Sexuality and Spirit

Every doctor has areas of expertise as well as weakness, areas about which they have great awareness and other areas where they are blind. Very early in my psychiatry residency, I noticed that psychiatrists were not interested in spirituality and did not ask spiritual questions.

A couple of weeks into my training I met a patient who suffered from schizophrenia, who wore anklets with quarter-inch silver beads. They were quite unusual looking. I directly asked him if he wore the anklets to prevent energy from leaking out of his body. He looked at me, rather pleasantly shocked, and simply said, “Yes. That is correct. The silver beads do prevent energy from leaking out of my body.” That was a question that would have caused my instructors to put me under surveillance had they known I had asked it.

Through the years spiritual questions became a dominant focus in my evaluations. I wanted to make sure, for example, that a patient really had mania and not a kundalini awakening. I asked all the questions psychiatrists need to ask in order to accurately diagnose and then treat. I also wanted to know about spiritual experience because these experiences are often life changing, in a positive way, and by returning to them, my patients' focus turned in a spiritual direction, and their consciousness was uplifted. I thought that was a very good thing, and I still do. The questions have gotten more refined and the many ways of integrating spirituality into the daily practice of psychiatry and medicine expanded.

While I was developing what I considered to be a broad vision, I had a blind spot, which came into focus this year, 2004. For several years I have been counseling a professional man, another doctor. I'll call him “Alan.” He came to me because he knew about my spiritual focus, and he was interested in approaching his issues of depression and fatigue from the perspective of spirituality and meaning. As with all my patients I look at body, mind, and spirit, and when indicated I order nutritional lab tests, as well as standard chem panels.

Two days after Alan had started the nutritional program I had recommended, I received this voice mail. “Hi Doc. Alan here. I feel incredible. My energy has returned to normal. Most of the depression is gone. My staff mentioned to me that my sense of humor is back. I didn't even remember that I had a sense of humor. And, my wife said that if I go off the program without asking you, she'll divorce me.” The threat of divorce was said in jest.

About five percent of people treated with a comprehensive nutritional program will have a 48-hour response. Physically, Alan had been so exhausted he was right at the edge of plunging into full-blown CFS/ME (chronic fatigue syndrome/ myalgic encephalopathy). Work on the physical plane was nearly over as soon as it started.

Through the years many discussions of home, family, wife, and kids came up. There were not any unusual issues for a double-income family, but I felt I was missing something. Near the end of one session I asked, “What is going on with your sex life? You never talk about it.” He replied, “That . . . is a great question. We'll start our next session on that note, and pick up where we left off.”

Of course, we began the next session talking about sex. Over the course of a couple of decades of marriage, Alan had gotten used to his sex life, which admittedly was “boring, uncreative, and rather rare.” He talked about DINS (double income no sex marriage) and how that had become pretty normal these days. I replied, “That is not acceptable. DINS is not acceptable. A marriage with a boring sex life is not whole. It is so much less than it can be. Society is beginning to consider a lack of physical intimacy to be okay, and with the explosion of Prozac, Paxil and Zoloft, millions of Americans have lost their libido to an anti-depressant, and a lot of them are happy to make the trade-off. Less depression. No sex. Fair trade. I don't think so.”

This one statement unleashed an avalanche of emotion, along with the strong desire for things to change. Alan simply didn't know how to make things change. He felt that he was much more interested in sex than was his wife, Elaine, that she would be okay with once a month, and twice a week would suit him fine. He wasn't angry or judgmental about Elaine, just stating the facts as he saw them. He thought Elaine just wasn't that interested and that sex was really not important to her.

I jumped in. “Alan, If there is going to be a change, who will initiate it?”

“That is a no-brainer. I definitely am the one who will need to take the bull by the horns, and make suggestions.”

I asked him if he had any concrete ideas and he didn't. So I offered some advice. “What would happen if you bought a video on Tantric massage, or something like that, and just sprung it on your wife. How do you think she would react?”

Alan replied, “I don't know, but I think she would be open to it.” “Okay, Alan, here is what I suggest. You buy that DVD or video, and then choose your timing, based on the kids and that sort of thing. Maybe it will be late Saturday night when you show Elaine the DVD, see how she responds, and then let her know that as of that moment your sex life as you have known it is over. Tonight, we begin a new chapter, and it's going to be an adventure. It's going to be fun. What do you think? If she is okay with it, pop the DVD in and change your sex life forever. How would she take such an approach? Would it just blow her out of the water?”

