Sexual pleasure: the next frontier in the study of sexuality.

In the related fields of sex therapy, sexuality education, and sexological research, the pleasurable qualities of sex have been almost completely disregarded in every way except cautionary.

The literature is rich with regard to sexual dysfunction, disease, abuse, addiction, and unwanted teenage pregnancy. But the pleasures of fulfilling sexual expression seem relegated to the realm of pornography or erotica--smut or art, depending on the eye of the beholder.

The science of pleasure would appear to be an oxymoron, with any sort of pleasure--sexual or otherwise--traditionally deemed unworthy of serious study.

PLEASURE DISCOVERED

Happily, things are changing. Pleasure has been discovered as a valid subject for systematic investigation.

Probably a major factor precipitating this new attitude is the wealth of data accumulated over the past three decades showing a direct correlation between pleasurable experiences and good health.

In the relatively new science of psychoneuroimmunology (PNI) there is now substantial evidence to demonstrate that a wide variety of pleasures can boost immunity and extend longevity.

Feeling hopeful or confident, being hugged, getting massaged, making love--or even just daydreaming about doing so--all have been shown to have a profound effect on the ability to resist or recover from illness and to mend after surgery. From an increased count of disease-fighting white blood cells, to a slower heart rate, to the release of endorphins and hormones that can regulate and balance every system of the body, research shows that feeling good is good for us. (1)

This is particularly true when it comes to sexual pleasure. With all its inherent opportunities for cardiovascular exercise, gratifying emotional connection, touch, playfulness, release of tension, and moments of sheer ecstasy, good sex can enhance physical fitness, strengthen the heart, and reduce stress. (2) On an emotional level, recent research shows that people with fulfilling sex lives tend to be less anxious or depressed and have greater self-esteem and better marriages than those who say they are sexually dissatisfied. (3)

This article will first offer a comprehensive view of pleasure and then, more specifically, of sexual pleasure. From there, it will examine some ways that people hold back sexually from feeling as good as they can and will offer an effective therapeutic approach for enhancing sexual pleasure. Finally, it will glance at the significance of making room for sexual pleasure across the life span.

WHAT IS PLEASURE?

A regrettable result of our Victorian and Puritan pasts and the current climate of mistrust of physical pleasure is that we do not generally have an adequate lexicon for describing what it feels like to feel good.

In my office, when I ask clients in pain what they are feeling, they have no difficulty finding words to describe their distress--they may say they are feeling tense, angry, anxious, resentful, lonely, guilty, or depressed. And then they have plenty to talk about. But if they are not in pain, they usually say that they are okay And that's it. As though only negative feelings count.

On the contrary, the right word clarifies a feeling, makes the unconscious conscious, and reinforces pleasure pathways, making a repeat more likely I usually ask patients who say that they are okay, "Okay what? Relaxed, energized, curious, calm, amused? What does feeling good feel like? What are you doing that's working?"

It pays to have a vocabulary for good feelings. The better we can describe an experience, past or present, the more aware we can become of its dynamics and the more deliberate we can be in shaping it to our liking.

The same is true for sexual pleasure. Sexual activity is often viewed in just two states--intercourse and orgasm. It's as though pleasure were on a toggle switch: getting it on and getting it off. The more aware we become of the wide spectrum of pleasures that make up sexual expression, the more charted the terrain--and the better we can explore the territory.

AN EMBODIED EXPERIENCE

The dictionary defines pleasure as the "feeling of enjoyment." While happiness is more about a positive state of mind, pleasure is always physical. (4)

If we look more closely at what actually takes place within the body, phenomenologically, we can see that pleasure is a visceral, body-felt sense of well-being that says "Whatever it is you are doing, keep doing it."

Pleasure is felt as sheer energy, an authentic enthusiasm that spontaneously propels us forward, drawing us to something or someone. We feel excited. Even when the source of the pleasure is mental and intellectual--like a good book or a stimulating conversation--the experience is a pleasure because of the sensation of inner activation in a relaxed and open body.

Freud originally defined pleasure merely as the absence, or alleviation, of pain. Until brain research identified pleasure centers in the limbic system, medical researchers believed that only pain was well represented physiologically while pleasure was more diffuse. (5)

We now know that feelings of enjoyment have brain and neural centers directly associated with them. More specifically, feelings like love, altruism, bonding, and sensory and sexual pleasures are all linked to pleasure centers in the limbic system, an area of the brain that helps to maintain homeostasis and is also associated with memory, emotion, and the ability to form loving attachments.

