Dr. Sandor Gardos Talks About Male Sexual Dysfunction

Dr. Sandor Gardos

Dr. Sandor Gardos, the founder and President of MyPleasure, is more than just the head of a successful sex-toy company. A licensed clinical psychologist and board-certified sexologist, Dr. Gardos has seen thousands of patients whose concerns run the full gamut of human sexual experience, from both the clinical and emotional sides of sexuality.

The author of over 100 articles, chapters, presentations, books and other publications, Dr. Gardos' expertise in matters of sexuality is often called upon not only by universities worldwide, where he is a frequent lecturer and visiting professor, but also by the courts, for whom he often serves as an expert witness.

QUESTION: From what I've heard, there are a number of different types of male sexual dysfunctions. Can you tell us a little bit about some of the more common ones?

ANSWER: Basically, you can divide or classify most sexual disorders into one of several groups:

  • Erectile dysfunctions are any disorder in which a man has a problem obtaining or maintaining an erection.

  • Orgasmic disorders have to do with orgasm -- some men find it very hard to have an orgasm or can't have one at all, but this is fairly uncommon.

  • Much more often, men will complain they can't last as long without ejaculating as they or their partner would like, a condition known as premature ejaculation or, more correctly, ejaculatory incompetence. Finally, there are desire disorders in which a man just does not feel "horny" or does not want to have sex. It's not that he has a problem getting physically aroused; he just doesn't want to put himself in a sexual situation.

Each of these disorders can be caused by physical, medical, pharmacological or psychological conditions -- or all of the above. In fact, men most often experience a combination of several different conditions and dysfunctions, and it is not unusual for one form of sexual dysfunction to lead to the other.

Many of these disorders can also be a sign of another illness, such as diabetes. So the first step is always to make sure there is no physical problem.

As with any medical condition, it is important that men speak to their physicians about any kind of sexual dysfunction. Even if the doctor thinks it is probably psychological, a physical condition can also contribute to the problem.

QUESTION: Traditionally, only women have been thought to suffer from lack of sexual desire. Can men really experience it, too?

ANSWER: In our society, it is often thought that men are always ready, able and willing to have sex at any time, with anyone. This is far from the truth. The reality is that everyone has different "appetites" when it comes to sex, just as they do with food. Sometimes, people don't have the appetite for sex, men as well as women. We think of this situation as lack of sexual desire, low libido or decreased sex drive.

Lack of sexual desire only becomes a problem when the man or his partner is unhappy with the situation, or what is known as a "desire discrepancy," the number-one condition seen by sex therapists. As most therapists will tell you, it is equally common for the man or the woman to be the one with lower desire.

Remember, there is no "correct" amount of sex to have or desire. Yes, there are norms, but what really matters is whether you and your partner are in harmony about how often you have sex.

QUESTION: I know many therapists differ in their views on sexual addiction. Do you consider sexual addiction a form of sexual dysfunction? Why or why not?

Like many sexologists, I do not subscribe to the concept of sexual "addiction." I do believe that people can develop a compulsive or obsessive approach to sex, but I think the term "addiction" should be reserved for those things that meet the usual medical criteria for such conditions.

To say that someone who masturbates ten times a day is an "addict" is a moral judgment, not a scientific one. Similarly, someone who has sex twice a day can be just as healthy as someone who has sex once a week. It is all very subjective.

Those little "tests" you see that claim to tell you whether you are a sex addict are worthless. I have rarely met anyone who doesn't meet criteria based on them. When I see a patient who thinks he is suffering from sexual addictions, I ask questions such as:

  1. Do you feel like you have to have sex?

  2. Do have sex even though you may not enjoy it?

  3. Have you lost your job because of your desire for sex?

  4. Has your sexual appetite affected your relationships?

  5. Do you frequently decide not to go out with friends or family, preferring to indulge in sexual activity?

  6. Is this behavior making you unhappy?


If a patient answers "Yes" to one or more of these questions, then we look at the source of the problem, rather than just labeling the patient as a "sex addict" and sending him to a recovery group.

QUESTION: What is your opinion of Viagra?

ANSWER: Viagra was an amazing invention. It was the first highly effective medical treatment for erectile disorders that did not require painful medical procedures or cumbersome devices. You just take a pill, and boom. However, Viagra is a prescription drug and should not be taken indiscriminately.

It is very important that anyone experiencing erectile difficulties gets properly evaluated by a physician. Viagra is not a cure-all. In fact, it can mask other underlying problems, whether medical or psychological. In an ideal world, a man would first be examined by a physician, and then meet with a sex therapist if physical reasons are ruled out.

As far as all these versions of "herbal Viagra" that have popped up in the last few years, the vast majority are completely worthless. Save your money.

QUESTION: Can men really increase their penis size through exercises? What about "grow larger" creams ... do those work at all?

ANSWER: No, no and NO. The ONLY way to increase penis size permanently is through surgery, which I strongly discourage. The surgery is an experimental, dangerous, painful procedure with numerous side effects and serious risks and consequences. Many men are quite unhappy with the results, and there is no going back.

In fact, the College of Cosmetic and Restorative Surgeons has come out very strongly against penile lengthening operations and said that none of its members should perform the procedure except in extreme cases. It's far better to learn to love what you have and learn how to use it.

QUESTION: Finally ... our most-often asked question: Do penis pumps really work?

ANSWER: It depends on how you define "work." Yes, you might be able to make yourself more fully erect and thus maybe a little larger, but penis pumps do not cause a permanent increase in size.

Penis pumps force extra blood into the penis by creating a vacuum. Many men and their partners enjoy the sensation and the extra feeling of "fullness." However, the results are short-lived. In order to keep the blood in the penis and sustain the "larger" appearance, you would have to use an erection ring in conjunction with a penis pump. Just remember to never leave one in place for more than 30 minutes, or you could create a dangerous situation.

APA Reference
Staff, H. (2021, December 21). Dr. Sandor Gardos Talks About Male Sexual Dysfunction, HealthyPlace. Retrieved on 2025, April 29 from https://www.healthyplace.com/sex/male-sexual-dysfunction/dr-sandor-gardos-on-male-sexual-dysfunction

Last Updated: March 26, 2022

Male Sexual Dysfunction

Our bodies function in many ways. Often, we are not sure how sexual functioning takes place. Below are stages that outline general physiological responses to sexual stimulation. Keep in mind, these stages are variable, and very individual. Although men will progress through the stages in order, the amount of time spent in each stage can vary dramatically.

FUNCTION

Stage One - Excitement

  • Vasocongestion, or the accumulation of blood in the pelvic area during early sexual arousal contributes to erection of the penis. The degree of erection during this phase depends on the intensity of sexual stimuli.

  • The inner diameter of the urethra doubles. The scrotum pulls toward the body.

  • Muscular tension increases in the body. Heart rate and blood pressure both increase.

Stage Two - Plateau Phase

  • The penis does not change markedly during the second stage of sexual response, although it is less likely for a man to lose his erection if distracted during plateau phase than during excitement.

  • The testes increase in size by 50 percent or more and become elevated toward the body.

  • Muscular tension heightens considerably and involuntary body movements such as contractions in the legs, arms, stomach or back may increase as orgasm approaches. Heart rate increases to between 100-175 beats per minute.

Stage Three - Orgasm

  • Actual climax and ejaculation are preceded by a distinct inner sensation that orgasm is imminent. This is called ejaculatory inevitability. Almost immediately after that feeling is reached, the male senses that ejaculation cannot be stopped.

  • The most noticeable change in the penis during orgasm is the ejaculation of semen, although orgasm and ejaculation are two separate functions and may not occur at the exact same time. The muscles at the base of the penis and around the anus contract rhythmically.

  • Males often have strong involuntary muscle contractions through the body during orgasm and can exhibit involuntary pelvic thrusting. The hands and feet show spastic contractions and the entire body may arch backward or contract in a clutching manner.

Stage Four - Resolution

  • Immediately following ejaculation, the male body begins to return to its unexcited state. About 50% of the penile erection is lost right away, and the remainder of the erection is lost over a longer period of time.

  • Muscular tension usually is fully dissipated within five minutes after orgasm, and the male feels relaxed and drowsy.

  • Resolution is a gradual process that may take as long as two hours.

Refractory Period

  • During resolution, most males experience a period of time in which they cannot be re-stimulated to ejaculation.

  • On average, men in their late thirties cannot be re-stimulated for 30 minutes or more.

  • Very few men beyond their teenage years are capable of more than one orgasm during sexual encounters.

  • Most men feel sexually satiated with one orgasm.

Sexual dysfunction may have physiological or psychological causes or a combination of both. Between 10-52% of men at some point in their lives will experience some type of sexual dysfunction. One study in the Journal of American Medical Association (1999) found sexual dysfunction common in 31% of men age 18 to 59.

Primary Sexual Dysfunction: Never having been able to achieve a particular function.
Secondary Sexual Dysfunction: Having been able to achieve a particular function previously but cannot now.
Erectile Dysfunction: Inability to maintain or have an erection that is firm enough for intercourse. 20-30 million men in the U.S. or about 10.4%, at any one time may experience erectile dysfunction.
Primary Erectile Dysfunction: Never before had an erection.
Secondary Erectile Dysfunction: Ability to have an erection and intercourse in the past but cannot now.
Premature Ejaculation: Ejaculation that occurs immediately upon entry or when becoming sexually aroused.
Ejaculatory Incompetence: Inability to ejaculate even when the penis is erect and sufficiently stimulated.
Primary Ejaculatory Incompetence: Never being able to ejaculate.
Secondary Ejaculatory Incompetence: Formerly able to ejaculate but cannot now.
Retarded Ejaculation: Ejaculation occurs but takes a long period of time.
Retrograde Ejaculation: The bladder neck does not close off during orgasm, and semen is pushed backwards into the bladder where it mixes with urine.
Dyspareunia: Painful intercourse occurring anytime during intercourse or even after intercourse.
Hypoactive Sexual Desire: Loss of interest and pleasure in what were formerly arousing sexual stimuli.
Sexual Aversion: Avoidance of or exaggerated fears toward sexual expression.

Sources: Kelly, G.F. (1994). Sexuality Today. Guilford, CN: Dushkin Publishing Group. Masters, W.H., Johnson, V.E., & Kolodny, R.C. (1997). Human sexuality. New York: Addison-Wesley.

APA Reference
Staff, H. (2021, December 21). Male Sexual Dysfunction, HealthyPlace. Retrieved on 2025, April 29 from https://www.healthyplace.com/sex/male-sexual-dysfunction/male-sexual-dysfunction

Last Updated: March 26, 2022

An Overview of Male Sexual Problems

Couples today expect more out of sex and intimacy than in any point in history. As we live longer, our expectations for conjugal bliss continue to grow, far exceeding those of prior generations. Current divorce rates highlight how rarely our expectations are fulfilled. So if you are like most people, and you are having sexual difficulties or simply want better sex and intimacy, you will be interested in what follows.

