Come as you are by Emily Nagoski, Ph.D

This book is an incredible book at women’s sexuality and how it works. It is based on brain research that will educate you and transform your life. It explains how each woman has her own unique sexuality, like a fingerprint, and how our bodies respond to the sexual world. Below are quotations from the book that I found incredibly interesting and wanted to share!  

On the day you’re born, you’re given a little plot of rich and fertile soil, slightly different from everyone else’s. And right away, your family and your culture start to plant things and tend the garden for you, until you’re old enough to take over its care yourself. They plant language and attitudes and knowledge about love and safety and bodies and sex. And they teach you how to tend your garden, because as you transition through adolescence into adulthood, you’ll take on full responsibility for its care.

And you didn’t choose any of that. You didn’t choose your plot of land, the seeds that were planted, or the way your garden was tended in the early years of your life. As you reach adolescence, you begin to take care of the garden on your own. And you may find that your family and culture have planted some beautiful, healthy things that are thriving in a well-tended garden. And you may notice some things you want to change. Maybe the strategies you were taught for cultivating the garden are inefficient, so you need to find different ways of taking care of it so that it will thrive. Maybe the seeds that were planted were not the kind of thing that will thrive in your particular garden, so you need to find something that’s a better fit for you.

Some of us get lucky with our land and what gets planted. We have healthy and thriving gardens from the earliest moments of our awareness. And some of us get stuck with some pretty toxic crap in our gardens, and we’re left with the task of uprooting all the junk and replacing it with something healthier, something we choose for ourselves.

Your sexual brain has an “accelerator” that responds to sexual stimulation, but it also has “brakes”, which respond to all the very good reasons not to be turned on right now.

The clitoris averages just one-eighth the size of the penis yet loaded with nearly double the nerve ending.

The prostate swells around the urethra so that it’s impossible for a man to urinate while he’s highly sexually aroused.

In some women, the Skene’s glands produce fluid, which is how some women ejaculate. Female ejaculation= squirting.

How you feel about your genitals and their secretions is learned, and loving your body just as it is will give you more intense arousal and desire and bigger, better orgasms.

The Dual Control Model of Sexual Response: 

Sexual Excitation System (SES)– This is the accelerator of your sexual response. It receives information about sexually relevant stimuli in the environment- things you see, hear, smell, touch, taste, or imagine- and sends signals from the brain to the genitals to tell them, “Turn on!” SES is constantly scanning your context (including your own thoughts and feelings) for thing that are sexually relevant. It is always at work, far below the level of consciousness. You aren’t aware that it’s there until you find yourself turned on and pursuing sexual pleasure.

Sexual Inhibition System (SIS)- This is your sexual brake. “Inhibition” here doesn’t mean “shyness” but rather neurological “OFF” signals. Research has found that there are actually two brakes, reflecting the different functions of an inhibitory system. One brake works in much the same way as the accelerator. It notices all the potential threats in the environment- everything you see, hear, smell, touch, taste, or imagine- and sends signals saying, “Turn off!” It’s like the foot brake in a car, responding to stimuli in the moment. Just as the accelerator scans the environment for turn-ons, the brake scans for anything your brain interprets as a good reason not to be aroused right now- risk of STI transmission, unwanted pregnancy, social consequences, etc. And all day long it sends a steady stream of “Turn Off!” messages. This brake is responsible for preventing us from getting inappropriately aroused in the middle of a business meeting or at dinner with our family. It’s also the system that throws the OFF switch if, say, in the middle of some nookie, your grandmother walks in the room.

The second brake is a little different. It’s more like the hand brake in a car, a chronic, low-level “No thank you” signal. If you try to drive with the hand brake on, you might be able to get there you want to go, but it’ll take longer and use a lot more gas. Where the foot brake is associated with “fear of performance consequences”, the hand brake is associated with “fear of performance failure”, like worry about not having an orgasm.

If you’re having trouble with any phase of sexual response, it is because there’s not enough stimulation to the accelerator? Or is there too much stimulation to the brakes? Indeed, a common mistake made by people who are struggling with orgasm or desire is assuming that the problem is lack of accelerator; it’s more likely that the problem is too much brake. And once you know whether its a problem with the accelerator or the brakes, you can figure out how to create change.

