 26:
Doc, this has never happened before. But I couldn’t get it up tonight, and this chick was H.O.T. Now I’m not gay at all, but I haven’t had sex in about 3 years because I was locked up…so I masturbated pretty regularly, about 3 or 4 times a week. But I can’t figure out why I was soft… the only thing I can think of is I ate clams tonight and I’ve never had them before. Could it be that or should I get checked out?
It weren’t the clams, darlin’! And I don’t think you need to get “checked out” either…at least not right away. If you could back away from the situation a bit and stop freaking out, I think you’d discover the source of your problem all on your own.
Here’s the thing—while you were out of commission there in the slammer, you relied, as you say, on jerking off. Okay, cool. We all do what we gotta do. Now the first time you try to score after your release…you go soft. This tells me you have a mild case of performance anxiety. We all get that from time to time.
There’s probably nothing wrong with you or your johnson. You just got the jitters first time you tried to get you some after being away, that’s all.
The anticipation of boning this H.O.T. chick—fueled by some predictable self-consciousness; what with just getting out of the big house and all—pulled the plug on your wood. No surprise there, right?
What I don’t want to see happen is for you to replay the incident over and over in your mind’s eye til that’s all you can think about. If you do, this proverbial molehill will become a mountain. You’ll then bring all this anxiety to your next encounter, setting yourself up for even more disappointment. You can see how this shit can snowball? If you interpret every less than satisfying encounter as a failure, your fears will become self-fulfilling. You’ll begin to avoid partnered sex and you’ll develop a full-blown sexual dysfunction. And your self-esteem will take a nosedive, too.
If you’re preoccupied with your performance, it’s less likely that you’ll be fully present during sex with a partner. This pretty much fucks up your sexual responsiveness and any hope for spontaneity. Why not just relax into the whole sex thing and not try to prove your manhood with your pecker?
Then there’s Steve with a slightly different take on this meddlesome problem:
My partner and I have been together for just over 3 years now in a monogamous relationship. I am the top and he the bottom. Our problem is not premature ejaculation on his part, but his inability to have an orgasm at all. No matter what I try and even if he masturbates, sometimes it is impossible to get him to cum. Is this a medical issue? Have you ever heard of this?
Delayed ejaculation is the difficulty one has ejaculating even with a firm erection and sufficient sexual arousal and stimulation. This problem is not uncommon. For most men, delayed ejaculation occurs during partnered sex more frequently than while masturbating. In fact, 85% of men with delayed ejaculation can usually cum by jacking off. However, in partnered sex, the guy may be unable to ejaculate at all, or only after prolonged partnered stimulation. This problem can be very frustrating and cause distress for both partners involved, as you already know.
What causes delayed ejaculation? Well, it could be a number of things. It could be something as simple as performance anxiety, or inadequate stimulation, or there could be neurological damage.
I don’t want to be too reductionist here, but most of us experts believe that the majority of instances of delayed ejaculation aren’t physical in nature, but rather are the product of psychological concerns. Simply put, there’s a difference between the psychosexual response we have when we are alone and the one we experience with a partner. There’s probably nothing wrong with your partner’s unit. It’s all in his head…or his mind, to be more exact. If I had to guess, I’d say he’s got a real bad case of performance anxiety.
When I see this sort of thing in my private practice, I always begin the therapeutic intervention by calling a moratorium on fucking of any kind. This immediately takes the pressure off the couple. From there we begin to rebuild the partnered psychosexual response one step at a time. We begin with sensate focus training (Sensate Focus is a series of specific exercises for couples that encourage each partner to take turns paying increased attention to their own sensations. More about these helpful exercises in the weeks to come.), stress reduction and relaxation exercises. These applications are designed to reduce performance pressure and instead focus on pleasure. The idea is to get them to stay in the moment; absorb the pleasure present without worrying about what is “supposed” to happen.
Finally we address as frankly and openly as possible any fears or anxieties that they may have—as individuals or as a couple. I have the greatest confidence in this method; it succeeds over 90% of the time.
Ok, let’s recap shall we?
Overcoming sexual performance anxiety is dependent on five simple things.