The good news is that men with sexual difficulties can anticipate more acceptance and better options than ever before. This has come about, in part, by women openly acknowledging their own sexual problems (e.g., lack of arousal and lubrication, difficulty reaching orgasm, low desire, and pain during sex). Likewise, more men today recognize the terrible burden of traditional male stereotypes. And more women refuse to silently endure years of frustrating and non-intimate sex the way their mothers did. For these and other reasons, couples today are increasingly open to new sexual information and/or consulting a therapist. Here is information about both:

Men's Sexual Problems

In the narrowest sense, male sexual difficulties involve getting or keeping an erection, ejaculating too rapidly, or difficulty reaching orgasm. What is hard enough, fast enough, and time enough (or too long) is best decided by the people involved, rather than by a clock or some arbitrary standard. When you are deciding, keep the following in mind:

  • Most men experience difficulty with erections, rapid ejaculation, or delayed ejaculation at some time, and this is entirely normal. When it is frequent or pervasive, one partner or the other usually decides this is a "problem."

  • Uneven sexual desire and dissimilar preferences in sexual style are normal and inevitable in long-term relationships. It is how you handle these that makes the difference.

  • Do not confuse the average guy with the Energizer © Bunny. Many men have low sexual desire, too. Just like women, lots of men know what it is like to feel pressured by their spouse's larger sexual appetite.

  • Men's sexual difficulties usually decrease intimacy, too. When either partner has frequent dysfunction or low desire, both partners eventually retreat during sex into separate mental worlds of worry and frustration. Mind-reading during sex is not quite "the most intimate thing two people can do."

Sexual Difficulties Are Normal

You do not need sexual dysfunctions to fall into this, either. Sexual boredom, lack of intimacy, low desire, and passionless sex are common and inevitable developments-potentially, mid-stages in the evolution of your relationship. Underneath common sexual difficulties, the natural processes of self-development are often playing out. While not enjoyable, they do not necessarily mean something is going, or has gone, wrong. Knowing this can help you relax and appreciate your relationship in new light.

Actually, sexual difficulties can be "beneficial" if you heed them as a wakeup call: There is more to sex than removing inhibitions or learning new techniques, and a great many things cause sexual performance problems and low desire. Do not blame everything on "hang-ups," sexual incompatibility, or the signs of aging or disease. And do not reduce current sexual problems to things from the past it may be the natural growth processes of your relationship at work in the present. To get the sex, intimacy, desire, and passion many of us want, there is a lot of growing up to do.

Embarrassment is understandable but neither necessary nor helpful. Part of growing up involves addressing sexual difficulties like an adult. When men finally realize the real issue is not about sex, but rather, about whether they will continue to apologize for themselves, they often step forward as acts of personal integrity. At its best, resolving sexual difficulties helps both partners see themselves and each other in some new way. This process deepens your capacity for intimacy and strengthens your bonds of love.

Sexual "problems" can turn out to be odd blessings. When things finally become insurmountable and intolerable, some couples seek a therapist who helps them have better sex, intimacy, and a better relationship than they had before their "problem." Some of my own clients, initially embarrassed about seeing a therapist, proudly revealed what they learned to a trusted friend or a valued grown child.

Treatment Options

Men with sexual difficulties in prior generations had fewer options available. Treating erection problems with surgically inserted silicone rods, vacuum pumps, and injecting drugs into your penis left much to be desired. Early versions of sex therapy seemed mechanical and technique-oriented to many couples, too. Today, erection difficulties, rapid ejaculation, delayed ejaculation, and low desire are all treatable problems. Advances in intimacy-based sex-and-relationship therapy and more convenient medicines, like or Cialis (tadalafil), offer far more effective and pleasant solutions than ever before. Even now, new medical miracles are on the horizon. But better genital function alone will not solve problems lying dormant in your relationship. There can still be some relationship repair to do.

When To Get Help

You probably do not have to worry about seeking help prematurely-the overwhelming tendency is to struggle along in secrecy for as long as possible. If things do not seem to be getting better, a marriage and family therapist can often be of help (especially one trained in treating sexual difficulties). It is always appropriate to consult your physician for a medical evaluation, too. Therapists can collaborate with physicians when medical treatment is indicated.

Parents' Sexual Relationship is a Family Matter Parents' sexual relationships are and should be private, but their impacts on their families, both bad and good, never are. Imagine a man who struggles with rapid ejaculation, or erectile difficulty, or decreasing sexual desire. Ask yourself: Is he more likely to over-react to normal authority challenges from his adolescent son, or to downturns in his income, or to his wife starting a new career?

Children monitor their parents' relationship with a hawk-eye. Lack of affection between Mom and Dad is as big an event as walking in on them smooching. When parents have a solid emotional and physical relationship, the household ambiance makes everyone more available to each other. Kids may complain about parents getting "mushy," but they are being blessed with a wonderful template that serves well in later life.

References and Resources

Passionate Marriage-Keeping Love and Intimacy Alive in Committed Relationships. By David Schnarch, Ph.D. Owl Books (1998). This book describes couples' bedroom behavior and therapy sessions to show how sexual problems can trigger personal growth and enhance intimacy eroticism, and desire. A revolutionary look at adult sexual relationships with specific suggestions for couples.

The New Male Sexuality: Revised Edition. By Bernie Zilbergeld, B. New York: Bantam Books (1999). The classic book for men who want to understand their sexuality, emotions, and dilemmas that are part of being male. Good self-help information on sexual problems.

American Association of Sex Educators, Counselors, & Therapists. P.O. Box 238, 103 A Avenue S., Suite 2A, Mt. Vernon, IA, 52314. (319) 895-8407.

Sexuality Information & Education Counsel of the United States. 130 W/ 42 Street, Suite 350, New York, NY, 10036. (212) 819-9770.

The text for this brochure was written by David Schnarch, Ph.D.

APA Reference
Staff, H. (2021, December 21). An Overview of Male Sexual Problems, HealthyPlace. Retrieved on 2025, April 29 from https://www.healthyplace.com/sex/male-sexual-dysfunction/overview-of-male-sexual-problems

Last Updated: March 26, 2022

Psychological Intimacy in the Lasting Relationships of Heterosexual and Same-Gender Couples

Published 8/00: Sex Roles: A Journal of Research

This research focused on the meaning of psychological intimacy to partners in heterosexual and same-gender relationships that have lasted for an average of 30 years. In-depth interviews were used to explore the meaning of intimacy to 216 partners in 108 relationships. The participants were whites, blacks, and Mexican-Americans, with Catholic, Jewish, and Protestant religious backgrounds; they were employed in both blue-and white collar occupations.

Psychological intimacy was defined as the sense that one could be open and honest in talking with a partner about personal thoughts and feelings not usually expressed in other relationships. Factors that had a significant role in shaping the quality of psychological intimacy in the last 5 to 10 years of these relationships (recent years) were the absence of major conflict, a confrontive conflict management style between partners, a sense of fairness about the relationship, and the expression of physical affection between partners. Women in same-gender relationships, compared to their heterosexual and gay counterparts, were more likely to report that psychologically intimate communication characterized their relationships. The findings are important for understanding factors that contribute to psychological intimacy in long-term relationships and how the gender roles of partners may shape the quality of psychological intimacy in heterosexual and same-gender relationships.

This paper explores the meaning of psychological intimacy from the perspectives of 216 partners in 108 heterosexual and same-gender relationships that have lasted an average of 30 years. The paper adds to the existing literature on relational intimacy. Most previous studies of intimacy have sampled younger participants in relationships that have not lasted as long as those in this study. Our research focused on the meaning of psychological intimacy among partners in middle and old age. In contrast to the white, middle-class samples utilized in many studies, we focused on couples in long-term relationships who were diverse in terms of race, educational level, and sexual orientation. Most research on relational intimacy has employed quantitative methodology; we used in-depth interviews to explore the meaning of psychological intimacy from the perspective of each partner in these relationships.

The research on which this paper is based started 10 years ago and was conducted in two phases. In phase one we focused on qualitative analysis of data from 216 in-depth interviews of spouses in 108 heterosexual and same-gender relationship (Mackey & O'Brien, 1995; Mackey, O'Brien & Mackey, 1997). In the second or current phase, we recoded the interview data so as to analyze them from both a qualitative and quantitative perspective.

The goal of the paper is to develop an understanding of factors that contributed to reported psychological intimacy in recent years, defined as the last 5 to 10 years of these relationships. The paper addresses the following questions:

1. What does being psychologically intimate mean to individual partners (i.e., participants) in heterosexual, lesbian and gay male relationships that have lasted for many years?

2. What factors are associated with the quality of psychological intimacy during the recent years of these relationships?

INTRODUCTION

The paper is organized as follows: Perspectives on defining psychological intimacy are discussed, which is followed by a review of recent empirical studies of intimacy, and the theoretical framework for the current study. The research methodology of the current study is summarized. A definition of psychological intimacy, the dependent variable, based on the reports of participants is presented, followed by the definitions of the independent variables that contributed to reported psychological intimacy in recent years. The findings are presented, including a chi-square analysis of those variables related significantly to psychological intimacy in recent years, correlations of the independent variable with the dependent variables, a logistic regression analysis of factors that contribute to psychological intimacy in recent years, and an examination of the qualitative data that help to clarify the effects of gender and sexual orientation on psychological intimacy during recent years. The limitations of the research are then discussed. The paper ends with a summary and conclusion.

Defining Psychological Intimacy

Despite the widespread attention in the professional literature to studies of intimate behavior, there has been little agreement about the meaning of intimacy in human relationships. Any attempt to define intimacy in a meaningful way must attend to various perspectives on the subject as well as clarify the potential linkages between differing perspectives. In addition, the meaning of intimacy must be differentiated from related concepts, such as communication, closeness, and attachment (Prager, 1995). If we are to be meaningful, not to mention relevant to human relationships in general, Prager cautions that any definition of intimacy needs to be compatible with everyday notions about the meaning of psychological intimacy. Because of the contextual and dynamic nature of relationships over time, however, a simple and static definition of intimacy is probably "unobtainable" (Prager, 1995).


Components of Psychological Intimacy

Summarizing a large body of research, Berscheid and Reis (1998) stated:

Intimacy has been used variously to refer to feelings of closeness and affection between interacting partners; the state of having revealed one's innermost thoughts and feelings to another person; relatively intense forms of nonverbal engagement (notably, touch, eye contact, and close physical proximity); particular types of relationships (especially marriage); sexual activity; and stages of psychological maturation (p. 224).

Most frequently, intimacy has been used synonymously with personal disclosure (Jourard, 1971) which involves "putting aside the masks we wear in the rest of our lives" (Rubin, 1983, p. 168). To be intimate is to be open and honest about levels of the self that usually remain hidden in daily life. The extent of personal disclosure is proportionate to how vulnerable one allows oneself to be with a partner in revealing thoughts and feelings which are not usually apparent in social roles and behaviors of everyday life.

Intimacy also has been thought of as companionship (Lauer, Lauer & Kerr, 1990) and has been associated with emotional bonding (Johnson, 1987). Others have defined intimacy as a process which changes as relationships mature (White, Speisman, Jackson, Bartos & Costos, 1986). Schaefer and Olson (1981) considered intimacy to be a dynamic process which included emotional, intellectual, social, and cultural dimensions.