Biochemically, pleasure is linked to the release of a variety of neurotransmitters and hormones such as endorphins, dopamine, phenylethylamine, oxytocin, and serotonin. (6)

The autonomic nervous system, with its complementary sympathetic and parasympathetic branches, also plays a major role in the experience of pleasure and pain.

Put simplistically, the sympathetic branch is linked to feeling threatened, the triggering of the fight-or-flight stress syndrome, and the secretion of adrenaline and other stress hormones. The parasympathetic branch is associated with tension-release and replenishment of energy once the danger has passed. Autonomic balance involves a calm in both segments and a resulting positive state of quiet alertness. Sexual activity is associated with a firing in both branches, where high activation coupled with dilation allows for the maximum experience of pleasure.

Internally as well as externally, we contract in pain and expand with pleasure. Feelings of pain cause the heart and other internal organs to constrict, muscles to tense, blood pressure to builds in the tightened vessels, breathing to become labored, and discomfort to grow.

Conversely, feelings of pleasure relax the muscles, and, with the parasympathetic system firing, the heart, viscera, and musculature also relax. The heart beats slowly and steadily, blood pumps through open arteries and veins, and the breath slows and becomes more rhythmic. The sensations associated with these internal events make pain inherently punishing and pleasure intrinsically rewarding

There is no direct research on the psychoneurobiology of pleasure development in infancy and early childhood. Yet, the extensive neuroscience now accumulating in the area of attachment theory shows that, in the moments after birth and continuing for the first 18 months of life, the infant's brain is literally shaped by how much the primary caretaker, usually the mother, can play intuitively with, and enjoy, her baby. The part of the brain most affected by eye contact, and the warmth, empathetic holding, and playful interaction between mother and child is the right hemisphere and limbic system. These areas are critical for an infant to grow into an adult who can feel secure, have empathy, bond with others, handle stress, and actually enjoy pleasure and positive affects. (7)

Studies in child development have traditionally explored the childhood traumas that can lead to adult disturbance but have offered little in the way of providing any understanding of the basic building blocks of human pleasure.

After more than 25 years of research into the topic of pleasure, I have identified eight categories of pleasure that appear immediately after birth, and at developmentally strategic junctures during infancy, childhood, and adulthood, which are critical sources of nourishment for humans to live healthy and fulfilled lives. The data from the multidisciplinary research--from neuroscience to PNI to public surveys--clearly show that each of these positive inner states contributes its own particular brand of vitality, provides both emotional and physical benefits, and continues to nourish individuals on a very fundamental level throughout the life span. (8)

As I conceptualize it, these eight core pleasures begin with the most primal pleasure of letting go and 'just being' move through the pleasures of pain relief (being soothed and comforted), play (humor, movement and vocalization), the mental pleasures (intellectual and aesthetic stimulation), emotional pleasures (all variations on a theme of love, like gratitude, courage, and faith), the sensual pleasures (taking delight in seeing, hearing, smelling, tasting, touching, and imagining), the sexual pleasures (involving a spectrum of arousal that runs from interest, to desire, erotic love, lust, passion, orgasm, and ecstasy), and finally the spiritual pleasures (a deep sense of being a part of something good that is larger than oneself). Each of these core pleasures can also be eroticized and serve to intensify any sexual encounter.

Most importantly, pleasure is a completely subjective experience--the individual is the ultimate authority. No one can impose on anyone else what should or should not feel good--it either does or it does not.

What draws us to another person, how we like to be touched, what makes us laugh, or what entices our mind are all very personal. That means that any pleasurable experience, particularly a sexually pleasurable experience, puts a person in touch with his or her most authentic nature.

WHAT IS SEXUAL PLEASURE?

The ability to derive pleasure from sexual activity is always a key feature of any definition of healthy sexuality. Yet what exactly does that entail?

Though orgasm is typically seen as the big pay-off in sexual contact, the magnitude of the release is completely dependent on the intensity of the excitement. On the most fundamental level, then, the scope of sexual pleasure is essentially a function of arousal. With the first stirrings of erotic interest, the genitals begin radiating a warm glow that, under the best of circumstances, spreads throughout the entire body. When a sexually excited individual is with a partner he or she also loves, the heart is enlivened as well. At its height, erotic excitement can potentially charge every centimeter of the body from head to toe with vibrant energy

When sexual pleasure is seen trough the lens of getting it on and getting it off, sexual activity becomes completely goal-oriented, moving along a specific and often ritualized trajectory sometimes known as "formula sex"--foreplay, penetration, male ejaculation, and occasional female orgasm. (9) On the other hand, when sexual arousal is allowed to build more slowly, a greater variety of pleasures are accessed, arousal can become more nuanced, release can be more exquisitely explosive, and the entire experience can become richer and more meaningful.

