The Neuroscience, Psychology and Physiology of Sexual Behavior

The Neuroscience, Psychology and Physiology of Sexual Behavior

What follows is a transcript for the podcast HomeGrown Humans - Nicole Prause, Ph.D. - Sexuality - Hosted by Jamie Wheal.

Topics within the interview include:

  • Navigating the culture of sexual physiology and psychology
  • How brain the grows, adapts, and rewires during sexual stimulation
  • The neurochemicals associated with sex
  • The link between sexual behavior and higher states of consciousness
  • The science and psychology of orgasms

Navigating the Culture of Sexual Physiology and Psychology

Jamie Wheal: I'd love to welcome everybody back to our latest episode of HomeGrown Humans where I get to check back in with a researcher and academic Nicole Prause, who I feature strongly in Recapture the Rapture. I consider her one of the bravest and most innovative researchers in the realm of sexual physiology, psychology, and healing that's potentially doing work today. So the last time we got to chat was offline in preparation for research for the book probably a couple of years ago now. And we're now getting to come full circle and actually get to have a conversation that we get to share with others. So, Nicole, thanks for making the time, and welcome to HomeGrown Humans.

Nicole Prause, Ph.D.: Thanks so much. I'm happy to talk about where we've gotten and where we might have overlap here.

Jamie Wheal: Yeah. And so just to establish context for our listeners, you were at the Kinsey Institute, you did your doctoral work at the University of Indiana, is that correct?

Nicole Prause, Ph.D.: Yep.

Jamie Wheal: And then also had postdoc appointments at Harvard and at the VA, and then you went to the West Coast and you did some work, this was at UCLA. Is that right?

Nicole Prause, Ph.D.: Yep.

Jamie Wheal: And then sort of found the increasingly shrinking walls of your field, of the discipline, which I actually hadn't really realized until going back and listening to some more of your interviews and podcasts kind of just how much that was a shrinking iceberg to be on particularly, in the United States and how many of your colleagues had ended up decamping to Canada, to Australia, to Western Europe where research and IRBs and things like that were more amenable to doing this kind of research. And you actually ended up stepping out of sort of institutionally affiliated academia and starting up your own think tank research project, do you want to just speak briefly to that experience?

Nicole Prause, Ph.D.: Sure. And I can even add a little bit there just with some recent news. So I had a project I really wanted to do that involved two people touching each other that my institution at the time said absolutely not. We could not get it through the boards. I got some funding to help study that and they refused the funding and I was like, okay, this is kind of writing on the wall. It seems I have reached the end of what I can do at university. And so I took the grant funding and started my own laboratory. Wasn't really a model for doing that. So I kind of had to cobble it together and figure out how to get space, how to ensure, how to work with still university IRBs to make sure I had proper oversight. Got all that cobbled together, I was able to do a couple of studies under that and actually just recently have rejoined UCLA.

Jamie Wheal: Oh, wow. So you're the prodigal daughter

Nicole Prause, Ph.D.: I have returned. So my plan moving forward is I do still think some of this is too hot to handle on campus. So I'm doing some of the work still as a part of my LLC, keeping that off campus as I encounter blocks, but still within the institutional setting. I'm excited to have those collaborative opportunities again with other scientists. And so it's uniquely American though, to your point. Most of my colleagues who even trained in the US moved to Canada afterwards because of the funding climate, the violence issues that we have here don't seem to exist there or to Europe. Sometimes they originated from Europe, came here to train, so they were just going back. But other times it really is we had a uniquely oppositional environment in the US to this type of research. They do not want it done here. So I'm finding ways to do it anyway.

Jamie Wheal: Well, I mean, this is a bit of a nerdy sidebar, but I am curious as to what was your sort of life and reason for being like how did it work when you basically decoupled your career and your research from academic institutions, right? Because there's a very standard playbook there. Right. You get published in peer-reviewed journals, you get a bunch of citations, you go from assistant professorship to tenureship, you keep the monkey chain going, you write your grants, you get your funding. And the more of those things that you do, the higher your status within that institution, et cetera. And on the one hand, you were fast-tracking through that space, and then you stepped out. You're like, hey, this just looks like this path just kind of pitches out it, cliffs out, it doesn't go.

What was your experience like in the "wilderness" years? On whose behalf did you feel you were doing the research? How did funding institutions see you and perceive you? Was it liberating or alienating or a little bit of both? What was your experience there as far as like I've done all this work, I've earned my credentials, I'm here to advance the field, and yet you're also sort of in an eddy or a pocket of your own?

Nicole Prause, Ph.D.: I very much wanted to continue the research that's important to me. I have thoughts about where I wanted to go next. I had already funding offers for projects I was excited about. I had written them because I was excited about them. But I also knew that I needed to do things within the rubric as much as I could, so that means continuing to publish in peer-reviewed journals. That means continuing to have federal oversight of my research. And what I discovered was some really nice partnerships with a few different institutions. So universities in the US that were very happy to collaborate with my LLC, so that the actual work that made them nervous, so somebody touching the genitals or somebody masturbating to climax was done on my site, not on their school campus, that's going to make their donors nervous or that's going to cause them consternation.

So those agreements, when we would work on some of these IRB-approved, institutional review board, or ethics oversight approved projects, we usually would just have the actual work done at my site. And it ended up being a great partnership so that schools, universities, were less nervous because I was off on my own kind of shouldering the weird stuff. And the tradeoff there, of course, is I was fairly isolated. I didn't have the protection of a large institution around me, and that was problematic for other reasons. I had lots of threats for the work, people that want you dead just because of what you're studying. And it's one thing to get death threats when you're sitting at an office at a university and have people to report these things to, it's quite different when you're running your own shop and you're responsible for other staff members and you have to worry about them and does this affect my research participants.

So there were lots of things to navigate there that made it worth it, that's part of why returning to that setting has attractions, that is I feel more protected, I feel like my staff are safer than when I was more isolated in that way. So I think that's just the trade off is wanting to do things as much by the book as I had previously to be sure that the work would be accepted, that we didn't do anything and start not having IRB-approved studies or start publishing stuff on a blog. I really wanted to keep everything as was as much as possible because even though they're obvious problems with that model and many people have pontificated on those issues, it is the accepted path forward. And I'm doing enough that's a problem that's outside of that path that I don't need to fight all those fights. That's kind of how I felt. I really wanted to be able to focus on the work as much as I could.

