In my last post, I wrote about how neuroscience identified seven core emotional systems embedded deep in the evolutionarily oldest brain. Here, I expand that conversation to the architecture of the whole brain–mind—and how understanding it can help us cope.

We’re living through what I call the Traumademic: the emotional aftermath of overlapping crises—pandemics, political polarization, climate threats, and chronic uncertainty—layered on top of our personal trauma histories. The result? We often feel emotionally hijacked and disconnected. Even as a neuroscientist and therapist, I’m not immune.

When Emotions Take the Wheel

You probably know the feeling: One moment you’re OK, and the next you’re flooded with fear, panic, or rage. That’s emotional hijacking—when the feeling brain temporarily takes over the thinking brain. These ancient emotional circuits evolved to protect us from immediate threats. But today’s “predators”—the nonstop news cycle, social media, economic stress—keep the brain’s alarm system permanently on. We marinate in fight-flight-freeze chemistry that fuels anxiety, burnout, and emotional numbness.

The Three-Story Brain–Mind

I often ask clients to imagine the brain–mind as a three-story house. Each level plays a role in how emotions move through us.

The Basement: Core Emotional Instincts

This is where our seven primal systems live. The defensive emotions, such as fear, rage, and panic, can activate before reason does. A tone of voice, facial expression, or memory can flip the switch. If activation is sufficiently strong, emotional “hijacking” can result. And once fear, rage, or panic gets turned on, we see the world through those goggles. For me, it is my “panic” mind that tends to take over.

Growing up in a chaotic home with a mom suffering from borderline personality disorder trained my fear and panic systems to stay on high alert. Even now, part of me sometimes feels the emotional ground could shift at any moment.

The Mezzanine: Emotional Memory and Habits

The middle layers of the brain, which I call the mezzanine, connect instinct with experience. Much of this level goes into automatic mode. It holds emotional learning—our safety and danger cues. For people with trauma histories, this level gets stuck on “replay.” My own mezzanine mind still runs old programs—urgency, vigilance, self-criticism—that once helped me cope but now can fuel anxiety and exhaustion. In times of mass uncertainty, this middle level hums with tension.

The Top Floor: Reflection and Regulation

At the top sits the prefrontal cortex, the command center for perspective and choice. When it’s online, we can notice what we’re feeling and respond rather than react. But when the lower floors flood the system with alarm signals, the lights upstairs dim. Healing isn’t about shutting down the basement—it’s about restoring communication and balance across all three levels.

The Traumademic’s Emotional Overload

Right now, many collective basements are overheating. The cultural atmosphere feels like a chronic alarm: too much fear, too little safety. Social media and nonstop news amplify panic while muting curiosity, play, and care.

Some mornings, I wake with a pit of dread in my stomach—my panic system lighting up, my body tensing, motivation fading. In neuroscience, this dampening of joy and motivation is called anhedonia: when our seeking and play systems go offline because survival alarms dominate. Here are some tools to deal with these challenges.

From Awareness to Action

Restoring emotional balance often starts from the bottom up. Here are some practices that help connect the three floors of the brain–mind.

Practice “one-minute breath regulation” to calm the body and the brain’s basement.

Inhale slowly through your nose to a count of four.

Exhale even more slowly to a count of six or eight.

Repeat for one minute when you notice anxiety, anger, or numbness. This slows the heart rate and signals to the nervous system that the threat has passed.

Use simple emotion labels.

Tune into your body sensations and then notice your emotions.

Silently name your state: “This is fear,” “This is sadness,” “This is anger.” Research on affect labeling shows that naming feelings reduces threat activation and strengthens regulation circuits—like dimming the basement lights and brightening the top floor.

When I pause and name what I’m feeling, something shifts. My top brain begins to re-engage. Awareness alone doesn’t erase the feelings, but it restores a degree of calm and choice.

Name your mind-mode.

Several times a day, pause and ask: Which mind and I in? Here’s a clue: Start with the basement:

Am I in raw fear, rage, or panic/grief/sadness? Or, alternatively, am I seeking care, play, or lust?

Then take inventory of the other “floors.”

Mezzanine: Am I replaying old stories or bracing for impact? If so, that is a sign of activation.

Top floor: Can I observe my feelings with perspective? That allows reflection.