We can see how--whether when self-pleasuring or with a partner--each of the core pleasures can augment sexual pleasure. (10)

Primal pleasure is the essence of all sexual pleasure. It is the basic enjoyment that comes with relaxing, letting go of resistance, breathing and opening as excitement builds, and taking delight in the present moment.

Pain relief. We now have substantial evidence that sex relieves pain. (11) When lovers massage and stroke one another they are not only being sexually inviting but they are also soothing each other's body from the stresses and tensions of the day, helping to make each other more receptive to pleasure.

Play. Sexy playfulness that has warmth and a sense of humor, that inspires smiles and even laughter, can create sexual interest and change a non-sexual situation into a sexual one. Flirting and seductiveness can lighten the heart and infuse magic and sweetness into an ordinary day or evening.

Mental pleasures. Sex can be boring when there is no real contact between lovers who are mentally in their own world. But when lovers can look into each other's eyes and talk sexy, maybe even share a fantasy or describe their erotic sensations, sexual activity can stimulate mind as well as body. Sexual intrigues and scenarios, real or pretend, are often used to stir up feelings of lust.

Emotional pleasures. Sexual excitement is generally most passionate when there are strong feelings of romantic love for the partner. Expressions of love and affection can ratchet up the thrill of intimate contact. Low levels of anger, guilt, shame, or fear can also have the effect of an aphrodisiac. (12)

Sensual pleasures. Sensuality is well recognized as a source of sexual pleasure. While the emphasis is typically on touch, excitement also grows with taking pleasure in the other senses. The intimate smell and sight of the other, the taste of their kisses, the sound of their breath and sighs all contribute to enhancing desire and making the encounter more passionate.

Erotic pleasures. Under the best of circumstances, as lovers avail themselves of the variety of pleasures their intimate connection allows, eventually manual stimulation, sensitive oral sex, or skilled intercourse can bring on an orgasm, the explosive release that is typically experienced as the utmost sexual pleasure. Often orgasm signals the end of sexual contact. However, for some individuals, continued focus and activity can bring multiple orgasms where each release is more intense and exquisite than the preceding. (13)

Spiritual pleasures. While spirituality and sexuality are often separated in Western culture, both qualities can interrelate and under the right conditions, give rise to the transcendent experience of ecstasy Melting into one another, and losing any sense of a separate self, lovers may feel transported into a profound spiritual and mystical union that is sometimes called sacred sex. (14)

Obviously, a multitude of delights make up the complex experience that people think of simply as sexual pleasure.

ELUSIVE SEXUAL PLEASURE

What individuals or couples seeking therapy for a sexual concern want more than anything is to experience sexual pleasure, usually in the context of a loving relationship.

Despite the variety of sexual issues which trouble individuals--a woman's inability to orgasm, a man's difficulty sustaining an erection, a couple's very different sexual appetites, or sexual fear or shame associated with incidents of sexual abuse in childhood--they all have one thing in common: an inability to surrender to, and to sustain, pleasurable sensation.

A major value of therapy is that clients can safely talk about areas of pain and frustration regarding their sex lives as they may never have before. There is no denying the benefits of focusing on their distress to clear up misinformation, to better understand the roots of their sexual content, and to move toward resolving past traumas and present fears.

When interpersonal conflict and other relationship issues dampen desire, better communication skills enable a couple to work through feelings of resentment that have created emotional barriers to their enjoying a physical connection. Homework in the form of structured touch exercises with an intimate partner is an important adjunct to any program to enhance sexual skills.

These cognitive and behavioral interventions have, over the years, proved effective in sex therapy--to a point.

My 30 years working with sexual issues, have, however, shown me that it is effective to add a somatic-experiential dimension to such therapy. People with sexual concerns need to learn to reconnect with their bodies. Simply understanding why they resist sexual pleasure does not automatically release their bodies to feel desire, sustain erections, have orgasms, or feel emotionally connected to their partners.

A more comprehensive sex therapy not only helps our clients to explore their sexual problems and pains but also assists them to make a more thorough investigation of their sexual pleasures.