Jamie Wheal: And I absolutely look forward to getting into the meat of both your kind of overarching perspective on human physiology, sexuality, and healing and even some of the terrain that I got to cover in the book featuring you and Helen Fisher as well. But before we drop into that, I'd love to just kind of hear any of your thoughts on kind of the cultural landscape that you're navigating because reading your work and talking with, you're very, very straightforward, you're remarkably effectively buttoned-down and rigorously professional. There's nothing sort of that I experience as flamboyant or controversial or edgy about what you're doing. It just happens to involve below the belt biology and you've alluded to it, and I deliberately kind of veered around it with half a sentence of that you've, you've had cultural blow-back, but I then concentrated on your comments on actually folks within the field, the kind of sex positivity shaming. Right. And how that was kind of a new crypto puritanism.

But it feels like you've ruffled feathers on all sides of the political spectrum, and I was curious as to where you felt the most heat. Like, the first place you would think to is you would be like, oh, it would be like anti-pornography, anti-sex, and pleasure, alt conserv... Probably not even alt I think they're burning capitols down. I think this is probably like more fundamentalist, traditionalist conservatism, but you were also getting this almost like a wave hitting a jetty, and then pulsing back into the ocean, you were getting this weird backlash from anti-porn crusaders on the left as well, is that right?

Nicole Prause, Ph.D.: Yeah. They formed some strange partnerships that a few folks have written papers about, and I'm now doing some research in that space myself having experienced some of it where I do think the core group of those folks are religious individuals. In the US, it's overwhelmingly religious groups that are advocating against this. But I think where we started to butt heads was they started to make scientific claims. So rather than just saying my religion opposes masturbation, you shouldn't masturbate, it's hard to argue with. That's your first amendment. You can do what you like sexually speaking. But then they started to say we want legislation against X, Y, or Z, especially in the pornography space because it's unhealthy because it's been shown to damage the brain. And those are scientific claims that are not true. So we ended up butting heads for that, but there are a number of different groups who oppose pornography for a variety of different reasons and they happen to kind of meet in this one unique space.

So the papers written about these groups often highlight kind of the strange bedfellows' aspect of like feminists working with these religious groups who oppose all kinds of women's rights, but on this one issue, they have some agreement. And so the feminists shut up about concerns about abortion to be able to work with these people. These people shut up about their other beliefs on abortion, you could say, or expectation of women staying at home so that they can fight together on this one particular area. So I think those have been some unusual partnerships. And then there are also some folks who are trying to profit off of it, so they're selling their treatment, their app in a lot of cases. And if pornography is not addictive, or if it doesn't do what they want to claim against the science, well, then I'm the enemy because there's this scientist who isn't helping us sell our product. So then they come into the picture and that's a more recent addition. So I think it's a combination of religious conservatism, capitalism in the US, and the strange bedfellows who've started kind of working together to shut down science that doesn't agree with their ideology.

Jamie Wheal: Well, and I think there was maybe an article maybe a month ago in the New York Times and it was sort of that question as to whether sort of were the second wave feminists right that sort of sexuality is imprisonment and the kind of the yoke and the ones who were explicitly anti-porn versus the kind of third wave. And correct me if I'm mangling any of these indexes, but the third wave pro-sex, anti-slut shaming, sex-positivity, age of Tinder, millennial hookup culture, which is anything goes and it's all good and no one should feel bad about anything they choose to do wave, and then a number of those third-wave feminists, at least as reported by this particular, I think it was a professor writing about her class, was like, oh no, we were sold a bill of goods. I thought this was going to be empowering. I thought that this kind of loosening of any shaming period would lift us up, but actually, weirdly I feel more exploited and lower self-esteem, et cetera than ever. I mean, obviously, your head's down, you're in the lab, you're looking for empirical results, but what's your sense of the pulse of the broader cultural conversation that your research often gets either co-opted or even weaponized by?

Nicole Prause, Ph.D.: I think it's acquired by both sides at different times so that people who are looking more for their sexual freedom that is anything, any time, I don't know anyone who actually says quite that extreme anything, any time, often it's kind of caveated by sane and consensual. So the same idea being things that don't risk death, don't risk health, so promoting condom use when it's appropriate. But I think the challenge is there are some real reasons to be concerned there. It's not like sexuality is just hedonism and just characterized by pleasure and connection. There are things there to be concerned about, but it's very easy... I think often the way conspiracies are started is there's some kernel of truth there. If there wasn't, it'd be difficult to build anything from it.

And so I think sometimes they'll pick a sentence out of a paper and, oh, this is now how things are. It's like we have one sentence in a paper that's been quoted probably thousands of times saying we're telling children to watch pornography. Never would I say such a thing. But it's useful in their rhetoric to say, oh, disregard all the concerns here, or you should overweight them because we have a child pornographer in our hands or something like that. So it's difficult for me to tell exactly which wave has done what with these different types of data. My sense is just, in general, there's a cultural shift towards realizing things need to be data-based, that there needs to be scientifically grounded decision-making and to do that when the science doesn't agree with you have to misrepresent it. And so scientists have been put an unusually kind of sensitive spot from that perspective. We see it most clearly, maybe with the climate scientists. We're just a tiny field, so most people don't know that this is happening with us. But yeah, I always say you think climate scientists have problems, wait until you meet the sex researchers.

Jamie Wheal: Yeah. I mean, fundamentally, although these days, even mathematics is getting weaponized in the kind of social justice conversations. Even the study of Greek and Latin at Princeton, you're like, wait, that was normally totally off-limits and total snoozeville, and no one cared, but if it was reading lists for literature or [inaudible 00:16:09] of history, everybody has an opinion on those two. Everybody else like, oh, chemistry, that's not in my pay grade, but everybody's got an opinion on books and stories, and obviously, everybody's got an opinion on sexuality and morality as well.

Nicole Prause, Ph.D.: It's like, no one wants to think they're dumb at sex.

Jamie Wheal: And I'm not sure, did you have a chance to scan the chapters that we sent you?

Nicole Prause, Ph.D.: Yes.

