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Writer's pictureFrederic Lowen

Health and Sex in 2021


Photo by Archie Fantom on Unsplash

As 2021 begins there appears to be a ray of sunshine and hope that restrictions and pandemic dangers will end. As daily rates of new virus cases decline, fear will give way to pent-up desires, and more normal activities may return sooner than most expect. Not only might the pandemic end sooner than later, but we may have a 21st Century version of the Roaring Twenties emerge, complete with excitement, good feelings, and resurging social and sexual activity and interactions.

In the meantime, during these dark moments of the pandemic, health is challenged. Health care services and hospitals are burdened and compromised, and emotional issues are exacerbated. Not coincidentally social interactivity, and sexual desire and availability is greatly diminished.


Sex, and its importance to health, is the ‘elephant in the room’ few talk about. Much discussion of sex, particularly in ‘sex education,’ is about physiology, anatomy, and safe sex procedures. While important, it is dry and boring, with little recognition that sex is a most powerful and important source of pleasure. In media, sex is commercialized as entertaining, titillating, and is used to drive sociopolitical agendas. Very little popular, academic, or scientific literature explores the nature of sexual experience and its effect on health.


It is the role of pleasure in health that is under-appreciated. Of course, it is not just sexual pleasure that is important, but sexual pleasure is key. It is more important than is generally acknowledged. Without pleasure life is less fulfilling, less meaningful, motivating, or relaxing. Yet, sexual frustration is so common and widespread, many give up on the desire, and to varying degree, on aliveness. Others use sex for manipulation, objectification, and as a weapon for power and control for narcissistic gratification. Some use sex just for survival.

I am convinced our individual and collective sexual difficulties and dysfunction is a result of fears embedded in our unconscious. Fears in the form of shame, guilt, emptiness, or sexual performance hiding fears of rejection, abandonment, humiliation, desire, and being judged and used. On a deeper level, we fear intense feelings of anger, sadness, fear itself, and even pleasure, robbing us of passion and motivation. Alexander Lowen’s Fear of Life could be entitled A Fear of Feelings. Yet our greatest fears are of sexuality and identity as sexual beings. Most settle for greatly compromised sexual experience, pleasure, satisfaction and fulfillment. I further believe that much social dysfunction, especially social, racial, and economic injustice and inequality, is largely a result of individual and collective sexual dysfunction.


The lack of sexual pleasure drives sexual dysfunction, and much emotional and psychological distress as well. I believe it negatively affects physical and medical health too, including heart disease and cancer. Although further and greater understanding is required to establish that link, Love, Sex, and Your Heart continues to be a state-of-the-art treatise on the connection between heart disease and love and sex. The Lowen-Sinatra discussion is another resource on this subject.


The evidence of collective sexual dysfunction is apparent. We especially demonize sexual criminals, even while leaders and celebrities commonly engage in highly inappropriate, unethical, and illicit sexual activity and systemic cover-up. Too, it is little known that pornography represents a huge proportion, some estimate a third, of total internet activity. It is HUGE, and hugely lucrative and damaging. I have more than a few male clients in psychotherapy who believe their exposure to pornography was destructive.


Further evidence of the fear of sex is interesting: over the course of recorded human history, about 6-7000 years, we have been able to piece together an astonishing amount of detail of human life: food and cooking, social and military affairs, industry, governing, architecture, beliefs and thinking. However, detail of sexual behavior, activity, and personal experience is almost entirely lacking in comparison. Sex has been ‘the elephant in the room’ for humans forever, perhaps since Adam and Eve.

Clearly, there is a tremendous fear of sex. It is not just private, personal, intimate, and subjective. The fear is evidenced not only by the embarrassed difficulty discussing sex and sexuality, but also in the dysfunctions of gender inequality, LGBTQ+ discrimination, sexual objectification, toxic masculinity, media sensationalism, and religious and politically correct mandates for moral sexual behavior and activity. Emotionally hot-button political issues of abortion rights, contraception, and sex work are explosive and restrictive, while sexual (and economic) slavery and exploitation are quietly conducted. It is high confusion driven by a fear of feelings associated with sex: desire distorted by insecurity, frustration, sexual and/or emotional abuse and neglect, fears of being used, or inadequacy, and unsatisfactory painful prior and current romantic sexual relationships. Politicians and commercial marketers are adept at exploiting and inflaming these feelings for their own enrichment.

The truth of sexual dysfunction may be seen by anyone who looks. Unfortunately, many people cannot see the sexual dysfunction if they are caught up in dysfunction themselves. It is a terribly widespread condition that has afflicted humans for a very long time. Sexual dysfunction is acutely clear to psychotherapists tasked with helping their clients feel better. While it is not often a central focus of therapy, sexuality and a capacity for intimacy and pleasure is never far away.

To be clear, I am not suggesting that ‘more sex’ is the solution to dysfunction. What is important is a person’s capacity for holding tension and energy associated with building pleasure, and then, the ability to ‘let go’ and surrender the ego to the body’s discharge of energy in orgasm. It is much more a function of the body than a state of mind.

An obstacle to clearing sexual dysfunction is fear, especially because the fear is not consciously recognized beyond a vague awareness. While the fear may present itself as a fear of being used, or a fear of being alone, or being inadequate, or being hurt, it is only the tip of the iceberg. Although the actual source and object of the fear is distant and far away, long forgotten, it is recorded in the body. Tight chests protecting a closed heart, or rigid pelvises restricting whole body engagement and feeling in sex, and reduced breathing protecting against too much scary and inconvenient feeling is common.

We know from Wilhelm Reich that fear and pleasure are energetically anti-thetical: fear produces contraction, while pleasure produces expansion. It means that one’s capacity for pleasure is limited by their capacity to experience fear. Many people do not acknowledge the depth and truth of their fears, predisposing some to denial, and others to anxiety and/or irrational fears. Both denial and irrational fearfulness diminish aliveness and pleasure, decreasing health, well-being, and interest in sex. It is a vicious cycle that robs one of the fullness of life, and ultimately, one’s health. It is one’s own prison.


The capacity for feelings of pleasure, particularly sexual pleasure, is not a mental condition, state of mind, or way of thinking. ‘Hook-ups’ and sexual conquests may stimulate narcissistic ego pleasures, but like pornography, it leads one further away from the bodily pleasure of sex that leads to joy. Pleasure in the body is a function of how well one breathes and allows the naturally graceful movement that is too often restricted by chronic physical tension, rigidity, tightness, holding, and control in most people,


It is recognized that healthy sexuality is not all about sexual activity. Sexuality, or the lack of it, is reflected in much of life and how we conduct our lives. Too, our focus on sexual activity does not diminish the importance and value of love, respect, and intimacy, which are integral to healthy sexuality, whether with a long-term partner, someone new, even casual, or in self-pleasure. What is helpful is to develop a capacity for pleasure for oneself, as one’s capacity for pleasure will determine how much pleasure may be offered to a partner.


Whether solo, or in coupledom, enjoy our American Valentine’s Day, with love, intimacy, and perhaps some good sex. Having good sex need be no more complicated than going out for dinner (in normal non-Covid times). Leave your baggage at the door, and imagine what the Roaring 2020s may feel like!


The Alexander Lowen Foundation (TALF) will increasingly focus on aspects of sexuality and pleasure. Freud, Reich, and Lowen considered sex and sexuality to be highly important to health. TALF shares and continues this commitment.

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