To do so, clients first need to see how, unwittingly, they may be habitually holding on to pain or tension in their bodies. This kind of direct observation helps them learn how to recognize and release emotional and physical holding patterns that put an automatic ceiling on their ability to tolerate pleasurable excitation.

PUTTING THE BODY BACK INTO SEX (15)

Whether I am working with an individual or a couple, I find it helpful at some point in the discussion, especially when painful feelings come up, to shift from a cognitive exploration to a body-based, present-centered way of observing inner experience. By taking a few deep breaths, clients can scan their bodies from the inside and look for sensations of tension and emotion.

While many people equate a somatic approach in therapy to touch, I find that breath awareness can encourage both body awareness and energy release without the therapist's hands-on manipulation. For many who seek therapy for sexual concerns, a therapist's touch is viewed as an intrusion and an invasion, particularly for those individuals who have been sexually molested as children.

When couples are dealing with sexual issues of an inhibitory nature--low sexual desire, erection difficulties, or inability to orgasm--feeling sexually aroused, or confronting the possibility of sexual contact can bring up feelings of fear, shame, and guilt. Memories of bad experiences and negative inner narratives further interfere and stress the body.

That means that whenever the person encounters a potential sexual situation or begins to feel turned-on, he or she is likely to unconsciously hold the breath and tense up. Under those circumstances, the sensation of increased excitement will trigger fear and tension rather than pleasure and letting go--what is called "pleasure-anxiety." (16)

By developing a phenomenological awareness of what occurs inside the body during the therapy session, clients learn to identify sensations of emotion and chronic muscle tension as well as the memories, mental images, and internal narratives that accompany those sensations. As they develop observational skills in therapy, they learn to transfer their inner experiences to sexual situations.

During sexual encounters, clients can catch themselves holding their breath or tensing their abdominal or pelvic muscles and then practice releasing these longstanding contractions. They can also learn to contain their pleasurable excitation rather than aim for immediate discharge, thereby building to a heightened level of physical and emotional excitement.

In dealing with arousal issues with my clients, I like to point out the intricate connection between the breath and passionate sex. For example, heavy breathing is the most arousing sound track for a sexually explicit movie. Clients can augment sexual excitement by focusing on where the breath is held during sex play and breathing into the tight areas. All of the homework assignments I give my clients encourage them to practice deep breathing during any kind of physical contact or sexual activity.

RECLAIMING SEXUAL PLEASURE

Some clients who seek sex therapy simply want to improve their sexual performance, looking to achieve desire, strong erections, or orgasm to please or impress their partner. But unless sexual contact is intrinsically rewarding, with personal enjoyment as a motivation, no amount of practicing the right moves will ever bring genuine gratification to their partners or to themselves.

For example, one of my female clients sought therapy because she had very little sexual interest in her husband. As she spoke to me, I realized that he was manipulative, demanding, and highly critical of her. He sent her to therapy to "get fixed" because she had no desire for him. Obviously, the goal of her therapy was not to help her derive greater pleasure with an emotionally abusive partner. It was to help her learn to trust her feelings and insist on loving and respectful treatment-hopefully by involving her husband in therapy. Having greater sexual pleasure is simply the carrot that motivates change, particularly for him.

If the client's sexual goals appear to be directed by performance standards, therapy will prove most effective by shifting the focus from a successful sexual performance to a pleasurable sexual experience.

Many of my clients, like the American culture at large, are imprinted from early childhood to suspect pleasure. One client had an astounding flash of memory during a session that illuminated the connection between her inability to achieve orgasm and her resistance to a pleasurable sensation. Lois had a good relationship with her husband, and they enjoyed their physical contact. Yet she had never had an orgasm and never had any interest in pleasuring herself.

At one session, at my encouragement, Lois took some deep breaths and scanned her body from the inside. She soon became aware of her tension. With her eyes closed, she felt the restraint in her shallow breath, in her tight jaw and belly, and in the way she held her forearms pinned to her sides.

As Lois held that tension pattern at my request, she suddenly recalled when she was five years old. She and her family were on a country outing picking blackberries. As she bit into each plump berry, she swooned with delight at the burst of the juicy sweetness in her mouth. At one point, her mother, tired of her little girl's exuberance, snapped, "Oh stop gushing." Everybody laughed. Lois was mortified. She said she believed that from that point on she learned to limit her expressions of joy and that she even became wary of feeling too joyful.