First, a guy needs to be attuned to his sexual response cycle — arousal, plateau, orgasmic and resolution phases. He should know what kind of stimulation he needs at each phase to fully enjoy himself and satisfy his partner.
Second, the more worried a guy is about a performance issue, the more likely that problem will present itself. A bad experience in the past can often set the stage for its recurrence.
Third, don’t be afraid to talk this over with your partner. Withdrawing from your partner or shying away from sex altogether will only increase the likelihood that the problem will persist.
Forth, be proactive! Fearing the loss of your sexual prowess or feeling sorry for yourself is counterproductive. Confront the challenge head on. Employ sensate focus training stress reduction techniques and relaxation exercises to help you push past this temporarily impasse and regain your self-confidence.
Fifth, free yourself from the mindset that your dick is the center of the universe. Your manhood or your capacity to be a great lover does not reside in your genitals. Expand your sexual repertoire. Remember, pleasure centers abound in your body as well as your partner’s.
In the prologue to her new book, What Love Is and What It Could Be, philosopher Carrie Jenkins is walking through Vancouver, from her boyfriend’s apartment to the home she has with her husband. She wonders at how the romantic love she experiences firsthand is so different than the model presented by popular culture and academic theory alike. “If indeed romantic love must be monogamous, then I am making some kind of mistake when I say, ‘I’m in love with you’ — meaning romantically — to both my partners,” she writes. “I am not lying, because I am genuinely trying to be as honest as I can. But if romantic love requires monogamy, then despite my best intentions, what I’m saying at those moments is not, strictly speaking, true.”
Her book examines the long, sometimes awkward legacy of philosophers’ thinking on romantic love, and compares that with a new subfield in close-relationships research — consensual nonmonogamy, or CNM. While singers and thinkers alike have been riffing on a “one and only” for decades, she argues that space is being made in the cultural conversation to “question the universal norm of monogamous love, just as we previously created space to question the universal norm of hetero love.” These norms are more fluid than they appear: In Jenkins’s lifetime alone same-sex and cross-ethnicity relationships have become common.
When I asked Jenkins to describe how it feels to have both a husband and a boyfriend — she rejects the “primary relationship” moniker altogether — she said that it’s like having more loving relationships in your life, like a close family member or friend. She and her boyfriend, whom she’s been with for about five years, used to work in the same building; he was teaching creative writing on the floor above her philosophy department, though they didn’t meet until they matched on OkCupid. While both men have met each other, they’re not close; Jenkins describes the relationship as having a “V shape,” rather than a triangle. Both helped in the development of the book: husband refining philosophical arguments; boyfriend editing the writing, and helping her to sound like a normal person, rather than an academic.
Still, CNM faces lots of stigma; even the study of it is stigmatized. Yet in the limited yet rich vein of research out there, the evidence suggests that it’s a style that, in some populations, leads to greater relationship satisfaction than monogamy. In any case, the researchers tell me, the insights into what makes more-than-two relationships work can be applied to any given dyad, given the communicative finesse required when three or more hearts are involved.
In a forthcoming Perspectives in Psychological Science paper, Terri Conley, a University of Michigan psychologist who’s driven the field, defines CNM as “a relational arrangement in which partners agree that it is acceptable to have more than one sexual and/or romantic relationship at the same time.” That’s distinguished from the “polygamy” practiced by some religious groups, where it’s not always clear whether wives can opt out of the relationship.
I was surprised to discover how common it is: A 2016 study of two nationally representative samples of single Americans — of 3,905 and 4,813 respondents, respectively — found in each case that about one in five people had practiced it during their lifetime. A 2016 YouGov poll found that 31 percent of women and 38 percent of men thought their ideal relationship would be CNM in some way. Other research indicates that around 4 to 5 percent of Americans in relationships are in some sort of CNM, be it swinging, where partners have sex with people outside their relationship at parties and the like; an open relationship, where it’s cool to have sex with other people but not grow emotionally attached to them; or polyamory, where both partners approve of having close emotional, romantic, and sexual relationships outside of the couple itself. People are curious, too: From 2006 to 2015, Google searches for polyamory and open relationships went up. Other data points to how sticking to the boundaries of monogamy doesn’t come easily to lots of people: A 2007 survey of 70,000 Americans found that one in five had cheated on their current partner.