Add compassionate self-talk.

Offer yourself gentle self-talk: “Of course I feel this way,” or “In this moment, I’m safe enough.” Notice how your body responds; this activates care and safety circuits.

Schedule one small dose of play or connection.

Once a day, deliberately engage your seeking and play systems: walk, listen to music, call a friend, share a laugh. Treat these as nervous-system medicine, not luxuries.

Rewiring the Emotional Brain

The truth is that the nervous system is plastic—it can learn to feel safe again. Each time we breathe through anxiety instead of escalating it, or replace dread with curiosity, we reshape old patterns.

This also applies collectively. Our culture’s chronic outrage resembles a shared neural hijacking—fear and rage circuits fired en masse. Recognizing this helps us respond with empathy instead of reactivity. Healing, for individuals and communities alike, begins with regulation and reconnection.

Every time we pause, breathe, or listen with curiosity, we help calm the emotional field—one nervous system at a time. Reconnecting the brain–mind’s three levels moves us beyond survival into thrival: a state where pleasure, play, and connection aren’t indulgences but signs of a healthy, balanced brain.

The more we notice, name, breathe with, and gently guide our emotional states, the more our brains—and perhaps our world—can move back toward safety, balance, and play.

If this resonates, stay connected for more insights on the neuroscience of emotion, healing, and pleasure—or share this with someone who might need a little more calm in their day.

The post When Even a Neuroscientist Feels Overwhelmed: The three-story brain-mind and simple ways to calm emotional overload appeared first on Nan Wise.

When I first began writing about the emotional brain for my book, Why Good Sex Matters, I approached it through the lens of sexuality because sex, desire, and pleasure are vivid reflections of our inner emotional life. Over time, I’ve come to see that how we experience pleasure, handle stress, and connect to others all arise from the same emotional architecture. Our struggles with joy, motivation, or intimacy are the canary in the coal mine—our brain’s way of signaling imbalance.

Today, that imbalance has become almost universal. We are living through what I’ve come to call the Traumademic—a convergence of chronic societal distress and the personal wounds, losses, and fears that this prolonged crisis has only made worse. Many people speak of feeling “revved up” yet emotionally numb, pulled between anger, anxiety, despair, and exhaustion. To understand why, we need to look beneath the surface of the brain/mind’s newer evolutionary operating systems—the top brain/mind (Neocortex), responsible for our executive systems, and the mid-level brain/mind, our learning and habit-making equipment, to the ancient emotional “basement” level of the mind/brain.

The Traumademic: When Collective Crisis Collides and Inflames Personal Pain

The last few years have brought a constant undercurrent of uncertainty—pandemics, social fractures, and economic worry. The Traumademic represents the merging of social upheaval with our private stress and trauma histories. Our FEAR circuits stay activated, our RAGE defenses flare, and our PANIC/GRIEF/SADNESS system—wired to preserve connection—keeps sounding alarms as we feel more isolated than ever.

None of this means we’re broken. These are ancient survival systems doing exactly what they were designed to do: protect us. The problem lies in their chronic activation. Emotional regulation begins not with judgment but with awareness of what is out of whack, so we can take steps to rebalance the core emotions.

The Brain’s Basement: The Seven Core Emotional Systems

The late neuroscientist Jaak Panksepp mapped seven core emotional systems in the deep subcortical brain: SEEKING, FEAR, RAGE, PANIC/GRIEF/SADNESS, LUST, CARE, and PLAY. These are not metaphors—they are hard‑wired neural circuits found across mammals. They produce the primal feelings that shape every choice, relationship, and behavior, forming the emotional “operating system” for human life. Imbalances of the core emotions can hijack the brain/mind and result in

You can think of these as the primary colors of emotion—basic patterns of energy and motivation that combine to create the full spectrum of human feeling. When in healthy balance, they help us navigate the world, connect with others, and pursue what we need for survival and meaning. When they fall out of balance—through trauma, chronic stress, or emotional neglect—we lose access to vitality, pleasure, and a sense of safety.

SEEKING: Restoring the Drive to Engage

The SEEKING system, fueled by dopamine (and too often hijacked by how we use our devices), motivates exploration and purpose—it’s the brain’s engine for curiosity, learning, and progress. When life feels unpredictable or overwhelming, dopamine production drops, and we lose energy, focus, and enthusiasm. Others swing the opposite way, staying endlessly busy, chasing distraction after distraction, but never satisfied.