Helgeson, Shaver, and Dyer (1987) asked individuals to describe instances where they had experienced feelings of intimacy with members of the same and opposite gender. Self-disclosure, physical contact, sexual contact, sharing activities, mutual appreciation of the other, and warmth emerged as the major themes. Sexual and physical contact were mentioned frequently in describing intimacy in heterosexual relationships, but rarely mentioned in describing relationships with members of one's own gender. Participants' definitions were not specific to either romantic or platonic relationships, so it is difficult to delineate what components of intimacy apply to different types of relationship.

Monsour (1992) examined conceptions of intimacy in same- and opposite-gender relationships of 164 college students. Self-disclosure was the most salient characteristic of intimacy, followed by emotional expressiveness, unconditional support, shared activities, physical contact, and lastly, sexual contact. It is important to note that the low ranking of sexual contact in this study may have been due to participants describing platonic, rather than romantic, relationships. This study also focused (like others) on short term relationships of young adults.

In studying the characteristics of relationships that had lasted an average of 30 years Mackey, O'Brien and Mackey (1997) reported that sense of psychological intimacy emerged as a significant predictor of satisfaction between partners. Across same- and opposite-gender couples, participants described intimacy as the verbal sharing of inner thoughts and feelings between partners along with mutual acceptance of those thoughts and feelings.

Relatively little is known about nonverbal communication as an aspect of intimacy. Prager (1995) suggested that a glance or a touch may have great meaning between partners because of the mutual recognition of shared, albeit unspoken, experiences. However, "it is less well known how nonverbal factors influence the development of intimacy in ongoing relationships" (Berscheid & Reis, 1998). It appears reasonable to assume, however, that metacommunications in the form of nonverbal messages must be congruent with the exchange of words, if a sense of psychological intimacy is to develop and be sustained between two individuals. At a minimum, metacommunications at a behavioral level cannot undermine or contradict words that may be used to enhance a sense of psychological intimacy between partners in a meaningful relationship.

Sexual involvement between partners in a relationship is another aspect of intimacy. The phrase "intimate relationship" has been equated with sexual activity in several studies (Swain, 1989). In a study of the meanings associated with close and intimate relationships among a sample of college students, 50% of the participants referred to sexual involvement as the characteristic that distinguished intimate from close relationships (Parks & Floyd, 1996). As mentioned earlier, Helgeson, Shaver, and Dyer (1987) also found that participants in their research associated intimacy with sexual contact.

Although studies tend to support the observations of Berschid and Reis (1998) regarding the components of intimacy, a significant issue in studies of intimacy is the failure to control for relationship type, the effects of gender, and relationship duration. All of these factors impact how intimacy is perceived and manifested by partners.

Gender and Intimacy

Intimate communication may be experienced differently by men and women. According to Prager (1995), "few contextual variables have been studied more than gender, and few have been found more likely to affect intimate behavior" (p. 186). In part, differences based on gender may be attributed to developmental experiences. What it is to be psychologically intimate in friendships and romantic relationships may be quite different to each gender, since males and females have been socialized to adopt different roles (Julien, Arellano, & Turgeon, 1997). Traditionally, males were prepared for the "breadwinner" role, while females were socialized "in ways that foster their abilities to maintain the emotional aspects of family life" (p. 114). Macoby (1990) cataloged some of the interpersonal behaviors that men may learn through socialization: competitiveness, assertiveness, autonomy, self-confidence, instrumentality, and the tendency to not express intimate feelings. Noller (1993) described some of the behaviors women may learn through socialization: nurturance, emotional expressivity, verbal exploration of emotions, and warmth. As a consequence, men may experience intimacy through shared activities and women experience intimacy through verbal self-disclosure and shared affect (Markman & Kraft, 1989). Changing cultural values toward androgyny in child-rearing and adult relationships are having a significant impact on gender roles today, and may be changing the meaning of intimacy for males and females in heterosexual and same-gender relationships (Levant, 1996).


In a self-report survey by Parks and Floyd (1996), 270 college students were asked what made their same- and cross-gender friendships close and how this closeness was expressed. Across same- and different-gender friendships the authors "found no support for hypotheses suggesting that women or those with a feminine gender role identification would label their friendship as 'intimate' more than men or people with a more masculine gender role identification" (p. 103). The findings of Parks and Floyd support their argument that "sharp sex (sic) differences in interpersonal behavior has always been scant" (p. 90). While helpful, this research, like many studies of intimacy, was conducted with a young adult and homogeneous sample that were reporting primarily on short-term relationships.

The extent to which men and women define and express intimacy differently remains ambiguous, not unlike the concept itself. Men may value shared activities as an instrumental means to experiencing relational connectedness that may lead to a sense of psychological intimacy, while women may place greater value on sharing thoughts and feelings about themselves. Even if these processes differentiate the meaning of intimacy to men and women, they cannot account for temperamental, contextual, or intervening factors in relationships at different points over their life spans.

Sexual Orientation and Intimacy

The research focused on qualities in the relationships of same-gender partners has been reported in the professional literature over the past two decades. Peplau (1991) observed that "research on gay male and lesbian relationships dates mainly from the mid-1970's" (p. 197).

Studies have found no significant differences between gay males and lesbians on measures of dyadic attachment and personal autonomy within relationships (Kurdek & Schmitt, 1986; Peplau, 1991). High dyadic attachment and low personal autonomy have been associated with the quality of relationships, a positive aspect of which was effective communication. Research on the quality of communication in same-gender relationships has been, however, inconclusive. Some studies have found emotional distancing (Levine, 1979) and impaired communication (George & Behrendt, 1987) between gay male partners. Perhaps, those characteristics of gay male relationships suggest gender differences, rather than differences based on sexual orientation. That is, males may experience comfort in valuing separateness and autonomony in relationships, whether or not they are gay or straight, a hypothesis originally proposed by Gilligan (1982) in her studies of gender differences. In gay male relationships, distancing may become mutually rein forcing and lead to impaired communication between partners.

There has been much discussion over fusion in lesbian relationships based on hypotheses that have emerged from women's developmental research. Fusion, as an element in lesbian relationships (Burch, 1982), has been characterized by high levels of self-disclosure between partners (Slater & Mencher, 1991). Elsie (1986) found that lesbian partners tended to merge emotionally, as compared to gay male partners who maintained emotional distance from each other. Mackey, O'Brien and Mackey (1997) found that a sample of lesbian couples together for more than 15 years valued autonomy within attachment and rejected the idea of fusion in their relationships. Although these discrepancies may reflect gender differences within the context of these committed relationships, they may also be affected by how attachment and autonomy were defined operationally and how they were measured in these studies. Moreover, there is the issue of clarifying self-disclosure, fusion, and differentation as elements in psychological intimacy, e specially in lesbian relationships.

The achievement of a sense of equity has been associated with mutuality in decision-making among heterosexual and same-gender couples (Howard, Blumstein, & Schwartz, 1986), and equity has been identified as a central value in relationships that last, especially in those of lesbians (Kurdek, 1988; Schneider, 1986). When partners in a relationship have felt relatively equal in their capacity to influence decisions, decision-making has been characterized by negotiation and discussion (DeCecco & Shively, 1978). Fairness in decision-making over roles, household responsibilities, and finances have been linked to relational satisfaction and potentially to perceptions of psychological intimacy.

In a recent study, Kurdek (1998) compared relational qualities among heterosexual, gay male, and lesbian couples at 1-year intervals over a 5-year period. These qualities were levels of intimacy, autonomy, equity, ability to constructively problem-solve, and the ability barriers to leave the relationship. Of particular interest to our research were the scales that purported to measure "intimacy." Although there were many similarities between the three groups on other measures of relational quality (i.e., problem-solving and conflict management styles), lesbians reported "higher levels of intimacy than partners in heterosexual relationships" (p.564). That finding resonates with other research on intimacy in relationships and has been attributed to the relational orientation of women. The valuing of mutuality rather than of autonomy within relationships (Surrey, 1987), may nurture the development of psychological intimacy in women's relationships.


The Significance of Psychological Intimacy to Well-Being

Apart from its heuristic value in understanding loving relationships, psychological intimacy is important to an individual's well-being. Prager (1995) summarized the research on the positive effects of being involved in psychologically intimate relationships. Citing several investigations by college students of Nazi Holocaust survivors, Prager argued for the benefits to well-being: individuals are able to share their thoughts and feelings about stressful events and receive support by someone who cares. Openness within a meaningful relationship has been found to reduce stress, enhance self-esteem and -respect, and reduce symptoms of physical and psychological impairment. Conversely, studies of isolated individuals unable to engage in relationships that promote openness and disclosure of inner thoughts and feelings are at risk for developing physical and psychological symptoms. Drawing from several studies, Prager concluded that "even people with sizable social networks are likely to develop symptoms of psycho logical disturbance in the face of stressful events if they lack confiding relationships." (pp. 2-3).

A THEORETICAL FRAME WORK

Our efforts to identify components of psychologically intimacy in a relationship underscored the complexity of the concept and the importance of being as precise as possible in developing an operational definition of it in our research. The definition that was developed (see Method section) was framed within the context of other contiguous dimensions of these relationships (e.g., equity, decision-making, and conflict-management styles).

In this framework, psychological intimacy referred to the meaning associated with relational experiences, as reported in participants' interviews. Operationally, psychological intimacy was defined as the sense that one could be open and honest in discussing with a partner personal thoughts and feelings not usually expressed in other relationships. This concept of intimacy is different from actual observations of verbal and nonverbal interactions, which may contribute (or not contribute) over time to an inner sense of being psychologically intimate in relationships. The focus of our research was on inner psychological themes (i.e., schemas of intimacy) as reported by participants, which were assumed to be contingent on the quality of specific relational experiences between partners.

Based on our review of the literature on the meaning and experience of psychological intimacy, we suggest that any approach to understanding this important dimension of relationships must consider four interrelated components: proximity, openness, reciprocity, and interdependence of partners. These elements must be assessed at different points over the life-span of individuals and within the context of culture. For example, these components may have a different significance for older couples who have been together for many years, such as those in this study, compared to couples who are at the beginning of a loving relationship. The meaning and expression of psychologically intimate communication may also vary between ethnic and racial groups, males and females, and partners in heterosexual and same-gender relationships. Given the potential connections between physical and psychological well-being, the quality of relationships and the demographic reality of an aging population, research into psychological inti macy among a diverse group of older heterosexual and same-gender couples is timely.

METHOD

A semistructured interview format was developed and pretested by the researchers. The resulting interview guide consists of focal questions that were designed to elicit how participants viewed several dimensions of their relationships. Collaborative researchers conducted additional pilot testing and provided feedback that led to further refinement of the interview guide.

The guide, which was used in all interviews, was divided into four sections: the participant's relationship; social influences, including economic and cultural factors; the relationships of the parents (all participants had been reared by heterosexual parents); and experiences of participants and views of their relationships from the early to recent years. The "recent years," the focus of this paper, can be categorized as the last 5 to 10 years prior to the interviews. The "early years" are the years prior to the birth of the first child for couples who had children, or the first 5 years for those without children or who adopted children after being together for 5 years.

