102: Understanding Low Sexual Desire with Dr. Nazanin Moali

“We all are so different and it’s normal to be different.  It’s just a matter of finding the ways that help you optimize your sexual desire and have a sexual relationship that you want to have.”   Many women experience diminished or decreased sex drive at one point or another in their lives.  However sex-negativity from our backgrounds, media, and society, can make these challenges difficult to discuss.   With over half the population experiencing some version of sexual dissatisfaction, we can acknowledge that frank discussions surrounding sex and intimacy have the potential to drastically improve our overall well-being.   Dr. Nazanin Moali has a Bachelor’s degree from the University of California, San Diego in biology and psychology, a Master’s degree in Clinical Psychology from Pepperdine University and a Ph.D. in Clinical Psychology from Alliant International University.   She specializes in working with couples and individuals struggling with issues of sex and intimacy. She also hosts a weekly podcast called Sexology in which she introduces listeners to the most intriguing findings in the psychology of sex.  She practices out of Torrance, California.  To find more information about Dr. Moali, visit:  https://oasis2care.com/  http://www.sexologypodcast.com/   Other Resources:  https://www.aasect.org/referral-directory  Better Sex Through Mindfulness: How Women Can Cultivate Desire – Dr. Lori Brotto   In this podcast, Dr. Viado and Dr. Moali discuss: 
  • Why one might seek a sex therapist  
  • Mindfulness and its influence on our sex lives 
  • Brakes and Accelerators: the dual control model of sexuality 
  • Self-image in sex 
 Time Stamps:  2:46 – What can sex therapy do for you?  7:35 – Discerning the nature of issues around sex  12:00 – Dual control model of sexuality: what is it and how does it affect us?   15:30 – Coping with sexual trauma   20:25 – Erotic templates and mismatched libidos   27:10 – Treatment for women whose libido is affected by a hormonal change  36:51 – The 20/20 Rule   39:30 – Sharing sexual fantasies with our partners  46:10 – Seeking sexual therapy for yourself 


5:26 “People, at times, they assume that they’re broken because of some of these issues around sexuality have been there for years and they haven’t talked about it and when they start therapy because this is something that they haven’t explored, people can see progress quickly. And they say ‘Oh my God, it didn’t mean I was broken or that’s not normal’ and they totally change their understanding of themselves and not only around sexual relationships, it can impact people’s confidence and that’s one of my favorite things to see that people, their confidence level change when they address some of the challenges.”    9:57 “What matters most is how much this is important to you, how much stress this is causing in your life because I think sexuality is an important part of ourselves and if that’s something that’s struggling, I don’t want people to then say ‘That’s not important,’ because I genuinely believe pleasure is one of the most important aspects of our lives and it’s important for us to have experienced that and have a good experience around sexually.”   11:10 “This is a time of high stress for all of us. APA released a study in 2013 that talked about one-third of the population experiencing acute stress, extreme stress on a daily basis. If you’re so stressed out, it’s hard to be in tune with our sexual desire…You’re right, in life, there are so many things going on currently that might cause us to not be in touch with our sexual selves…  12:30 “Imagine these are the brakes and accelerator pedals in your car. Sexual facilitators are the gas so these are an environment that can be arousing, so sometimes I hear from my clients it can be the environment that is arousing for them, things in their partner they find arousing, at times they’re talking about music that’s playing and you know most of the time, at least…the gas pedal is not the issue. The issue is that our brakes are on. So brakes can be things in the environment that prevent us from experiencing sexual arousal. So they cause things to not be just right. For example, if we have lots of stress and our brakes are on, no matter how hard we’re pressing on the gas pedal, the car is not going to move…Some of the common brakes are stress, relational issues, so if you have struggled with your partner, you don’t like the relationship you’re in, that can be a source of inhibition for you. At times, guilt and shame around sexuality can be a brake. These low desires could be something that kind of starts from teenage years because of you being exposed to sex-negative messages in religion, in media, from the family of origin. There’s a number of different things that could be brakes and I always encourage my clients to kind of take a look at it. ‘What are some of my accelerators and what are some of the brakes? What can I do to remove the brakes?’”  15:30 “We need to experience emotional safety in order for us to experience arousal…When we experience trauma, that can be a huge brake because it jeopardizes our safety and you need to be in optimal mood of relaxation and arousal in order to be able to experience desire, to experience sexual satisfaction and we’re body gets overwhelmed with cortisol, you’re feeling hypervigilant and it’s hard to experience sexual arousal…Our bodies remember and it’s just hard to get into this optimal mode of relaxation and experience arousal.”  20:25 “We all have different erotic templates. The way we talk about it in sex therapy is like our fingerprints, no two people have the same fingerprints. So it could be emotions that you find erotic. For some people love, it can be feeling loved or feeling adventure or excitement, so it could be the emotions that are arousing for you, it could be images, it could situations, so a number of different things and a combination of things that creates this optimal experience of feeling sexual arousal.”     24:46 “One other brakes are mental health challenges. It could be totally not related to your partner but I have females who struggle with OCD and their constantly preoccupied with obsessional compulsive thoughts during the act of sex and it’s just hard for them to get into feeling aroused and being engaged with their partner sexually…As me and you both know, depression is another huge brake because when you’re depressed, we don’t experience or get pleasure from the things we used to get pleasure from. So it’s just all around, everything looks gray and gloomy and at times I have people coming in saying ‘I don’t find sex enjoyable,”…Speaking of other brakes, hormonal changes can be a huge brake. That’s why when people are coming in, I often refer them to do a medical evaluation because, at times, these hormonal changes in our bodies are impacting arousal…Another huge brake that I said is issues around self-image. People feeling horrible about their bodies, they don’t want to show their bodies, they’re feeling shame and that can impact their experience of arousal because they don’t experience themselves being desirable, so it’s hard to experience desire with the partner.”    27:42 “One of the interventions that I love and is very impactful is coming from the research of Dr. Lori Brotto on implementing mindfulness, so I always recommend that people start practicing some kind of mindfulness in their daily activity because what happens when we’re having all these brakes going on, we are feeling distracted and it’s just hard to pick up sexual cues. So I think in her research…she talks about a minimum of fifteen minutes to twenty minutes, time around mindfulness, doing some kind of a breathing exercise, anchoring yourself in your body, noticing what’s going on, that can be impactful long term.”  39:32 “At times when I assign couples in my office to share their sexual fantasies with each other, I feel this hesitation. Most of the time…among the couples I see in my practice, the experiences and fantasies they have is a common fantasy and their partner wouldn’t be shocked about it, it’s just their fear of showing vulnerability…At times, depending on the content of it, I have clients that they have the kinks that are not necessarily common…with that, I would recommend maybe exploring it with a therapist and seeing what would be the best way of addressing it.”  44: “We all are so different and it’s normal to be different, it’s just a matter of finding the ways that help you optimize your sexual desire and have a sexual relationship that you want to have.”