Both extremes signal dysregulation. True SEEKING feels like guided curiosity, not hypervigilance. Rebuilding it starts small: setting meaningful goals, pursuing novelty with purpose, or reconnecting to creative practice. Each moment of healthy engagement tells the brain, “You’re safe to move forward.”

Defensive Systems on Overload: FEAR, RAGE, and PANIC/GRIEF/SADNESS

The defensive circuits evolved to save our lives. FEAR prepares the body to flee danger. RAGE defends boundaries. PANIC/GRIEF/SADNESS is wired to connect us to others to avoid the pain of separation. It signals the need for comfort and bonding. Yet in an era of isolation and loss, this system can dominate, pulling many into cycles of loneliness and despair.

 But in the Traumademic, these circuits rarely shut off. Continuous alarm signals flood the nervous system, keeping cortisol high and pleasure low.

Chronic FEAR erodes sleep and concentration. Overactive RAGE appears as road rage, online outrage, or rigid self‑criticism. Prolonged PANIC/GRIEF/SADNESS can slide into despair or clinical depression. The way back isn’t suppression but recalibration—slowing breath, noticing physical tension, reconnecting with the present. Even short moments of grounded awareness interrupt the brain’s defensive cascade.

The Healing Triad: CARE, PLAY, and Connection

If the defensive emotions keep us alive, the social emotions help us live well. The CARE system—powered by oxytocin and endogenous opioids—creates feelings of warmth, empathy, and belonging. It’s what allows both nurturance of others and self‑soothing. When we lose access to self-CARE, we often become overly attuned to others’ needs but unable to comfort ourselves.

PLAY, meanwhile, revitalizes the nervous system. Its laughter, movement, and spontaneity counteract the contraction of fear. Play teaches flexibility and trust. Yet adults frequently suppress it, believing it to be frivolous or unproductive. The safety required for PLAY to emerge signals deep regulation. Moments of humor or shared joy rewire the stress response more effectively than constant vigilance ever could.

Connection, through CARE and PLAY, restores psychological safety—reminding the brain that it no longer needs to defend itself at every turn.

LUST Reimagined: The Energy of Aliveness

LUST, too often reduced to sexuality, is at its core a drive for vitality and connection—the urge to merge with life itself. Balanced LUST energy fuels creativity, intimacy, and a sense of embodied presence. When it’s suppressed through fear, shame, or exhaustion, our world feels colorless; when it dominates, it becomes compulsive.

Reawakening LUST is less about eroticism and more about embodiment: movement, affection, music, art. Reconnecting with the body communicates to the emotional brain that pleasure and safety can coexist. It reignites the will to live fully rather than merely cope.

Emotional Regulation as Dynamic Balance

Emotional regulation begins with awareness. When these core emotional systems are out of whack, they can hijack our cognitive processes and decision-making in ways that can lead to substance abuse, psychological disorders, relationship disasters, self-sabotage, and even result in one of the most dangerous addictions of all–revenge addiction, as recently documented.

Regulation is not emotional control—it’s fluidity. The goal is to let all the core systems work together instead of allowing one to dominate. When SEEKING, CARE, and PLAY are active, they naturally calm FEAR, RAGE, and PANIC/GRIEF/SADNESS. Practices like rhythmic breathing, soothing touch, mindful movement, and supportive relationships act as tuning forks for the nervous system, shifting us from a state of defense to one of balance.

In a state of balance, we can feel fear without panic, anger without destruction, grieve without collapse. The emotional brain reclaims its natural rhythm—protection and connection working hand in hand.

From Survival to Thrival

The capacity for pleasure, curiosity, and joy is the hallmark of a balanced emotional brain. When our core systems regain harmony, SEEKING restores motivation, CARE deepens empathy, PLAY invites creativity, and even the defensive emotions operate in proportion. We stop living on high alert and start living with purpose.

The Traumademic has revealed how deeply interconnected we are—biologically and socially. Emotional regulation is not a solo project; we regulate best in connection. Shared laughter, compassion, and even quiet presence with another nervous system help reset our own.

