Like Jasmine, many people come to my office wanting, very badly, to find a pill to cure all of their ailments, even their sex life. If your doctor can cure your sore throat and help to treat your diabetes, why can’t she fix your sex life? Because, in truth, relying on your doctor without participating, actively, in the healing of ANY of your medical issues, will not lead to true health. And creating a beautiful, precious, intimate, sexual relationship with your long-term partner takes time, effort, creativity and sometimes a few externally provided “tricks”. But the key components are not from the pharmacy, they are the two of you.

The biggest issue with arousal is that most forms of treatment focus on the biology of being aroused including the swelling and lubrication response of the genitalia, while actual arousal is more all-encompassing. No amount of body oil or rubbing will create sexual arousal for a woman who is otherwise pre-occupied with dirty laundry, ailing parents, work stress or her flabby thighs.

Arousal is a physiologic response of the body to pleasurable sensations, usually touching, kissing and body contact and it has to be ALLOWED to happen. A woman must feel relaxed and unpressured enough to focus on the sensations and the communication (verbal and non-verbal) so that her mind and body can respond. Dr. Louann Brizendine, the brilliant author of “The Female Brain,” elaborates that if we watched an MRI of Jasmine’s brain as she entered the bedroom, pleasure centers would light up during fondling and worry/anxiety centers would eventually deactivate completely to allow orgasm. However, even one wrong move or negative thought can trigger the amygdala (the worry/anxiety center of the brain), back into action so that arousal is abruptly blocked. It should be no surprise that multi-tasking, overachieving women have more distractions occupying their brain circuits and interrupting even the most worthy attempts at foreplay.

The biggest sex organ is the brain and if you’ve ever read something erotic, you have likely demonstrated that for yourself as you sat blushing and “turned on” by your book at the airport. The quality of the marital relationship over the recent past will determine how mentally cooperative a woman’s brain is for sex. Some say that foreplay lasts 24 hours and if you include emptying the garbage, helping the kids off to school, texting something loving at lunch and bringing dinner home – they are right. If there is even a tinge of resentment in the relationship, arousal and orgasm are almost impossible (unless the brain is able to escape into a fantasy life that doesn’t involve the obligations or bitterness). It saddens me every time I ask a woman to describe her relationship and her eyes look downward, face falls and she appears deflated as she searches for the words and the honesty to express that her marriage has been dead for years. In a medical practice that focuses on women’s health, it happens all too frequently that women have insight into the failings of their marriage but lack the strength, resources or willingness to move beyond a situation that is so clearly compromising who they are. But even for women in the best, most intimately, connected bonds that should foster the kind of sexual connection that we romanticize, it is all too easy to get distracted in the bedroom. Remaining present in the moments of life is one of the biggest struggles women face but one of the most worthwhile skills to learn. Beauty surrounds us every day and we must truly see, hear, feel, taste and touch it in order to experience life as it was meant to be. Making love is one of those experiences that needs our full attention to be passionately enjoyed. Eye contact, although potentially intimidating, is very connecting for a couple because it elevates sex to another level of togetherness, the mental and emotional level. It is difficult to be distracted when you are staring into your partner’s eyes as he makes love to you!

This week, work on being present in the real moments of life. Start a nightly journal entry about 1 or 2 events occurring in the daytime that you really lived and want to remember. It doesn’t have to take long, only a few minutes. This intentional activity will highlight how much of your day goes by without notice and remind you to really see, hear, feel, taste and touch the only thing you have for sure – the right now. As you continue date-night, use your journal as a conversation starter and see if you can both slow down enough to enjoy life together, in and outside the bedroom.