Jamie Wheal: I know it was short notice. Okay. So we can jump into that, but in the meantime, I'm sort of dying to know what the results have been you sent on the citations for a couple of your most recent papers. And the last time we spoke, it felt like it had been forever since I had first heard of you doing that clitoral stimulation study and the potentials of substituting either just straight stimulation or climax in a woman for pharmaceutical interventions, for pain, depression, anxiety, insomnia, a host of physical and psychological ailments. And the last time we spoke, I felt like you were keeping your cards super close to the chest, I think it was pre-pub. And you're like, I'll tell you later. You can see this stuff later. So fill me in; your research over the last few years, what are the top three to five insights, conclusions, hypotheses validated, or falsified? What have you been finding?

Nicole Prause, Ph.D.: Oh gosh. So the biggest is probably our large study of 250 folks who actually came into the laboratory where we paired them off. And about half of them were romantic partners, the other half were not, and they did this manual clitoral stimulation protocol that is referred to as orgasmic meditation in some circles. It's a little misnamed because they typically don't reach orgasm and they're not really taught to meditate.

Jamie Wheal: It was really good branding.

Nicole Prause, Ph.D.: Yeah, it was like very [inaudible 00:18:06]. So in that study, they're stroking beside the clitoral shaft for 15 minutes. That's the bulk of it. And the only instruction is just to feel. And so we did a whole series of assessments before and after that. And the things that we published from that so far are things looking at the connection that people feel between one another before and after this protocol. I'll preface it like you're going to think, well, no kidding, this is not exciting stuff, but you have to show it first. You can't just assume. So what we found was, you're going to be shocked, that the feeling of connection between two people after a non-communicative genital stroking practice of 15 minutes. But what I think was more remarkable in that paper is we found that the folks who actually did not have a romantic connection experienced more increase in connection between them. And that's not supposed to happen

Jamie Wheal: More increase than stable partners.

Nicole Prause, Ph.D.: Yes. And so we speculate as to why that might be. But the bottom line is a lot of therapists would say you're not supposed to have sex with strangers, it's wasted sex, it's risky sex, which is ridiculous. Like, people are doing it for some reason. They're motivated by some benefit and more important that we understand what those benefits may be than saying, oh, it's just bad, I judge you for your acts. So that to me was one step is we often study connection in the studies of loneliness, so we have this culture where we feel often disconnected and that's shifted a lot, obviously with the pandemic, kind of how we connect with one another, but still that feeling that we're not close to someone or we don't share a space and experience, why would you not want to capitalize on a sexual experience just because it happens to not involve a long term relationship or be embedded in that kind of a structure? It looks like it's beneficial anyway.

Jamie Wheal: Or the Dutch in their typically blunt fashion public health like, get a fuck buddy for COVID.

Nicole Prause, Ph.D.: Yeah. It's so lucky over there. Right. So we need evidence though to support making those kinds of recommendations, and now we have it to say like this procedure was helpful even for the people in our sample who didn't have a romantic connection.

How the Brain Grows, Adapts, and Rewires During Sexual Stimulation

Jamie Wheal: I mean, the question is, were you able to isolate a mechanism of action? I mean, my first guess would be increased saliency and novelty-seeking and the dopamine reward loop kind of a la Sapolsky's models. I mean, were you able to capture any of the kind of neurochem stuff in real-time to explain that the positive delta between novel partners?

Nicole Prause, Ph.D.: We're recording electroencephalography of both partners in that case or EEG, which is brain waves, so the neurochemistry or like dopamine, et cetera, chemicals, we did not record. There are lots of ways to understand the mechanism potential there. And my sense is there's quite a lot of research in social for both romantic couples and friendships that simply novel, exciting activities done together, increased closeness and sex is a novel, exciting activity to do together. I feel silly saying it, but this is a largely rejected idea by a lot of therapists and a lot of scientists.

Jamie Wheal: Wait, which idea?

Nicole Prause, Ph.D.: Just that sex is another activity that is both novel and exciting that you can do with someone. It can be a recreation. It can be a... I always think it's funny in those papers, studying that topic, they'll give examples like, oh, go do jet skis together. Those are also fine.

Jamie Wheal: Like how else could we boost romantic connection, roller coasters?

Nicole Prause, Ph.D.: Yes. The roller coaster example. [crosstalk 00:22:04]. But we need to do that work. You have to do the research to support someone who's saying that. And so now there's a basis for that. And with the EEG, those papers are still under review. As you know, it takes forever to triple out. But I can speak kind of in broad strokes, what we're looking at is the difference and the experience between the person providing the stimulation and the person receiving the stimulation. We don't have them swap. There are all kinds of reasons for that. So it could be gender-related as well because the person receiving stimulation always had a vulva, the other person was usually male, but could vary.

And so we're looking at the extent to which the person riding the stimulation is having a more effortful experience where they need to focus and concentrate and monitor the situation where the person who expects just to lay back and feel the entire time is able to more have that just experience where they have a higher alpha, which is sometimes interpreted as cortical idling, having a relaxed wakeful state that may look a little bit more like meditation. So I'm really interested in that state because I think mindfulness meditation and the benefits that can come from that as something where you have to have a practice where you sit and you direct it to your breath or to a mantra and try and produce the state in yourself. Well, that can be difficult for people who have wandering minds, who may not find that, that pleasurable.

Jamie Wheal: Wait, which end of the stick is this, is this the receiver or the stroker that you're describing right now?

Nicole Prause, Ph.D.: Yeah. So the receiver, that looks a bit more like that to me in the EEG signal. So if we can provoke that same kind of state in a sexual experience, why would we not use that? This is something that's very difficult to ignore. So the attention is a bit more overwhelming, it's easier to capture attention. It's pleasurable to do, so in contrast to a meditative practice that may be difficult to kind of establish a habit around. I think this is something people would be more likely to engage in on a regular basis and could have side benefits. If you have a partner to do these things with, could that produce some connection that reduces the feeling of loneliness? So I do see a lot of potential for this kind of a procedure if you look at it that way, for using sexual stimulation to improve and get the health benefits that you might see with any kind of meditation practice.

Jamie Wheal: Well, to say nothing else of just relational intimacy and closeness, which for most people who are attempting to live anything resembling a stable pair relationship, particularly with kids and domesticity and all the grindy grindies, that the capacity to help each other feel better seems like a no-brainer. Like, when you decouple it from all the drama and all the narratives and all the romantic fantasy projection and all that, you're just like, hey, you've got 7,000 neurons in your magic little spot, I got 8,000, and when we wiggle them together, we both feel awesome. In fact, we probably feel better if we do it right. Amazingly super awesome. And we might defrag our nervous systems and we might even enter some form of peak state or consolidation or homeostatic reboot of brain stem level physiology let's do that on a regular basis as just pure sexual hygiene.

