Beyond Dysfunction: Why Sexual Pleasure Deserves a Central Role in Therapy
Key Takeaways
One of the great things about attending a conference in another country is that you get to learn a lot more about the kinds of research being done in there. One talk that stood out to me at this year’s Society for Sex Therapy & Research (SSTAR) conference in Vancouver, Canada, was presented by Ela Turkkan, from the Sexuality and Well-Being Lab at the University of British Columbia. Traditional sex therapy has focused on understanding and treating sexual dysfunction, not on the nuances of sexual pleasure. In 2002, the World Health Organization (WHO) integrated pleasure into its fundamental definition of sexual health. This pivotal inclusion has further advanced a sex-positive framework across clinical practice, academic research, and sexual advocacy.
In my clinical practice, I certainly engage in deeper inquiry into the lived experience of pleasure to foster greater satisfaction; however, if I’m being truly honest, the primary objective has historically centered on mitigating dysfunction. This clinical lean is reflected in my academic work as well; in my research exploring the impact of childhood maltreatment on sexual health. I realized that I, too, have omitted specific metrics for assessing sexual pleasure.
This got me thinking— how does a sex therapist really assess and measure sexual pleasure as part of sexual health outcomes in clinical practice?
Turkkan’s talk presented original research that sampled university students in a qualitative study to learn more about the nuanced ways in which they described sexual pleasure. While this sample is limited with regard to the demographics, it was most interesting learning that very few individuals in the study defined sexual pleasure on the basis of penetrative intercourse or orgasm.
The Nuanced Lived Experience of Sexual Pleasure
Research consistently shows that sexual pleasure is a deeply personal phenomenon that extends well beyond the singular event of an orgasm. Researchers, such as Turkkan and the team at the Sexuality and Well-Being Lab, have begun to map these experiences across several interconnected, nuanced dimensions.
Physical & Sensual PleasureThis encompasses the direct sensory experiences of sexuality, including the body's emotional and physiological responses to touch, arousal, erotic anticipation, and the specific sensations of physical release.
Personal & Psychological PleasureSexual satisfaction is also rooted in internal psychological states, such as sexual confidence, a sense of empowerment, and the feeling of being personally validated and deserving of affirming sexual experiences.
Relational & Interpersonal PleasureFor many, pleasure is inextricably linked to emotional closeness and relational safety. This includes the capacity for intimacy, trust, and the mutual exchange of pleasure through a bonded connection with a partner.
In similar research*, sexual pleasure is conceptualized as a multifaceted phenomenon, woven from threads of physical sensation, emotional resonance, psychological meaning, and validation found in relational experiences and personal fulfillment. This work highlights that sexual pleasure is not a singular event, but a sophisticated interaction among our bodies, minds, and the lived history of our relationships.
A distinction is also made between:
Trait: a person’s broader, long-term capacity or tendency to access sexual pleasure over time.
State: the immediate, moment-to-moment experience of pleasure during a specific encounter, and
This nuance helps us understand why some individuals may struggle to achieve consistent satisfaction, even when a pleasurable experience is possible. Below is a model of sexual pleasure from this research.
Domain: Physical & Sensual Pleasure
Capacity for Sensual Enjoyment (Trait / Long-Term Tendency)
A person’s general ability or tendency to experience pleasure from physical, erotic, and sensory stimulation, including the body’s emotional and physiological sexual responses.
Experienced Sensual Pleasure (Moment-to-Moment Sexual Experience)
The actual feeling of physical and sensual enjoyment during a sexual experience, including bodily pleasure, arousal, and orgasmic sensations.
Domain: Relational & Interpersonal Pleasure
Capacity for Emotional Connection During Sex (Trait / Long-Term Tendency)
A person’s tendency to experience pleasure through emotional closeness, attachment, trust, affection, and relational safety during sexual experiences.
Experienced Emotional & Relational Pleasure (Moment-to-Moment Sexual Experience)
The degree to which someone feels emotionally connected, safe, cared for, affectionate, and bonded during sexual interaction.
Capacity to Enjoy Shared Pleasure (Trait / Long-Term Tendency)
The ability or tendency to enjoy both giving and receiving pleasure with a partner, including mutual responsiveness and sexual reciprocity.
Experienced Shared Pleasure (Moment-to-Moment Sexual Experience)
The pleasure experienced through mutual interaction, emotional exchange, and the shared experience of sexuality with a partner.
Domain: Personal & Psychological Pleasure
Sexual Confidence & Competence (Trait / Long-Term Tendency)
A person’s belief in their ability to engage in pleasurable sexual experiences, including confidence, knowledge, communication, and sexual skills.
Experienced Sexual Mastery (Moment-to-Moment Sexual Experience)
Feeling capable, effective, confident, and empowered in creating or participating in pleasurable sexual experiences.
Sexual Self-Worth (Trait / Long-Term Tendency)
A person’s overall sense that they are deserving of positive, pleasurable, healthy, and affirming sexual experiences.
Experienced Sexual Validation (Moment-to-Moment Sexual Experience)
Feeling valued, worthy, emotionally affirmed, and deserving of pleasure during sexual experiences.
Ultimately, sexual pleasure is a sophisticated and multifaceted phenomenon, weaving together the immediate, moment-to-moment sensations of an encounter with a person’s broader, long-term capacity for fulfillment. Furthermore, this pleasure extends far beyond the singular event of an orgasm; it is rooted in the nuanced ways we perceive and experience both our internal selves and our relational connections. For me, as a sex therapist, this perspective is vital. By helping clients who are navigating sexual dysfunction recognize that they are already accessing dimensions of pleasure, we can foster greater sexual confidence and a more expansive, affirming understanding of who they are as a sexual person.
If you are interested in exploring how to foster greater satisfaction and increase your experience of sexual pleasure, contact me today!
References
*Werner, M., Borgmann, M., & Laan, E. (2023). Sexual pleasure matters – and how to define and assess it too. A conceptual framework of sexual pleasure and the sexual response. International Journal of Sexual Health, 35(3), 313-340. https://doi.org/10.1080/19317611.2023.2212663
