S2E4 Sex and Human Connection

In this episode, Dr. Pete and Dr. Rubin start a conversation about the role of sex in human connection, while also distinguishing between the biological function of sex, sexual behavior, and intimacy. They model a mindful approach to exploring a discussion about sex by cultivating curiosity and nonjudgment, while also understanding behavioral functions of this aspect of human experience. By the end there was one clear finding- Dr. Pete and Dr. Rubin will definitely need another episode to continue this conversation.




Pete: If we had our producers and our engineers here, we would start this episode with TLC. Let's talk about sex, baby, from the 90s.

Nikki: Well, 90s hip hop is my most favorite musical genre,

Pete: Me too, it makes me feel so good. I don't listen to the radio that often but if I do, I might put on once in a while, like a 90s, early hip hop Spotify.

Nikki: We have KDAY in LA 93.5, which is the greatest radio station of all time. So just

Pete: So they might want to be a sponsor for When East Meets West.

Nikki: They might.

Pete: Let's contact. So yeah, let's look at and discuss sex today. And sex is one of those things that's like taboo. I you remember as a kid, you'd like sneak, you'd see like, a boob on TV or you have to sneak like one of the prime show. Oh, God, I can't believe I'm saying that because we're sounding so old. Because these days you just click on something and then there would be…

Nikki: Yeah, it’s very different. It's a very different…

Pete: Well we couldn’t do that.

Nikki: No. Well it's different across cultures. So like in American culture, it's a lot different than if you go to France.

Pete: We are so stupid about that. I'm sorry. I'm saying just going to put that out there.

Nikki: Well, that's a judgment.

Pete: I'm owning that.

Nikki: Yes, you're owning, yeah. Well it's a different, but there's strengths and limitations of every world view.

Pete: I know. I remember going to France for the first time and feeling like some of the commercials were like porn.

Nikki: Yes.

Pete: They would be considered like porn here.

Nikki: They would, yeah, they would. Well, and so I think it's important to say Pete and I are not sex therapists, like we're not. And yet, as psychologists, who our job is to invite in all of the aspects of human experience, anything related to sexuality, sexual behavior, or sexual identity, sexual thoughts, feelings, emotions, connection, all of these aspects are all major, hardwired biological parts of our experience. I should say on the other side as well, even like asexuality. This is a part of our species. So just want to make sure we clarify that.

Pete: Well, I'm going to get a little defensive, and a little righteous in that because… May I?

Nikki: Oh, sure.

Pete: We will describe there, there's the Association of sexuality educators and therapists, AASECT, great organization. Certainly on my clinical team, we've had people that were certified. It's another certification, and…

Nikki: Sure.

Pete: There's really good cognitive behavioral therapists who don't have certifications, and they do amazing CBT.

Nikki: Agree, I just more mean it’s not like our… like if you were looking for somebody who's like primary focus, for example, was like substance dependence, like, I'm not upset. And yet, I see lots of people that struggle with substance use.

Pete: So what you're saying is that you and I are not like… who was it, Barbra Streisand and Meet the Fockers? When she's like, I think she’s the sex therapist.

Nikki: I think she's a sex therapist. Or if anybody's seen [inaudible 3: 24], have you seen the show Sex Education on Netflix?

Pete: Oh my god, it's so good.

Nikki: Oh, Gillian Anderson in that is just phenomenal.

Pete: So good.

Nikki: Yes, so highly recommend to our listeners.

Pete: I'm going to put that… I'll put that in our description.

Nikki: Yeah, that's a great, that's a great. We're also not like that, no.

Pete: We’re not like that. And I've done sex therapy,

Nikki: Same.

Pete: And I actually have done sex therapy with couples. So, in our practice, our clinical director, that's her specialties, working with couples. So I have worked with couples, especially in coordination with her. And we have to talk about things, and in many couples, sex becomes a thing. And so we'll talk… that's what today is about. So I will say that sex is easy. That's often what I say to clients or couples that the sex is the easy part, the connection is what becomes challenging. And I'll also say this, which I don't know if it's what the research says about this, but sex isn’t what keeps a relationship together.