Nicole Prause, Ph.D.: And if you can remove some of the performance demands because that's often part of the tripping point in an established romantic relationship is am I going to want it when they do? And, well, now this is divorced from that, I don't have to be wet, I don't have to be vasocongested, I don't have to be this kind of a protocol that orgasm meditation removes that demand. And so it resembles in some ways the old sensate focus I think of Masters in Johnson, 1960s kind of sex therapies. And I really like it about that. I think you don't have that expectation. Like, are you going to wait for my orgasm, are you going to do this thing I like, or not? No, this is a procedure. We have a very safe kind of container to facilitate that kind of experience that reduces a lot of the demands where the conflict tends to arise.

Jamie Wheal: And then I remember, and I don't know if this persisted, so you said one of the criteria that you were checking was relational closeness. That it went up actually in novel partners even more than in existing ones. What were the other sort of hypotheses you were testing and then also metrics you were tracking? So you said EEG was one.

Nicole Prause, Ph.D.: Yeah. We had a whole series of cognitive tests, pre-post looking at frustrative experience, how good are you at tolerating frustration, where we had a very difficult math task they had to do before and after.

Jamie Wheal: Before and after, but not during.

Nicole Prause, Ph.D.: Not during. A persistent vigilance task, which is your ability to keep your attention on something. We often think this has been impacted by current society and having too many things going on at once. So we look at that performance before and after. And then a whole series of other kind of self-report experiences. And it's largely that last set that we've gotten out the door that we've published about. So another one is looking at folks who've had a sexual abuse experience so they may have had sexual molestation as a child, often struggle to experience pleasurable sex, or report sexual dysfunction. Again, in this particular procedure, those who had that history actually report more sexual arousal in this context than people who didn't, which is to be clear, not to say it's a benefit to have been molested, it's more that in this context when this sexual experience is kind of safe and contained and you know what's going to happen next, it appears to kind of release that ability to just experience pleasure.

You're not needing to monitor and like, is this going to be safe, is this experience going to be okay? That is, I know what's going to happen next, it's all structured. And so we think that's why we found that result. So yeah, we're still very much in the middle of looking at a lot of this data, it's a very rich data set. 250 is a huge lab sample, so I expect we'll continue to publish in that space.

Jamie Wheal: And did you ever sort of track down that idea, which I think was maybe prevalent in that orgasmic meditation community, which was something resembling after three months or some sustained period of repeat practice that a woman might undergo some palpable shift in physiology, personality, so less anxious, less depressed? I think they ascribe the term a turned-on woman, which could mean anything, but in this instance effectively sort of what was it, all the benefits of alcohol and Christianity and none of the side effects, which was [inaudible 00:29:11] description of soma. Right. So all the benefits of Prozac and Landmark with none of the side effects. Right. Like, did you notice, or were you even doing anything other than a singular episode, where you saw any kind of positive, psychological shift over time for people experiencing that neurochemistry physiology repeatedly?

Nicole Prause, Ph.D.: So our main limitation is we chose in the first study to work with people who were fairly experienced. And what that means is they had a restricted range towards the high-end. You had to have done orgasm meditation at least 10 times before to be in our study, but most people had done it far more than that. They had been involved in that community for quite a long time. And so it's difficult for us to see a shift. We did record that anyway. We note how long our participants have been doing this or how regularly and those kind of things. So we do check that. And there were some areas where we said, okay, this could be a relationship that's relevant for longevity, but that's absolutely next step is to try and...

Jamie Wheal: Like big five, ocean test, neuroticism, whatever it might be.

Nicole Prause, Ph.D.: Yeah. We collected those, but we just had such a restricted range of very experienced owners that the next step I think is to train people to do this practice and see how they change over time.

Jamie Wheal: Okay. Neat. And then you were meant you were describing something a moment ago and I think... Oh, I know what it was, it was the recipient state, the alpha wave states, that sort of sense of... You didn't call it rumination, what did you call that? You called that state something.

Nicole Prause, Ph.D.: Oh, let's see. Relaxed wakefulness is a common way of describing it, I don't know if that was it.

Jamie Wheal: Yeah. And so I just wonder if you've come across and I mentioned him in the book as well, but Brad Sagarin, I think he's a social psych guy who's done that work on the BDSM community and they found some difference in states. And the reason it came across our desk was because they ascribed to the... What do they call it, it's tops and bottoms, but it's the doms and subs. Right. So they said that the person performing the actions would go into a sort of more alpha wave flow state because like you said, it required some manual dexterity and some focus and concentration, and that would send them into a sense of flow-based mastery. And that the sub the person receiving the experience would often drift off into a dreamy subspace, which was a potentially different and lower frequency. So it's interesting that they tease those apart. And I'm just wondering if that research or dataset could be something that you could sort of basically hit a [inaudible 00:31:44] off like it exists, it's there, they've got a thesis that they've at least established within their protocols and does it lend any insights or perspectives.

Nicole Prause, Ph.D.: Yeah, with the kind of things that we find. And so I don't know in their case exactly how that was recorded, but those sound very consistent with the kind of things we see. And it's such I think just an unfortunately new and sparse area. I just want more people doing the work in this space so we can see kind of how far out this goes. We have some couples research folks who look at things like handholding and the ability of a romantic partner to reduce our pain experience. Those are great, good start, and I would collaborate with some of those folks, but what happens when we notch that up, if we can increase the intensity, if we add a sexual component to things?

So, I'm also very interested in... There's a whole line of research that's specific to these things called C afferent fibers that are uniquely stimulated when your [inaudible 00:32:54] fast, like in between anywhere on non-glabrous skin, so hairy skin. So this is essentially what we think of as the right touch and how you know if someone's just, oh, atta-boy, kind of a quick coach's rub or something to something very slow that might be massage-based to something that you're like, oh, this person's flirting with me. That's kind of how you get that perception. And the C afferent fibers uniquely innovate the brain in areas that are associated with social interaction. So I think this is part of how we get that cue to say, oh, this is...

Jamie Wheal: So wait, so there's a certain rate or speed of touch, and then that is picked up by you said the C afferent fibers. So are they neural or are those epidermal?