Pleasure and play are not distractions from crisis; they’re signs of recovery. They tell us the canary is singing again, and the emotional brain has found its way home.

The post The Emotional Brain in the Time of Collective Crisis: Rebalancing core emotions to relieve stress and heal collective trauma appeared first on Nan Wise.

As the new year unfolds, I—along with many others—continue to struggle with painful levels of stress and anxiety. Beyond the evidence that political polarization is taking a toll on our collective mental health, waking up each day to alarming news only adds fuel to the fire. As Bob Dylan famously sang, “You don’t need to be a weatherman to know which way the wind blows.”

When stress and anxiety reach these levels, our nervous systems are warning us loudly. Bottom line: chronic stress creates systemic dysregulation that slowly wears us down.

What Is Stress—and Why Does It Matter?

The pioneering stress researcher Hans Selye defined stress as the body’s response to a demand placed upon it. Stress is not the event itself, but our physiological and emotional response to it—an adaptive survival mechanism wired into us.

Selye described three stages of stress, known as the general adaptation syndrome: alarm, adaptation, and exhaustion. While we cannot always eliminate stressors, research shows that it is not stress itself that harms us—it is the inability to shut off the stress response. Chronic activation erodes mood, cognition, immunity, and our capacity for pleasure and connection.

Bottom line: we need tools to turn down the temperature of our stress responses.

When Personal Pain Meets Collective Distress

Recently, I’ve been caring for our Chihuahua, Jilly, who has advanced heart disease. We are adjusting medications, monitoring her breathing, and watching for signs of decline. Anyone who has loved a pet through illness knows this ache—the anticipatory grief, helplessness, and fierce desire to protect them. The loss of a beloved animal can be profoundly heartbreaking.

Layer personal pain like this onto collective distress, and it’s no wonder so many people feel anxious, dysregulated, or numb.

I call this convergence the Traumademic—the collision of personal challenges and trauma with ongoing societal stress. It reactivates old wounds, intensifies fear learning, and makes it harder to access joy or pleasure, particularly for those prone to anxiety or anhedonia.

I am struggling, myself, to accept what is so.

Why Acceptance Matters to the Brain

From a neuroscience perspective, chronic resistance to reality keeps the brain’s threat systems—fear, rage, and panic-grief—on high alert. This fuels anxiety and, over time, suppresses motivation and pleasure.

Radical acceptance does not mean liking what is happening or giving up. It reduces defensive reactivity and allows SEEKING—the core emotional system that supports curiosity, motivation, and forward movement—to come back online.

The goal is not to feel good all the time. The goal is to reduce suffering and make more room for positive experience, even when life remains hard.

Ventilation: A Powerful Tool for Regulation

One of the most underappreciated tools for radical acceptance—and for easing anxiety and anhedonia—is ventilation: giving the emotional brain a safe, nonjudgmental space to express itself.

As I have written about in my book, our emotional lives are organized around core wired-in brain systems—fear, rage, grief/panic, seeking, care, play, and lust. Under chronic stress, fear, rage, and grief/panic dominate. Anxiety reflects anticipation of threat; anhedonia emerges when SEEKING is dampened.

Ventilation helps by allowing emotions to be named, felt, and witnessed rather than suppressed. When someone listens without fixing or minimizing, the nervous system settles. Fear softens. Grief eases. Pleasure and motivation can re-emerge.

This kind of attuned listening is a powerful form of co-regulation. A great way to cultivate a safe space for ventilating feelings is to learn active listening tools.  Here’s a link to learn more about how to practice this form of ventilating feelings.

Know Your Defensive Style

Under stress, we default to familiar survival strategies:

• Fight: blame or attack
• Flight: overwork or distraction
• Freeze: numbness or paralysis
• Fawn: people-pleasing

These are learned adaptations or habits that don’t always serve. Without awareness, they keep the nervous system locked in a state of threat, preventing us from connecting with others. If you know your own defensive style, you can learn how to manage it.

Pressing Pause

Learning to recognize activation and press pause is essential. Tight chest, shallow breath, agitation, or muscular tension are cues to stop and regulate—not push through.

You can name this in relationship: “I need a few minutes so I don’t say something I don’t mean.” Regulation is a prerequisite for communication. And communication promotes connection.  And connection can soothe our nervous systems like nothing else.