According to the dual control model, arousal is really two processes: activating the accelerator and deactivating the brakes. So your level of sexual arousal at any given moment is the product of how much stimulation the accelerator is getting and how little stimulation the brakes are getting.

We all have different sensitivities of SIS and SES, which leads to different arousability (the potential to be aroused).

The sensitive accelerator plus not-so-sensitive brakes combination describes between 2-6% of women, and it’s associated with sexual risk taking and compulsivity. Because the brain mechanism responsible for noticing sexually relevant stimuli is very sensitive, you’re highly motivated to pursue sex, and because the brain mechanism responsible for stopping you from doing things you know you shouldn’t do is minimally functional, you may sometimes feel out of control of your sexuality, especially when you’re stressed. You’re likely to have more partners, use less protection, and feel less in control. You might also be more likely to want sex when you are stressed (redliners), whereas other women are likely to find that their interest in sex plummets when they’re stressed (flatliners).

If you have the opposite combination- sensitive brakes plus not-so-sensitive accelerator? That makes up 1-4% of women and is associated with difficulty getting aroused, lack of interest or desire, and problems with orgasm. If you have sensitive brakes, you’re very responsible to all the reasons not to be aroused, and if you have a relatively insensitive accelerator, it takes a lot of concentration and deliberate attention to tune in to sex.

The book has a Sexual Temperament Questionnaire included in it. 

On average, men have a more sensitive accelerator. Women, on average, tend to have more sensitive brakes.

The book tells a story of a women who had a multitude of responsibilities in her life. It goes on to say “she didn’t have a particularly sensitive brake- she had an avalanche of stuff constantly putting pressure on a very average brake”. It doesn’t matter how hard you hit the accelerator if the brake is on the floor.

There’s virtually no “innate” sexually relevant stimulus or threat; our accelerators and brakes learn when to respond through experience. And that learning process is different for males and females.

A survey was done by Katie McCall and Cindy Meston about what turns women on and found the results were in 4 general categories:

*Love/Emotional Bonding Cues– feeling a sense of love, security, commitment, emotional closeness, protection, and support. A feeling of “special attention” from partner.

*Explicit/Erotic Cues– watching a sexy movie, reading an erotic story, watching/hearing other people have sex, anticipating having sex, knowing your partner desires you.

*Visual/Proximity Cues– seeing an attractive, well-dressed potential partner, intelligence, and class.

*Romantic/Implicit Cues– intimate behaviors like dancing closely, sharing a hot tub or massage, watching a sunset, laughing or whispering together, or smelling pleasant.

Another study was a focus group of women regarding the thoughts on things that cause them to turn on or to “keep the brakes on” :

• Feelings about one’s body
• Concerns about reputation
• Putting on the brakes
• Unwanted Pregnancy/Contraception
• Feeling desired versus Feeling Used by a Partner
• Feeling “accepted” by partner
• Style of approach/Initiation and Timing
• Negative mood

What a woman wants and likes changes based on her external circumstances and her internal state. It’s all about context!

In a culture where women have to spend so much time with the brakes on, saying no, it’s no wonder we have fantasies about abandoning all control, relaxing into absolute trust (turning off the brakes) and allowing ourselves to experience sensation.

When you are in external circumstances or internal brain state- it doesn’t matter how sexy your partner is, how much you love them, or how fancy your underwear is, almost nothing will activate that curious, appreciative, desirous experience.

When your stress levels are high, practically anything will cause your eagerness to activate in an avoidant, “What the hell is this?” mode.

The context for a sex positive generally is:

• low stress
• high affection
• explicitly erotic

Physical activity is the single most efficient strategy for completing the stress response cycle and recalibrating your central nervous system into a calm state.

Books about sex as a survivor- Healing Sex: A mind-body approach to healing sexual trauma by Staci Haines and The Sexual Healing Journey: A guide for survivors of sexual abuse by Wendy Maltz.

Mindfulness is good for everyone and everything. It is to your mind what exercise and green vegetables are to your body. The practice grants the opportunity to “cultivate deep respect for emotions” differentiating their causes from their effects and granting you choice over how you manage them. If you change only one thing in your life as a result of reading this book, make it this daily 2 minute practice of mindfulness.