This was a far cry from several years of psycho-spiritual counseling, focusing heavily on meaning and purpose. Alan wasn't immediately sure what to do, but he was immensely cheered up about beginning to develop a strategy. “Believe me,” He said. “I do not lack imagination. This will be fun and interesting. I will give it a lot of thought, and when the time is right, we'll see what happens.” I asked if he needed any more suggestions from me. He didn't. His creative mind was already making connections. He just needed to know that a no-sex marriage is not okay, that it did relate to how he felt in life in general, and that, given his particular situation, he needed to take charge.

The next session began with Alan saying, “So, you probably want to know about sex.” “Correct,” I replied. “How are things going?” He did not go into any details at all. He had obviously introduced something novel into their sex life, but more importantly, he and his wife had a long-overdue discussion about sex. It turned out that she was as frustrated and bored as he was and equally wanting to do something about it. She was open, eager, and willing for their sex life to change. Alan was surprised at her response, perhaps expecting rejection. It was a relief to discover that they were both on the same page. I don't know any details beyond that. I don't know if Alan introduced a new idea, a new method, or a DVD, but I do know that his sex life totally shifted. He had a happy smile on his face and it was clear that a weight had been lifted. Where there had been a weight, there was now a lighter countenance. It was obvious that Alan was the one who had to initiate a change, and it was clear he had done so successfully.

It became clear to me that sexuality had been a blind spot of mine as a doctor. I am becoming more and more aware of the need to not let a patient's sex life drop off my radar. Interestingly, neither sexuality nor spirituality were given much attention during my psychiatry training. Spirituality, sexuality, and nutrition were the most ignored aspects of my training. The only instructor I had who advised about the nature of questions he would ask a patient about sex was a pervert. The way he talked about sex gave me the chills. A few years later he lost his medical license for numerous proven allegations of sexual misconduct with patients. So, I was wise to ignore his advice, but I had no mentoring at all in this area, nor did my colleagues.

In America we face a barrage of marketing and media that stimulates sexual curiosity, fantasies and urges. At the same time, this is a society that is repressive in its attitudes towards sex. The flesh and the spirit do not mix well in standard American “values.” Therefore, the task of integrating sexuality with spirituality has been very slow. When you have stimulation and repression at the same time, people are not going to regard sex as a neutral topic. For most of us “sex” has a special ring or sting, depending on how you feel about the word, and sexual discussion does not naturally flow in conversations. It is titillating, exciting, curious, and dangerous. It is the source of endless jokes, but it is not natural.

While reading Dr. David Hawkins' book “Power Versus Force,” I was amazed at his descriptions of sexuality in other countries. In Argentina, there are areas of public parks set aside for lovers. Police walk the beat of these parks to protect the lovers. What a shock. In America, police would not be protecting lovers. Sexuality consciousness varies from culture to culture, and ours is not a country with a healthy attitude. To quote Hawkins from “Power Vs. Force,” “Ours is a society that idealizes the pleasureless — hard work, stoicism, self-sacrifice, restraint — and condemns pleasure in most of its simpler forms, frequently even declaring these illegal . . . the illusion proferred is that the more hellish one's life is, the more heavenly the reward will be . . . The paradox of our puritanical society is that it encourages constant seduction but denies satisfaction.” Naturally, given our societal programming, each of us has work to do to embrace sexuality and spirituality, and to enjoy pleasure, rather than reveling in sexual guilt.

There are areas in which sexuality becomes undeniably spiritual. In particular, there are countless reports of people who had mystical experiences during sex, and these were not people who were necessarily on a conscious spiritual path. Some, in fact, were atheists. They were quite surprised to find themselves out of their bodies, or in realms of nirvana, a state of bliss that transcends worldly pleasure. This transcendent sex is described by people as incomparably better, more ecstatic than the best orgasm of their lives. Like all mystical experience, it cannot be expressed in words.

The connection between sexuality and spirituality is “love.” The goal of spirituality is a divine love for all beings, of forgiving all beings, of experiencing the unity among us, rather than the differences and separation. Love is the goal of spirituality as well as the means of attaining that goal. Sexuality is also about love. Men don't talk about this much, but sex is about merging, about becoming one with one's lover. For most women, lovemaking is more about the “process” than it is about “getting there.” For most men, sex is more goal-oriented. It is more about “getting there.” While men focus on “getting there” or “getting off,” the truth is that sexuality is where men find the deepest love and connection.

Women, on the other hand, also find intimacy in their circle of female friends. Woman-to-woman bonding is powerful and healing. Very few men have access to the kind of closeness, intimacy, and bonding that women have. Much of male conversation is about goals, who did what, how to make more money, and how to solve problems. Once problems are solved, male-to-male conversation may be over, and it may be time to reach for a beer and watch the football game.

