The Orgasm.

We live in a time of lauding actions and plans for action, where people often seek relief by ‘taking action’, be it a ‘strategy’, a ‘hack’, or ‘one weird trick’. The orgasm is a reflex that offers most clarity on the fallacy of applying universally this approach to problem solving.

Photo by Darius Bashar on Unsplash

Psychotherapists have often complained to me that Medical Practitioners refer them patients whom they have primed to expect ‘strategies’ for their maladies. ‘My doctor said you would give me strategies for my anxiety.’ Or ‘What strategies do you have for my ADHD?’ I’ve treated other psychotherapists who endorse this expectation and have told me how they often feel they have failed their patient, unless the patient leave the session armed with a clear, deployable technique of actions. (Or at least some piece of paper with writing on it.) Something has at least been ‘given’ to the patient. A ‘mere’ insight, explanation, or experience of emotional contact would fail to satisfy that requirement. You’ve got to do something.

Psychoanalytic colleagues often lament this expectation among new patients, whether it should come from the patient’s medical doctor or from a TikTok. Psychoanalytic therapists are not usually ‘all about action’. Psychoanalytically speaking, taking quick action runs the risk of avoiding contact with the feelings and dynamics of the problem itself. We can guard against this pitfall by not conflating the unpleasant feeling (e.g., anxiety) with ‘the’ problem and using that to justify quick action, before the feeling can even be given a moment to explain itself. The risk is, in other words, that the problem won’t be understood, and the unpleasant feeling won’t be recognised as the mere herald of the problem itself. From the psychoanalytic point of view, there can be no rational strategy in response to (say) anxiety until that specific anxiety has been understood for that specific patient. Usually, by the time the fuller understanding of the problem has been reached, it leaves the patient with their own sense of what action (if any) need be taken. Psychoanalysis tells us that we are more helpless in influencing the parts of ourselves we don’t understand, and so understanding expands our range of natural and unforced impact upon the parts of our life that we do not like.

The problem with strategies.

Many strategies for ‘coping’ with emotional unpleasantness share the element of deploying the cognitive faculty to assert influence over the emotional one. ‘If I feel anxious, I can tell myself X, and my anxiety will be silenced¹.’ Coping with anxiety can then come to sound like coping with an irritating and noisy neighbour: If you cannot have her evicted, you must find a way to put up with her, including responding in a premeditated way when she intrudes. This rhetorical stance implies that the anxiety is a foreign body in the patient’s psyche, and something to be removed or annihilated. The jargon for subjective experiences like these is ‘ego dystonic’, meaning that the person themselves does not identify with the experience/feeling they are having. It is an intruder. So invoking a ‘strategy’ serves, in that sense, to keep the unwelcome feeling identified as an interloper and thus maintain existing self-definitions, by delineating and undoing whatever feels foreign. The strategy keeps the anxious part of the person in conflict with the rest of the person. It maintains the split. Naturally, this will also, therefore, prevent expanding definitions of self that might emerge from integrating the ego dystonic feelings (in some evolved form) instead of keeping them at bay.

I’ve positioned psychoanalysis here as an alternative, an almost perfectly opposite approach to the ones of taking action and deploying strategies. But in the culture that trusts action, analysis itself can easily be mistaken for a number of conventionally denigrated approaches to life. Some of these might include self-pity, navel-gazing, wallowing, etc… Notice how each of these carries an implication of futility in the vernacular; nobody says, ‘If we would only spend days wallowing in self-pity and navel-gazing, we would emerge with a real solution to world hunger.’ No: these descriptors carry a prejudice for impotence. And the accusation of not taking action is implicit: Whatever you do, you must do something. But while analysts might argue with behavioural therapists about the virtue of not beginning with action, there is at least one area where trying to ‘do something’ is a sure path to hopeless failure: The orgasm.

The problem with the orgasm.

The orgasm is a reflex. Psychoanalyst Wilhelm Reich wrote many books in the first half of the twentieth century on the role of the orgasm in the psychic economy, most notably his ‘Function of the Orgasm’ in 1927. His clinical thesis included a treatment pathway of rehabilitating the orgasm reflex as as a cure for neuroses that is an alternative to classical psychoanalysis. He is remembered for his emphasis on the correlations between the psyche and the physical features and expressions of the patient (e.g., gait and posture as reflections of psychological defences). Today we see a better integration of physicality into psychotherapy than was the case in the epoch of Reich, whose trajectories from physicality to bioenergetics render him at once a genius among many practitioners of body psychotherapy and an outcast among classical analysts.

