Healthy/Unhealthy Sex: Whose Definition? What To Think?

Dear Dr Pinhas

How would you describe a “healthy” sexual relationship between any couple? What would make it “unhealthy”?

Mari

Response from Dr Pinhas

The idea of healthy and unhealthy sex is not an either/or phenomena, like two sides of a coin, but rather can be viewed along a spectrum, a continuum from healthy sexual thoughts, feelings and behaviors  gradually moving to sexual thoughts, feelings and unhealthy behaviors. In my opinion, the content of the sexual thoughts, and feelings is not as important in constituting a healthy status or an unhealthy status, as is the way individuals and couples FEEL about the sexual thoughts,  feelings, and behaviors. By way of example, let’s suppose a man wants to cross-dress during sexual activity with his partner and his partner enjoys his actions, who is to judge whether cross dressing for men during sexual activity is “unhealthy”.  I suppose on a bell-shape curve, most men do not  have cross-dressing fantasies nor do they act out them out with their significant others. This would not be normative from a statistical sense.  But humans are not statistics.  They are individuals with complicated feelings, that may not match the norms of Ma and Pa Kettle from the Heartland.   Value judgments, sometimes derived from religion, which dictate what is moral and immoral  complicate the discussions of healthy/unhealthy sexuality;  you know where this leads—- heartache and heartburn!  LOL !   From  a psychological perspective, only if a couple find this behavior  not acceptable internally to the self, is the behavior now morally troublesome  or unhealthy to this specific couple.  Once we start judging the content of sexual behavior, the issue of healthy and unhealthy sex becomes more nettlesome.    More to be said about the content of sexual behavior later.

The notion of what constitutes healthy vs unhealthy sex between couples depends upon a number of factors:

First and foremost are either you or your partner ANXIOUS about what you are about to engage in sexually?   If you feel uncomfortable and fretful about a particular sexual behavior or sexual fantasy and you do not want to participate in it but you become compliant just to please your partner, this would would move you on the continuum  in the direction toward unhealthy sexuality.  You should want to be involved sexually  out of your own  volition;  out of free, informed, worked-through, choice.  If the majority of the time you participate in order to please your partner at the expense of your wishes, your relationship is starting to become unilateral.  If  only one person’s needs and feelings are important,  and not the other’s, this will create a lopsided unhealthy relationship.  Resentment and distrust builds, which may corrode a relationship.

If you are both anxious about particular sexual thoughts, feelings and behaviors,  but feel that you have been keeping yourself ” sexually small,”   you might want to experiment.    This is a good thing.  If both of you have become aware  that you have been living in a small, sexual, rigid box , trying to break out of it will have initial repercussions that include feelings of doubt, discomfort, and feelings of confusion… but with time, the tension inside of you will ease up…. you are on the road to enjoyable sexuality, particularly if both of you have a mutually respectful relationship and enjoy what you’ve done, in spite of initial, ambivalent feelings.  But if  something keeps nagging at you, why would you try to participate in sexual behavior that is “stressing you out”, no matter how hard you try to extend your sexual parameters?    Just to be cool?  Not to be a loser?  If both of you think you want to try something different and unique, from your value system, but neither of you can tolerate what you’ve just done, consider that you have been flexible enough, in character, to try.  This shows that you are trying not to be rigid.   But if you are becoming terribly unglued and unhinged, which means uber-ANXIOUS, helping each other rationalize what is unacceptable to one’s sexual self  will cost you comfort, trust and security.  This moves you in the direction of unhealthy sexuality.

Rigidity vs  flexibility in your sexual thoughts, feelings and behaviors is another major factor in assessing healthy/unhealthy sexuality.  If you find yourself becoming increasingly disrespectful to your partner in terms of  sadistic sexuality and your partner is unwilling to play out  masochistic fantasies with you, this is a rigid, unhealthy sexuality.  One person’s rights are being violated.   Not cool at all.

A further complication is the psychological need to split love from sex.  I am not suggesting that men and women have to love and respect every sexual partner that comes into their midst, but  an unhealthy problem develops when it is necessary, on a constant basis, to keep love and sex far apart from each other, usually to protect oneself from ANXIETY.     For example, a man suffering from the madonna-whore complex who is unable to love, respect,  and admire a woman he is lusting for, and sexual with,  and in an alternate way,  is unable to eroticize the woman he respects and cares for,  is moving in a sexually unhealthy direction. The developmental task for people is to eventually  integrate love with sex so in a healthy sexual relationship.   A man should be able to adore his woman and make her his eroticized woman and perhaps even his “slut”, at the same time.  This moves a man in the direction of healthy sexuality.  When men split love from sex on a fairly consistent basis, problems may develop with sexual desire and arousal  for the “loved” partner.  Sex with the “brazen hussy” also becomes problematic after a while.  As indicated above, rigidity creeps into sexuality.  Only certain  limited specific sexual behaviors, done in certain ways, accompanied by certain  “talking dirty” words, under specified conditions will do the trick in getting the man to orgasm.  You are ritualizing your sexuality.   Furthermore, if  you  are sexually limited in this type of obsessive-compulsive way, only able to do sexual acts in a proscribed, rigid, limited manner,  eclipsing your options and choices for sexual freedom, you are moving in an unhealthy,  sexual direction. Women who prevent themselves,  on a consistent basis, from establishing enduring, connectable  relationships with partners, in favor of “one night stands”, are also suffering from a split in the psyche.   A woman’s anxiety about her worth only as a sexual object moves her in the direction of an unhealthy sexuality.  Also not cool.

