Castellanos - Wanting to Want: What Kills Your Sex Life and How to Keep It Alive

Having practiced sex therapy in New York City for over a decade, I can tell you that most people still arent sure exactly what sex therapy is about. Besides fielding questions about how long therapy takes and what it entails, Ive also had questions like, Am I going to have to take my clothes off?

Sex therapy is based on classic talk therapy, where the therapist and client explore all the factors that may be preventing a full expression of that persons sexuality. Although physical factors can play a major role in sexual dysfunction, psychological causes are actually more likely, and a combination of both factors is usually involved. Its not unheard of to see an eighty-year-old with plenty of sexual desire who enjoys his or her sex life, or instead a physically healthy twenty-five-year-old who is unable to find sexual pleasure either with a partner or alone. As a medical doctor (M.D.) specializing in psychiatry, I am in a unique position to help patients address both the physical and psychological aspects of sexual dysfunction. Interestingly, its usually the psychological aspect that causes the most difficulty in the area of sexuality. Fortunately, gaining a better understanding of how those forces work, everyone can significantly improve his or her sex life.

Its not uncommon for people to enter into sex therapy with the romanticized hope that the therapist will utter a magical phrase that will somehow turn everything around for them. Part of this comes from feelings of helplessness and frustration in dealing with sexual difficulties. Part of it also comes from not being aware of the major factors that can derail ones sex life.

I am honored to be able to teach people about the makeup of their sexual nature and how they can improve their sex lives and relationships. Everything you have learned about sex over your lifetime, all your desires and curiosities, all the ways you like to express yourself sexually, and all the ways your personality is channeled through your sexual expression are all facets of your sexual self.

One of my passions is getting people in touch with their true natures, both physically and psychologically. When you get to know your sexual self and nurture and support it, you experience more pleasure and personal growth, not just in your sex life but in all areas of your life. This is why I want to give you some insight into the most common roadblocks to good sex. Since what you experience psychologically gets translated into your physical body, internal factors can often manifest as physical symptomsa sign that your sexual self is trying to tell you something.

Much of the advice readily available about how to improve your sex life is focused on aspects outside of youhow to give oral sex, how to dress up date night, and ways to excite your partner. But based on my clinical experience with thousands of people, I can tell you that the biggest factors affecting your sex life come from within. Usually your own insecurities and fears and the limits of your comfort zone contribute more to the quality of your sexual pleasure than any external factors.

In this book, I want to introduce you to the factors I see most commonly in my practice that affect peoples ability to have maximal sexual pleasure. Each of these can be a potential roadblock that keeps you from creating powerful, exciting experiences time after time. What youll learn is very different from what the majority of sex advice offers because Im not promising a quick fix. Instead, well take a good, hard look at the realities of our sexual nature, how its influenced by our internal world, and how to work with it for a happy sex life.

The most common difficulties I see in my practice are problems with low sexual desire and problems with sexual arousal. There can be several different causes for problems with sexual desire, sexual arousal, and other sexual dysfunctions that people dont usually think about. Clients often lump together the difficulties of desire and arousal, especially since there is so much overlap between the two. In fact, desire and arousal can either reinforce each other or sabotage each other. When one is present, it usually affects the other.

The problem of low sexual desire is perhaps the most common sexual difficulty that I (and other therapists) see. Despite the hope for a simple answer, low sexual desire is an extremely complex dilemma. Sexual desire is dependent on the interplay of whats going on physically, psychologically, emotionally, and in relation to your partner. Of course, dissecting the entire web of interactions that take place to either boost or to ruin desire is beyond the scope of this book. Instead, I want to give an honest and approachable look at the things you can do today to give you maximum sexual pleasure for a long-lasting sex life.