Jenkins says that as a tenured philosophy professor at the University of British Columbia, she’s in a unique, privileged position to openly talk about being in a nonmonogamous marriage. She’d been interested in being in more than one relationship ever since she can remember, but it used to seem like some sort of impossible dream situation — she didn’t realize it could be an option in her real life until she was about 30. (She’s now 37.)
Jenkins met her husband, Jonathan, who’s also a philosopher, back in 2009, at a philosophy workshop that he organized at the University of St. Andrews in Scotland; they later got married in the same hall the conference took place. They took one another’s last names as middle names.
Now married for almost eight years, they talked about polyamory early on, though defining the relationship that way came later. As philosophers are wont to do, they soon wrote a bit of a manifesto about their arrangement. They observed that even if their wedding guests were woke in any number of ways — not batting an eyelid if a colleague was gay or bi, eschewing heteronormative assumptions, and the like — there’s still the shared assumption that a nonmonogamous relationship is less sexually safe and less committed than a regular ol’ monogamous one. “Even our very liberal pocket of our relatively liberal society is massively — and, to us, surprisingly— mononormative,” they write. “Acquaintances, friends, and colleagues are constantly assuming that our relationship, and indeed every relationship that they think of as ‘serious’, is a sexually monogamous one.”
To Jenkins, the biggest struggle with polyamory isn’t from managing multiple relationships — though Google Calendar is a crucial tool — but rather the strong, sometimes violently negative reactions that she gets, especially online. When I spoke with her by phone, she was struck by a comment to a YouTube interview of hers, where a pseudonymous user invited “everyone” to read her column in the Chronicle of Higher Education about having multiple loves.
“THIS WOMAN IS A DISGUSTING ANIMAL,” the troll wrote. “Every bit as twisted and queer as the Mormons with their multiple lives [sic]. This femme-pig is the spectral opposite of Trump; a far far left-wing freak that desires to completely overthrow Western Christian Civilization.” Jenkins walked me through a deep reading of the bile: Bundling in politics — the “left-wing freak” bit — with the monogamy norms signals to her that there’s a judgment of what it means to be a good person in here, since politics is about living correctly, collectively. Plus “if you’re an animal, you’re out of the range of humanity,” she says. She’s also gets a lot of “get herpes and die, slut” suggestions, she says, which speaks to the hypersexualization of CNM. Nonmonogamy leads to lots of sex, the presumption goes, and with that STIs, and it proceeds from there. The way news articles covering CNM tend to be illustrated with images of three or four people in a bath or bed doesn’t help, either.
“The way we normally think about romantic love, we don’t imagine that it’s entirely about sex,” she says. “For a lot of people sex is a part of it; if we’re just having a hookup or a friend with benefits, we don’t call that romantic love. When it comes to polyamorous relationships, if you’re in love with more than one person, the same applies — to fall in love with someone is not the same as to sleep with them. We’re clear with that distinction in monogamous relationships, but in CNM that distinction between love and sex gets collapsed.”
Researchers who have studied stigma around CNM have found lots. In a 2012 paper, Conley and her colleagues found that monogamous relationships were better rated on every metric by different sets of the population, including nonmonogamous people. When 132 participants recruited online read relationship vignettes that were identical except for one being monogamous and the other not, the CNM was seen as riskier sexually, more lonely, less acceptable, and having a lower relationship quality. People in CNM were also seen as worse with non-relational things, like making sure to walk their dog or paying their taxes on time. Amy Moors, a co-author on the paper, says it had some of the biggest effect sizes she’s seen in her research. Elisabeth Sheff, a leading polyamory researcher who left academia for lack of grant funding, now frequently serves as an expert witness in custody battles; she says that often a grandmother or a former spouse will find out that a co-parent has multiple relationships, be scandalized, and demand to take the kids — even though her longitudinal research, reported in The Polyamorists Next Door: Inside Multiple-Partner Relationships and Families, indicates that kids who grow up in polyamorous families aren’t any more screwed up than average American children.