Pleasure as Resistance and Repair

If suffering narrows our world, pleasure expands it.

As I suffer from anhedonia when stressed, I need to make pleasure-seeking a daily practice. Often, what helps me open to pleasure is to first ventilate my pain and worries.  I ask my husband to give me an active listening session. I pour out my pain, listen to my deepest fears, regrets, hopes, and dreams. Often, I have a good cry.  I grieve, I mourn, and then I move more into the moment.  And being in the moment is a major tool for stress reduction.

For those with trauma histories or harsh inner critics, pleasure often requires intention and permission.

Pleasure is not frivolous. It is how the brain relearns safety and hope.

Re-orienting to the moment

Re-orienting to the moment does not erase suffering, but it stabilizes the nervous system. Sometimes it’s as simple as:

• “In this moment, I am safe.”
• “Right now, we are okay.”
• “We will get through this together.”

Not forever. Just now.

Making Peace Without Losing Heart

Life is challenging. Loss is inevitable. Both my parents have died in the past few years. My dog is sick and not going to get better. The world is a hot mess. Many of us are carrying more than we expected.

Radical acceptance asks us to stop arguing with reality long enough to care for ourselves inside it—to ventilate, regulate, connect, and seek pleasure not as denial, but as devotion to being alive.

To the extent that things are okay, let them be okay.
And where they are not, let us meet ourselves with compassion.

That, too, is resistance.
And it is how we (I) heal.

The post More Tools for Emotional Regulation When Life Hurts: How to Ventilate Big Feelings to Relieve Distress and Promote Pleasure appeared first on Nan Wise.

At the same time, we are living in a culture saturated with anger, grievance, and revenge addiction—a very real phenomenon fueled by hate speech, polarization, and outrage-driven media. Add to that the endless barrage of high-stimulation, engagement-maximizing (anti)social media, and it becomes clear: our emotional and nervous systems are under siege.

This is why rebooting our pleasure brains is no longer a luxury—it is an urgent act of self- and collective care. Pleasure is not frivolous. It is regulatory. It is grounding. It is essential for emotional wisdom. That urgency is why I wrote Why Good Sex Matters, and why I’m writing this now.

In this post, I would like to offer some guidance on how to begin pleasure practices that actually stick.

Why Resolutions Fail—and What to Do Instead

Every New Year, we resolve to do better: eat better, drink less, exercise more, work harder—fill in the blanks. I have written previously about how New Year’s resolutions can backfire. We white-knuckle these intentions for weeks or months, then inevitably slide back into old habits. The result? Shame, self-criticism, and a renewed cycle of comfort-seeking to manage the distress of “failing.”

Our internal critics double down: Try harder. Do more. Be better. The result? We land in an exhausting loop of stress begetting distress begetting more frantic doing, which only deepens the problem.

What I’m proposing—for myself and for you—is something radically different.

It’s time to hit the reboot button and prioritize pleasure as a well-being practice—one that feels good and is good for you. I call this healthy hedonism, and it’s the foundation of a new project I’m birthing: The Wellness Collective, devoted to reclaiming pleasure as medicine.

What Pleasure Is (and Isn’t)

When I talk about pleasure, I’m not talking about having more sex, better sex, or even sex at all. I’m not talking about vacations, spa days, or adding more items to an already overloaded to-do list.

I’m not talking about doing.

As I write in Why Good Sex Matters, one of the most important lessons I’ve learned is that happiness works in the opposite direction than we’re taught. We believe that if we do the right things, we’ll have what we want, and then we’ll finally be happy. But lasting happiness doesn’t come from doing or having—it comes from being. When we cultivate presence, self-connection, and meaning from the inside out, satisfaction follows naturally. The relationship, the job, the house, and the achievements may enrich our lives, but they don’t create happiness. Who we are does.

Pleasure, at its core, is about being.

Being present is a skill that can be cultivated. Being present, with the willingness to accept what is happening in reality without fighting it, denying it, or resisting it, is called radical acceptance. Radical acceptance is the active ingredient in all mindfulness practices and is well worth exploring. This involves being present to your thoughts, feelings, moods, and challenges. (Tolerating and navigating big feelings can become easier with some tools.) Being present with your parents, children, partners, friends, colleagues, and neighbors fosters true connection. Pleasure arises from being connected to your senses, your body, and to others—not just living in your head.