Women may hang out for hours talking. When a woman returns home to her husband, he may ask, “So what did you and your friends do for five hours?” And she may reply in a puzzled way, “Do? We talked.” He responds, “What did you talk about for five hours? What did you accomplish?” She is again puzzled, for she and her friends may have just shared their lives for five hours without any particular desire to solve a bunch of problems. Women are much more involved in the “process” of communicating and connecting than are men. The process is its own reward. Men rarely communicate in a way in which the “process is the goal.”

The point of discussing these differences in communication styles is that men have a similar outlook in the boardroom as the bedroom. They are initially goal-oriented. However, in the afterglow of lovemaking, many men let go into love. Their ego boundaries temporarily dissolve, and all that remains is Love.

By its very nature, love needs to flow. If it is obstructed in any part of our life, it will be obstructed in other areas. The more love flows, the more spiritual we feel, and the more our consciousness evolves. Love needs to be able to flow through sexuality and if it doesn't, that energy gets re-routed, suppressed, repressed, or buried . . . thereby short-circuiting our spiritual growth. Because we live in a society that is sexually stimulating and repressive at the same time, many of us have sexual conflicts. Many of us actually feel relieved when the Paxil knocks out the sex drive. At least sexuality ceases to be a conscious issue in that marriage, but deeper and higher levels of love and intimacy are lost in the process.

In the Western World, religion is the main source of sexual conflict, teaching us that 1) sexuality equals sin, 2) God punishes us for our sins, and 3) sexuality is dirty and bad. Because we are a “God-fearing country” rather than a “God-loving country,” many of us associate sex with sin. We feel guilty and dirty about it and afraid of God's retribution. Hell is supposed to be the final destination of sinners, so you can quickly see why so many of us are not sexually free. By “free,” I mean free to share our sexuality in a playful, creative, fun way with the one we love. Those of us who were raised with “sex, sin, dirt, and punishment,” will be conflicted about having sex, and will feel guilty after having sex. In other words, they are denied the pleasure of sexual intimacy.

The core sexual hang-up of Western religion comes from the Bible. In the story of Adam and Eve, sex was interpreted as the cause of man's downfall. God was seen as the one who created something just to tempt us. If God is love, then everything that God creates is also love. From a spiritual viewpoint, everything in God's creation was made for the joy, love, and happiness of all. God is not a punitive, bearded, old man who takes notes all day long, keeping score of our sins. God is not separate from us. Our soul or spirit is a spark of God, made of the same “soul-substance.” There is no thing or being in the Universe that is not permeated with Universal Energy. There is no part of the human body that is less divine than any other part of the body. It is not as if God installed Himself/Herself in our head, hands, and hearts, but stayed away from our genitals. It is partially the sexual guilt and repression induced by Western religion that has driven many to search for loving, universal principles that we call “spirituality.”

If you believe that sex is sinful and dirty, then that is how you feel about your body. In order to love fully, you must start with yourself, and you must learn to love your body, including your sexuality. Only after you have developed healthy self-love, will you be able to love others. You will not even be able to deeply love God until you love yourself. You can't hate yourself and love God. It doesn't work that way. You will be better able to bring sexuality and spirit together when you realize that God does not roll dice, that there are no accidents or mistakes, and that God knew what She was doing in the creation and evolution of homo sapiens. Men and women were created with polarities that complement each other perfectly. One of our spiritual tasks is to embrace and love male-female polarity. Yin and yang cannot exist independently of one another. Together, yin and yang make life (and creation) whole.

Try having a discussion with your spouse or lover about God and sex, using both words in the same sentence. Carry on this conversation for a while. At first you will notice that there is a very different quality to each word. When you say or think “God,” how do you feel inside? When you say or think, “sex,” how do you feel inside? My guess is that God and sex create very different thoughts and emotions. The Eastern practice of Tantric yoga brings a neutrality to these words, a sense of unity. The physical practice of Tantric sex has the purpose of raising our consciousness and bringing us closer to God. Would it be safe for you to imagine that God is a third party while you are making love? Would that seem strange? If so, why? When sexuality reaches the point of pure love, there is a new Presence. There is man, woman, and a third entity, namely the “Relationship,” which is more than one plus one. You can consider the “relationship entity” to be God. In conscious spiritual practice, you can feel free to invite God into the experience, either verbally or in your minds. I know this concept will rub some people the wrong way, because it isn't written in the Bible.