The interview structure was designed to acquire in-depth information from the point of view of individual participants, to develop an understanding of how each partner adapted over the life span of their relationships. An open-ended style of interviewing allowed for freedom of expression, to elicit information from the perspectives of participants about interactions with partners. The approach, which adapted clinical interviewing skills to the needs of the research, explored the experiences of individuals within relationships as they remembered and reported them.

The interviewers, advanced doctoral students with extensive clinical experience, were trained in the use of the interview guide. They were respectful and accepting of the uniqueness of each participant's perceptions. Their empathic interviewing skills were a valuable resource in collecting the data (Hill, Thomson & Williams, 1997).

The interviews were held in the participants' homes, which provided additional information about lifestyles and environments. Prior to each interview, participants were told about the purpose of the study, given an overview of the interview schedule, and assured their identities would remain anonymous. Informed consent for audiotaping and the use of interviews for research were obtained. Each partner was interviewed separately; the length of each of the interviews was approximately 2 hours.


Sample

Couples were recruited through business, professional, and trade union organizations, as well as through churches, synagogues, and a variety of other community organizations. Most couples resided in the northeast part of the country.

The sample was chosen purposively to fit with the goal of developing an understanding of a diverse and older group of heterosexual and same-gender couples in lasting relationships. Couples were recruited who met the following criteria:

1. They were married or in a committed same-gender relationship for at least 15 years.

2. They were diverse in race/ethnicity, education, religious background, and sexual orientation.

Of the 216 partners who were interviewed, 76% were white and 24% were people of color (African-Americans and Mexican-Americans). The religious background of the couples was as follows: 46% were Protestant; 34% were Catholic; and 20% were Jewish. Fifty-six percent were college graduates and 44% were non-college graduates. The mean age for the sample was 57 years (SD = 10.24): 27% of participants were in their 40s, 33% in their 50s, 26% in their 60s, and 14% in their 70s. Sixty-seven percent of couples were heterosexual and 33% in same-gender relationships. The mean number of years shared together was 30.22 (SD = 10.28): 18% of couples had been together 40 years or longer; 29% between 30 and 39 years; 34% between 20 and 29 years; and 19% less than 20, but more than 15 years. Seventy-seven percent of the couples had children; 23% did not have children. By total gross family income, 7% of couples earned less than $25,000; 25% between $25,000 and $49,999; 29% between $50,000 and $74,999; and 39% had gross incomes of $75,000 or more.

Coding

Each interview was tape-recorded and transcribed to facilitate coding and prepare the data for both quantitative and qualitative analysis. Interview passages were coded for relational themes, which were then developed into categories (Strauss & Corbin, 1990).

Initially, a research team (two women, two men) coded eight transcriptions blindly and individually. Detailed notes were kept and categories were generated. A relationship coding sheet was developed and used in subsequent coding of eight additional interviews. As new categories arose, previous interviews were recoded in keeping with the constant comparative process. Having both genders involved in that process helped control for gender bias and contributed to the development of a shared conceptual analysis. A scoring system was developed to identify themes that evolved from each section of the interviews. There were over 90 categories in 24 topic areas for every participant.

Once the Relationship Coding Sheet was developed, each interview was coded and scored independently by two raters (one male, one female), who noted themes and categories as they emerged from the transcripts. One of the authors coded all 216 interviews to ensure continuity in the operational definitions of variables and consistency of judgments from case to case. The agreement between raters, determined by dividing the number of identical judgments by the total number of codes, was 87%. Cohen's kappa, used as a measure of interrater reliability, ranged from .79 to .93. When discrepancies occurred the raters met to discuss their differences and to re-examine the original transcripts until a consensus was reached on how a particular item was to be scored.

HyperResearch software (Hesse-Biber, Dupuis, & Kinder, 1992) enabled the researchers to perform a thorough content analysis of interview transcripts (totalling over 8,000 double-spaced pages) and identify, catalogue, and organize specific interview passages on which categorical codes were based.

In the second or current phase of the study, we re-examined the codes so as to prepare the data for quantitative analysis. Many variables were re-coded into dichotomous categories. For example, psychological intimacy was originally coded into three categories (positive, mixed, and negative). Because we were interested in understanding factors that contributed to psychological intimacy during recent years, the positive category was retained and compared with a recoded mixed/negative category. Vignettes from the transcripts are used in the following pages to illustrate the meaning of psychological intimacy to participants during recent years.

Data-Analysis

The coded data from the scoring sheets yielded frequencies that were analyzed using SPSS software. Chi-square analysis was used to examine the relationship between the independent variables--which included personal, demographic, and participants' reports of various dimensions of relationships--and the dependent variable of psychological intimacy in recent years. The Alpha criterion was set at .01 for the chi-square analysis.

The chi-square statistic seemed appropriate, since certain conditions were met. First, it has been very difficult to ensure randomness of samples in social and behavioral research, especially in studies that focus on new territory. This nonprobability sample was selected deliberately to include older couples who have been understudied in previous research--namely, heterosexual and same-gender relationships that had lasted an average of 30 years. The goal was to identify factors that contributed to satisfaction from the perspectives of individual partners rather than to test hypotheses. Second, compared to other tests of statistical significance, chi-square has fewer requirements for population characteristics. Third, the expected frequency of five observations in most table cells was met.

To assess the strength of the associations between psychological intimacy and the independent variables, a correlation analysis was conducted. Because of the dichotomous nature of the variables, a phi coefficient was computed for the dependent variable and each independent variable.

Variables that had been related significantly to psychological intimacy in the chi-square analysis and identified in previous studies as having importance to understanding psychological intimacy were selected for building a theoretical model. Based on the phi coefficients, communication was not included in the model (see next section). Two models were tested using logistic regression: one model included the sexual orientation of couples (heterosexual, lesbian, and gay males), the other substituted gender (male and female) for the sexual orientation of couples. Logistic regression was a useful tool in this exploratory research, where the goal was to develop theory rather than test it (Menard, 1995).


TOWARD A DEFINITION OF PSYCHOLOGICAL INTIMACY

The dependent variable was psychological intimacy. Participants talked of experiencing psychological intimacy when they were able to share their inner thoughts and feelings they felt to be accepted, if not understood, by the partner. Such experiences were associated with feelings of mutual connection between partners. When participants talked of being psychologically intimate with their partners, a sense of peace and contentment permeated their remarks. This definition, derived from the participants' reports, resonated with components of psychological intimacy identified in the literature review of this paper.

Coding this variable involved an assessment of responses to questions that asked each partner to talk about their relationships. These questions included a range of topics such as what the partner meant to the participant, how their relationships may have been different from other relationships, how participants felt about being open with their partners, what words best described the meaning of the partner to a participant, etc. Of particular importance were questions that elicited responses about the quality of communication such as, "How would you describe the communication between you?" Communication was coded "positive" in recent years when participants spoke positively about their comfort in carrying on discussions with their partners about a wide range of issues. Otherwise, communication was coded as "poor/mixed." Positive communication was essential for the development of psychological intimacy. Although positive communication could be present without having a sense that the relationship was psychologically intimate, at least in a theoretical sense, the two factors were correlated substantially (phi = .50). Therefore, we decided not to include communication as an independent variable in the regression analysis. Psychologically intimate communication captures what we are referring to as "psychological intimacy."

When responses reflected themes of openness, reciprocity, and interdependence between partners, psychological intimacy was coded as "positive." Opposite responses were coded as "negative/mixed." A lesbian participant discussed the meaning of psychological intimacy in the relationship with her partner that had lasted over 20 years:

I feel like I can be who I am. Now, she doesn't always like everything about that. But I can still be that way, and I don't have to pretend. That's never been something that we've had to do. I would be horrified if that had to be. I just can't imagine what that's like . . . I don't see us as fused. It's important to me not to be. I don't like it. I don't think it's healthy . . . I don't want to be in a relationship like that. It's important to me, for us, to be individuals, as well . . . She's my best friend . . There's a peacefulness about that . . . I can be whoever I am. I can say stuff to her that I would never say to anyone else. There are parts of myself that I don't particularly like, and I don't really share with other people, but it's OK to share with her. She'll take them in. She'll understand where it's coming from.

The partner spoke of how their psychological intimacy had evolved:

Although we like a lot of the same things, our interests are different . . . I've appreciated the fact that she has been the one who will raise an issue or problem for the purpose of resolution or improvement, and not just because she's angry. She seems to be willing to take that initiative. I didn't grow up in that kind of setting, so I think that's one reason this has worked. I think we both each really like the other one a lot ... There was a bond early on, in part because it was a different kind of relationship ... we were isolated for a long time, but that experience also bonded us ... I can be much more vulnerable now ... I look to her for help with it, which wasn't something I knew how to do before.

As the couples in this study grew older together the experience of psychological intimacy was marked by a deepening sense of relational communion between them, yet a respect for their differences, as illustrated in the relationships of that couple.

A heterosexual couple reflected on the meaning of intimacy in their relationship that had lasted 30 years. The wife experienced her spouse as:

My best friend, best lover ... the person I can come home to when something bad happens to me. Unfortunately, we have not had parents for many years. He is my parent as well as my friend. He is the person who most cares what is happening to me.

The meaning of intimacy to her husband was described by him:

I just like her to be next to me, near me. If you don't have that feeling, I think there is a piece that is missing. I think we are our own people, but we do it together. You just have to respect the other person ... trust their decisions and beliefs and want to be with them.

The responses of these four partners reflected several themes that were central to understanding and defining psychological intimacy. One theme, openness, reflected a sense of comfort in "being one's self," to be able to reveal and say things to a partner that one felt could not be said to others; the use of the expression, "best friend," was often used by participants in describing this reciprocal dimension of their relationships. The second theme, interdependence, referred to maintaining separateness within the attachment to a partner. Maintaining interpersonal boundaries in these relationships apparently helped to sustain a sense of psychological intimacy; that is, individuals felt "safe" in revealing their inner thoughts and feelings because they could count on a partner to respect their separateness and to accept, if not understand, them. Third, psychological intimacy was not a constant in relationships but a sense or a representation in one's mind that one could confide in a partner if one needed to discuss personal matters. For both women and men, themes of connectedness, separateness, and mutuality were apparent in their responses, although men tended to emphasize proximity and women mutuality.


INDEPENDENT VARIABLES

In selecting the independent variables, two criteria were used:

1. The variable had to be identified in previous studies as a significant factor in shaping psychological intimacy.

2. The variable had to be related significantly to psychological intimacy in the chi-square analysis (see Table I) and not be correlated substantially with the dependent variable.

Based on these criteria, the independent variables were: conflict, conflict management style of the partner, decision-making, equity, sexual relations, importance of sexual relations, and physical affection.

There were questions that explored the nature of conflict. If disagreements and differences between partners had a negative effect on a participant and were viewed as disruptive to relationships, such as a cut-off in all verbal communication, conflict was coded as "major." Other conflictual matters between partners were coded "minimal."