Pleasure is also about being in your truth—about authenticity. Years ago, I read the Radical Honesty series by Brad Blanton, which argues that one of the greatest threats to mental health is our habit of withholding our truths from ourselves and each other.

Simple Pleasure Practices That Matter

Be here now.

Take a shower. Eat a meal. Walk outside and actually be there. Turn off your phone and turn on your senses—your eyes, ears, skin, breath, and body.

Be authentic.

Speak your truth while remembering that your truth in this moment is not The Truth—and that it will likely change over time. We often withhold honesty to protect others, avoid discomfort, manipulate outcomes, or maintain control. The cost is disconnection—from ourselves and from those we care about most. When we allow ourselves to ventilate our thoughts, feelings, judgments, and interpretations, we often release resentment, fear, anger, and shame. As Blanton notes, what we often fear more than the pain of disconnection is the intensity of pleasure and freedom that comes from being fully expressed, fully seen, and deeply connected.

Be willing to take relational risks.

You can be both kind and truthful. And if honesty hurts someone’s feelings, be willing to stay—stay present, stay connected, stay engaged. That’s where real intimacy and pleasure live.

In Closing

This New Year, I invite you to move away from do-have-be and toward be-have-do. Let yourself feel your big feelings and share them. Keep things simple. Go back to nature. Spend time inhabiting your body and living your truth.

So, who’s up for the challenge?

Key Points

Pleasure is not a reward for a life well-lived. It is the foundation that makes a life well-lived possible.

Chronic stress and cultural overload dysregulate the brain—pleasure helps restore balance and resilience.

Sustainable well-being comes from being, not doing—presence and acceptance change the brain.

Authenticity and relational risk foster connection, intimacy, and genuine pleasure.

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One of the biggest debates in the field of human sexuality is whether sex addiction is a real thing. Some colleagues adamantly deny that the label “addiction’ is ever appropriately applied to sexual behavior. In contrast, others have overzealously applied this diagnosis when not warranted. Understandably, my colleagues are reticent about validating a diagnosis that has been erroneously aimed at people whose sexual behaviors don’t match what the larger society considers “conventional”.

In other words, anybody who did anything a little bit kinky or had a bit higher libido than deemed “normal” was labeled as being disordered. Remember, up until 1974 homosexuality was diagnosable as a mental disorder.

Recently I was called to weigh in on the topic because of my unique qualifications as a sex therapist/neuroscientist after another sex therapist dismissed the validity of the diagnosis during an appearance on the popular podcast Shameless Sex. This resulted in a backlash from some listeners who felt that their experiences with problematic sexual behaviors were being invalidated. I discussed both the dangers of over-diagnosing sexual behaviors as problematic, as was as the hazards of dismissing concerns. To listen to the full interview, click here. Here are the highlights.

Is Sex Addiction a Real Diagnosis?

Short answer: No. But Compulsive Sexual Behavior Disorder is.

There are two main guides for diagnosing diseases and disorders: the DSM (Diagnostic and Statistical Manual of Mental Disorders) and the ICD (International Statistical Classification of Diseases). The main guide for mental health professionals in the US is the DSM and it does not include a diagnosis of Sexual Addiction in its most current version (DSM 5 R). The diagnosis of Compulsive Sexual Behavior Disorder is included in the current version of the ICD ( ICD 11 ).

What is CSBD?

Short answer: a pattern of engaging in repetitive sexual behaviors despite experiencing adverse consequences.

Long answer: To qualify for the diagnosis, several criteria must be met, and the symptoms must persist for six months: The sexual behavior needs to become the central focus of life, to the point of neglecting health, other interests, and responsibilities. The person has been unable to control the sexual behaviors despite making attempts to do so. The sexual behaviors result in adverse consequences such as disruption of relationships and cause marked distress or significant impairment in personal, family, social, educational/occupational, or other important areas of functioning. Additionally, sexual behaviors are often associated with a lack of enjoyment or satisfaction.

How to better understand problematic sexual behavior?