We can think of insecure attachments as fitting into two different strategies: anxious and avoidant. With an anxious attachment style, you cope with the risk that your attachment object might abandon you by clinging desperately to them. Anxiously attached children get jealous and experience intense separation distress; so do anxiously attached adults. People with an avoidant attachment cope with the risk that their attachment object might abandon them by not attaching seriously to any specific individual. Avoidant children don’t prefer their parents to other adults; avoidant adults, according to the research, are more likely to approve of and have anonymous sex.

SECURE ATTACHMENT

*I feel comfortable sharing my private thoughts & feelings with my partner.

* I rarely worry about my partner leaving me.

*I am very comfortable being close to romantic partners.

*It helps to turn to my romantic partner in times of need.

ANXIOUS ATTACHMENT 

*I’m afraid I will lost my partner’s love.

*I often worry that my partner will not want to stay with me.

*I often worry that my partner doesn’t really love me.

*I worry that romantic partners won’t care about me as much as I care about them.

AVOIDANT ATTACHMENT 

*I prefer not to show a partner how I feel deep down.

*I find it difficult to allow myself to depend on romantic partners.

*I don’t feel comfortable opening up to romantic partners.

*I prefer not to be too close with romantic partners.

I’ve come to think of staying over your emotional center of gravity as the “sleepy hedgehog” model of emotion management. If you find a sleepy hedgehog in the chair you were about to sit in, you should:

*give it a name

*sit peacefully with it in your lap

*figure out what it needs

*tell your partner about the need, so you can collaborate to help the hedgehog

Getting mad at the hedgehog or being afraid of it won’t help you or the hedgehog, and you certainly can’t just shove it into your partner’s lap, shouting “SLEEPY HEDGEHOG!” and expect them to deal with all its spiky quills. It’s YOUR hedgehog. The calmer you are when you handle it, the less likely you are to get hurt yourself, or to hurt someone else.

We’re raising women to be sexually dysfunctional, with all the “NO” messages we’re giving them about diseases and shame and fear. And then as soon as they’re eighteen they’re supposed to be sexual rock stars, multi-orgasmic and totally uninhibited. It doesn’t make any sense. None of the things we do in our society prepares women for that.

Health at every size: the surprising truth about your weight by Linda Bacon focuses on her decades of research on nutrition, exercise, and health. There are 4 major tenets, according to “The HAES Manifesto”: 1) accept your size, 2) trust yourself, 3) adopt healthy lifestyle habits including joyful physical activity and nutritious foods, and 4) embrace size diversity.

Moral Foundations Theory from Jonathan Haidt and his team found that there are 6 “moral foundations” in the human brain, each of which is a solution to a particular evolutionary problem our species has faced. Of the 6, its the “sanctity/degradation” moral foundation I Find most relevant to sex.

The sanctity foundation is about containment avoidance, and it’s powered by DISGUST. Humans have generalized from avoidance of physical contaminants (rotting corpses) to avoidance of CONCEPTUAL contaminants (we feel grossed out by just the word ‘rotting corpses’). You can visualize sanctity as a vertical axis, with stigmatized and taboo behaviors described as “low” and “dirty”, and socially sanctioned behaviors as “high” and “pure”. We judge as wrong anything associated with lowness. In the Judeo-Christian ethic, bodies are low and spirit is high, animal instincts are low and human reason is high, and very often women are low and men are high. Sex draws attention downward to the base, the animal, the contemptible, and it therefore triggers the disgust response.

Sex and bodies are not “low” or “degrading”, they can be sanctified and glorious. But many of us were raised in cultures that say our own sexual bodies are disgusting and degrading, and so are the fluids, sounds, and smells those bodies make, as are a wide array of the things we might do with our own bodies and our partner’s.

For sex educators, the rule is, “Don’t yuck anybody’s yum”. And since we can’t know what everybody else’s yums are, we don’t yuck anything.

Sex negative culture has trained us to be self-critical and judgmental about our bodies and our sexualities, and it’s interfering with our sexual wellbeing. So how do we create a bubble of sex positivity for ourselves, where we can explore and celebrate and maximize our own sexual potential? How do we maximize the yum, in a world that tries to convince us we’re yucky?

I’ve found persuasive evidence that the following strategies can genuinely create positive change.

Self-Compassion-which has to do with self-kindness, common humanity, and mindfulness. 

