Dr. Lori Brotto’s Mindful Path to Better Sex

Can a raisin improve your sex life?

The short answer is yes. How requires a longer explanation—one Dr. Lori Brotto is happy to elucidate.

When working with a client—one of the 40 per cent of women who view sex as a source of anxiety, distress, or resentment—the sexual health researcher and clinical psychologist will hand her a plate of raisins. She then guides her through a 10-minute body-awareness exercise. Sniff the raisin. Note the colour variations. Put it against your lips. Place it in your mouth. Don’t chew. Sense the increased salivation.

“It’s about tuning in to your body,” Brotto explains when we meet at her home off a busy Coquitlam street. People learn to pay attention without judgement. They re-engage sensuality, which opens the path to eroticism. Strawberries seem sweeter; the tang of salty sweat, a whiff of perfume, the warmth of flesh more tangible. Desire long dormant breaks through winter soil.

The clinical term is “mindfulness,” a science-backed therapeutic technique originating in traditional Buddhist meditation that explores the mind-body connection. It is a cornerstone of Brotto’s clinical practice and the foundation of her two books about improving one’s sex life. This experiential mindfulness technique with the raisin is described in the first chapter of her latest book, The Better Sex Through Mindfulness Workbook: A Guide to Cultivating Desire.

Brotto is a University of British Columbia professor in the department of obstetrics and gynecology and Canada Research Chair in Women’s Sexual Health. She studied mindfulness by first immersing herself in historical texts on meditation as well as the teachings of Buddhist master Thich Nhat Hanh during her postdoctoral fellowship at the University of Washington. Mindfulness, she came to realize, is critical for good sex. In turn, good sex is critical for happy lives, families, and ultimately society. Yet women, so conditioned to appeasing others and downplaying their needs and wants, tolerate bad sex in silence.

Brotto says she commonly hears from women in therapy who experience painful sex but won’t tell their partner “because she doesn’t want to hurt him. She doesn’t want him to think that she’s not attracted to him.” Another habit is giving in to compliance sex that doesn’t come from a place of desire. This is “a straight path to resentment,” Brotto says. “If sexual arousal isn’t happening, then sex isn’t going to feel good, pleasure is down, and your interest in that is going to go down.”

Current dating conventions don’t help, she notes. The emotional barrenness of hookup culture ignores what is most important and healthy about sex: pleasure and desire. Media have indoctrinated us further into the idea that good sex is only achievable for those with perfect bodies. Photoshopped images of influencers and surgically sculpted Kardashians make each new wrinkle, grey hair, or added pound feel like an obscenity. “Partners don’t care,” Brotto assures women. But desire wanes, and the banality of life steals into the bedroom. Women confess that they’ll start thinking, “Did I sign my kid’s permission form? Did I turn the oven off?” while under the sheets with a partner. Sex is relegated to a household chore.

“The average person thinks about sex nine times a day and checks their phone something like 80 times a day. When you compare, even just with that crude estimate, sex is really low on the priority list.”

Brotto grew up with her parents and two sisters on a small farm in Surrey, carrying buckets of water for the sheep, pigs, and cows, cutting grass to feed the rabbits, and helping butcher the chickens. Her Catholic Italian father, Renato, was traditional in his beliefs, his attitude toward sex or anything sexual starting and ending with the word no. “What’s so interesting now that I’m spending my days and nights working on sexuality, research, and treatment,” Brotto notes, “is there was never a single mention about sex growing up, except to say that this is something you don’t do.” Boyfriends were forbidden, and, she says, the weight of her father’s repressive parenting lasted well into adulthood, but he is now “quite proud” of her work.

She moved out to study at UBC, living in East Vancouver with her maternal grandmother, Ernesta Deluca. A Second World War survivor, Deluca, who was “tough as nails,” immigrated to Canada when Brotto’s mother, Germana, was young. Brotto would come home after university classes to find Deluca had prepared a huge dinner. Food was the anchor for conversation, and the two women explored an array of subjects, some that would have been taboo in her childhood home, such as stories about when Deluca dated Brotto’s grandfather, and her own and her friends’ unintended pregnancies. “My mother was born out of wedlock”—a shocking revelation.

“I felt like she was giving me permission to discover who I was,” Brotto recalls. “She was definitely a strong role model in my life.” Encouraged by Deluca to push boundaries, as a psychology undergrad Brotto explored the influence of antidepressants and stress on the sexual activity of rats. She was so leery of her father’s disapproval, however, that it wasn’t until she defended her master’s degree at UBC that Renato discovered the focus of her research.

Eventually, Brotto felt morally and ethically compromised by research that involved stressing rats, recording their sexual activity, then euthanizing them. Broader questions were raised when, just as she finished her master’s degree at 25, Viagra was approved in Canada. At the same time, the seminal article “Sexual Dysfunction in the United States: Prevalence and Predictors” was published in the Journal of the American Medical Association. It reported that 43 per cent of women experienced sexual problems: low desire and painful sex, as well as difficulty getting aroused and reaching orgasm.

Inspired by the article, Brotto convinced her academic supervisor, Dr. Boris Gorzalka, who studied animals rather than humans, to let her create a sexual psychophysiology lab. For the next four years, she researched sexual arousal in women. During the experiments, her female subjects would “tell me the stories of their suffering,” she says. The women’s revelatory confessions marked a turning point for her, laying the groundwork for the visionary academic and clinician she would become. “Once I made the switch to humans, I was like, this is where I belong.” She realized that her work validated the women’s concerns about sex in a way that was helpful for them. But the scientific world was having a hard time taking Brotto’s work seriously. Even her now husband, Ed Fontana, introduced her as the “girlfriend who’s getting a PhD in pornography.” Brotto says with a wry smile, “He had no choice but to evolve.”

“Why are the rates of sexual problems higher than asthma, diabetes, depression, and other ailments that we talk a lot about and provide support for?”

There is no chemical treatment for female sexual interest/arousal disorder. The two medications approved to boost low desire in women, Addyi and Vyleesi, barely work, Brotto says. And physicians often aren’t helpful, shrugging off women’s complaints, suggesting a glass of wine as a panacea.

She bristles at the apathy. “Why are the rates of sexual problems higher than asthma, diabetes, depression, and other ailments that we talk a lot about and provide support for? Entire units at hospitals are dedicated to these.” The important role that sex plays in our lives needs to be acknowledged and given the respect it deserves, she insists, with physicians making it part of their routine care to ask patients about their sex lives.

Sex releases oxytocin and dopamine, the bonding hormones, and a couple that stays physically connected for at least seven minutes after a sexual encounter will solidify emotionally what’s happened physiologically. Such connection, Brotto says, leads to better communication between couples, in turn enhancing problem solving within the family and more cohesive parenting.

After 25 years of trying to advance knowledge and awareness about women’s sexual health, Brotto is aghast at the evangelical, political swing to the right in the United States, resulting in a clawback of women’s reproductive rights and access to health care. Will this spark a resurgence in sexual anxiety? Brotto fears it might. “Feminism is the new F word,” she says. “We have these many victories, and that’s not just a victory about sexual health, that’s a victory for science and advocacy. It becomes all the more important that we have people and governments who recognize that sexuality is part of our identity, part of our quality of life.”

Good sex is a critical part of human connection. And while “mindfulness is not going to cure all ills,” she notes, sex, and pleasure, should be respected for the role they play in general well-being.

Read more from our Summer 2023 issue.

Post Date:

June 19, 2023