Can I Talk About Sex in Therapy?
I’ve been a therapist who helps adults with ADHD for about 15 years now. I can tell you without a doubt that sex is one of the most common topics that clients with ADHD want to talk about in therapy. And, rightly so! Sex is already complicated enough, and neurodivergence like ADHD and autism can bring on even more complications.
Sex is a taboo topic. It’s not comfortable to talk about because of the stigmas associated with it. A stigma is a mark of disgrace or a complicated, judgmental attitude associated with a particular thing. When you hear the word “sex,” what do you think of? How do you immediately feel?
Some people feel judged or insufficient. Some feel a pressure to perform, or even a need to prove themselves. Very few people seem to feel wholly comfortable talking about sex. Now, to be clear, I’m not even talking about the details of the act itself. I’m talking about the emotions associated with sex!
Feelings get in the way when we talk about sex! And, they probably should, right? Sex isn’t just about pleasure and/or reproduction. In its healthiest form, it’s about the experience of intimacy and connection through which relationships are formed and sustained. Don’t get me wrong, sometimes it’s just about the pleasure. But the life-giving, balanced, stabilizing, life-long partnerships we all admire are usually built on a solid foundation of sex. (Don’t think about your grandparents!…Don’t think about your grandparents!…)
If you’re thinking “Hmm, words like “stabilizing”, “balanced”, and “sustaining” don’t sound like ADHD,” then you’re right! However, for the adult with ADHD, a healthy sex life with an understanding partner can actually help regulate the ADHD and improve both lives!
Trouble with ADHD and Sex
As you may have already experienced, ADHD can bring about problematic behaviors related to sex. As soon as unmanaged impulsivity enters the chat, the situation becomes much riskier! Spontaneity can be a great thing, but if you’re in a committed, monogamous relationship, then that sex probably needs to be only with your partner!
The current body of research available does not suggest that there is a direct link between ADHD and infidelity. Therefore, we can know that simply having ADHD doesn’t mean that someone will certainly cheat. However, common sense tells us that impulsive decision-making, drinking more, using drugs, and/or staying out late can be associated with both ADHD and infidelity. Likewise, possessing wild levels of creativity can sure gain the attention of those around us! A choice is a choice, though, and we all have to manage our choices as adults.
If you are reading this as a partner of someone who has ADHD, you can rest easy knowing that infidelity remains the choice of the individual person, and it’s not a foregone conclusion that a person with ADHD will cheat. (Phew!)
ADHD and Sex Drive
ADHD sometimes means a heightened sexual drive. But, sometimes it means a decreased sexual drive, too! In the academic world, we use the prefix “hyper-” to mean “too much” and “hypo-” to mean “not enough”. ADHD is linked to both hyper-sexuality and hypo-sexuality.
Simply put, some of us ADHD’ers want sex “too frequently” while some of us “don’t want it often enough”. These are subjective terms and not an indicator of a problem. Those of us with hypERsexuality may spend a lot of our time fantasizing about sex or use pornography often. Meanwhile, those of us with hypOsexuality may lose focus during sex and not pay attention to our partner. Still others of us may have found a balanced sexual approach that is neither “too much” or “not enough”.
ADHD and Hypersensitivity
We have learned over the past decade that ADHD is closely associated with an increase in sensitivity toward our surroundings, including touch. This sensitivity likely shows up during sex, which can amplify things! I’m going to be careful to consider my wide audience here. Just know that there are several authors out there who say that ADHD is a gift in this area!
Creativity and feeling free to express feelings of love and affection are wonderful add-ons to the sexual experience. Remember that ADHD doesn’t always mean a lack of focus. In fact, it likely results in a highly-focused effort over a sustained time toward something (or someone) we find interesting.
Instead of the word “neurodivergent”, I like the term “neuro-spicy”! I think this word speaks better to the topic at hand. When we learn to emphasize the strengths ADHD can bring to the table, we can better appreciate people with ADHD!
How to Improve Things
Here are some practical ways to help improve things in the bedroom if you are someone with ADHD.
- Exercise. I don’t want to sound like a broken record, but getting adequate exercise will always improve your focus, stamina and mental clarity.
- Communicate. Talk to your partner about your needs and theirs. Remember that emotional connection helps make sex enjoyable.
- Enjoy it. When you let yourself relax, you can enjoy the process more and be your true self during the experience.
- Be creative. Your partner was probably attracted to your spontaneity and creativity. Run with that!
- Manage your emotions well. Try not to get bogged down in strong feelings that could distract you. It’s OK to suppress them for a bit, as long as they’re not saying “this is wrong” or raising red flags.
- Pay Attention to Red Flags. If it’s not right, then don’t. If you feel major resistance or legitimate, warranted conviction, it’s probably not meant to be. It’s OK to listen to the parts of you that are trying to keep you safe.
Get Help for ADHD (Including ADHD and Sex)
I work with creative professionals across Georgia who deal with Anxiety, ADHD, or Autism (Level 1). If you’d like help with these or related issues, give me a call at 770-615-6300.
You can also schedule a session here. I offer both telehealth and in-person sessions, and I’m in-network with Aetna insurance and Lyra EAP. I also provide paperwork if you want to file with your out-of-network insurance.
Sources:
The Association of Intimacy and Sexuality in Daily Life
https://pmc.ncbi.nlm.nih.gov/articles/PMC5987853/
6 Genuine Signs You’re Making a Genuine Connection with Your Partner
https://www.xonecole.com/signs-emotional-connection-sex/
ADHD and Affiars
What to Know About Hypersexuality and ADHD
https://www.verywellhealth.com/working-through-adhd-and-hypersexuality-in-relationships-5207993#:~:text=Summary,Read%20more: