My husband and I were fortunate to be raised in sex-positive households. Gary’s father worked in schools as a sex educator as part of his career. My grandmother was a social worker - for whom no questions were off limits - and my mother’s attitude was quite open too. Religion was not a big factor in either of our families.

When we became sexually active in our late teens, long before we met, we did so with enthusiasm. Orgasms were a natural part of our explorations. Like most folks, we assumed they were the ideal conclusions to a sexual encounter - for both partners. Sex clearly seemed meant for pleasure.

Yet cracks appeared. Gary struggled with chronic depression and ultimately addiction - not to mention relationship troubles. I suffered from urinary tract infections, and emotional drama in my fragile relationships. Neither of us connected these conditions with our activities in the bedroom…until years later.

An explanation finally showed up in a Taoist lovemaking book. It said that orgasm could be "draining." Not only could it cause feelings of depletion or neediness, but those feelings could also result in resentment, uneasiness or anger between partners - well after the pleasures of the bedroom. These same feelings of depletion and neediness indirectly affected our physical and mental health, too…at least our wellbeing certainly increased as we explored the Taoist approach.

It was still hard to believe that passion was causing trouble, but the results spoke for themselves; mankind had a hidden weakness - or untapped potential, depending upon your point of view. Then came Gary’s insights about the brain chemistry of the reward circuit and the benefits of oxytocin. Wow! So many things came into focus. Even the cultural contradictions between "sex positive" and "sex as sinful" began to dissolve. It wasn’t a case of either/or. Used carefully, sex healed. Used impulsively, sex eroded wellbeing and willpower.

The result? I became really "sex positive." Just as I'd always suspected, intimate union held enormous beneficial potential, even though I was only beginning to learn how to tap it. However, my definition of "positive sex" inevitably moved toward "sex that heals and unites." Without intending it, I thereby created a large gulf between myself and much of the current "sex positive" crowd, who equate "sex positive" with celebrating orgasm. For example, I recently received this email from a reader:

I told a psychologist friend about your book when he said he had two clients struggling with masturbation addictions. He replied that he favors "sex positive" thinking. I told him, "you can favor it all you want and nobody wants to go back to the days of shame, but is that black-and-white thinking going to help your clients?"

The psychologist obviously meant that he favors "orgasm positive" thinking. He would prefer a solution for his clients that assures them that orgasm itself isn’t contributing to their distress.

It now seems strange to me that if an approach is not "for" orgasm it registers as "against" sex. Then again, I once defined my ability to produce orgasms in my partner as healthy lovemaking. It took time to see that my partner grew healthier and more comfortable with intimacy when we practiced careful lovemaking without orgasm, channeling our sexual energy through our hearts.

I now doubt whether the current definition of "sex positive" serves either those hooked on orgasm or sexual anorexics (those who avoid sex).

Addictive Sex

As orgasm is addictive (thanks to the reward circuitry of the brain), it is easy to confuse "sex positive" with "hooked on orgasm." Unwary pleasure seekers can end up not only hooked on orgasm, but also emotionally isolated and susceptible to other addictions as a result of over-stimulating the reward circuit of the brain. Yet what is a therapist to do?

Suppose masturbation addiction is isolating a client, or leaving the client depressed, hyperactive or otherwise suffering from the extremes of the dopamine roller coaster. Current thinking obliges the therapist to make no constructive suggestions for managing sexuality to achieve balance because his client is defined as "sex positive," and therefore "healthy."

If, however, the therapist were to consider his client’s plight in light of the possibility that careful management of sexual desire can heal, he might suggest that the client experiment with solo cultivation techniques to play with moving his sexual energy upward rather than outward. Or perhaps that he learn about the neurochemistry of the reward circuit to better understand how masturbation has gained such a foothold in his life. Such knowledge can make it easier to experiment with alternative ways of managing sexual desire, particularly once the client also realizes that oxytocin-producing activities can ease his sexual frustration while he moves toward greater inner balance.

As an aside, men often tell me that when they cut back on masturbation, they attract potential lovers into their lives within weeks. However, I do not believe that most single folks can give up masturbation entirely, unless they are receiving lots of loving attention and hugs from others, or pouring themselves into selfless service. Cutting back, though, seems to work well for some.

Greater understanding of brain physiology offers the added benefit of eroding the concept that sex is sinful. As a Catholic friend once confided after he made love without orgasm, "I don’t feel guilty when I make love this way." He quickly realized that the "guilt" he formerly felt after sex was not God’s disfavor, but simply a neurochemical jolt that left him uneasy. Making love without orgasm was like a visit to the Garden of Eden by contrast; God liked sex after all.

Unhooking masturbation from guilt (through understanding the neurochemistry of reward circuitry highs and lows) offers yet another benefit. It makes masturbation less addictive. Risky behaviors raise dopamine higher (which makes it drop lower afterward). If you believe you’re going to hell for masturbating, it is deliciously risky and quite addictive. But if you understand you’re just dealing with the brain chemical cycle of fertilization-driven sex, the thrill is not "dangerous," and therefore not as addictive.

Sexual Anorexia

The definition of "sex positive" as "pro-orgasm" can blind us to healthier options, and the trend seems to be in this unfortunate direction. Patrick Carnes has popularized the term "sexual anorexic" for anyone who consistently avoids sex. It is an easy leap to apply this label to anyone who avoids orgasm, thereby pathologizing a way of managing sexual energy that has offered benefits for thousands of years to those few who happened upon it.

I once worked with a man in his late forties who was still a virgin. We had long talks about the material in Peace Between the Sheets. The concepts comforted him because they confirmed that there was a reason casual sex was so unfulfilling. Even from the sidelines he had long recognized that most intimate relationships ended in heartache. He clearly wanted a connection with more depth. Also, he had observed that he felt empty and "off" for days after ejaculating, even after a wet dream.

Having a way to talk about his life choices that didn't make him wrong - yet also pointed out the benefits of intimacy and a way to align it with his past observations - was very healing for him. It sanctioned making love without ejaculation and without making him feel like a misfit. He connected with his first lover within a year or so. It didn't turn into a marriage. He refused to "impose" the Peace ideas on his girlfriend...or even ask her to read the book. They ended up "just friends," after she decided his earning capacity was inadequate (post-orgasmic scarcity feelings projected onto him?).

Positive Sex

People who want orgasms should pursue them - preferably after some education about how dopamine in the reward circuit sets up addictive highs and lows, which can alienate lovers as they project their discomfort outward. But those who want to try something different, who want to cut back, or who have some intuitive understanding of the principles of sacred sex, should not be encouraged to conform to the expectations of today’s "sexperts." By putting all the healthy options on the table, therapists can help people to make their choices freely, with full information and without the stigma bestowed by the "I'll decide what's sex positive" specialists.

Gentle cultivation of sexual energy offers a solution that makes no one wrong. Of course lovers may still have painful issues from the past, and emotional healing techniques can be most helpful. In fact, in our experience barriers to intimacy gradually bubble up for healing with this practice of mutual giving. By helping lovers feel increasingly safe, this approach may complement emotional healing techniques. It wards off the recurring feelings of deprivation, neediness, depression, extreme vulnerability and so forth - which often follow the orgasms therapists currently insist are the critical element of a healthy sex life.

For better results, perhaps we should stop striving to be "sex positive"and instead reach for "sex,"that is, sex that heals by creating feelings of wellbeing and dissolving emotional separation. This lodestar would make it far easier to choose behaviors that benefit our relationships and us.