Conflict management style was defined as the predominant way in which a participant and the partner dealt with differences and disagreements. Direct or face-to-face discussions of interpersonal differences between partners were coded "confrontive." If participants reported that they did not or could not discuss their thoughts and feelings in face-to-face encounters with their partners, such as denying their feelings or leaving the scene, the style was coded as "avoidant."

Participants were asked to discuss their "ways of making decisions." If decisions were usually made separately by one partner without the involvement of the other one, decision-making was coded "separate." If important decisions were made together, this variable was coded "mutual." The latter involved separate decision-making, depending on circumstances. For example, mothers at home with children often made decisions about discipline without talking with their partners. The criteria dealt with predominant modes of making decisions about significant matters, such as major purchases.

"Equity" referred to the sense of fairness in relationships. The questions were framed as follows: "Overall, have you felt a sense of fairness in the relationship?" "Despite differences, have things balanced out?" "Do you feel that your ways of solving problems as a couple has been generally fair to each of you?" If the responses to these inquiries were in the direction of an overall sense of fairness, this variable was coded "yes;" if not, it was coded "no."

Sexuality in relationships was explored through several inquiries. Participants were asked about physical affection, which referred to physical contact, such as hugging. If touching was a regular part of the relationship, physical affection was coded "yes;" if it was not, it was coded "no/mixed." This was part of the exploration of sexual relations, which included such questions as, "How have you gotten along sexually in terms of nonsexual intimacy, like hugging and touching?" Participants were also asked to assess the importance of genital sex in their relationships, coded as "important" or "not important." Genital sex that was "very important" early in relationships began to wane after several years. As the frequency and satisfaction with genital sex declined, psychological intimacy developed among most participants. For example, during the early years of these relationships, 76% of participants reported satisfaction with the quality of their sexual relations compared to 49% in the last 5 to 10 years. Alth ough comparable figures for psychological intimacy were 57% in the early years and 76% in recent years, this change was not statistically significant. Physical affection, such as hugging and touching, remained relatively constant throughout the years in contrast to the regression in sexual intimacy and the progression in psychological intimacy. Despite the change in sexual intimacy, genital sex continued to be seen as important from early through recent years.

FINDINGS

Cross tabulations were done for all research variables with reports of psychological intimacy in recent years. Personal and demographic factors did not have a statistically significant relationship to psychological intimacy during recent years (i.e., p [less than].01). The gender of participants was not related significantly to psychological intimacy, neither was the age of participants (categories = 40s, 50s, 60s and 70s). The number of years together (15-19, 20-29, 30-39, and 40 or more) was not significant. Indices of socioeconomic status were not significant: gross family income (5 categories, from [less than]$25,000 to [greater than]$100,000), and level of education (less than college, and college graduate graduate or more). Other social factors that were not significantly related to psychological intimacy in recent years included religious backgrounds (Protestant, Catholic and Jewish), race (white and non-white), and whether couples had children.

Table I shows the relational variables that were related significantly to psychological intimacy in recent years (p [less than] .01). More than 9 out of 10 participants described their relationships as psychologically intimate in recent years if they had also reported positive sexual relations and physical affection. Eight out of ten participants felt psychological intimacy in recent years was significantly associated with minimal relational conflict, a confrontive conflict management style in one's partner, mutual decision-making, a sense of relational equity and a continued importance of sexual reactions in their relationships.

Table II shows the phi coefficients of a correlation analysis between the dependent variable and each of the independent variables. A substantial correlation was found between psychological intimacy and the quality of communication ([phi] = .50). Based on this analysis, communication was not included as an independent variable in the theoretical model tested with logistic regression. (The rationale for that decision was discussed under the definition of psychological intimacy in the Methods section.) Low to negligible correlations were found between psychological intimacy and the independent variables of gender and sexual orientation. These variables were included in the two theoretical models: the first model contained the sexual orientation of couples, along with the other relational variables; the second model substituted gender of the participants for sexual orientation.


Table III shows the results of a logistic regression analysis--this includes variables from Table I, which had also been found in previous research to be related significantly to psychological intimacy. Included in the model was the sexual orientation of couples. Variables in the model that were not related significantly to psychological intimacy included decision-making, the quality of sexual relations, and the importance of sexual relations to relationships. Factors that were predictive of psychological intimacy during recent years were physical affection between partners (B = 1.63, p = .01); the seriousness of conflict between partners (B = -2.24, p = .01); the conflict management styles of partners, as reported by participants (B = 1.16, p = .01); and the fairness or equity of relationships (B = 1.29, p = .01). On the factor of the sexual orientation of couples, lesbian couples differed from heterosexual couples (B = 1.47,p = .05) and gay male couples (B = 1.96, p = .03). Compared to the gay males and heterosexuals, lesbians were more likely to report that their relationships were psychologically intimate in recent years: 90% of lesbian, 75% of gay male, 72% of heterosexual participants; ([X.sup.2] = 6.04 (2df), p = .05).

To clarify whether the differences between lesbians and the other two groups was a matter of sexual orientation or gender, a second model was constructed and tested with logistic regression. Gender was substituted for sexual orientation of couples in that model. The results are shown in.

Factors that contributed to understanding psychological intimacy in the first regression analysis continued to have a similar effect in this modified model. The gender of participants had a moderate effect on the reported psychological intimacy in recent years (B = .81, p [less than] .08).

Sexual Orientation, Gender, and Psychological Intimacy

To examine the interacting effects of gender and sexual orientation on psychological intimacy, we returned to the original qualitative data. The four elements in the theoretical model for this study discussed earlier in this paper (proximity, openness, reciprocity and interdependence) were useful in this task. Subtle differences were found in how these elements were weighed by participants, as they talked about the meaning of psychological intimacy in their relationships.


 


Themes of proximity and interdependence were evident among males, as illustrated in the responses of a gay male:

Emotionally, things are really good now ... it feels good knowing I'm growing old with [his partner], even though we're very different people ... I'm very social and I have a lot of friends, and he's not as social and he doesn't have as many friends . . . We both place a really great importance on togetherness. We make sure that we have dinner together every night and we have our weekend activities that we make sure we do together. . . I think that both of us understand it's also important to be an individual and have your own life, . . I think you become really uninteresting to each other if you don't have another life you can come back and share . . . You need to bring things into the relationship . . . [things] that keep it growing and changing.

The importance of proximity in the connection to his partner became evident as this individual responded to our inquiry about psychological intimacy. At the same time, he noted the value that he placed on separateness from his partner. By implication, he was also talking about the element of interdependence as he expressed the joy of "growing old" with his partner in spite of the differences in their individual psychological makeups. He emphasized proximity along with interpersonal differentiation as he discussed the relationship in recent years.

The responses of many women tended to reflect themes of openness and mutuality, along with differentiation in the psychologically intimate connection with their partners. A lesbian participant spoke of those elements in her relationship:

What has been good is the ongoing caring and respect and the sense that there is somebody there who really cares, who has your best interest, who loves you, who knows you better than anybody, and still likes you. . . and just that knowing, that familiarity, the depth of that knowing, the depth of that connection [that makes it] so incredibly meaningful. There is something spiritual after awhile. It has a life of its own. This is what is really so comfortable.

Variations by gender may have reflected how individuals perceived and valued different elements of psychological intimacy within themselves and in their partners. Because of the gender differences between partners in heterosexual relationships, these variations on the theme of psychological intimacy were manifested in a different way. The following observations of a heterosexual male illustrated those variations; he viewed his wife as

very unselfish, and she would sacrifice so that I could go out and do my thing. One thing that we have always done, always, is talk constantly to each other. I don't know what we talk about, and I don't know what we've had to talk about all these years, but we still communicate with each other. . . We've had fights . . . when she gets mad at me I stop talking to her. And then she feels very bad, and this may last a day or two, and then it passes and everything is fine again . . . She's more open than I am. I keep a lot inside and I don't let it out, and that's probably not good. But, that's the way I am.

Many heterosexual males viewed observable qualities in their wives, such as support and their style of managing conflict, as important in developing and maintaining a sense of psychological intimacy in their marriages. Females, on the other hand, often commented on the observable and then went on to identify their understanding of the underlying dynamics that shaped behavior. More than men, women talked about the interplay of relational dynamics. The spouse in this marriage reported that she filled certain needs in him, and I know he filled certain needs in me . . . he didn't have very high self-esteem. I may have boosted his confidence a lot . . . He tells me I go ballistic over stupid things, and he is outwardly very calming . . . I don't always agree with him, and he does not always agree with me . . . but we're good friends through it all, and I think that if you have a good friend, you should be able to disagree or agree, or get angry or be happy, or any number of emotions, if that's your friend, that's your friend ... I don't even know how to describe it, you just have that closeness . . . there has to be enough there so that when all these little outside things are finally gone, it's not "Who are you? I don't know you, and we don't have anything." You have to really work at keeping that level of a relationship active . . . not just a physical spark, but just the whole picture.


Themes of connectedness and separateness in these four interview passages were important dynamics in understanding the meaning of psychological intimacy to participants. The elements of proximity, closeness, mutuality, and interdependence may have been shaped most significantly by the interaction of males and females in same- and opposite-gender relationships. That is, it may not be gender alone that accounts for the differences between males and females. If women value attachment in relationships in a way different from men, then the data may suggest a mutually reinforcing process toward strengthening connectedness in lesbian relationships. In heterosexual and gay male relationships, the value that males place on separateness in relationships may temper the quality of attachment that develops over the years, and therefore results in different forms of psychological intimacy.

Psychological intimacy between lesbian partners had a different relational history from that of heterosexual and gay male partners. From the early years to recent years, our data suggest a progressive shift toward psychological intimacy between lesbian partners. Lesbians were as evasive of face-to-face discussions of conflict as heterosexual and gay male males, during the early years of their relationships. For lesbians, the avoidance appeared to be a consequence of fearing abandonment by their partners if they openly confronted differences. Only as lesbian couples became increasingly disenchanted with their relationships did modification in conflict management styles occur. Usually, one partner took the risk of expressing her unhappiness. That encounter resulted in 85% of lesbians applying for couple therapy. Based on the reports of lesbian respondents about the meaning of therapy to their relationships, being involved in treatment may have supported the development of psychologically intimate communication between partners.

LIMITATIONS

Qualitative modes of data collection based on in-depth interviews conducted are an effective tool for studying elusive phenomena, such as psychological intimacy. The richness of data elicited through the method used in this study is quite different from data collected through other means, although there are concerns about validity and reliability, as well as the nature of the sample.

To clarify whether the differences between lesbians and the other two groups was a matter of sexual orientation or gender, a second model was constructed and tested with logistic regression. Gender was substituted for sexual orientation of couples in that model. The results are shown in.

Factors that contributed to understanding psychological intimacy in the first regression analysis continued to have a similar effect in this modified model. The gender of participants had a moderate effect on the reported psychological intimacy in recent years (B = .81, p [less than] .08).

Sexual Orientation, Gender, and Psychological Intimacy

To examine the interacting effects of gender and sexual orientation on psychological intimacy, we returned to the original qualitative data. The four elements in the theoretical model for this study discussed earlier in this paper (proximity, openness, reciprocity and interdependence) were useful in this task. Subtle differences were found in how these elements were weighed by participants, as they talked about the meaning of psychological intimacy in their relationships.