Self-kindness is our ability to treat ourselves gently and with caring. Common humanity is viewing our suffering as something that connects us with others, rather than separates us. Mindfulness is being nonjudgmental about whatever is happening in the present moment.

Nonconcordance is normal, everyone experiences it, and that you must pay attention to your partner’s words, rather than their genitals. Nonconcordance is about the relationship between the peripheral system (the genitals) and the central system (the brain): two separate but interconnected systems. And the relationship between these systems is different for women and men. Nonconcordance shows up in many kinds of emotional experiences, and men and women experience nonconcordance differently in those emotions. It’s not a sex thing; it’s a human thing. Nonconcordance isn’t news- or it shouldn’t be. So what gives? Why does it feel so new, when every other year a book comes out that talks about it? PATRIARCHY. For centuries, male sexuality has been the “default” sexuality, so that where women differ from men, women get labeled “broken”. Even men who differ from the standard narrative get labeled “broken”. Men have, on average, a 50% overlap between their genital response and their subjective arousal, and therefore, the patriarchal myth goes, everyone should have a 50% overlap. But women aren’t broken versions of men; they’re WOMEN.

Every guy, at some point in his life, has the experience of wanting sex, wanting an erection, and the erection just isn’t there. In that moment, the erection (or lack thereof) isn’t a measure of his interest- he might even wake up the very next morning with an erection, when it’s nothing but an inconvenience. Guys sometimes wake up with erections, not because they’re turned on but because they’re waking up out of rapid eye movement (REM) sleep, and one of the things that happens during REM is “nocturnal penile tumescence”. Erections come and go throughout the sleep cycle, whether or not you’re dreaming about sex. It doesn’t mean anything, it’s just an erection. It’s nonconcordant.

Genital response is not desire; response isn’t even pleasure. It is simply response. For everyone, regardless of their genitals. Just because a male body responds to a particular idea or sight or story doesn’t mean that he necessarily likes it or wants it. It just means it activated the relevant pathways. 

At most, blood flow to the genitals often- not always-is simply information about whether they have been exposed to something that their brain interpreted as sexually relevant- with no information about whether they liked it. Your genitals are telling you something, and you can trust them. They’re telling you that something is sexually relevant, based on their experience of Pavlovian conditioning. That’s not the same as sexually appealing. 

Bodies don’t say yes or no, they only say, “That’s sexually relevant”, without any comment on whether it’s appealing, much less whether it’s wanted. 

Male and female sexualities are made of the same parts, just organized in different ways, and you know that no two people are alike. You know that what activates your accelerator or hits your brake is context dependent. You know that women’s sexuality is even more context sensitive than men’s, that developmental, cultural, and life history factors all profoundly shape how and when our bodies respond. You know that sexually relevant and sexually appealing are not the same thing. 

Pink Viagra-the elusive “pink viagra” doesn’t exist because the drug would be designed to turn off your brakes by changing your brain rather than by changing the context to which the brakes are responding. 

The reason to bother is that life factors like relationship satisfaction and trauma history significantly impact sexual wellbeing. We don’t need to reduce nonconcordance. We need to improve the contexts-external circumstances and internal states such as stress, attachment, self-criticism, and disgust. It doesn’t take a pill to do that. 

Remember that you are heathy and functional and whole. Your body is not broken and you are not crazy. Your body is doing what bodies do, and that’s a beautiful thing. Hooray! So know that you are normal. 

The standard narrative of sexual desire is that it just appears – you’re sitting at lunch or walking down the street, maybe you see a sexy person or think a sexy thought, and POW! you’re saying to yourself, “I would like some sex!” This is how it works for maybe 75% of men and 15% of women. That’s “spontaneous desire”. But some people find that they begin to want sex only after sexy things are already happening. And they’re normal. They don’t have “low” desire, they don’t suffer from any ailment, and they don’t long to initiate but feel like they’re not allowed to. Their bodies just need some more compelling reason than, “That’s an attractive person right there”, to want sex. They are sexually satisfied and in heathy relationships, which means that lack of spontaneous desire for sex is not, in itself, dysfunctional or problematic! Let me repeat: Responsive desire is normal and healthy. And it’s how roughly 5% of men and 30% of women experience desire. Only 6% of women lack both spontaneous and responsive desire. You’ll notice this leaves about half of women and about 1 in 5 men unaccounted for. These are folks whose desire style is probably context dependent. 