The problem he found common among all his neurotic patients was their inability to surrender completely to the orgasm reflex. The orgasm is an involuntary reflex that offers great health benefits to the body and mind, and great compromises to the health of body and mind ensue if it is not achieved completely. That it is an involuntary reflex implies that its achievement depends upon psychological surrender; not surrender to anything external, but surrender to an internal, natural, and healthy reflex. Reich’s neurotic patients were not ‘orgastically potent’, because they did not fully discharge at orgasm the sexual energy cultivated during the sexual act. What is crux for psychotherapy is the assertion that any undischarged remnants of sexual energy serve to fuel neuroses secretly, because the neuroses need such energy to survive. The treatment was a starvation of the neurosis, rather than an unravelling of the neurosis.

Note how the goal of surrender stands in maximum contrast with the contemporary faith in actions and strategies. The solution to the neurotic structure is not to do something, not to learn how to do something, but rather to learn how to do nothing. I choose the word ‘learn’ deliberately, because I see in almost all of my patients this very ‘need’ of learning how to do nothing, precisely because taking action and striving are so culturally ingrained. For many of my patients, becoming orgasmic was a matter of learning how to stop doing a number of other things psychologically, in order ‘to allow’ their reflex to take them over.

So what were they doing that they had to learn how to give-up doing? Mostly things in their minds, which involved ‘concepts’ about sex that begat efforts to adhere to a mode, attitude, or countenance during the sexual act. Our culture abounds with ideas about what sex is that serve readily to prevent direct experience of sex. Let us consider some of them.

I hear sex often described in terms of a ‘technique’ of actions. But this essay is a discussion of a different perspective, from which the decisive technique is to have no technique in your mind: No self-consciousness, no restraint, no stress over curation of the moment. Instead, it begs a neglect of any mentation that takes one away from the subjective physiological and psychological experience. What is happening from the external point of view on a sexual encounter can be profoundly distracting from the meaning of the sexual experience. How it looks is irrelevant. Again there are great obstacles here: We live in an age where watching others have sex (usually staged, performed, and directed) is mistaken for an accurate telling of sex itself. Young people often take this equivalence as read, but an analogy might be to imagine living in an age where nobody listened to Beethoven anymore, but only read the score. ‘How it looks’ is not sex, it’s erotica; and while erotica is not wrong, sex is more than erotica. (Just as theology is not God, it’s the study and examination of God; God is not exhausted by the concepts of theology.) One clear example can be found in videos of sex. It is the (correct) requirement of video, as a principally visual medium, to have something to look at; erotic movies must necessarily privilege any visually obvious sexual interaction, even though the most profound and devastating sexual experiences might be nothing to look at from the outside. But for video, the medium demands it. The more violent frictions of the sexual embrace are more evident visually and will, therefore, be privileged in video; while the subtler and more gentle frictions are routinely identified by the sexually potent as the most powerful. They just doesn’t look as good on film.

The internal experience that transcends our normal, everyday consciousness in space/time is the essence of the orgasm. Even preoccupation with orgasm as the goal of sexual activity can itself become a decisive obstacle to reaching it. And for men in our culture this can be more difficult, because ejaculation is often (wrongly) equated with orgasm². One must surrender up one’s concepts about the orgasm, and surrender itself is a complicated issue.

The problem with surrender

Many patients who are not orgasmically potent, i.e., who cannot surrender fully to their own orgasm reflex, also have a corresponding difficulty with surrender per se, which extends outside the bedroom. This difficulty is usually part of a (broader) Masochistic character defence. I have written about this defensive configuration in other Substacks, but, in summary, it refers to a problem of blocking one’s own feelings and energy flow as a misguided response to an anticipated or already-felt boundary invasion. (Sex is a profoundly intimate exchange, and so any proclivity for boundary-problems will surely be activated by the sexual encounter.) In those moments we fear being manipulated or controlled by a foreign will (say, another person, or agency), and so we organise ourselves psychologically around a position of non-yielding. What makes this manoeuvre defensive (and not successful) is that the cost of this response is the disconnection from one’s own will (desire, volition, autonomy). In other words, the defence often leaves us to defy the feared controlling influence, as a way to avoid acquiescing to it, which is not the same as the third option of remaining in touch with and acting from our own (actual) wishes. Such patients usually had invasive parents (especially mothers) who would seize and re-define the child’s self-expression, leaving a confusion in the child’s internal pathway from initial impulses to manifest (creative) expressions. Your mother is meant to help you bring your creative impulses into expression, but many mothers fear their child’s real identity and creative energy, so they want to intercept it and steer it. Eventually, this repeated experience leads the child to defy the parent’s attempts at redefining their expression. The effect is most easily seen in teenagers who may default to doing the reverse of their parent’s wishes, instead of finding and acting from their own autonomy (regardless of whether they want the same or different from what their parents want). It is important to remember that this problem obtains whether or not one’s own will is indeed the opposite of the foreign will, because doing something clearly because I want to do it is different from doing it because someone else wants me not to do it.