Nicole Prause, Ph.D.: It's epidermal. And so those get transmitted into these social areas. And so to me, to the kink research and then our research, and then I'm looking at the folks doing handholding stuff, and I'm seeing we're kind of marching towards each other. I think eventually, we'll find overlap and that's another step where they look at kind of this social... They call it social touch. I'm like, you're flirting. That's what that was, what they were studying.

Jamie Wheal: That's fascinating. And so wait, so unique fibers in the skin and then with a specific EEG signature as well, does it get routed to a social center of the brain and like something's happening here with another person?

Nicole Prause, Ph.D.: So I haven't seen work done with EEG, but with FMRI and that's where they have evidence. Yeah. And I love that. I was like, that's so cool that it's not just the genitalia, it's not unique to having your vulva or penis touched, that there's something in the skin that also detects like this is sexual. Something about this is hedonistic or it has a bit of a different flavor. I love that. And maybe kind of a way to join from the research that's coming from this other direction with the couples and kind of how we make marriages better, totally worthwhile study, but not so much what I'm interested in.

Jamie Wheal: I mean, that almost feels like the ASMR stuff, is that right or AMSR, what is the whisper [inaudible 00:35:07] stuff?

Nicole Prause, Ph.D.: I don't know. I'm not sure exactly... Yeah, I've seen...

Jamie Wheal: Is that like an auditory version because it almost always makes people wiggle and squiggle, like, ah, [inaudible 00:35:18] is giving me goosebumps? Like, there's some effect. Right.

Nicole Prause, Ph.D.: It looks eroticized that ASMR and I haven't seen a study that kind of describes to my satisfaction why that is because we're capable of eroticizing lots of things. And some people are studying that trying to develop sexual responses to images of a penny is the classic old study in that space. So I wonder with ASMR, if there's something prepared to it. Like there is some way in which we're predisposed to experience that as erotic or if it's just a preference because we've been told that this has some erotic quality, we start to ascribe that. I don't know.

Jamie Wheal: Yeah. I mean, I wonder if it's even just the idea that normally for you to receive that if it's not just on prerecorded YouTubes. Right. In real life, you would've had to have somebody intimately in your space. Right. Near your ear at low volume, which might be the equivalent of those C afferent fibers, but acoustic. I just wonder if there's kind of a proximity priming.

Nicole Prause, Ph.D.: There could be. That's a great mechanistic idea.

Jamie Wheal: Now, let's kind of get into you... I mean, because I'd obviously love to pick your brain, you were one of the kind of icons for me as far as who's out there in the field holding down a body of research and how did these maybe connect? Right. So obviously, in those couple of chapters on sexuality and to your point about getting tons of blowback, right, I took one chapter on respiration, everyone's like, yay, breathing, tell me about it. I had to dodge it, music, same thing, like music is cool, everybody loves music, this is neat too. And then you get into substances, you're on a few more minefields. But sexuality, I was like, there's no way in hell I can cover this in a chapter.

The Neurochemicals Associated With Sex

Jamie Wheal: Right. I have to spend one entire chapter just sniping all the wires to the bomb and then a chapter maybe getting to say what I think might be forward-looking. So one of the ones, and I think we might have chatted shortly after I actually had this real-world encounter with Rick Doblin, the founder of MAPS, where he had shared that idea that the MDMA PTSD therapy they've been doing had been boosting vasopressin, prolactin, oxytocin, those kind of things, and that in some of their papers, they had ascribed the closest analog in the rest of waking life to be the post-orgasmic state. How does that track with your own research? Because I mean, I was like, whoa, that seems like this crazy plausible bridge between that neurochemical profile, whether it's derived pharmacologically or psychosexually with a partner or solo, and the potential benefits of healing trauma and integrating people. So what's your take on that sort of accidental cross-pollination of both fields, very different, landing in that same backyard?

Nicole Prause, Ph.D.: Yeah. It seems like they share some features and also, clearly distinct in some others. So for example, it is a common misconception that orgasm floods the system with dopamine. Dopamine doesn't increase at climax.

Jamie Wheal: It does not.

Nicole Prause: No. To be fair, not been studied many times, but the times people have looked in blood plasma and cerebral spinal fluid, don't find an increase post-orgasmic, it's more associated with the sexual arousal, so kind of proceeding state. What does spike at that time is vasopressin, which I find hilarious. It's a somnolent we think in this case, so that's why people tend to conk out after they have sex.

Jamie Wheal: I thought that was just guys, is it equally distributed?

Nicole Prause, Ph.D.: So it's equal and it's a whole side research I could go into about women and climax that we recently studied. So I think a lot of women are not having climax when they think they are. I've got some physiology to back that up. So the vasopressin thing is really interesting because I'm interested in developing that for getting folks away from somnolent aids pharmacologically. What could we do if we understood kind of the trajectory of somnolence with the vasopressin bolus at climax.

So during sexual arousal, one of the strong effects we've observed is there's a strong suppression of ghrelin or hunger hormone, which could be why after you have a climax, ghrelin comes back online. You've also got a bolus vasopressin, and so your body kind of has to make a choice. Am I hungry enough that I'm going to get up and go feed myself, move around, or am I so tired that the ghrelin coming back online is not enough to keep me from falling asleep, which I think is why people have very different experiences sometimes after sex? They'll say I'm hungry or sleepy as the case may be after

Jamie Wheal: And where would the smoking of the cigarette come in because that's typically an appetite suppressant and nicotine, unless you're I think super habituated to it, is a stimulant? So what are people doing there? What is that?

Nicole Prause, Ph.D. I don't know. Yeah, I don't know any data to speculate how those two might map on. I wonder how often that's the case these days, but man, that was in every movie [crosstalk 00:41:36].

Jamie Wheal: Isn't that the thing? That was like Donald Sutherland and Jane Fonda, like you remember all those classics.

Nicole Prause, Ph.D.: [inaudible 00:41:44] universe.