Themes of proximity and interdependence were evident among males, as illustrated in the responses of a gay male:

Emotionally, things are really good now ... it feels good knowing I'm growing old with [his partner], even though we're very different people ... I'm very social and I have a lot of friends, and he's not as social and he doesn't have as many friends . . . We both place a really great importance on togetherness. We make sure that we have dinner together every night and we have our weekend activities that we make sure we do together. . . I think that both of us understand it's also important to be an individual and have your own life, . . I think you become really uninteresting to each other if you don't have another life you can come back and share . . . You need to bring things into the relationship . . . [things] that keep it growing and changing.

The importance of proximity in the connection to his partner became evident as this individual responded to our inquiry about psychological intimacy. At the same time, he noted the value that he placed on separateness from his partner. By implication, he was also talking about the element of interdependence as he expressed the joy of "growing old" with his partner in spite of the differences in their individual psychological makeups. He emphasized proximity along with interpersonal differentiation as he discussed the relationship in recent years.

The responses of many women tended to reflect themes of openness and mutuality, along with differentiation in the psychologically intimate connection with their partners. A lesbian participant spoke of those elements in her relationship:

What has been good is the ongoing caring and respect and the sense that there is somebody there who really cares, who has your best interest, who loves you, who knows you better than anybody, and still likes you. . . and just that knowing, that familiarity, the depth of that knowing, the depth of that connection [that makes it] so incredibly meaningful. There is something spiritual after awhile. It has a life of its own. This is what is really so comfortable.


Variations by gender may have reflected how individuals perceived and valued different elements of psychological intimacy within themselves and in their partners. Because of the gender differences between partners in heterosexual relationships, these variations on the theme of psychological intimacy were manifested in a different way. The following observations of a heterosexual male illustrated those variations; he viewed his wife as

very unselfish, and she would sacrifice so that I could go out and do my thing. One thing that we have always done, always, is talk constantly to each other. I don't know what we talk about, and I don't know what we've had to talk about all these years, but we still communicate with each other. . . We've had fights . . . when she gets mad at me I stop talking to her. And then she feels very bad, and this may last a day or two, and then it passes and everything is fine again . . . She's more open than I am. I keep a lot inside and I don't let it out, and that's probably not good. But, that's the way I am.

Many heterosexual males viewed observable qualities in their wives, such as support and their style of managing conflict, as important in developing and maintaining a sense of psychological intimacy in their marriages. Females, on the other hand, often commented on the observable and then went on to identify their understanding of the underlying dynamics that shaped behavior. More than men, women talked about the interplay of relational dynamics. The spouse in this marriage reported that she filled certain needs in him, and I know he filled certain needs in me . . . he didn't have very high self-esteem. I may have boosted his confidence a lot . . . He tells me I go ballistic over stupid things, and he is outwardly very calming . . . I don't always agree with him, and he does not always agree with me . . . but we're good friends through it all, and I think that if you have a good friend, you should be able to disagree or agree, or get angry or be happy, or any number of emotions, if that's your friend, that's your friend ... I don't even know how to describe it, you just have that closeness . . . there has to be enough there so that when all these little outside things are finally gone, it's not "Who are you? I don't know you, and we don't have anything." You have to really work at keeping that level of a relationship active . . . not just a physical spark, but just the whole picture.

Themes of connectedness and separateness in these four interview passages were important dynamics in understanding the meaning of psychological intimacy to participants. The elements of proximity, closeness, mutuality, and interdependence may have been shaped most significantly by the interaction of males and females in same- and opposite-gender relationships. That is, it may not be gender alone that accounts for the differences between males and females. If women value attachment in relationships in a way different from men, then the data may suggest a mutually reinforcing process toward strengthening connectedness in lesbian relationships. In heterosexual and gay male relationships, the value that males place on separateness in relationships may temper the quality of attachment that develops over the years, and therefore results in different forms of psychological intimacy.

Psychological intimacy between lesbian partners had a different relational history from that of heterosexual and gay male partners. From the early years to recent years, our data suggest a progressive shift toward psychological intimacy between lesbian partners. Lesbians were as evasive of face-to-face discussions of conflict as heterosexual and gay male males, during the early years of their relationships. For lesbians, the avoidance appeared to be a consequence of fearing abandonment by their partners if they openly confronted differences. Only as lesbian couples became increasingly disenchanted with their relationships did modification in conflict management styles occur. Usually, one partner took the risk of expressing her unhappiness. That encounter resulted in 85% of lesbians applying for couple therapy. Based on the reports of lesbian respondents about the meaning of therapy to their relationships, being involved in treatment may have supported the development of psychologically intimate communication between partners.

LIMITATIONS

Qualitative modes of data collection based on in-depth interviews conducted are an effective tool for studying elusive phenomena, such as psychological intimacy. The richness of data elicited through the method used in this study is quite different from data collected through other means, although there are concerns about validity and reliability, as well as the nature of the sample.

It is difficult to assess the validity of the data in the traditional sense of that concept since we were eliciting the personal perceptions and evaluations of participants about the meaning of psychological intimacy in their relationships at a particular point in time. The candor of participants on highly personal matters, such as the decline in sexual relations because of sexual dysfunctions, suggests that participants were equally candid about other aspects of their relationships, such as psychological intimacy. By interviewing partners separately and asking them to talk about themselves, as well as their observations of their partners in these relationships, we were able to compare responses to determine if there were significant differences over common realities. For example, did both partners assess the nature of conflict in their relationships similarly? Did a participant, in commenting on an aspect of a partner's behavior, come close to the partner's observations about the same factor? Correspondence between partners was permitted in the study, which was illustrated in the responses to conflict management styles when participants were asked to describe their style as well as the style of their partners. For example, partners who described themselves as having an evasive style were viewed by their partners in an equivalent way.

In a cross-sectional design in which participants are asked to report on their life today and in the past, traditional measures of reliability are inadequate. The meaning-of-life events and an individual's response to these events will vary, and may even vary within the same person at different points over the lifespan. While longitudinal designs may be superior in contending with problems of validity and reliability, cross-sectional designs that use interviews to uncover the meaning of behavior have the strength of eliciting the richness in the experiences of human beings.

There is a shortfall in recoding the data from multiple categories into dichotomous ones. This step built onto the earlier qualitative analysis by offering a different lens through which to understand the data. To offset the potential reductionistic effects of recoding, we have incorporated a discussion of the qualitative data into the results. The integration of qualitative and quantitative procedures was intended to enhance the theory development objective of the research.


The use of an interdisciplinary team throughout the research process enhanced the quality of the study. Issues of bias, misinterpretation, and other matters that could affect the validity and reliability of the data were discussed. One of the principal investigators read all 216 interview transcripts and served as a second blind coder for each interview. Having one researcher read and code every interview provided for continuity in the operational definitions of variables. To insure that there was both a male and a female perspective on the data, the second coder was a woman. As a measure of inter-rater reliability, Cohen's kappa was used and ranged from .79 to .93.

The sample was selected purposively to include participants not often included in other studies in lasting relationships; namely, people of color, blue-collar participants, and same-gender couples. The goal was not to test theory but to develop an understanding of a subject--psychological intimacy among an older group of diverse partners in lasting relationships--that has not received much attention by researchers. The sample fit with the goal of this exploratory study.

SUMMARY

The study of psychological intimacy in human relationships is a highly complex and dynamic process. Defining intimacy is a challenge, as is the importance of specifying the operational parameters. We defined psychological intimacy as the sense that participants had of their relationships as a place in which they could share personal thoughts and feelings about themselves and their relationships not expressed customarily with others. In this definition, positive communication was a quintessential component of psychological intimacy. We focused on cognitive themes about the meaning of relationships to individual partners rather than on specific interpersonal behaviors. The sample consisted of heterosexual and same-gender couples in relationships that had lasted approximately 30 years.

A chi-square analysis of all research variables with the independent variable revealed that social and demographic factors such as age, race, education, income, and religion did not have significant relationships to psychological intimacy in recent years. That finding is important to the process of understanding factors that contribute to the quality of psychological intimacy in committed relationships that last for many years. It may also suggest that factors within relationships are more important than are socioeconomic and demographic factors in shaping psychological intimacy between partners in these relationships.

In the chi-square analysis, several factors were associated significantly with reports of psychological intimacy in recent years, defined as the last 5 to 10 years of these relationships. They were the quality of communication between partners, minimal relational conflict, conflict management style of partners, couple decision-making, relational equity, quality of sexual relations, importance of sexual relations, and physical affection. These data are similar to findings reported in previous studies that have explored psychological intimacy (Berscheid & Reis, 1998), although those studies tended to focus on younger participants.

Phi coefficients were then computed to determine the strength of the associations between the dependent variable and each of the independent variables. Based on the substantial correlation between communication and psychological intimacy ([phi] = .50), communication was not included as a dependent variable in the theoretical models that were tested with logistic regression. In this study, it is appropriate to consider psychological intimacy as psychologically intimate communication.

Based on the statistically significant relationships of the above variables with psychological intimacy, along with their identification in previous research as important factors in shaping intimacy (Kurdek, 1998; Swain, 1989; Howard, Blumenstein, & Swartz., 1986), two theoretical models were constructed and tested with logistic regression analysis. The first model included the sexual orientation of couples (heterosexual, lesbian, or gay male) as an independent variable. The results pointed to five factors predictive of psychological intimacy in these lasting relationships. They were minimal levels of relational conflict (B = -2.24, p = .01), a confrontive conflict management style in the partners of participants (B = 1.16, p = .01), a sense of equity about their relationships (B = 1.29, p = .01), and expressions of physical affection between partners (B = 1.63, p .01). The fifth factor was sexual orientation of couples: more lesbians reported their relationships as psychologically intimate i n recent years than did heterosexuals (B = 1.47, p = .05) and gay males (B = 1.96, p = .03), a finding that resonated with the work of Kurdek, who compared intimacy in heterosexual, lesbian, and gay male relationships (1998).

To assess the significance of gender over sexual orientation on reported psychological intimacy, gender was substituted for sexual orientation in a second model. The four factors that contributed significantly to psychological in the first model did not change substantially in this second model, and the gender of participants had a moderate effect on the results (B = .81, p = .08). That finding is compatible with those of Parks and Floyd (1998), who argued that gender role identification of males and females is not as powerful a factor in shaping intimacy in friendship relationships as may be assumed.

CONCLUSIONS

This study focused selectively on a sample of 108 heterosexual and same-gender partners in 216 relationships that had lasted an average of 30 years. The results suggested that factors within relationships themselves had a more powerful effect in shaping the meaning of psychological intimacy than did social and demographic factors. The data suggested that a sense of psychological intimacy was nurtured when interpersonal conflict was kept to minimal levels, when one's partner dealt with conflict in the relationship by initiating face-to-face discussion of differences, when one had a feeling that the relationship was fair, and when there were expressions of affection between partners through touching and hugging. Perhaps, a reason that these relationships endured was that these factors nurtured a sense of psychological intimacy that contributed to relational stability.

The data offer hypotheses for exploration and testing in future research on lasting relationships. In addition to the factors that had a shaping effect on psychological intimacy in recent years, subtle differences were found between lesbian and other participants. Differences based on gender and sexual orientation suggest a subtle interacting dynamic of these factors on psychological intimacy in relationships that last. We suggest that a mutually reinforcing dynamic between two women committed to personal and relational development may explain the subtle yet important differences between lesbian couples and the other couples in this study. We hope that these findings and our observations about them will be helpful to other researchers engaged in the study of lasting relationships.

Source: Sex Roles: A Journal of Research


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Kurdek, L. A. (1988). Relationship quality of gay male and lesbian cohabiting couples. Journal of Homosexuality, 15, 93-118.

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APA Reference
Staff, H. (2021, December 21). Psychological Intimacy in the Lasting Relationships of Heterosexual and Same-Gender Couples, HealthyPlace. Retrieved on 2025, April 29 from https://www.healthyplace.com/sex/good-sex/psychological-intimacy-in-the-lasting-relationships-of-heterosexual-and-same-gender-couples

Last Updated: March 25, 2022

How Premature Ejaculation Affects Couples and Partners and Your Quality of Life

How Premature Ejaculation affects couples

Since it was first described in 1887, Premature Ejaculation has had serious effects on the quality of life of millions of men and their partners. Today estimates of the prevalence of Premature Ejaculation indicate that Premature Ejaculation affects the majority of all men at some point in their lives.

A recent observational study of the impact of Premature Ejaculation was conducted by Patrick and colleagues. It provided extensive observational data for the validation of patient-reported outcomes in measuring future treatment effects. Of 1,587 men enrolled, 207 had Premature Ejaculation and 1,380 did not have Premature Ejaculation. Group assignment was based on patient report and physician assessment by DSM-IV criteria. All subjects provided stopwatch-derived intravaginal ejaculatory latency times (IELTs) for the construction of single-question, patient-reported outcomes scales for ejaculatory control and intercourse satisfaction. They found that longer IELTs were associated with higher levels of both control over ejaculation and patient and partner satisfaction with sexual intercourse.

While the causes of Premature Ejaculation can be complex, the effects of Premature Ejaculation are also complicated. Premature Ejaculation can have an impact on a patient's self-esteem, sexual relationships, and family life. When anxiety over Premature Ejaculation leads to other sexual dysfunction, the cycle can turn in on itself.

How Premature Ejaculation affects partners

Although Premature Ejaculation is a condition that affects men, it also concerns their sexual partners. Even though the vast majority of research has focused on the impact Premature Ejaculation has on the male patient and his sexual health, some researchers have examined the effect Premature Ejaculation has on the sexual health of the partner.

A study of 152 men and their female partners assessed men's and women's Premature Ejaculation receptions of the impact of having a Premature Ejaculation problem on their own and their partner's self-esteem and sexual pleasure. The study also looked into the impact of Premature Ejaculation on the sexual relationship.

The study found that more than a quarter of both men (29.3%) and women (26.5%) reported that the female partner had expressed dissatisfaction about the timing of the man's ejaculation. Men who self-reported a problem with Premature Ejaculation also reported a very negative impact (1 or 2 on a 7-point scale) on:

  • Their own self-esteem (17.1%)

  • Their partner's self-esteem (8.6%)

  • Their own sexual pleasure (17.1%)

  • Their partner's sexual pleasure (28.6%)

  • Their sexual relationship (22.9%)

How Premature Ejaculation affects quality of life

There is a strong association between sexual dysfunction in general and impaired quality of life. Sexual dysfunction is highly associated with negative Premature Ejaculation experiences in sexual relationships and overall well-being. Sexual dysfunction, including Premature Ejaculation, is an important concern and warrants further study.

APA Reference
Staff, H. (2021, December 21). How Premature Ejaculation Affects Couples and Partners and Your Quality of Life, HealthyPlace. Retrieved on 2025, April 29 from https://www.healthyplace.com/sex/male-sexual-dysfunction/premature-ejaculation-affects-couples

Last Updated: March 26, 2022

Erectile Dysfunction

Laumann's study showed that 7% of men in their 20's complained of difficulties in getting or maintaining an erection satisfactory for sex. This nearly tripled to 18 % in the fifth decade. The Massachusetts Male Aging Study showed that while 52% of men age 40 to 70 had some degree of erectile dysfunction, 5% of all men at 40 have complete erectile dysfunction. With age, this increases to 15% for men at age 70.

Medical treatment for erectile dysfunction has become a primary care skill with the introduction of oral proving to be effective in 72% of men and generally well tolerated. Men need to practice with a few doses and need to be cautioned that onset of action depends on how much food and liquor has been consumed prior to taking the sildenafil. Waiting for 1 - 2 hours increases clinical effectiveness but may increase anxiety. Partners benefit from hearing how sildenafil works, and that it is safe. This has not been born out in clinical practice. Given its mode of action blocks the breakdown of intracellular nitric oxide, it cannot be taken by men using nitrates for coronary artery disease and angina. Otherwise, it is quite benign.

Other treatments include intra-urethral MUSE and intra-cavernosal injectable Caverject. These prostaglandins work by non-nitric oxide pathway and are safe with nitrates. Patient acceptability remains an issue, but they provide highly effective therapy if sildenafil fails. Penile prostheses are still a fallback treatment if all others fail, however, given the effectiveness of newer medications; they are much less often performed currently. Assessment of the couple is imperative before an implant is considered.

APA Reference
Staff, H. (2021, December 21). Erectile Dysfunction, HealthyPlace. Retrieved on 2025, April 29 from https://www.healthyplace.com/sex/male-sexual-dysfunction/erectile-dysfunction

Last Updated: March 26, 2022

Yoga for Anxiety Is Very Helpful

yoga helpful anxiety healthyplace

Yoga is a complete mind-body experience that has been shown to reduce anxiety and increase inner calm. Yoga for anxiety is more than a set of stretches; indeed, it’s a philosophy of life and a complete system for transcending anxiety (Bourne, 2010). Using fluid postures and stretches, mindfulness, and meditation, yoga connects us to ourselves. In uniting breath, movement and action, thought, emotion, brain, and body, yoga works wonders in reducing anxiety.

Traditionally, yoga has helped people seek enlightenment and hasn’t always been considered to be a self-help tool for anxiety. Yet yoga is the perfect means for helping anxiety. When people set out to do more than get rid of anxiety, when they seek to transcend it and replace it with meaning and purpose and personal values, yoga is highly appropriate for anxiety.

“[Yoga and enlightenment] mean becoming healthy, happy, and successful, becoming one’s true self, free of the need of external validation” (Imparato, 2016). And of course, as a natural part of this yoga and this enlightenment, we begin to live a life free of anxiety.

Yoga for Anxiety Works

Yes, yoga for anxiety works! Research has provided evidence of yoga’s wellness-enhancing abilities; indeed, yoga has been shown to increase our control over our bodies and minds by allowing us to lower our heart rate and our level of anxiety (Chopra, et al, 2010). Other studies have shown that people have been able to eliminate anxiety medication after several months of regular yoga practice (Balch, 2012). (Note: This is a decision that must be made with a general doctor or a psychiatrist. Abruptly stopping any medication can cause dangerous withdrawal symptoms as well as increased anxiety.)

There is power in the postures of yoga. The postures and movements that have been practiced for millennia foster specific qualities within us that we can tap into to move past anxiety and live a life of mental health and wellbeing.

Yoga offers numerous benefits, among them

  • relaxation and inner calm,
  • stress reduction,
  • enhancement of the mind-body-spirit connection,
  • increasing feelings of physical and mental wellness,
  • slowing the body systems and metabolism,
  • slowing anxious thoughts, and
  • healing the dis-ease of anxiety.

How to Use Yoga for Anxiety

Yoga can be done with a trained instructor in a group class setting. If you’re not keen on the idea of group classes in a studio, there are many DVDs available as well as programs online. You can even buy or borrow from the library books that contain illustrated yoga poses and instruction. Anything goes when it comes to practicing yoga for anxiety.

Top lifestyle, wellness, and yoga expert Lauren Imparato (2016) shares what she has found to be successful with yoga for anxiety. She combines poses for breathing to induce calm and balance with energetic, stress-burning, anxiety-relieving, exercise. She ends this practice with yoga poses for relaxation. This encourages calm while simultaneously releasing pent-up anxious energy.

Sometimes, you might have time for the three-step regiment that Imparato proposes. Other times, you’ll have less time or would prefer to practice yoga a different way. Yoga isn’t all-or-nothing. Yoga, a practice that increases mental and physical flexibility, is itself flexible and forgiving.

Start with what feels right to you and your anxiety, and make adjustments as you go. Don’t add to anxiety by fretting over doing it “right” or “wrong.” Your goal isn’t to get an A+ on the yoga test but instead is to surpass anxiety and live the life you want to live. No matter how you want to do it, yoga for anxiety works. And eventually, it will no longer be yoga for anxiety. It will simply be yoga.

article references

APA Reference
Peterson, T. (2021, December 21). Yoga for Anxiety Is Very Helpful, HealthyPlace. Retrieved on 2025, April 29 from https://www.healthyplace.com/self-help/anxiety/yoga-for-anxiety-is-very-helpful

Last Updated: January 6, 2022

Using Mindfulness for Anxiety: Here’s How

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Mindfulness is a terrific tool for anxiety. It’s more than a mere tool, however. Mindfulness is a way of experiencing yourself and the world that allows you to live fully and completely without anxiety getting in your head and in your way.

Mindfulness is many things. Mindfulness is

  • being present in the moment, right here and right now;
  • focusing on what’s around you to pull your thoughts away from the anxious ones in your head;
  • attending to all your senses so you feel and experience things other than the physical symptoms of anxiety;
  • letting yourself be as you are without fighting with and getting tangled in anxiety;
  • living in the present, ready to live fully without anxiety being at the forefront of your thoughts and emotions.

Mindfulness for Anxiety: Our Thoughts and Emotions

Racing thoughts are a component of anxiety. Our thoughts are full of worries, fears, doubts, regrets over perceived past mistakes, and imagined future horrendous outcomes. Thoughts and emotions are connected, so our anxious thoughts create anxious, roiling emotions, which in turn create more anxious thoughts, and we are caught in a jagged trap.

When you engage in mindfulness for anxiety, you begin to remove yourself from anxiety’s trap. With mindfulness, you are replacing your worries about the past and fears about the future with neutral, non-judgmental observations about the present. This calms both thoughts and emotions.

When you use mindfulness to extricate yourself from anxiety’s trap, you allow yourself to let go of anxiety. You stop struggling and just accept things for what they are. Acceptance isn’t giving in to anxiety; it’s stepping away from the negative thoughts and emotions so you can observe them from a distance.

Rather than an escape from anxiety and problems, mindfulness lets you step away from them so you can live fully in the present moment. With mindfulness, you live in the present moment without judging anything. When your thoughts are centered on what is happening now, there is less space for anxious thoughts and emotions.

Knowing that mindfulness reduces anxiety is one thing. Actually practicing it is another thing altogether, for it’s not always easy and natural. The following tips show you how to use mindfulness for anxiety.