The tragedy of this scenario is that the surrender to the intruder, which these patients are (rightly) trying to avoid, is not the same surrender required to obtain full benefit from the orgasm. The orgasm requires surrender to oneself, not surrender to another. But if we have a problem feeling pressured to surrender to others, the internal surrender is often (separately) hampered also³. These early childhood complexes around autonomy and surrender/defiance stances can be recruited by the sexual energy and played out in sadomasochistic sex, which often carries an extra charge of sexual pleasure because of its connection to the functioning of the Self. But again, this is an independent issue from the capacity to surrender to the orgasm reflex, regardless of the path taken to get there.

The problem with guilt

Complete surrender is never fully possible where guilt is present, and nobody is completely free of sexual guilt. Most of my patients have previously lived with sex being more or less saturated with guilt. Guilt needs to be handled carefully in psychotherapy. It has a dynamic relationship with other feelings, and thus it must not be mistaken for ‘just another feeling’, and most especially, it must not be mistaken for a feeling to be reasoned away. In my experience, guilt is often stitched into the fabric of a person’s desire itself, so that the expression of desire with any degree of abandon will trigger the guilt, regardless of the concepts the mind uses in attempting to explain what happened post hoc. And likewise, triggering guilt will trigger guilt’s attempts to influence other relevant feelings.

Many people will tell you they have no sexual guilt. But these people may often be in a mere denial of guilt, rather than a true absence of it. You cannot simply declare yourself guilt-free around sex, just because you disagree with (say) religious dicta about sexual behaviour. You may recognise that you have ‘no good reason’ to feel guilty about sex, but noting that your guilt is irrational has nothing to do with whether it persists; you can’t pretend to exist only in a rational sliver of your personality, while your irrational feelings run wild in your body and your subjectivity. Guilt can’t be reasoned away. Why? Because wherever there is guilt, there will be other feelings not consciously acknowledged. And absent those other feelings, the guilt will not leave. Only those displaced feelings can push guilt out by leaving it no room. You can think of guilt as a squatter, occupying the home of other bona fide feelings; you get rid of it by bringing your other feelings home to reclaim their house.

These other feelings and the guilt that occupies their negative space can be worked through therapeutically, only after they have all been accepted for their effect on you (not just denied for being silly, old-fashioned, or crazy.)

Sexual liberation and Love

The kind of surrender that is requisite for orgasmic potency is easier for many people to achieve in a loving and established relationship than in the act of sex with a near-stranger. Do not mistake this for a moral imperative; it’s not a black and white question. But most people are, I claim, unable to experience complete release except with someone they know deeply, for a long time, and to whom they can entrust themselves. Again, this should not be confused with surrender to that trusted person; it is a question of the atmosphere in which one is trying to achieve surrender to oneself, and one’s company in that moment can be decisive. But a long relationship in itself is not a guarantee either, because many people are too afraid to reveal themselves completely in a(ny) relationship, even a longstanding one. On the contrary, I have seen many people in a cycle of believing that they ‘protect’ their relationship only by not revealing themselves fully.

Summary

The orgasm is a reflex of great therapeutic benefit to the body and mind. It cannot be achieved with strategies; strategies will make it more difficult to experience. Many different psychological problems insinuate themselves in the sexual realm, so that a complete and thorough analysis of a patient’s sex life can theoretically be an assessment of the whole personality in miniature. (Despite this, I still hear of colleagues who enact and promulgate a policy of not speaking about sex with their patients; it would take another essay to address that topic.) The popular approach of deploying strategies to solve psychological problems is utterly unsuitable to addressing compromises in the orgasm reflex, which is fully achieved only by complete internal surrender to the curve of the reflex. Common obstacles include problems with surrender itself, and the nature and degree of sexual guilt present for any given person.

1. Let me emphasise that whereas this is a description of the hoped-for outcome in some other, non-analytic kinds of psychotherapy, it is for me, as a psychodynamic therapist, a description of a problem I often treat.

2. There is no scope here to elaborate on this distinction. I expect to write more on that topic in the future.

3. This says nothing of the problems where it is the partner’s sexual desire that lands as invasive and potentially controlling.