That same paper finds that there were no differences in relationship functioning between monogamous and nonmonogamous couples. People in CNM had lower jealousy and higher trust — yet also lower sexual satisfaction with their partner. Polyamorists were more satisfied than people in open relationships, perhaps because it’s hard to block of feelings for people you sleep with frequently. Polyamorous people were a special case, with higher satisfaction, commitment, trust, and passionate love than monogamous individuals, though they had lower sexual satisfaction. CNM people also had higher sexual satisfaction with their secondary partners than their primary partners, though that difference fell away when controlling for relationship time, with primary relationships averaging three times the length of secondary relationships.
“Overall, the standard for human responses for relationships is habituation,” Conley says. “That involves a loss of sexual attraction, and we can tell that from stats from therapy. And to the extent that a couple is frustrated sexually, it spills over to other parts of life.”
There are other explanations for high satisfaction scores for polyamorous people, she adds. It could be that they’re just acting out a social desirability bias, given that they’re participating in a study about CNM and want the lifestyle to look good; it could also be that people who enter into polyamory have self-selected themselves into a hypercommunicative population — all the poly self-helpbooks emphasize the importance the need to explicitly talk things out. “People interested in polyamory are more relationship-y than the average person,” she says. “They like thinking about relationships, talking about relationships. That’s great in monogamy, but needed in polyamory.”
All this suggests the kind of people that are the right fit for CNM. Beyond being relationship-y, a Portuguese study out this year found that people with a high sociosexuality, or disposal to casual sex, had less relationship satisfaction when in a monogamous relationship, but those effects disappeared if they were in CNM. Still, they were just as committed to their relationships — signaling that exclusivity and commitment may not be one and the same. Harvard sexologist Justin Lehmiller has found that people who are more erotophilic — i.e., that love sex — will be a better fit for CNM; same with if they’re sensation-seeking.
Amy Moors, the Purdue psychologist, has found that people with higher avoidant attachment — where you’re just not that into intimacy — have positive feelings about and a willingness to engage in polyamory, but they were less likely to actually partake of it. While a correlational study, Moors explained that from a subjective perspective, it makes sense: “When you have avoidant attachment, you like a lot of emotional distance, physical distance, time by yourself,” Moors says, which is not a fit for the relationship-y remands of a poly lifestyle. Also, there’s reason to believe that folks who have relational anxiety, and are thus sensitive to separation, might be prone to the jealousy that’s known to flare up in CNM, though it’s not like that doesn’t happen in monogamy, too.
What motivated Jenkins to write What Love Is, she says, was a gap — or silence — in the philosophical literature, that polyamory was rarely discussed or even acknowledged as a possibility. “Noticing these philosophical silences and denials, while simultaneously being made aware of how society at large viewed me for being a polyamorous woman, made me realize there was something important here that I needed to do,” she says. “To do it meant bringing my personal life and my philosophical work into a conversation with one another. The familiar slogan says that the personal is political, but the personal is philosophical, too.”
Two key themes emerge from reading the book: that love is dual-layered, with social scripts overlaying evolutionary, physiological impulses. And that the “romantic mystique,” like the feminine one before it, assumes that love is mysterious and elusive and corrupted from examination — a sentiment that protects the status quo. But with investigation, and conversation, the mechanics of love reveal themselves, and norms can change socially, and be tailored locally. Like Jenkins, you can custom-fit your relationships to your life — if you dare to talk about them.
Why is care for sexual health issues considered a luxury when it’s a necessary part of population health?
By Zachary Hafner
When Americans seek care for most common health conditions, there is rarely much question about coverage. Every day, consumers—including those on Medicaid and Medicare—seek care for sore joints, depression, and even acne without worrying about whether or not their insurance will cover their doctor visits and medications. For the most part, coverage for sexual health issues is less straightforward—but why? Is it because sexual health issues are not considered legitimate illnesses? Because the costs are significant? Or is it because raising the topic of sexual health can offend certain personal and organizational values? Whatever the reason, it is time for a change.