In my opinion, what makes this topic so controversial in mental health circles is a misunderstanding of what “addiction” is. Rather than the old view of addiction as a disease, a newer model informed by neuroscience looks at this kind of behavior as “learning gone bad”. We can learn habits to self-soothe or regulate painful feelings by using behavior or substances. I address this kind of emotional learning in my book as a hijacking of the SEEKING system, a core emotional system that drives our attention, motivation, and learning. And yes, some people might be predisposed to learn to regulate painful feelings with sexual habits because of issues with how the reward circuitry of their brains work but to think of these habits as an addiction is both misleading and inaccurate. The term addiction when applied to sexual behavior lacks scientific validity and hijacks the conversation by attaching a label that stigmatizes rather than explains. It is my experience as a sex therapist that this label is used far too often as a matter of opinion rather than based on evidence. For example, how do we decide when a person has a problem with porn? How much porn is okay? Who decides? The client? The partner? The professional?

We need to keep in mind that the determination of the diagnosis of CBSD cannot be made based on moral disapproval or opinion which is far too often the case.

What about CBSD and porn use?

Most people who use pornography don’t have problems regulating their behaviors. A recent study that examined pornography use across 42 countries and over 82,000 participants found that a total of 3.2% of participants were estimated to have problematic pornographic usage. That’s a lot of people but considering the frequency that the “porn addiction” label is bandied about, one would expect a far larger percentage of people studied to be at risk. There are indeed individuals for whom pornography usage is problematic, but is it the epidemic that some would have us believe?

Listening rather than labeling.

It is my opinion as a clinician and human being that many of us are suffering from a rush to judge. Whether it is about sex or politics, we appear to have knee-jerk reactions that shut down our ability to hold the space to listen deeply and climb into each other’s experiences in ways that foster connection and compassionate inquiry. Whether we rush to judge a person’s sexual behaviors as problematic or at the other extreme, be too ready to dismiss concerns, we are not doing what needs to be done: a deeper dive into understanding another person’s experience. Slowing down sufficiently to listen over time to the many levels of an issue is a necessary skill. For example, I saw a couple in my practice who on the surface appeared to be dealing with a discrepancy in sexual desire, as is often the case with the male partner wanting more sex than his wife. Upon deeper listening, it became evident that the male partner was experiencing signs of problematic sexual behavior which warranted attention. The ability to listen deeply and tolerate our feelings in holding space is a skill that we could all benefit from honing.

Building a Sex-Positive Future

My work as a sex therapist extends beyond addressing the challenges associated with CSBD. It involves fostering a sex-positive mindset – one that embraces healthy and consensual sexual expression. By destigmatizing discussions around sexuality, we create a space for individuals to explore and understand their desires without judgment.

The post Unraveling the Controversy: Is Sex Addiction a Legitimate Diagnosis or a Misunderstood Phenomenon? appeared first on Nan Wise.

KEY POINTS

• Sexual satisfaction is now considered an important factor contributing to overall well-being by the WHO.
• It is widely acknowledged that the most important single predictor of sexual satisfaction for women is orgasm.
• Thirty to fifty percent of women worldwide report some level of orgasm difficulty.

It is widely acknowledged that the most important single predictor of sexual satisfaction for women is orgasm. The ability to experience sexual satisfaction is now considered by the World Health Organization as an important factor contributing to overall well-being and impacting global health. Because this is so critical, I have addressed this issue in a previous post where I share tools for working through obstacles to experiencing orgasm. Here, I give an update about new developments in the field of sexology.

Thirty to fifty percent of women worldwide report some level of orgasm difficulty (OD), a statistic that has not changed in 50 years. Studies show that although women may not be formally diagnosed with OD, about half still indicate moderate to high distress regarding their condition. It is the second most frequently reported sexual problem (with lack of sexual desire coming in at number one).

A conversation with a pioneer in sexual wellness

In this post, I share the highlights of my conversation with Suzanne Mulvehill, founder of the Female Orgasm Research Institute (for the full interview, see here).

We discuss the correlation between mental health conditions and OD in women and highlight the importance of relaxation and focus during sexual experiences. Last but not least, we discuss how research has shown that cannabis may be of help.

Orgasm difficulty in women can have various underlying psychological and physical factors

The most frequently mentioned reasons for OD are (in order) stress/anxiety, arousal difficulty, sex-specific anxiety, and issues with their partner.

