Sexual Healing


By Mark Epstein, M.D.  |  

With the passing of the so-called “sexual revolution,” the consensus seems to be that sexuality is no longer the centerpiece of neurosis. “Money is the new sexuality,” I’ve heard people say. “It is the one thing we don’t talk about, even in therapy.” But in my experience, there is no such thing as a new sexuality. The new one is the same as the old one, tarnished a bit by the assumption that we should be beyond all this by now.

As a psychiatrist to people with spiritual aspirations, I am witness to some of the ways in which spirituality and sexuality interact, not always to either of their benefits. Freud once said that sexuality contained a “divine spark,” but his indefatigable promotion of the instinctual components of desire has done much to remove its connection to the sublime. The recent surge of interest in Tantric sexuality has sought to reestablish that lost connection. There is a groundswell of attention to aspects of sexual relations often overlooked in our culture of immediate gratification. In most portrayals of sexual yoga, for example, the man is encouraged to give priority to his partner’s arousal rather than his own. Both people are urged to bring pleasurable feelings upward from their genitals to the heart and head, prolonging their intermingling while allowing sexual bliss to course through mind and body. In a reversal of the usual sexual dynamic, men are urged to absorb the female secretions—to drink their bliss—rather than ejaculating.

In actual practice, most of the popular seminars and literature on Tantric sex seem to be oriented toward helping people over their sexual inhibitions. Men are given something other than their own release to focus on, and women are affirmed in the richness and complexity of their sexual response. Yet there is no denying the changes in attitude that these efforts encourage. A movement is afoot to reclaim the sacred quality of sexual relations, to rescue it from the language of instinct and from the commercial exploitation of Madison Avenue. People want something more from their sexual lives, and they are turning to the East for a reminder of what that might be. In a new book called Darwin’s Worms (Basic Books, 2000), the British child psychoanalyst Adam Phillips writes of Freud’s discussions of desire in a way that suggests that Freud knew more of Tantra than we might have suspected.

Phillips retells a story of Freud’s from an often overlooked paper called “On Transience.” In this vignette, Freud told of walking in the countryside with two friends who were resolutely unmoved by the beauty of all that surrounded them. Freud was puzzled by their failure to open and began to analyze what their problem might be. It was the transience of the physical world that was unnerving his friends, he decided. They were guarding themselves against a feeling of sadness that was an indivisible part of appreciation. Like a lover who has been hurt one too many times, Freud’s friends were keeping themselves unapproachable. They were stuck in a state of abbreviated, or interrupted, mourning. Unable to embrace the object of their desire, they retreated to a sullen and unapproachable place.


But Freud was soon persuaded that his friends’ reactions were not an anomaly. As Phillips concludes, in a deft twist of phrase, there seems to be two types of people in the world, “those who can enjoy desiring and those who need satisfaction.” Freud’s companions were definitely of the school that needed satisfaction; but Freud, the apostle of instinctual gratification, was someone who could understand the enjoyment of desire.

Like Freud’s friends, most of us are conditioned to look for satisfaction. When it is not forthcoming, or not lasting, we tend to withdraw. Freud proposed an alternative. It is possible to be in a state of arousal in which desire itself is valued, not as a prelude to discharge but as a mode of appreciation. In sexual yoga, this is usually described, for the male, as separating orgasm from ejaculation. Orgasm becomes more female in form, coming in waves that wash over one another. When release is not linked to emission, there is more room for spirit to fill the space of sexuality.

As this possibility has filtered into popular consciousness, it has sometimes been put to defensive uses, not just to spiritual ones. I have heard a number of stories in my therapy practice, for instance, about men who will not come. Under the guise of Tantric sexuality, these men withdraw from sexual relations after some period of intercourse, leaving their partners dissatisfied. Rather than choosing between desire and satisfaction, like Freud’s friends, they turn their backs on both, closing themselves off from the beauty that surrounds them while priding themselves on their ability to withhold.

A patient of mine named Bob, for example, was an appealing man with a winning smile who was a great devotee of female beauty and charm, but he was something of a tease with women. He gave the impression of whole-hearted interest when he met someone he was attracted to, but he would often disappear if she too obviously returned his attentions. He puzzled many would-be lovers with his skittishness. Married once in his 20s, Bob was now a successful physician in his mid-40s. He had been single for close to 20 years. He lived a quiet, self-contained life and was much attracted to the philosophies of yoga and meditation.

In his sexual relations, Bob often took the ascetic path. He would initiate sex, participate for a while, but then refrain from orgasm, explaining his actions in terms of sexual yoga. I was suspicious, however. I did not hear reports of resounding bliss, only what sounded like gradual disengagement.

In Miranda Shaw’s Passionate Enlightenment (Princeton University Press, 1995), she emphasizes the quality of relationship that defines yogic union. It is a relationship in which the energies, breath, and fluids of each partner mix to such an extent that blissful states are achieved that would otherwise remain inaccessible to an individual practitioner.

“Are you experiencing this kind of mutuality?” I asked Bob. Over time, Bob came to appreciate that he was not. Feeling guilty about his unreliability, Bob tried to avoid getting any of his girlfriends too attached to him. “I don’t want them to see what a cad I am,” he admitted. I pointed out that this was exactly what they were seeing.


Bob believed in romantic love and was disappointed over the failure of his first marriage, but in a reversal of the model of courtly love that is the basis for our notions of romance, Bob made himself into a receding object of desire. His girlfriends were like medieval knights questing after his ever-dissolving affections. Bob abandoned the role of the pursuer, but he had not freed himself from the entire schema. He had simply made himself into the pursued.

Bob and his lovers were not enjoying their desire, nor were they obtaining satisfaction. As we talked about all of this, Bob saw how much he blamed himself for the inevitable demise of his first marriage. He had not really let go of his ex-wife, or at least not of his feelings of failure in the marriage.

His incomplete mourning, like that of Freud’s friends, interfered with his ability to give himself over to more current passions. His Tantra was not really Tantra. Rather than opening himself and his partner to unexplored states of bliss, Bob hung on to one particular state of arousal. He hid himself within that state, under the guise of being a sexual yogi.

In some ways, he was like a person addicted to his peaceful meditation. He found solace in his ability to prolong his arousal, just as many meditators take comfort in their self-induced relaxation. But he was stuck there, using notions of sexual yoga to limit his engagement with another.

There is an old Tibetan saying that goes something like this: “Just as the waters in the high mountains improve by falling, so do a yogi’s meditations improve by dissolving.” Perhaps the same can be said of a yogi’s erections. Attachment to any state, no matter how idealized, only perpetuates suffering.

Mark Epstein is a psychiatrist in New York and author of Going on Being, (Broadway Books, 2001). He’s been a student of Buddhist meditation for 25 years.