Nikki: Totally sure. Well sex is, again, I'm going to be like really, me and operationalizing here. I mean, there's sexual behavior, there's the experience of sex as a behavioral practice very literally. What that behavior means for an individual is going to vary, it can be a mean to connect with somebody, emotionally. It can be just a physiological release, it can be avoidant, the function of the behavior varies and that's what, in third wave cognitive behavioral therapies, we’re [inaudible 5:06] and as much as for it, we call it, there's functional contextualism, which means we're constantly asking from a curious standpoint, ‘what does this behavior mean?’ ‘What is its function, its purpose in this context?’ And sex is no different, there's many functions to it.

Pete: Well, and so I think many listeners are probably thinking about, like intimacy versus sex, because that's a big thing. And intimacy doesn't mean sex. It can be sitting on a couch holding a hand, it can be just that look, we're just kind of like, what's that call? Oh, wink.

Nikki: Wink.

Pete: Thank you.

Nikki: “What’s that called?”

Pete: I'm having a hard time operationalizing. That's what, you operationalize so well, I just feel like I don't need to, so just that part of my brain just shuts down when we talk.

Nikki: “What’s that called? Right, wink.” That was like a very little mermaid moment. Like, “what is this called, was it fork?” That was you.

Pete: Or, I was just listening to this other podcast, where apparently Paris Hilton created this like Airheads character, for things. But we should do an episode.

Nikki: Another time, sure.

Pete: Anyway, so love language is another thing that I was thinking when you talk, so Gary Chapman. And physical touch is one love language, there's acts of service, words of affirmation, gifts. So love is different than sex. What we're talking about today is the sexual behavior, and how that may or may not foster connection between people, and I'm not going to say couples.

Nikki: No, between people

Pete: Between people.

Nikki: And can I say, this is important to clarify, and with oneself.

Pete: With oneself, yes.

Nikki: Because again, I think that's often miss,

Pete: I was thinking groups.

Nikki: No, but that's right. That's like it could be with people, one person, many people,

Pete: And self.

Nikki: And self, because I think that's something that I always end up, like up against, I think, a lot of times when patients were when they're talking about… like if the topic is wanting to experience connection via sexual behavior. And again, I'm saying it that way, because I want to clarify, that doesn't have to be that.

Pete: Saying beautifully.

Nikki: Yes, thank you. That I think a lot of people don't start with this recognition of sexuality. And then therefore, like sensuality. Connecting with that, it does start with oneself and internally, and if there's no vulnerability with oneself in that way to explore those emotions, and even like physiological sensations, that it's going to be very difficult to then translate that with another person.

Pete: Why are we so uncomfortable around sex? I mean, I think that that was what my statement was about, that I think America sucks when it comes to this stuff. Because I do feel like our, another word I can't find right now. I’m having word finding difficulties. What's that called, when TVs like…?

Nikki: Oh, censorship?

Pete: Thank you.

Nikki: It's lucky, lucky that Pete and I [inaudible 8: 06] psychic connection that we're, yeah.

Pete: So the censorship, I think, does fosters this discomfort and creates like a level of shame.

Nikki: It does. And well, it's so interesting, and this is of course, important in terms of talking about dialectics and the middle path, that I think that that comes from, obviously, I mean, this is… I was going to say we're a puritanical society. And I don't mean that as a judgment, I mean that very literally, like who colonized, where we was now, the United States, puritans. So those cultural themes run deep, I think, number one. And it's also, I think, sometimes confusing for people, because there's a balance of also, ‘what is too rigid?’ ‘What's a judgment?’ ‘What causes shame? And, ‘what are boundaries’, because it can go the other way too, where then there's a belief of like, ‘everything's open’, [inaudible 9: 05] well, that's also not effective, either.

Pete: Like the 70s, like sex, drugs, and rock and roll.

Nikki: Well, sure. Or like, sometimes there's questions of like, ‘how do you talk to kids about sex?’ Like, how are you clear about that, without inducing shame, without being inappropriate?

Pete: So I'm thinking culture and values. Because there's got to be this spectrum that people… I mean, I've certainly seen kids where their parents are so open about all things, in an appropriate way. Which still leads to like, the other kid whose parents are the opposite coming home from school being like, “what's that?”

Nikki: Yeah. So I don't know. So that's what I think. I think it's like, I don't know if you agree with that. It's like I think that most of that, at least in American culture, is just driven from just the puritanical framework, that sort of is systemic, and how we talk about these things.