Jamie Wheal: Yeah, absolutely. So, let's keep going on this then because I am curious to how and if... So you were correcting some misassumptions both about dopamine, vasopressin, those are to relaxation. I think Arianna Huffington famously a few years ago when she kind of was thumping the for sleep stuff, she said orgasm is nature's ambient. And obviously, right, ambient is whacked and completely disrupts people's neurochemistry. And obviously, if a simple self-priming can lead you into somnolence, great. What about some of the potentially deeper healing aspects that the MDMA research is showing, that sense of safety, satiety, connection trust, the ability to explore emotions? I don't know if there's correlation here, but even what you just shared about the orgasmic stroking, the idea of closeness to a partner, intimacy, any of these things, how far down the road of being able to stab good old Marvin Gay, sexual healing as a true modality? What do you see in contrast to the MDMA research and what threads are you following of your own?

Nicole Prause, Ph.D.: Sure. So I think you mentioned in the text from your book, some of the mystical experience, things that people report with drug-taking and we have those anecdotally, but they're not nearly as well characterized in sexuality. So understanding where some of those feelings of disconnection and reconnection come from, so that's the kind of out of body. And people have speculated about the extent to which sensate focus, those exercises, where people do progressive touching with a partner to try and kind of reestablish an intimacy or discover new pleasure areas, like may be able to foster some of those things, like an ability to relax into an experience and to just feel sensation and maybe disembodied sensation. I just don't know with sex kind of how common those types of experiences maybe, and if they're beneficial or problematic for good sex. I don't know. It sounds like they should be good.

Jamie Wheal: Well, those are the macro ones. Those would be truly boundary-dissolving, ego-dissolving accidental, or intentional. Or at least in Jenny Wade's book, Transcendent Sex, she specifically sussed out naive practitioners. So her sense was I accidentally stumbled into a non-ordinary state via sexuality and typically didn't know what it was and was too embarrassed or self-conscious to even share it with my partner, which is clearly a sad, missed opportunity. But what about just on the micro-level, what about on just neurophysiological discharge of accumulated stressors, are you seeing that? I mean, most of the MDMA PTSD studies are not like full send, shoot the moon, there you are in the heart of a loving, compassionate sun god and you were one with everything, it's much more like...

In fact, they've found that I think it's 85 milligrams, maybe even 120, they found that actually lower dose MDMA was actually more therapeutically valid than their initial threshold doses because it appeared the person was not just pie-eyed and grinning, they had access to the therapeutic material, and they were sort of able to take it off the shelf of their memories. They were able to discuss and discourse and they were able to kind of work with it with higher efficacy. So are you seeing anything kind of down at that side of the fence, not full-blown mystical sexual healing, but actually just kind of I would say yeah, neurophysiological, psychological? Yeah.

Nicole Prause, Ph.D.: Yeah, sense may be closest along those lines as just looking at kind of ability to tolerate intense experiences. Right. So kind of a key symptom or component of PTSD, it's things that aren't perturbances to someone who's not having that experience or just intolerable. You can't have those kind of stressors around. And so sexuality, sexual stimulations, or climax are these very intense experiences that happen to be on the positive spectrum of things. And so our speculation was if part of PTSD is this affective flattening, so to keep yourself safe if you have PTSD, you say I need to cut off emotional experience because I can't go there. I can't be that low. I can't be that scared or that down. It comes with losing the positivity as well, often. It's like, I also don't have joy or ecstasy because it's safer to just stay in this very flat space.

So my sense is the sexual experiences kind of give you the ability to have this safe, intense experience where, to your point, you can maybe access some of the things that are on the other end of that spectrum, the very unpleasant memories or things that had happened in a space where there's generally pleasure in the state. So it doesn't feel dangerous perhaps than to talk about or experience those kind of things or re-experience, as you're trying to work through them. I don't know of any direct evidence for that, but it makes a lot of sense that sexual interaction may be a way of getting past that affective of flattening so that you can have an intense emotional experience that's not frightening that allows you to work through something that otherwise you can't discuss.

Jamie Wheal: And then what about the sort of capacity because I think again, Rick Doblin had mentioned this, I mean, this is congruent in the broader field of memory research, but just that idea of memories aren't static, we're forever formatting and reformatting, rewriting, overwriting them, is there the capacity in that let's say sort of optimize and resourceful post-orgasmic state, not that many people do this, but does it seem plausible to you that in that state you could particularly revisit sexual traumas, although obviously any other would potentially work as well and learn to rewrite or overwrite your narrative relationship with them from a more resourced state? And is that potentially a way to effectively kind of lighten the burden both in your physiology and your memory of past adverse events?

Nicole Prause, Ph.D.: My guess is it's probably not post-orgasmic, it's probably the exact pre-orgasmic. So part of what we're interested in with orgasm physiology studies is what we think is a missing phase that's not been well characterized. As we think with sexual interactions we get aroused and we get more aroused and more and more and more aroused until [blemo 00:49:13], we have a climax and some resolution. What we've been seeing in our physiology studies is that, yes, there's arousal, increased heart rate, increased breathing rate, everything they expected and have always talked about, but then when you say, okay, try and experience a climax, there appears to be a peri-orgasmic period where that physiology completely shifts. So that sympathetic nervous system tone actually decreases. We see dropping galvanic skin response, for example.

Jamie Wheal: So wait, and which phase, you said pre?

Nicole Prause, Ph.D.: Peri. So we're defining this kind of new phase that I think has been overlooked because research never follows people all the way through, like just never does. And so it turns out when you instruct people to start to try to have a climax, the physiology shifts remarkably so to the point we thought our instruments had fallen off when we first started to see this. We were like, what is happening, did they shake it off? And we were like, is your thing okay? Oh yeah, we're doing great. So I think the climax itself is really just a resolution. And so we see the brain start to come back online after that. Our kind of functions come back and accessible to us. I would do it in that peri-orgasmic period. I think that's where the remarkable shift is.

Jamie Wheal: And so when you say peri, you're saying around, but in this case, prior to, is that right?

Nicole Prause, Ph.D.: Very highly aroused state approaching climax I think is when the brain starts to... So one of the theories about climax is part of what triggers it is a lot of synchronous brain firing. That's not safe in normal states because that's a seizure. That's a lot of synchronous brain firing as a seizure, maybe not in the case of climax. And if that's what triggers it, if you think evolutionarily, you need to limit the period in which you're exposed and unable to respond adequately to stimuli in the environment. So that's the classic tiger approaching, I need to know that he's there so I can run away. Well, if you're in a peri-orgasmic period, presumably, you're in a safe space where you can have this experience and be checked out for some period. And so there's a nice kind of evolutionary, potentially explanation there as well for some unique phase there. And so, to me, I think it's not actually post-orgasmic, I think it's the peri-orgasmic that most strongly resembles what some of the drug interventions may be trying to capitalize on. It's this [inaudible 00:51:42] state where they're still very activated, whereas afterwards, I think they're coming back and it's like, all right, got to go back to work.