How to Practice Mindfulness for Anxiety

Mindfulness is a state of being. Like anything, it takes patience to achieve it. Mindfulness in its most basic form is simply paying attention to what is happening around you instead of getting caught in your anxiety. Here are some ways to pull your attention away from the anxiety within and onto the world around you.

  • Use your vision and notice colors, sizes, movement, and more.
  • Listen. What sounds do you hear? Running water? The click of dog feet on the floor? Tune in completely.
  • Touch stuff. Feel different textures, such as the smooth leaf of a houseplant or the rough edges of a rock.
  • Use your sense of smell. Essential oil burners release scents that are calming, energizing and more. Light a candle. Step outside and smell the grass.
  • Taste is another good way to experience the present. Drink tea, eat a piece of chocolate, or anything you can concentrate on and savor.
  • Engage in deep breathing techniques and be mindful of the sound of the air and the feel of your diaphragm expanding and contracting.
  • Take a mindful walk. Walk at any speed that is comfortable to you and notice what’s around you, again using your senses.
  • Eat mindfully. Instead of gulping down a meal or snack while your mind races with anxiety, pull your thoughts gently to the experience of eating.

These are just a few examples of how to use mindfulness for anxiety. There are no hard and fast rules. The main idea is to pay attention to your present moment instead of being caught in the trap of anxious thoughts and feelings.

While there are truly no rules, there is something important to remember. Be patient with yourself and allow yourself to be mindful without judging. When your anxious thoughts return to the forefront of your mind and attention, accept that this is normal. Acknowledge them and return to your senses. The very process of doing this is what trains your brain and tames anxiety.

Using mindfulness for anxiety is a process that can be rewarding. Mindfulness gives you space from anxiety, and it allows you to replace worries and fears with things in the present moment that are much more pleasant.

article references

APA Reference
Peterson, T. (2021, December 21). Using Mindfulness for Anxiety: Here’s How, HealthyPlace. Retrieved on 2025, April 29 from https://www.healthyplace.com/self-help/anxiety/using-mindfulness-for-anxiety-here-s-how

Last Updated: January 6, 2022

How to Use Meditation for Anxiety and Panic Attacks

meditation anxiety healthyplace

Meditation is a proven means to drastically reduce anxiety as well as the frequency and intensity of panic attacks. Meditation is the act of being still and creating space between yourself and your problems. It has proven therapeutic powers and can noticeably diminish stress, anxiety, and panic (Chopra et al, 2010). It disrupts obsessive and negative thought patterns and then allows us to restructure our thoughts (Bourne, 2010).

Purpose of Meditation for Anxiety, Panic Attacks, and Stress

The purpose of meditation isn’t to eradicate difficulties in an instant. Instead, the purpose of meditation for panic attacks, anxiety and stress is to help you step away from these experiences and witness them nonjudgmentally from a distance (Bourne, 2010). When we’re tangled in anxious thoughts, struggling against them, we are too trapped to deal with them.

Meditation allows you to become still and quiet, centered. No longer ensnared by problems, you can exist freely. This distance allows you to simply observe yourself and your situations. Rather than thrashing against anxiety and stress, which can lead to panic attacks, you have room to breathe and make choices regarding your actions.

It is this quiet, distant space that brings peace and the ability to deal with stress and anxiety in a way that doesn’t limit your life. Acceptance and commitment therapy calls this defusion because you are defusing, or separating, from your troubles. Bergland (2015) calls it the power to ignore. Whatever you call it, meditation isn’t about getting rid of problems but is instead about helping you create distance.

Physical and Mental Benefits of Meditation for Anxiety

Mediation works because it produces changes in the mind and body. Numerous studies (Balch, 2012; Bemis, 2008; Bergland, 2015; Chopra et al, 2010) have demonstrated that meditation

  • produces alpha waves in the brain, the brainwaves associated with relaxation,
  • induces overall relaxation,
  • increases awareness,
  • decreases heart rate,
  • lowers respiratory rate,
  • reduces blood pressure,
  • increases blood flow to the brain, and
  • physically changes the brain and its behavior.

Initially, these changes are short-lived and almost imperceptible. When meditation is a regular part of your life, the changes become permanent and you are able to feel the peace and calm.

How to Use Mediation for Anxiety, Panic Attacks, and Stress

Types of Meditation

There isn’t a wrong way to meditate. As you learn how to use meditation for anxiety, panic attacks, and stress, try these different methods to see what feels right for you.

  • Structured meditation involves using a focus object (something in the room, an object you hold, etc.). Breathe slowly and deeply, and concentrate on your object. When your mind wanders, gently return your focus to the object.
  • In unstructured meditation, you don’t try to pay attention to anything. You just let your thoughts wander without judging or sticking to any of them.
  • Mantra meditation uses a single syllable, word, or phrase. This pairs well with affirmation. Repeating an affirmation while meditating helps you focus as well as restructure your thoughts.
  • Breathing meditation has you counting your breaths, either silently or aloud. All meditation involves breathing slowly and deeply; this type uses breath counting for concentration.
  • Mindset meditation (Imparato, 2016) uses visualization to help create the life you want. Similar to affirmations, visualization allows you to hold an image of your values and dreams and concentrate on it. This trains your brain to shift its focus from anxiety to your values.

Meditation for Anxiety Tips

Sitting quietly and calming the mind doesn’t come easily for humans. Use these tips to cultivate a mediation for anxiety practice.

  • Be patient with yourself. Meditation for anxiety, panic attacks and stress is about the long run, not quick fixes.
  • Drop the “shoulds” and harsh expectations you have for yourself. A big part of meditation is letting thoughts come and go without judging them. Avoid judging yourself and how you’re meditating.
  • Sit in a comfortable position. You don’t have to be cross-legged on the floor. Lying down is okay, too, but it often causes people to fall asleep.
  • Pay attention to your breath, keeping it deep and slow. Breathe in through your nose and out through your mouth.
  • Find a place that is quiet and a time when you won’t be disrupted. Keep your phone out of your meditation space.
  • When you notice anxious thoughts, worries, and strong emotions, just let them be. Meditation isn’t about banishing your thoughts but is about distancing yourself from them.
  • Ritualize your meditation practice. Do it as many days each week as is reasonable for you, find a consistent time, and make your space pleasant.

Meditation for anxiety works. By distancing yourself, calming your brain, and adopting a non-judgmental mindset, you will, over time, drastically reduce anxiety, panic attacks, and stress.

article references

APA Reference
Peterson, T. (2021, December 21). How to Use Meditation for Anxiety and Panic Attacks, HealthyPlace. Retrieved on 2025, April 29 from https://www.healthyplace.com/self-help/anxiety/how-to-use-meditation-for-anxiety-and-panic-attacks

Last Updated: January 6, 2022

Anxiety and Insomnia: Don’t Let Anxiety Keep You Awake

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There’s a strong relationship between anxiety and insomnia; so much so, Asnis, Caneva, & Henderson (2012) point out, that sleep difficulties are listed as one of the potential criteria for generalized anxiety disorder in the American Psychological Association’s (2013) Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Anxiety can cause insomnia, but insomnia can also cause anxiety. Each one fluffs up the other while you fluff your pillow in a frustrated attempt to get to sleep.

How Does Anxiety Cause Insomnia?

Anxiety’s racing thoughts get in the way of a good night’s sleep. The brain is like the rest of our body and uses energy (Thomas, n.d.). Racing thoughts are for the brain what running is to the body (especially one that is not used to running). Racing thoughts physically tire us out, increasing our need for quality sleep. However, these racing thoughts continue into the night and prevent the sleep we need to get rid of anxiety.

We have few things to distract us from anxiety and racing thoughts in the middle of the night. With distractions such as work, family, chores, and more asleep for the night, anxiety has free reign to play. And play it does. It frolics through our thoughts, emotions, and physical bodies. We are awake the entire time. When we can’t sleep, anxiety takes over. When we’re anxious, we can’t sleep.

Anxiety can have a negative impact on its own, as can insomnia. Together, they are a perfect storm that negatively affects our daytime lives and potentially lowers the quality of our relationships and life in general. You don’t have to take this lying down, figuratively speaking. You don’t have to let anxiety keep you awake or insomnia make you anxious.

How to Treat Anxiety and Insomnia

Self-awareness is an important first step in breaking the cycle of anxiety and insomnia. What factors, other than insomnia, increase your anxiety? What things, other than anxiety, contribute to insomnia? Among the common contributors to both are

  • caffeine,
  • alcohol use, even in small amounts,
  • medical conditions,
  • excessive stress and/or tension,
  • other existing mental health conditions (such as depression), and
  • medications (prescription and over-the-counter).

When you are aware of how you are living, you can take measures to change situations around anxiety and insomnia by eliminating things that contribute to your own difficulties. Healthy living leads to better sleep and less anxiety.

Ansis, et al (2012), advise that anxiety and insomnia be treated at the same time but separately, each receiving targeted treatment approaches. Treating insomnia separately will allow you to get better sleep so you can deal with anxiety. The following approaches work well for ending insomnia:

  • good sleep hygiene, which means cutting out daytime naps, late-night snacks, exercising too late in the evening, watching TV using other screen devices in bed, and sleeping in a room that is too light and/or noisy;
  • daytime exercise;
  • yoga and yoga meditation;
  • medication; and
  • cognitive-behavioral therapy (CBT) (Asnis, et al, 2012). CBT for insomnia is a structured, time-limited program that addresses the anxious, negative, and distorted thoughts that interrupt sleep. The racing thoughts of anxiety are present day and night. By addressing them, you aren’t letting anxiety keep you awake.

Don’t Let Anxiety Keep You Awake: Reduce Nighttime Anxiety

While you are working to end insomnia, you can also work to reduce the anxiety that is keeping you up at night. Some of the techniques for reducing anxiety to induce sleep:

  • meditations for anxiety,
  • avoid eating heavy foods, especially those with simple sugars, before bed,
  • use relaxation techniques,
  • drink warm milk (because it creates melatonin),
  • avoid caffeine,
  • visualize a peaceful scene,
  • write down your worries so you can let them go until morning,
  • while lying in bed, do some gentle stretches to release tension,
  • use aromatherapy in the form of sprays or oils to infuse your sleeping area with calming scents,
  • detangle yourself from your anxious thoughts, letting them go rather than becoming trapped by fighting with them, and
  • enjoy the moment—if you truly can’t sleep, simply lie comfortably, practice deep breathing, and relax. Focus on how pleasant it is to rest and that it’s okay to just rest.

By doing things to reduce anxiety while simultaneously addressing and helping insomnia, you come ever closer to breaking up the relationship between anxiety and insomnia. Take the necessary steps, and you don’t have to let anxiety keep you awake at night.

article references

APA Reference
Peterson, T. (2021, December 21). Anxiety and Insomnia: Don’t Let Anxiety Keep You Awake, HealthyPlace. Retrieved on 2025, April 29 from https://www.healthyplace.com/self-help/anxiety/anxiety-and-insomnia-don-t-let-anxiety-keep-you-awake

Last Updated: January 6, 2022