The use of antidepressant and antipsychotic medications, illness, sexual trauma, and stigmatization can also contribute to sexual dysfunction and OD.

The psychological toll of orgasm challenges

The feelings reported by women with OD include frustration, feelings of inadequacy, relationship issues, familial discord and divorce, and a negative impact on general mental health.

The loop of stress leading to sexual and general frustration can lead to more feelings of inadequacy, brokenness, and loss of self-esteem which in turn creates more stress. The feeling of brokenness for women about their sexuality is common.

These difficulties can be influenced by multiple factors such as age, hormonal status, sexual experience, history of physical or psychological trauma, general mental health, type of stimulation, and the nature of the sexual activity.

A recent study by Mulvehill found that women diagnosed with OD reported 24% more mental health issues than non-OD women, 52% more PTSD, and 29% more depressive disorders.

Three types of OD

OD can be broken down into three categories: primary, acquired and situational. (Anorgasmia is the technical term for problems experiencing orgasm.) Primary OD is when the person has never ever had an orgasm. Acquired or secondary anorgasmia is when one could previously orgasm but is no longer able to do so. Situational OD refers to particular circumstances in which one is unable to orgasm
(for example during partnered sex vs. masturbation).

What you can do if you are experiencing OD

First and foremost: Don’t panic. It is not unusual for our ability to experience orgasm to come and go (pun intended). It is precisely when people start to panic about not experiencing orgasm that it becomes a thing. As I like to say, “A watched orgasm never boils.” Once we become self-conscious about orgasm, we tend to get into our heads about it. Good sex starts with being in our bodies and our sensations. When we can be in our sensations, sex tends to be sensational.

I advise clients who report ongoing symptoms of OD to learn to take a stand for what they need and want to increase the probability that they will experience orgasm, whether it’s with a partner or solo.

Mulvehill says we need to become friends with our sexual style (and yes, we all have unique erotic fingerprints, which is how we inhabit and express our own sexuality and relate to lovers) We also need to know what relaxes us, helps us focus and turns us on. She emphasizes the importance of feeling safe and understood by our partners.

New report: Cannabis and OD

Recently, for her doctoral dissertation, Mulvehill studied the use of cannabis before sex by women with OD. In her study, women who reported a history of sexual abuse had a more positive orgasm experience when using cannabis before partnered sex. Another recent study found that women who use cannabis arebtwice as likely to experience orgasm.

Mulvehill, together with Jordan Tischler, a Harvard Medical School professor and cannabis specialist who treats sexual issues are behind efforts to get OD on the list of conditions for which medical cannabis can be prescribed.

This important new research into this aspect of women’s sexual wellness deserves more attention and study.

Related conditions and how to navigate OD

An experience related to OD is a lack of spontaneous sexual desire. Although lack of desire might be a factor that contributes to orgasm disorders, in my clinical experience I see many women who orgasm easily but report no spontaneous sexual desire.

My advice for women experiencing OD is to communicate, explore, practice masturbation, and Kegel, Kegel, Kegel. A Kegel practice can be a powerful part of tuning up the orgasm machinery. Remember you can’t play in a band unless you’ve already learned how to play your own instrument!

Further, if you have shame about sex or have traumas large or small, you should talk to a therapist. It will allow you to unpack and reevaluate old learning around sex and update your map.

We need to radically accept what is while at the same time celebrating our bodies, our senses, and our sexual selves.

In conclusion

It is important to know that orgasms, while not the be-all-end-all of the sexual world, can become more available when we say “Yes!” to the experience we are having. When we can simply allow the sensations to feel good, without striving for an orgasm or bigger or better sexual experiences, paradoxically we can release ourselves into the sensations, and feel more connected to ourselves and our partner. What we know from individuals who report sexual satisfaction over a lifetime is that good sex is sex that is about connection.

References

Mulvehill, S. (2023). Cannabis for the Management of Female Orgasm Difficulty/Disorder: An Observational Study (Doctoral dissertation, Florida Atlantic University).

Wise, N. (2020). Why good sex matters: Understanding the neuroscience of pleasure for asmarter, happier, and more purpose-filled life. Houghton Mifflin.

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