Jamie Wheal: Okay. And so sensory loading and I would imagine sort of imaginal narrative vibrancy would probably be at their peak in that stage as well. Like, maximum kind of suggestibility impressionability.

Nicole Prause, Ph.D.: That sounds very reasonable.

Sexual Behavior and Higher States of Consciousness

Jamie Wheal: Okay. Well, let's keep going then. So if this is kind of the realm of present tense singular people, trauma relief healing, and it's basically the role of sexual fitness potentially in just overall health and resiliency and adaptiveness, let's make that evolutionary leap. Right. So the first chapter on sexuality, I started with that story of the blue lagoon and that the goofiness of hominoids figuring out how to put our bits together, the profound basically just evolutionary and adaptive priming and incentivization to get us to figure that out, which is actually a rather obscure act compared to like stuffing things in our mouths and eating things, or tasting things or whatever babies do. Right. And then all of these sort of unintentional backlash and tragic comedy as all of those impulses play out through the arc of our adolescent to menopausal or senescent lives.

Right. But then to tee up the thought, most of our listeners will be familiar with Terence McKenna's Stoned Ape Theory and it's been getting a bit more airplay lately with the psychedelic renaissance, the idea that some early access to typically fungal psychedelics, et cetera, were a key part of waking up humans. And I just kind of, again, working backwards from some of your work and then getting into Jeffrey Miller, who I believe you did that UCLA study with as well as Jared Diamond, which is just a funny drive by, he wrote that book, Why Is Sex Fun, which was actually not that fun a book to read. It was a surprisingly dull book with a cool title.

But just making the case, hey, we humans are absolute aberrations from almost every other species in the animal kingdom and even, and especially our nearest primate cousins and that what you were just describing of the peri-orgasmic state, the potential for that really rare and novel cascade of neurochemistry, the fact that we have frequent and regular sex out of ovulation, that there's frequent female orgasm, that there's permanently large breasts and buttocks and oversized penises as a signaling mechanism, that there's all these things that we do that virtually no other animal on the planet does, what's your take on the Horned Ape hypothesis versus the Stoned? What would be your sense, is any of that divergent sexual behavior in homo sapiens possibly co-arising with or causal with higher states and stages of consciousness?

Nicole Prause, Ph.D.: Honestly, I hadn't considered those questions and that's something I'd probably have to think more about to be fair, but I see that as like how much of it is social, the sexuality and that evolution has something to do with how we're valuing the things around us. And is it related to just wanting to be able to manipulate our own physiology? So I think about what do I know about interception research and how we've come to be able to tell what's going on in our bodies or not. Is it a way of feeling in control?

Jamie Wheal: Is what, a way of feeling in control?

Nicole Prause, Ph.D.: Like is developing the sexual experiences, so having women have a climax, which we still don't know why that's there. Why do we pursue that? Why is that present? What's the benefit?

Jamie Wheal: So are you really not even down to a shortlist of your most reasonable hypotheses? I mean, wasn't there something like upsuck theory or additional... I mean, where are you on that? Why do women have orgasms?

The Novelty of Human Sexual Patterns of Behavior

Nicole Prause, Ph.D.: Currently, I'm more on the byproduct theory. And there are plenty of folks who will disagree with me on that. So byproduct is the idea that orgasms weren't especially meant to exist in women, that they're a byproduct of having evolved from the same physiology that men did, who need to be able to ejaculate and have some motivation for pursuing ejaculation to reproduce. That seems like the most likely to me. We just got lucky.

Jamie Wheal: Okay. So I understand why you get all the blowback because basically, you take away everybody's fun, including the anti-porn crusaders. You're like, nah, sex addiction, that's not really a thing. Right. Now, the question here is... Well, I mean, I'm just fascinated by where you come down on the whole novelty of human sexual patterns of behavior. Right. Because, yes, you can say everything's an accident of biology for sure and writ large across the animal kingdom, yes, it could have just been we were zygotes, one of them ends up with a penis and that needed to work that way, and the other one got most of the nerve endings and the neurological wiring but didn't have the same adaptive need for it.

And on the other hand, human females do have orgasms and do have sex outside of estrous. So what is your sense of how we got to here because I mean, we really are a novel cul-de-sac in the animal kingdom and we're not the only ones with opposable thumbs, and we're not the only ones with tool making, we're not the ones with a bunch of things. There's that joke of like every time somebody has started a nature channel special or a book for the last 100 years has been like, man is the only animal who... Like a decade or 50 years later, they've had to change it. Right. But I think it is fair to say that our sexual patterns remain remarkably distinct, other than blind accident, and we are arguably the most self-conscious and we deploy the most energy over the longest time in raising offspring and a whole host of other things, do you have any sense of the connections between those two realms?

Nicole Prause, Ph.D.: Yeah. Maybe the distinction between the kind of drive or incentive and motivation. So we often make this distinction of why are you having sex? And it could be for these internally endogenous driven reasons that I want to feel pleasure, I want to feel this person touch me, I want to have a climax, whatever kind of falls in that realm. Whereas usually when we talk about sexual motivation, that's I want to reward my partner, I want my partner to stay with me. And these may sound like they're gender divided, but I don't mean them to be. Either gender could have that, either motivation potentially. And so I wonder if the outside of estrous experiences, for example, are more reflecting our ability or interest in engaging in sexually motivated behaviors for complex social reasons. That is, I don't have this endogenous motivation necessarily, I've got lots of exogenous reasons and rationales for wanting to have that type of connection. And we could speculate as to what that is, and there's Cindy Meston, David Buss, I think had 1,001 sexual motivation things in their book that have been cited. So we just have so many reasons for engaging sexually, that have nothing to do with getting off. And so it seems to me there might be a lot there to explore.

Jamie Wheal: Well, and then did you track that book, Sex at Dawn, when it came out? Was that something that [crosstalk 00:59:59]?

Nicole Prause, Ph.D.:  I'm familiar with it but haven't done anything special with it or the author.