It turns out everyone’s sexual desire is responsive and context dependent. It just feels more spontaneous for some and more responsive for others, because even though we’re all made of the same parts, the different organizations of those parts results in different experiences. 

Desire is arousal in context. And then we’ll talk about what desire is not- it’s not a drive, not a “hunger”- and why that matters so much. 

Here’s how sexual desire really works. First, arousal begins when you activate the accelerator and take pressure off the brake- turn on the ons and turn off the offs. (And you know that arousal is what happens between your ears, not what happens between your legs). And then desire comes along when arousal meets a great context. 

Below are 3 scenarios, each with the same stimulation, same brakes and accelerator, but different contexts.

Scenario 1- You’re feeling very calm and happy and trusting, not doing anything in particular, and your partner comes over and touches your arm affectionately. The touch travels from your arm, up your spine, to your brain. In this state of mind, your central nervous system is very quiet, there’s very little other traffic, and the sensation of your partner’s touch says, “Hey, so, this is happening. What do you think?” And your brain says “Affection feels nice”. The stimulation continues, your beloved partner touching your arm affectionately, and the sensation travels up to your brain and says, “This is happening some more. What do you think?” And your brain says “Affection feels really nice”, and tunes it attention more to that sensation. Then your partner starts kissing your throat, and that sensation makes its way to your emotional brain and says, “Now this is happening too. What do you think?” And by then the brain says, “That is fantastic! Go get more of that!” In that context, sexual desire feels responsive. 

Scenario 2- You’re stressed, exhausted, or overwhelmed, it’s very noisy in your brain, there’s heavy traffic, lots of yelling and horns honking about all the stuff that’s stressing you out. Your partner’s affectionate touch travels from your arm, up your spine, to your brain, and it says “This is happening. What do you think?” And your brain says, “”WHAT? I CAN’T HEAR YOU OVER ALL THIS NOISE!” And by then the sensation is over. If your partner keeps touching you, the sensation keeps asking your brain, “This is still happening. What do you think?” And eventually is might get your brain’s attention, and your brain might say, “ARE YOU KIDDING ME? I’VE GOT ALL THIS OTHER NOISE TO CONTEND WITH!” And if the sensation ever gets noticed enough to expand our of your brain’s emotional One Ring, it comes out in the form of, “Not now, honey”. 

Scenario 3- Your sexy, sexy partner has been away for 2 weeks, but you’ve been sending each other frequent texts, which started out flirty but have been gradually escalating in explicitness and intensity as you get more and more into teasing and tormenting each other. By the end of the 2 weeks, just the sound of your phone receiving a text makes you gasp and tremble. There’s noise in your brain, but all of it is chanting, “Sexy, sexy partner!” By the time your partner gets home and touches your arm affectionately, you’re set to go off like a rocket. In that context, sexual desire feels spontaneous. 

Arousal comes first, before desire- for everyone. Desire emerges when arousal crosses the person’s individual threshold. 

A lot of women, on learning that they have a responsive or context sensitive desire style, feel instantly relieved to know that there’s nothing wrong with them, that they just need more of a reason to have sex than folks with a spontaneous style do. They get busy understanding the contexts that make them hot and talking with their partner about ways to increase access to those contexts. 

The cultural dominance of spontaneous desire is actually grounded in the myth of sex as a drive. A drive is a biological mechanism whose job is to keep the organism at a healthy baseline- not too warm, not too cold, not too hungry, not too full. A traditional metaphor for a drive system is thermostat. Appetite is the classic example of a drive. Hunger for food drives foraging and eating, and then when you feel full, you stop eating. There are lots of other drives: thirst drives fluid consumption, fatigue drives sleep, thermoregulation drives shivering, sweating, taking off a sweater, or turning up the thermostat. These are all drives, BUT SEX IS NOT A DRIVE.

When your stress response kicks in, your interest in sex evaporates. In a calm state of mind, pretty much anything will evoke curious, “What’s this?” exploration, while in a stressed state of mind, almost nothing will. It is important to get ALL THE WAY OUT of the parenting-bosslady-worker-omg-life state of mind and into a state of mind that allows your stressors to slip into the shadows of your attention for a bit while hey-sexy-lady stands in the spotlight. All that needs to change is context. 