Fred, another client, was a retired businessman in his late sixties. He had lost his first wife to cancer six years earlier, after 25 years of marriage. He was now remarried for almost two years. Even though his new wife was 15 years his junior and very attractive, he was having trouble sustaining an erection with her. He had used Viagra on several occasions with mixed results. After a thorough medical examination showed that he was totally healthy, his physician recommended psychotherapy and referred him to me.

In an early session, after some minutes of deep breathing and at my suggestion, Fred pictured his first wife in his mind's eye. He immediately welled up with tears and was too choked up to talk. He then revealed that he had lost sexual interest in his wife for the last seven years of her life and had had a series of brief affairs with other women. He said he felt terribly guilty that he had treated such a wonderful woman so shabbily. When I asked where he now felt tension or tightness, he pointed to his diaphragm and said he felt a knot in his gut and that his chest was heavy. He became aware of the physical components of his guilt and grief.

It turned out that Fred and his second wife were still living in the same house he had shared with his first wife and even slept in their same bed-the very bed in which his first wife had died. I gave Fred a homework assignment. I asked him to be physically affectionate with his wife, anywhere but in bed, and to do anything sexual they felt like doing, except intercourse. I suggested that he use the breaths we had practiced, paying particular attention to when he held his breath and where he held the breath in his body.

During our next session, Fred reported that he and his wife did the experiment and were both able to pay attention to the breath. He found that he did, indeed, have a tendency to hold his breath and tense his abdomen. He said that they had had a lovely sexual encounter in which they laughed a lot and that he was able to sustain an erection for a longer period than he had in the recent past. Fred has continued to show progress as he practices releasing tension in his gut and belly, addresses the issues that led to his infidelity with his late wife, and works on his feelings of guilt that seem to infuse all of his relationships.

I recently began working with a couple who came to me hoping to consummate their marriage of 18 months. Even though Maria and Ted had enjoyed a variety of sexual activities culminating in orgasm for both of them, Maria, at 28, was still a virgin and was terrified of penetration.

In their first session, Maria said that she had no memories of being sexually molested as a child. She reported that she felt very loved and supported by her husband who made it clear that he looked forward to having intercourse with Maria but that he was prepared to wait as long as it took for her to be ready.

During their second session, I asked Maria and Ted to take some deep breaths and to scan their bodies from the inside. Maria realized she was holding her legs tightly together. As we began to focus on her tension patterns, Maria remembered something that surprised them both. She recalled a time when she was nine years old and had been constipated for days. Her mother, determined to help, pushed her down on the floor of the bathroom and jabbed an enema into her rectum as Maria screamed in pain. Her father yelled encouragement to the mother from another room and Maria remembered feeling betrayed by both of them.

Maria had completely forgotten about this and felt relieved to discover a legitimate reason for her fears. She did, however, say that her folks were ideal parents and that she not want to blame them for her troubles. She never discussed her feelings with them about that disturbing event.

I gave the couple several breathing exercises to practice together and specifically told them to give up any attempts at penetration for the time being. In the meantime, Maria has begun to recognize how much she has learned to hold herself back to please her parents and how little she has spoken up about her true feelings. We shall soon see how Maria's recognition of stifling her authentic self will affect how she will speak up with her new husband.

All these people have learned to become more attuned to their bodies by delving into their sexual fears and inhibitions and allowing themselves greater sexual pleasure. As our work has progressed, many have also come to recognize the variety of other ways they have resisted good feelings. As our clients accept their right to pleasure, not only does it enrich their sex lives and deepen their bond with their partner, it also enhances their sense of personal well-being.

SEXUAL PLEASURE ACROSS A LIFETIME

Humans are capable of enjoying sexual pleasure from early childhood through adolescence, young adulthood, middle and old age. When sex fails to bring gratification, at any age, a valuable source of vitality is forfeited.

Children are sexual beings. The fact that our society pathologizes, even criminalizes, juvenile sex play without really understanding it is among the most destructive influences in sexual development and is responsible for a wide range of adult sexual difficulties. (17)

Most of my clients, even those born in the so-called sexually liberated seventies, report that no adult ever gave them useful information about sex. Many of them trace their present distress to sexual shame sustained during their earliest experiences as a result of their sexual naivete.

On the other end of the age spectrum, sexual pleasure can be a quality of life issue for older singles and couples. Some elderly people, depressed and craving physical connection, may be ashamed to talk about their sexual needs and desires. Yet more individuals and couples in their seventies and eighties, emboldened by daytime talk shows and magazines, are acknowledging their sexual interest and are seeking therapy and other learning opportunities to enhance their physical intimacy.