Addiction to sex moves a person in the direction of unhealthy sexuality. If an individual feels powerless over internet porn, whether it is pictorial or live interaction, for example, and their preoccupation is interfering with their interpersonal functioning and intra-psychic functioning, this may create feelings of guilt/and or shamefulness.   This is no doubt a problem and is unhealthy sexually.   Once again, the criteria is whether  an inflexible compelling  sexual rigidity has taken hold of a person preventing them from being able to have sexual freedom and comfort.   Sometimes we get confused about what might be seen as sexual addiction.   For example,  if you come from a  religion and culture which suggests that masturbation is sinful and immoral, having the urge to masturbate and bringing it to fruition because you enjoy the pleasure of it, but pay  the emotional price for it,  may cause you to wonder whether your hand-penile connection is problematic.  Masturbation may not be the problem but rather your feelings of guilt and shame about this developmentally normative childhood and adult behavior.   If, however, you are walled off , deep in cyberspace, with you, your penis and your internet sexual stimuli, never to see the light of day,  your masturbation may be eclipsing your personal freedom and other life options.  It  is time to take a look inside.  You may be moving in the direction of unhealthy sexuality.

Critical  in the discussion of healthy/unhealthy sex is your surrounding and feelings about others in your environment. Both of you may feel comfortable in your sexual thoughts, feelings and behaviors and decide that what you do sexually  is earth shattering, awesome and magnificent.  You want to share this with the world.  Acting this out without regard to the people around you  ( let alone  in the presence of children) , that might be inadvertent onlookers with no voyeuristic bones in their bodies, will move you in the direction of unhealthy sexuality.  Even standard “vanilla” missionary position of intercourse that would be acceptable to the infamous Ma and Pa Kettle, has no place being acted out in Macy’s showroom window during the holiday season.

This brings us to the difficult discussion of what constitutes   two consenting individuals. If you are of legal, consenting age  and so is your partner, expressing your sexual thoughts, feelings and behaviors with mutual consent and respect for others puts you on the continuum in the direction of healthy sex.  If, however, your partner, which you have rationalized is “sexy” enough to make adult choices but is a minor, you are def on the end of the continuum of unhealthy sex.  Minors cannot give legal consent.    By way of  example, sex offenders who “love” children , are less concerned for  child welfare and more concerned about their own narcissistic needs.   Often times, they rationalize their unhealthy sexual behavior by pointing out how sexually provocative  little girls have become.  (Readers please note: that if sexual abuse survivors are “sexually stylized”, it is the result of the sexual abuse, not the cause of it!!).

Human beings have  complicated sexual fantasies which are borne out of  genetic endowments;  exemplified by early experiences with significant others, interplay with family members, and internal psycho-sexual stages of development.   Sometimes the content of a sexual fantasy can be quite disturbing to an individual and is better tolerated in the psyche allowing expression in the theater of the mind.  Sadomasochistic charades, homoerotic endeavors among heterosexual folk, oral/anal incorporation among legions of humans and beasts…..etc…. you get my drift… may be safe to play out on the mind’s stage.  Some of you will take an acting-out risk, others not.  The key is to respect yourself, your partner, your environment.

This brings me to children as sexual object choices.   There is no doubt that the media has inundated us with stories of the horrors of  child sexual abuse in all aspects of society. We have become aware and sensitive to these issues as the decades have rolled by. Individuals with a preponderance of erotic thoughts of children  know full well they are not society’s  little darlings.  We are mere mortals.  Those who struggle to maintain their  anti-social/sexual  impulses and succeed in doing so should be given credit for their ability to manage their inner lives.  When you cross over from fantasy to reality you have gone too far and are moving towards the unhealthy sexual side of the continuum.  If sexual thoughts (as distinguished from actions) mattered and counted in the real world we would all be behind bars!  In other words, you can’t go to jail for what you’re thinking.

I hope this begins a meaningful conversation about the continuum healthy/unhealthy sexuality. What’s your definition?