Pete: Totally. And the other piece I wanted to add was like the fluidity of sexuality, which is another thing that I think, again, shame. It's so cool for females to be sexually fluid and to make out with a girl once in a while. The same is not whole true for males, and everything in between. And so I think that that's another piece of this that people really struggle with. So you want to take a stab at like, just at least maybe operationalizing sexual fluidity or talk about that for a moment?

Nikki: Yeah, sure. I mean, I guess I would say that again, coming from a mindful lens, that I'm always encouraging people to just be curious about, like, what shows up for them. And so sexuality is no different than that. So it's like, if they have sexual thoughts or images about anything or anyone? It's like, ‘what are those?’ So if it's a man who, for example, identifies as heterosexual, and then is sharing that on occasion they've had sexual, maybe just random thoughts, sometimes fantasies about men, it's like, ‘okay, just allowing that’. And so in saying that doesn't have to mean anything. It's just like, that's just what's showing up. And so…

Pete: Just another thought, yeah.

Nikki: Yeah. And then I would say, and then whether that translates into behavior, that's up to somebody to determine for themselves of like, what matches with how they identify, what they're actually interested in the external world? I don't know. Does that…

Pete: Yeah, exactly. And also, this has been studied from… Oh, god, this is where our preparation comes in… the 50s was,

Nikki: Oh, the Kinsey scale.

Pete: Yeah, I should know this. This is like all my original research. But so we know that about like 10% of the general population represents some like, say LGBTQ identity, and that the fluidity of sexuality. And so I think the other way I would describe it to people is like, if there's straight, and then gay fluidity means that there's a pendulum in which sexuality swings. Which means that I might be entirely straight, and then if it swings a little bit, like I might look at somebody in a locker room, or some other type of behavior. And I like that you differentiated that, because I think that's really key. And none of it has to do with identity necessarily.

Nikki: No, it's just like, observing,

Pete: It’s just like observing what it is. So I think these are all things that are really difficult for people to talk about. And I'll bring in a little bit of Eastern spiritual practice, where the teachings are interesting related to sex, because they don't talk explicitly around it, per se, other than the fact of like, as long as there's cordial sort of commitment to the behavior from all parties involved, that would be right action.

Nikki: In terms of like… let me make sure I'm understanding accurately, I’m kind of hearing it as, as long as there's respect around it.

Pete: Exactly. Well, I like that you said that. I mean, certainly respect, so there's no place for any kind of like sexual perpetration, obviously. That's against the law.

Nikki: Yes, and what sounds like from that framework too, it's also saying, it's not moral,  

Pete: It's immoral.

Nikki: It’s immoral, yeah.

Pete: Exactly. And that I think, helps some folks that are exploring sexual identity, so that's different. So sexual identity, we could talk about that there's heterosexual, which is the vast majority of the population. And then there's homosexual, there's pansexual, there's asexual, we have LGBT…

Nikki: There’s bisexual,

Pete: Bisexual. There's others that we're going to miss, so we're not trying to name all of them. But just identifying that there's other groups. And certainly, they become more and more nuanced over time, because people find a terms that kind of help fit the identity they have for their behaviors. And we can maybe talk a bit about the DSM, the Diagnostic Statistical Manual that we use here in the US. So here's another shit on US, in a way about sex. Because there's a whole section about sexual fetishes, which are seen as pathologizing in a way, and that's not cool. I mean, I think, what do you think about that?

Nikki: Well, yeah, no. And I mean, I think it's important to say… And up until, I think the year is, it's either 1972 or 1973.  

Pete: You’re so smart, yeah. Well 72 was when the APA was 73 was when it was removed. You go girl.

Nikki: Okay, good. I got a good memory. Thank you… That up until that time, homosexuality was classified as a mental disorder which is so horrifying. And actually, and this is… I'm going to miss. I think it was even up to DSM4, which was 94, it was like gender dysphoria, was the term for… wasn't that right.

Pete: Oh, I actually have a DSM three in my faculty office.

Nikki: Okay, so that's it. And obviously, gender identity is different than sexuality. I'm just trying to give the example of like, there's a history in our field of pathologizing these very normative aspects of human experience.

Pete: Yeah, and it pisses us off, is what we're also saying.