The differential in desire is the single most common sexual dysfunction- but it’s not the differential itself that causes the issue; it’s how the couple manages it. Problematic dynamics emerge when the partners have different levels of desire and they believe that one person’s level of desire is “better” than the other person’s. 

What men-as-default puritanical culture expects, wants, and likes is pleasure for men and babies for women. 

Understanding that sex is an incentive motivation system- that responsive desire is normal and healthy- will give everyone a better sex life. If you have responsive desire and want to experience more active desire, you don’t need to change YOU, you can just change your context.

In terms of managing sexual desire in your relationship, the key is to differentiate between the desire and your feelings about the desire. 

It took decades of planting and cultivation to create the garden you currently have. It won’t change overnight. Give yourself permission to make progress gradually, and celebrate all the incremental steps between where you are now and where you’d like to be. And the most important turnoff the offs practice of all: self-kindness. 

It’s about  what happens when you make contact with the peace at the center and core of yourself, which is the same peace at the center and core of the universe, and it resonates through you, like you’re a bell that’s ringing. 

For many of us, the goal states we have in mind-such as spontaneous desire or orgasm with intercourse- are not goals we have chosen consciously for ourselves. We absorbed them from our culture in the form of sexual scripts. These scripts provide the structure for the beliefs through which we interpret the sexual world. Becoming aware of your scripts is the first step to changing your meta-emotions. 

Over the last few decades, research has followed how sexual scripts have changed in Western culture. Recent cultural scenario scripts may include: 

• Men’s sexuality is simple and women’s sexuality is complex.
• Women don’t have as strong a sex drive as men.
• Orgasm is central to a positive sexual encounter.
• Sex is more emotional for women than for men.

The scripts are written into your brain early, by your family and culture. You can disagree with a script and still find yourself behaving according to it and interpreting your experience in terms of it. The technical term for this process of organizing your experience according to a preexisting template is “probabilistic generative model”. It means that information- anything you see, hear, smell, touch, or taste- goes first to your emotional brain, where prior learning plus your present brain state combine to shape the initial decisions your brains makes about whether to move toward or away from that information. A simple way to understand it, is in terms of maps versus terrains. Your knowledge about sex is a map of the sexual terrain where you experience sexuality. We’ve got this map in our heads and we step into the terrain expecting to find a path in one place, and instead we’re instantly lost. Perhaps the biggest challenge is that when the map and the terrain don’t match, our brains try to make the map true, forcing our experience into the shape of the map. “No, no, no, this is the trail” we say as we stumble through the thicket. “It says so on the map”. Frustration will ensue when you keep trying to make the experience match the map. 

The first step in changing your meta-emotions is recognizing the difference between the goal state dictated by the script and what you’re actually experiencing. I have two general rules of thumb for navigating this difference:

*When the map (script) doesn’t seem to fit the terrain (experience), the map is wrong, not the terrain.

*Everyone’s terrain and everyone’s map are different from everyone else’s. 

What these 2 rules mean is that your best source of knowledge about your sexuality is your own internal experience. When you notice disagreement between the terrain and the map- and everyone does, at some point- always assume your body is right. 

There are two especially important ground rules for couples when it comes to communicating about sex. Neither of you chose your feelings- but both of you choose how you feel about those feelings. One of the most problematic messages in emotion dismissing meta-emotions is that emotional reactions are a choice. Like you’re “choosing” to have responsive desire or “choosing” not to have orgasms with intercourse. But you don’t choose that stuff. You didn’t choose the brain chemistry you were born with, you didn’t choose the family or the culture you were born into, and you don’t choose what your body does today in response to sexually relevant stimuli. What you can choose is how you feel about all of that- and so can your partner. And feeling okay with it is what makes the difference. If you’re in  relationship where one partner wants sex more than the other, it is seriously unhelpful if one partner feels that the other is “choosing” their desire level. 

Remember that the way to make someone feel better and fix the problem is to allow the person to move all the way through the tunnel, complete the cycle. This is not a stimulus-response kind of problem- like “IF partner is crying, THEN cheer partner up instantly”. No. If your partner is crying or otherwise having an intense emotional experience, remember it’s their sleepy hedgehog, and your job is to listen for what the hedgehog needs while allowing your partner to complete the cycle. 

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