Arousal: reactive
versus proactive

Image: Mathilde Langevin | UnsplashArousal is the way our body responds in pleasure. Sometimes we are mismatched with our partners, though, so here are some tips on what to look for, and what we can do.
by Tess Devèze
I was diagnosed with stage-three breast cancer in 2018, and over the years since my cancer diagnosis and endless treatments, only twice did a healthcare professional voluntarily bring up the topic of sexuality. I know I’m not alone in this. The thousands of people I’ve met through online support groups have the same experience. Why is no one talking about this? Where is the support?
For those fighting or living with cancer, things like connection, love, support, and intimacy can be incredibly important. Unfortunately, treatments and their side effects often make maintaining these connections much more complicated. But there is hope!

Although every person with cancer is unique, we have one thing in common: no matter who we are or what we are going through, we’re all worthy of love and connection.
Types of arousalArousal is the way your body responds in pleasure. Your arousal responses could include things such as an increase in heart rate, pupils dilate, skin sensitivity increases, tissues become engorged, you become wet, you become hard, and more.

Delayed arousal responses are extremely common from treatments and medications, and can also be caused by many psychological aspects like stress and nervousness. Just like you have the many layers (physiological, psychological, and neurological) that can impact your libido, these layers potentially impact your arousal. This can look like you ‘don’t want it as much’ (or at all). Or perhaps it takes a lot longer for you to ‘get into it’ than it used to. You might notice it feels like maybe you’re forcing yourself at the start, but after some time, things start to feel more enjoyable. Sound familiar?
Reactive vs proactive pleasure and arousalReactive means, in response to something. You react to a thing or stimulus. With arousal and pleasure, that could look like only feeling aroused after you have been kissing and touching for some time. You’re reacting to the touch and intimacy.

Proactive means something that happens without prompt or stimulus. It happens without needing something to react to. In pleasure and arousal this could look like you’re watching television and, all of a sudden, you’re hot for it. Or you walk down the street enjoying the sun on your face and you then notice your underwear is damp and the breeze feels soooo good!

Countless people feel their enjoyment of sex is gone forever, that they have lost their desire completely because their pleasure and arousal seem now absent, when it is no longer proactive. But in actual fact, it’s simply now reactive, and it needs something to respond to, and a bit of time to kick in. There’s a gigantic difference between someone who doesn’t enjoy sex at all vs someone who needs time to enjoy it.

I support many who think they cannot stand sex at all any more and are desperate to reclaim this part of their lives, and when I ask, “So what do you do to warm-up before sex,” this question is followed by silence, a tumbleweed rolls past, and that’s the moment where I get my whiteboard out.

I’d like you (and anyone you’re with) to grab a piece of paper and a pen, a notebook, or anything you can individually draw and write on. Now, draw a very basic XY graph (just a small graph is fine) with the Y axis labelled as ‘arousal’ and the X axis labelled as ‘time’.
It should look something like this:
This graph is going to represent how much time you need for your arousal and pleasure to kick-in, once you’ve started touching and playing, either with yourself or a partner. You’re tracking your arousal response. As you move to the right, this indicates time passing. As you move upwards, this indicates your level of arousal increasing.
Imagine now that you’re getting sexy with yourself or a partner. This is where you’re at the very start of the graph, where X and Y connect at the bottom left. I want you to draw a line on this graph, starting at this point, which shows what you feel your current arousal response is over time. You could get specific with this if you like, but mostly, let’s just use this broadly as a guide and note that this graph could represent around an hour of time.
This graph shows that this person doesn’t have an immediate arousal response (which is very normal during and after treatments). However after some time and a bit of lovin’, they start to enjoy things more.

Now, if you’re currently doing this with another person, I’d like for you to draw a second graph, and on this one, you’re going to redraw your own line, and also in the same graph in another colour, copy this other person’s line into it. Then, circle where those lines intersect (if they do). So, you have two (or maybe more if you’re with multiple people) lines on the one graph, giving you a comparison.

It could look something like this:

For many people the lines vary quite a bit and, for others, not so much. There’s no right or wrong here. You’re simply visualising the invisible processes within your body. No matter how similar or different these lines are, it’s extremely rare that the lines would be identical.
Why? Because we are all different, as is our sex and our pleasure. But the two parts of this graph I want you to focus on are the part where the lines intersect, and the space in between the lines, which I’ve cross-hatched.
The space between the lines represents the time in your connection and intimacy, where you’re mismatched in your pleasure and arousal. One of you is more aroused, faster. What we want to do is get you to the point where those lines intersect, because this is your happy spot.

This is where sex is pleasurable and enjoyable for all involved. This is the sexy goldilocks zone.

That highlighted space is the guide for you to know how much more time and attention one person needs, so you can get to that intersection point for mutual enjoyment. This is fantastic to know, because, guess what? If you need more time and attention, we can give you more time and attention!
Image: Mathilde Langevin | UnsplashBrainstorm togetherRight now, think of some things you can do, together or alone, which will help the person needing a little more time to feel relaxed, calm, and sexy. What things could you do at the start of your play and intimacy that will help this person arrive into their body and pleasure, so you’re both on the same page? Is it a massage? A warm bath followed by some soft touch? Is it soft kisses on the neck and lower back? Is it watching some porn together? Use that space in the graph, the mismatch in your pleasure, as a guide to get your pleasure to match.