It’s hard to deny the human and economic burden of sexually transmitted infections (STIs) on this country. The CDC estimates that 110 million Americans are infected with an STI, resulting in direct medical costs of $16 billion annually. The most common and fastest growing STI in this country is human papillomavirus (HPV), and it is estimated that half of sexually active men and women will get HPV at some point in their lives. In 2006, a vaccine for HPV was introduced and now there are several. CDC guidelines recommend administering a multi-dose series, costing about $250–450, to all boys and girls at age 11 or 12. (Some states require the vaccine for school admission.) It was included in mandatory coverage under the ACA. Since the HPV vaccine was first recommended in 2006 there has been a 64% reduction in vaccine-type HPV infections among teen girls in the United States.
It seems clear that this kind of care for sexual health is necessary for public health and is also part of caring for the whole individual, a central tenet of population health. But what about sexual health care that doesn’t involve infectious disease? Is it still a population health issue if there’s no communicable disease involved?
Let’s take erectile dysfunction (ED) for example. It is nearly as common in men over 40 as HPV is in the general population—more than half of men over 40 experience some level of ED, and more than 23 million American men have been prescribed Viagra. With a significant portion of the population suffering from ED, is it important for payers and providers to consider ED treatment to be essential health care and to cover it accordingly? Medications like Viagra and Cialis are an expensive burden at upwards of $50 per pill. Medicare D does not cover any drugs for ED, but some private insurers do when the medications are deemed medically necessary by a doctor. A handful of states require them to do so, but they are typically listed as Tier 3 medications—nonessential and with the highest co-pays.
Almost 7 million American women have used infertility services. Coverage for infertility diagnosis and treatment is not mandated by the ACA, though 15 states require commercial payers to provide various levels of coverage. The cost of infertility treatments is highly variable depending on the methods used but in vitro fertilization treatments, as one measure, average upward of $12,000 per attempt.
Are treatments for ED and infertility elective or necessary? In an age of consumerism and heightened attention to the whole patient across a broader continuum of care, organizations that support the availability of a broad set of sexual health services to a diverse group of consumers will have a big competitive advantage, but they may face challenges balancing the costs. Health care has advanced in both technical and philosophical ways that allow people to manage their diseases, cure their problems, and overcome limitations. It has also shone light on the significant advantages to considering a diagnosis in the context of the whole individual—their social and emotional health as well as coexisting conditions. Studies have shown, for example, that infertility, ED, and STIs all have a significant relationship with depression and anxiety.
It’s time sexual health was folded in to the broader definition of wellness instead of marginalized as a separate issue. For too many Americans, it’s too big an issue not to address.
Not too long ago, I took my first step into the world of kink. I was a baby gay coming to terms with my borderline personality disorder (BDP) diagnosis, looking for any and every label that could help alleviate the lack of self-identity that comprises my BPD.
I knew I was queer. I knew I identified as femme. But I didn’t know if I was a dominant (top), a submissive (bottom), or a pillow princess; I didn’t even know if I was kinky.
So I tried to find out.
I began to notice a pattern. The sheer rush of euphoria and affection created a high I felt each time I “topped” my partner, and it would sharply drop the minute I got home. I was drained of energy and in a foul mood for days, often skipping work or class. I felt stuck on something because I wanted to feel that intensely blissful sex all over again, but I couldn’t figure out how to get it back.
If you’re familiar with the after-effects of taking MDMA—the crash, the lack of endorphins, the dip in mood for up to a week later—then you’ve got a pretty good idea of how a “drop” felt for me. Just add in an unhealthy serving of guilt and self-doubt, a pinch of worthlessness and a dash of contempt for both myself and my partner, and voila! Top drop: the less talked about counterpart to sub drop where the dominant feels a sense of hopelessness following BDSM—bondage and discipline, domination and submission, sadism and masochism—if after care is neglected.
In the BDSM community, it’s common to talk about the submissive (sub) experience: To communicate the expectations and needs of the submissive partner before engaging in consensual kinky play, to make sure the safety of the sub during intense physical and/or psychological activities is tantamount, to tend and care for the sub after the scene ends and they’re brought back down to earth.