Both spirituality and sexuality are about love. Physical sexuality can be a mirror for you that reveals your:

1. Ego problems

2. Capacity to give love

3. Capacity to receive love

4. Capacity to experience joy

5. Capacity to make another joyous or happy

6. Ability to let go into the moment

7. Capacity to choose love over fear

How do you begin to implement some of these ideas? Start talking about sexuality in an open way with your partner. Try to shift your orientation from “sex as a goal” to “sex as a process.” Dare to be creative and have fun. Dare to be vulnerable with your partner. This is a huge issue. You may not get what you want. Let that be okay, but ask. Identify your sexual “needs.” There aren't any sexual needs. There are sexual “wants” and “preferences.” We do need food, water, and air to survive. When you bring the pressure of sexual “need” into the bedroom, you interrupt the flow of love and increase the chance of your feeling hurt, rejected, and angry. When you consciously decide that there are things you would like sexually, but that you do not need them, your sexual life will change. When you express a “want,” your partner is much more likely to oblige, but he or she must be granted permission to say, “No.” When you express (or demand) a “need,” then force and control enter the equation.

By gently entering the hallway that connects sexuality with spirituality, love will flow throughout your life. The rough edges of your ego will slowly be chipped away and removed. Thousands of years of sexual negativity, that all of us have carried to one degree or another, can be released when seen in the light of truth. Don't assume anything about your partner's sexual motivations, likes, and dislikes, even if you've been married for twenty years. Ask!

Dennis Gersten, M.D. practices nutritional medicine and psychiatry out of his Encinitas office and can be reached at 760-633-3063. Please feel free to sign up for Dr. G's Health Digest newsletter at and access 1,000 on-line pages about holistic health, amino acids and nutritional therapy.


Dear Louise

Dear Louise,

I have the best life in the world—healthy children (from a previous marriage), a good job, a great lifestyle, and a fabulous and supportive family. The only thing missing is a man, but even so, I can't seem to understand why I'm so miserable, lonely, empty, and unhappy. I fell in love recently, but he has many problems including losing his twin brother and a fear of commitment. Although I love him and miss him and we remain friends, we're not really seeing each other. My question is, how can I get out of this rut? I used to be such a content person, but I can't seem to feel any emotions for anybody now. At times I don't feel life's worth living.

G.A., Greece

Dear G.A.,

What's missing in your life is gratitude and appreciation for all the good you do have. Don't concentrate on what you don't have. You're only miserable because you're choosing to think thoughts of loneliness and unhappiness. You must turn your thinking around. Every hour, stop and be appreciative for your healthy children, good job, great lifestyle, your fabulous and supportive family, and anything else you can think of. This is the best way to get out of a rut. When you choose to feel gratitude, the Universe brings you many other people, places, and things to be grateful about.

If you're looking for more love, then you need to love yourself more. You'll never accomplish this by whining and complaining. Affirm: I love myself. I love my life. I am filled with gratitude and thankfulness. Only good lies before me. I am excited by this adventure called Life. All is well. I am safe.

Dear Louise,

Now that I've learned how to release negative emotions, I seem to have lost my self-discipline—for example, the discipline to control toxins I put in my body or the discipline to go to church regularly. I'm satisfied meditating at home but feel I'm missing out on positive social outings. I'm lazy, but forgive myself for drinking and never let any guilt in. Can you help me?

S.P., Atlanta

Dear S.P.,

I'm not sure that anything I say will be of help to you. You're so powerful and seem to have made lifestyle decisions that are bringing about certain outcomes. We all have the freedom to make any choices we want. We're never stuck. There's always a new moment to think a new thought.

Thinking always precedes action. The choices we make aren't necessarily action choices, but rather thinking choices. You know where you are. Now decide where you want to go.

Affirm: I move forward into my greater good. Life loves me and I love Life. All is well in my world.

Dear Louise,

I would like to know how to create the right partner in my life for my sons and me. Thank you! Peace, love, and light.

P.C., New Zealand

Dear P.C.,

You can create a new relationship just as you would create a new job or a new car or anything else you want to appear in your life. But you might take a look at whether or not your sons want a partner for you. If they're very small, they may prefer to have you all to themselves. I would talk to them and find out how they feel about this. Then if you're all in agreement, here are some affirmations to guide you:

I forgive and release the past. I am now open to a new life. The person I am seeking is also seeking me. We are being brought together on the checkerboard of Life in a delightful way. I open my consciousness to accepting this new relationship. Everything that I desire comes to me easily and effortlessly because I express gratitude all the time. I am one with all of Life, and I am cherished by Life.