Nikki: Yes. Though, I can also say… but so again, on the other end of it, just to clarify the boundaries. Though, pedophilia, for example…

Pete: Well, exactly. So perversion.

Nikki: Perversions, right. So that also goes in there as… absolutely that would [inaudible 15:58] that hurts people.

Pete: Would probably be limitations that you and I would not treat, that we talked about. Because we're not equipped to… So the DSM5 came out in 2013. And what I'll say about that is like, I feel like what happened in 72, 73, was homosexuality being removed from the DSM. In 2013, the conversation was around transgender essentially, gender identity disorder. And so, what a lot of the literature was making links between these two movements, because in 72 and 3 people were like, “Well, how do you take it out?” And that's the same thing about transgender. Because we're not pathologizing gender identity, but we're not talking about gender identity today. But that we're recognizing that the reason we connect to this is because sex is always linked with gender. And they both present on a spectrum. And that is the thing that's really hard for people to understand, because our brain is so good at putting things into discrete little boxes.

Nikki: That's right. And I want to kind of circle back to something you said in the very beginning, because I think this is a… I know this is something you wanted to really make sure we highlight today, which is, so how can sexual behavior be a part of connection with other humans or with oneself? Like how do you work with that, Pete?

Pete: Yeah, it's one piece of the values. So I think the love languages that I mentioned earlier, are a big piece of it. So the other thing that's important is 50% of sexual encounters within relationships are unsuccessful. And I think…

Nikki: Defined to unsuccessful.

Pete: I think a way that they would define some of that research is that, there was one partner doesn't climax. And that, on average, monogamous relationships have sex 54 times a year. So I like those data, because I think that they help people sort of normalize...

Nikki: It's not perfect.

Pete: It’s not perfect, exactly.

Nikki: Well, so, I mean, I understand why they define it this way. That's so interesting, also, to use the term, it's like successful if someone climaxes, so takes away from that, like, the whole experience, like the myriad of behaviors. Intercourse isn't what defines sexual behavior. It's a behavior, it's a sexual behavior.

Pete: And it depends on who you ask, like Bill Clinton,

Nikki: Right, that's what I’m saying, that’s what I mean. And it's like, that can be a part of connection. So as you said, could like, making eye contact.

Pete: And some of these millennials, so it's important to ask what it actually means. But yeah, I had somebody actually saying that the other day, and I just assumed that's what it meant, but it meant something different. So I think the connection… and so that's what we do clinically, is help the couple define it. And so there's even heterosexual literature on this. There's a book called Open, which is about a female author that wrote about how she and her husband entered into like a non-monogamous relationship, where they had sex outside of their marriage, which again, seen as taboo. And yet, there's space for it,

Nikki: It worked for them,

Pete: It worked for them. And so being able to help them define what it is. So the connection piece, again, it's one piece of that relationship. But finding ways that can connect you to sexual behavior is something that I think our society puts a lot of pressure on.

Nikki: Well, I mean, the movies. Think about it, it's like as if it's…

Pete: Well Porn,

Nikki: Yeah, well that I would say isn't putting pressure for connection, and that's putting pressure for climax. And, for certain… and obviously, I'm not as familiar with the research around this, but I’m somewhat familiar with research discussing the kind of pornography that men, and I'm actually afraid like to cisgender men view, probably particularly maybe heterosexual cisgender men versus cisgender women, and how does that impact expectation? How does that impact actually even, not just connection, but ability to feel physically connected? Because if they're visually overstimulated, regular humans aren't going to activate that level of arousal.

Pete: Yeah. And it creates the expectation that's just unrealistic. And one that actually is pathological and problematic, for sure. And so, hey, this… Okay, we're going to need a Part Two on this.

Nikki: Yeah, I think we do.

Pete: Yeah, we're going to do part two. This was great, though. I think, listeners, this was at least a first introduction to sex and connection. And we're really excited to be able to bring you some more of this in season two, so stay tuned.

Pete: This has been When East Meets West. I'm Dr. Pete Economou.

Nikki: And I'm Dr. Nikki Rubin. Be present. Be brave.

Pete: This has been When East Meets West, all material is based on opinion and educational training of doctors Pete Economou and Nikki Rubin.

Nikki: Content is for informational and educational purposes only.