This is how sex becomes more enjoyable for everyone, and ties into the thing that will contribute to your wanting it more. If you’re having lovely experiences with yourself or your partner/s, you will be creating those positive pleasure neurological associations, and want it more!

For people doing this individually, look at the curvature of your line of arousal. Is there a lot of time where you aren’t feeling pleasure and those arousal responses? Think about your self-pleasure practices. Are they rushed? Do you go straight to the genitals? Do you feel frustration that you’re not ‘getting there’ fast enough or at all? Brainstorm for yourself; are there things you could do to help you drop into your body and its pleasure before you self-pleasure? Erotic dancing. Full body touch. Porn. What can you integrate into your pleasure practices so you can really connect with your pleasure and arousal?
Remember the game planThe next time you’re planning a sexy date with yourself or another, remember the graph, your reactive arousal, and look at these things you’ve brainstormed. Plan a few of these at the start of your connection, to give the person who needs a little more time and attention just that. This is how we can ensure a pleasurable experience for all, even with a slower arousal response.

This can be tricky for some people, and the idea of receiving more attention than the other may be surprisingly difficult. We’re raised in a culture to believe that sex is some form of an exchange. Well, it’s not. You don’t give just so you can receive. There should be no agenda in sex. If you need to receive more attention, more touch, and more focus in sex, please know you’re not a selfish lover. You don’t need to ‘return the favour’. Sex is a gift and doesn’t need to be strictly two-way all the time. Remove the agenda so you can access your pleasure.

If you drew a comparison graph and the multiple lines on it don’t intersect – perhaps one of your lines looks almost horizontal – that’s okay. That happens, and you’re definitely not the only one.

Please know that there is hope. You can rehabilitate your arousal and work towards getting those lines to intersect, towards getting your line to move upwards more quickly. How? There are many sensate activities that you can learn. It’s all about neurologically rewiring our pleasure pathways.
A way to connect intimately‘Active receiving’ is a way to connect with a lover/partner to the level that is right for you. It is a one-way touch experience; a great way to enjoy touch, especially if you’re not feeling ‘sexy’.

There are many expectations and misconceptions in intimate activities, and a common one is that it should always be a two-way experience where you give and receive pleasure at the same time. Well, this doesn’t necessarily always have to be the case! This is wonderful for people with mismatched libido, or delayed arousal responses. It’s great if someone is not wanting to receive intimate touch, or may not know what they want at that moment, but would love to see a partner have pleasure and enjoy themselves.
How it worksSomeone lies/sits down (or is in any comfortable position), asks for what type of touch they want, and constantly directs the other person in how they touch them, and the ‘giver’ does exactly what they are being told to do. That’s it! It’s incredibly fun and accessible.

Imagine that the person giving the touch and receiving the directions has no mind of their own. They are an inanimate object that only responds to commands. For the person following instructions, it can free you from that common brain chatter – “Am I doing this right? Are they enjoying this? Are they pretending?” – as you’re just doing what you’re told.

Some examples of directions the receiver could give are: “Massage my shoulders. Can you now scratch my back? Yum, thanks. Can you go slower and a bit firmer? Softly touch my body up and down, neck to feet, with your fingertips and don’t stop until I say. Now, lightly pinch my inner thighs. Breathe cool breath on my nipples.”
Anything you want, just askThe person giving the touch can check in to see if it’s how the receiver wants it – “How is this pressure? Would you like me to move my hands, faster or slower?”

The person following directions doesn’t change anything, doesn’t alter any style, without being directed. What if the giver doesn’t receive any directions for a while and isn’t sure if this is still what the receiver wants? Ask the question, “How could you enjoy this more?”

This is an incredible skill to learn in the bedroom. Giving directions. Asking for what we want. Checking in with a lover to get feedback on their level of enjoyment. Communicating your desires. All of this leads to better communication, and better sex. If you get tired? Simply stop the activity whenever one of you wants. The goal is to enjoy receiving and to enjoy giving. 1 minute, 10 minutes, 20 minutes – it’s all perfect.

If you’re unsure, give it a go, clothes on, on the couch, using just an arm or hand. Practise following directions, practise giving directions, practise checking in and identifying what you want. There is no goal here, just to have a touch experience. To give or receive pleasure, and enjoy connecting with a partner. It may feel clunky at first, but with practice it flows very easily.

You will be amazed at how much you learn about your partner and their body (and yours!).
This article is an adaptation from the book A better normal – your guide to rediscovering intimacy after cancer, available on Amazon.
About the author:
Tess Devèze is a clinical occupational therapist (OT) and certified somatic sexologist who works with people living with cancer, chronic illness, and disability to live more pleasurable and sexually healthy lives. Since 2018 Tess has been fighting stage 3 breast cancer, and has personally experienced the severe impacts treatments have on sex. Being a member of the LGBTQIA+ community, a sexuality clinician, and a cancer survivor has given Tess the determination to offer support and help to as many as possible around those more ‘intimate’ challenges we face.
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