Episode Summary
Executive Summary: Dan Harris interviews psychologist and sex researcher Dr. Lori Brotto about how mindfulness can improve sex by reducing stress, shame, and distraction while increasing body awareness, self-compassion, and presence. They discuss evidence for treating low desire, pain, arousal issues, and discrepant desire in couples, plus practical exercises for individuals and partners.
Main Topics: Mindfulness as a treatment for sexual concerns: Brotto explains how mindfulness interventions improve sexual function and reduce distress across groups with low desire, pain, arousal issues, and orgasm difficulties. Stress, distress, and sexual function: The conversation centers on chronic day-to-day stress as a major driver of sexual difficulties and how reducing distress can restore desire and pleasure. Gendered patterns of shame and sexual distress: They compare how women more often experience interpersonal/relational shame and how men often experience performance-based shame, while emphasizing both are affected. Interoception, self-compassion, and reduced self-criticism: Brotto highlights bodily awareness and kinder internal dialogue as key mechanisms through which mindfulness improves sexual response. Practical mindfulness exercises for sex and couples: Specific interventions include back-to-back sensing, sensate focus, and a sexual sensations awareness practice that can be used alone or with a partner. Pleasure, awakening, and sex education: The discussion broadens to pleasure as a form of self-knowledge, healing, and perhaps spiritual development, with calls for better sex education and normalization of sexual autonomy.
Key Arguments: Mindfulness is not just relaxation; it changes how people relate to thoughts, sensations, shame, and arousal during sex. The main cause of sexual distress is often chronic stress and distraction, not simply biology or hormones. Reducing sexual distress often precedes and predicts improvements in desire, arousal, orgasm, and satisfaction. Women commonly report relationship-centered distress, while men more often frame sexual problems as threats to identity or performance. Body awareness (interoception) helps people notice subtle arousal cues that they otherwise miss when mentally distracted. Self-compassion and letting go of self-criticism reduce the mental interference that blocks sexual response. Couple-based practices like sensate focus create a safe lab for noticing patterns, building communication, and restoring presence. Planning sex is not unsexy; anticipation and intention can increase erotic connection and reduce avoidance. Pleasure should be understood broadly, beyond orgasm, as a subjective, embodied, and potentially transformative experience. Better sex education and naming body parts accurately are important for both sexual autonomy and safety.
Data Points: Women reporting sexual problems: upwards of 40% - Referenced from a large study published around the year Viagra was approved. FDA-approved medications for women’s sexual dysfunction: 2 - Brotto notes there are only two FDA-approved medications for women, and they work only marginally better than placebo. Couples in long-term relationships have sex about: once a week - She gives this as an average from big surveys, while stressing wide variability. Couples with discrepant desire: 30% - She says this is the most common sexual difficulty and affects roughly a third of couples in America. Mindful sex group format during pandemic: online - Her groups moved from face-to-face to online, improving access for people who couldn’t attend clinic settings. Sexual sensations practice prep period: about 10 minutes - Participants use an erotic tool first to prime arousal before doing the mindfulness exercise. Sensate focus touch interval: about 15 minutes - In the first stage, one partner touches the other (excluding breasts/genitals) and then they switch roles. Mindfulness program duration referenced: 8 weeks - She mentions testing a standalone practice outside of a formal eight-week mindfulness program.
Pivotal Quotes: "I feel pretty strongly that opening to sexual/slash sensual desire is the next step in the evolution of awakening." — Unnamed meditation teacher quoted by Dan Harris: Dan introduces the episode by describing how several experienced meditation teachers have recently connected awakening with sexuality and pleasure. "There is, in fact, a geopolitical case for you to get your shit together." — Dan Harris: Promotional explanation for his app, framing mental training and self-care as socially beneficial, before the interview begins. "We spend more time our bodies showing up for sex and our minds not showing up for sex." — Dr. Lori Brotto: Brotto explains why distraction is such a central barrier to sexual arousal and satisfaction.
Implications: Listeners may see sexual difficulty less as personal failure and more as a modifiable mind-body issue. For clinicians, mindfulness offers a low-risk, scalable tool. For culture, the episode argues for shame reduction, better sex education, and a broader, more humane definition of pleasure.