Outside of this, the rush of sadness and anxiety that hits after sex is known as post-coital tristesse, or post-coital dysphoria (PCD). It is potentially linked to the fact that during sex, the amygdala—a part of the brain that processes fearful thoughts—decreases in activity. Researchers have theorized that the rebound of the amygdala after sex is what triggers fear and depression.
A 2015 study published in the Journal of Sexual Medicine found that 46 per cent of the 230 female participants reported experiencing PCD at least once after sex.
Aftercare is crucial and varies for subs, depending on their needs. Some subs appreciate being held or cuddled gently after a scene. Others need to hydrate, need their own space away from their partner or a detailed analysis of everything that happened for future knowledge. But no matter what the specific aftercare is, the goal is still the same: for a top to accommodate a sub and guide them out of “subspace”—a state of mind experienced by a submissive in a BDSM scenario—as directly as they were guided in.
I asked one of my exes, who’s identified as a straight-edge sub for several years, what subspace is like. As someone who doesn’t drink or do drugs, I was curious about what it was like for them to reach that same ephemeral zone of pleasure.
“It gets me to forget pain or worries, it gets me to focus only on what I’m feeling right then,” they told me. “It’s better than drugs.”
My ex gave up all substances in favour of getting fucked by kink, instead. I’m a little impressed by how powerful the bottom high must be for them.
“The high for bottoms is from letting go of all control,” they added. If we’re following that logic, then the top high is all about taking control.
We ended the call on a mildly uncomfortable note, both trying not to remember the dynamics of control that ended our relationship.Those dynamics were created, in part, by my BPD, and, as I would later discover, top drop.
In the days to follow, I avoided thinking about what being a top had felt like for me and scheduled a lunch date with another friend to hear his perspective.
“Being a dom gives you the freedom to act on repressed desires,” he told me over a plate of chili cheese fries. This is what his ex said to cajole him into being a top—the implied “whatever you want” dangled in front of a young gay man still figuring himself out.
He was new to kink, new to identifying and acting on his desires, and most of all, new to the expectations that were placed on him by his partner. He was expected to be a tough, macho top to his ex’s tender, needy bottom. His after-care, however, didn’t fit into that fantasy. If that had been different, maybe he wouldn’t have spiraled into a place where his mental health was deteriorating, along with his relationship.
The doubt and guilt that he would often feel for days after a kinky session mirrored my own. We both struggled with the idea that the things our partners wanted us to do to them—the things that we enjoyed doing to them—were fucked up. It was hard to reconcile the good people that we thought we were, the ones who follow societal expectations and have a moral compass and know right from wrong, with the people who are capable of hurting other people, and enjoying it.
For my friend, there was always a creeping fear at the back of his mind that the violence or cruelty he was letting loose during sex could rear up in his normal life, outside of a scene.
For me, there was a deep instinct to disengage, to distance myself emotionally from my partner, because I thought that if I didn’t care about them as much, then maybe I wouldn’t hate them for egging me on to do things I was scared of.
My friend has since recognized how unhealthy his relationship with his ex was. These days, he identifies as a switch (someone who alternates between dominant and submissive roles). The deep-seated sense of feeling silenced that was so prevalent in his first kinky relationship, is nowhere to be seen. He communicates his sexual needs and desires and any accompanying emotional fragility with his current partner. He’s happy.
I’m a little envious of him. My second-favourite hobby is rambling about all of the things I’m feeling, and it’s a close second to my favourite, which is crying. I credit my Cancer sun sign for my ability to embrace my insecurities, but there’s still something that makes me feel like I’m not equipped to deal with top drop.
There’s an interesting contrast between how a top is expected to behave—strong, tough, in control—and the realities of the human experience. When a top revels in the high of taking control, but starts to feel some of that control fading afterwards, how do they pinpoint the cause? How do they talk about that insecurity? How do they develop aftercare for themselves?
One of the hallowed tenets of BDSM and kink is the necessity of good communication; to be able to recognize a desire, then comfortably communicate that to a partner. Healthy, consensual, safe kink is predicated on this.