Libido is a strong life force and sexual health is an important factor in mental and physical fitness, gratifying intimacy, and personal happiness. Just as any aspect of life can evolve with awareness and practice, clients in therapy can discover that the ability to maximize sexual pleasure can also continue to evolve over their lifetime and contribute to an overall sense of meaningfulness and contentment in their lives.

CONCLUSION

Science is just beginning to investigate the value and role of pleasure in enjoying a healthy sexuality. As therapists, we can provide more comprehensive sex therapy by not just working with our clients to explore their sexual problems and pains but also helping them thoroughly investigate their sexual pleasures.

REFERENCES

(1.) R. Ader, editor, Psychoneuroimmunology (New York: Academic Press, 1981); R. Ornstein and D. Sobel, Healthy Pleasures (Reading: Addison-Wesley, 1989); H. Benson, The Relaxation Response (New York: Avon Books, 1975); D. Beck and J. Beck, The Pleasure Connection (San Marcos: Synthesis Press, 1987); S. Locke and D. Colligan, The Healer Within (New York: E.P. Dutton, 1986); R. McCraty, et al., "The Effects of Emotions on Short Term Heart Rate Variability Using Power Spectrum Analysis," in American Journal of Cardiology, vol. 76, no. 14, pp.1089-93; G. Rein, et al., "The Physiological and Psychological Effects of Compassion and Anger." Journal of Advancement in Medicine, vol. 8, no. 2, Summer 1995; H. Selye, The Stress of Life (New York: McGraw-Hill Book Co., 1956).

(2.) S. Resnick, "Sex and Pleasure," in Bullough and Bullough, editors, Human Sexuality: An Encyclopedia (New York: Garland Publishing, 1994), pp.457-64; A. Lowen, Love, Sex, and Your Heart (New York: Macmillan Publishing Co., 1988); M. Liebowitz, The Chemistry of Love (Boston: Little, Brown and Co., 1983); A. Walsh, The Science of Love (Buffalo: Prometheus Books, 1991); R. Ornstein and D. Sobel, Healthy Pleasures.

(3.) R. T. Michael et al., Sex in America (Boston: Little, Brown and Co., 1994); A. Greely, "Better Than a Gold Watch," Newsweek, August 24, 1992, p. 71.

(4.) Webster's New World Dictionary of the American Language (New York: World Publishing Co, 1966).

(5.) T. Szasz, Pain and Pleasure (Syracuse: Syracuse University Press, 1988).

(6.) R. Ornstein and D. Sobel, The Healing Brain (New York: Simon and Schuster, 1987); M. R. Liebowitz. The Chemistry of Love; A. Walsh, The Science of Love.

(7.) A. N. Shore, Affect Regulation and the Origin of the Self: The Neurobiology of Emotional Development (Mahwah, NJ: Eribaum, 1994); A. N. Schore, "The Effects of a Secure Attachment Relationship on Right Brain Development, Affect Regulation, and Infant Mental Health," Infant Mental Health Journal, vol. 22, pp. 7-66.

(8.) S. Resnick, The Pleasure Zone: Why We Resist Good Feelings & How to Let Go and Be Happy (Berkeley: Conan, 1997).

(9.) S. Hite, The Hite Report (New York: Dell Publishing Company, 1976).

(10.) S. Resnick, The Pleasure Zone: Why We Resist Good Feelings, pp. 223-61.

(11.) J. Couch, "Relief of Migraine Headache with Sexual Orgasm," Headache, May 1987, vol. 27, no. 5, p. 287.

(12.) J. Morin, The Erotic Mind (New York: Harper Coffins, 1995).

(13.) M. J. Sherfey, The Nature & Evolution of Female Sexuality (New York: Random House, 1966); W Hartman and M. Fithian, Any Man Can (New York: St. Martin's Press, 1984).

(14.) C. Feuerstein, Sacred Sexuality (Los Angeles: Tarcher, 1992).

(15.) Much of this section is based on material in S. Resnick "A Somatic-Experiential Approach to Sexual Issues in Therapy." (Submitted for publication.)

(16.) W. Reich, The Function of the Orgasm (New York: Farrar, Straus & Giroux, 1961).

(17.) T. Mazur, "Children and Sex," in Bullough and Bullough, Human Sexuality, pp.107-11.