Jamie Wheal: Okay. Because I'm just curious, right, because there's been a wave of like we're chimps or bonobos. And actually, Neolithic women were lusty and non-monogamous and all this stuff, and then became agrarians, boo, an attempt to control fertility and certainty of offspring and all that kind of stuff. And obviously, that's the realm of sort of paleo sexual politics, which can be forever speculated on. But I think the reason that book landed, even though most of my colleagues in the field of anthropology kept it at arms-length were kind of like, yeah, kind of, sort of, not really. It obviously hit a nerve because it was basically permission for a bunch of horny polyamorous these days. Right. So it was like because science, because history, we get to go get busy because that's the way it's always been.

What is your take on that? You alluded to lots of basically tangential or pro-social reasons to engage in sexual acts, sexual activities that aren't necessarily specifically rooted to immediate gratification on a physical erotic level. And, interestingly you've also said, I think a bunch of women are, are misguided about their orgasms. So on the one hand, Sex at Dawn and some of those books would actually say, hey, women were empowered and they were not slut shamed and they were actually kind of running the table back in the day, including vocalization, including frequent multiple orgasms, including the ability to have multiple partners, all that, and on the other hand, you're saying, yeah, but I think a lot of women are missing the boat quite literally. What's your stake of bridging those two worlds or stories? What's really going on.

Nicole Prause, Ph.D.: There's been a lot over time to your point of research on consensual, non-monogamy and all the structures that entails. So that's everything from open to poly, swingers, that old 1970s term, to promote the discussion. And so certainly we talk a lot more about that than we ever have. There's a lot of discussion about it. But what I find interesting is the studies over time actually don't find that people are engaging in those relationship types any more than they had in the past. And I find that...

Jamie Wheal: You mean just sheer demographics, there actually hasn't been an uptick.

The Science and Psychology of Orgasms

Nicole Prause, Ph.D.: Yeah. They appear to be stable. So despite our fairly recent obsession or interest in these non-monogamous structures, that they're not being widely adopted. Certainly, some people absolutely do and have them stable over time, I don't think there's any debate about that, but I think it's interesting that still, primarily strongly pair bonds, maybe serially so, it appears to be pretty robust. It's hard to up even with more acceptance and openness to those types of things. So yeah, the thing with the women's climax and openness to those types of experiences, part of what we were finding is from a physiological perspective, we're trying to document how orgasm actually unfolds or occurs. And we thought we were just verifying exactly the timing and then come to find out half or so of the women we were testing weren't actually having a physiological climax when they reported that they were. And so then the question is like, well, what was that? I don't think they're lying to us because they know we're in a lab, that we have measures on them. I believe they think they actually are, and that from a physiologist's perspective, they're not.

Jamie Wheal: So what's that, is that Cosmo did us dirty when we were teenage girls and got the wrong signposts?

Nicole Prause, Ph.D.: So my colleague and I disagree about the interpretation of this, but that's my interpretation is that I believe the education is not good enough that women expect a series of rhythmic contractions in their pelvic musculature. Like guys know they have visual feedback to know when a climax has occurred. And for women they're told, oh, it's warm, it's fuzzy, you feel a rush of pleasure. And so they say, well, I felt that I guess that was it.

Jamie Wheal: Well, I mean, do you ever hook them up with a Sybian or a Rabbit and say see you in 30 minutes? Do you ever give them a hyper-stimulated override to what they had experienced as a sort of stretching the Overton window a bit?

Nicole Prause, Ph.D.: So yeah, we used primarily the Magic Wand in our research, so that's the kind of standard, so it's not like the intensity wasn't sufficient. And occasionally we'll have participants who'll differentiate and say, oh, well, I didn't know, I just reported my mental climax, I didn't know you wanted me to report my physical climax. And we're like, excuse me, we didn't know we needed to differentiate there's one. You're messing with our data, man. My guess is assuming this continues in the next 10 or so years, there's going to need to be a lot of rewriting of our understanding of how orgasms work. So we tested many women who said, oh, we're multiple orgasmic, and we're like, they're not having a climax at all.

Jamie Wheal: So it was waves of sensation that they might have been experiencing in their body and what do you isolate as the telltale go, no go for actual orgasmic climax?

Nicole Prause, Ph.D.: Yeah. So we've got a highly specific signal for physiological climax, I'd say the 12 contractions that occur starting 0.8 seconds apart and increasing in latency to their termination. There's very little... You don't get part of that. It's reflexive. So once it starts, it doesn't stop. Like, it's a very nice physiological marker and we just have never observed it in men yet, but we observe it in a lot of women that they're reporting climax experience without this kind of telltale phenomenon.

Jamie Wheal: Well, wait. You say you've never observed the telltale orgasmic signal in men or you've never observed men thinking they have when they haven't.

Nicole Prause, Ph.D.: Exactly, the latter,

Jamie Wheal: Hence patriarchy.

Nicole Prause, Ph.D.: Sure.

Jamie Wheal: I mean, there's also that question that comes to mind as both John Lilly's early research with neuroelectric stimulation of brain and teasing apart erection, ejaculation, and orgasm as distinct neurological destinations and prompts or primes, but are you basically saying that in your average, dude off the street, those still come bundled together?

Nicole Prause, Ph.D.: They rarely disassociate. When they do, it's usually due to medication in guys. That's what we know. And so my collaborator's interpretation of our female data is maybe women have just dissociated those processes. And so they're having that mental thing without the physiology, without the equivalent ejaculation experience. So that's the alternative interpretation and I don't know which is going to win.

Jamie Wheal: And I know I asked you about this last time because I was about to write about it, and there may not be any research since, but the Aneros, that sort of peristaltic prosthetic massager for men that with sort of involuntary muscle contraction has been doing some combination of prosthetic stimulation and vagal nerve stimulation in men that practitioners in that specific community have been reporting as a super orgasm, which they have expressed as non-erection or sort of whatever, it depends, but it's nonspecific on erect or not and non-ejaculatory, but can be waves and waves of arguably, at least as they report, the most intense experiences, the most intense pleasure they've ever had. Yeah, what's your take on that? Because I mean, obviously, for the women, you're holding some sense of like, hey, you might have been socialized into thinking a thing is not a thing, but for these guys, they're post the certainty of direct stimulated response and they're finding their way into some other cascade of sensation.

And I think there's been those studies, and I don't know if this tracks with your research, but of women with spinal cord injuries and those kind of things being able to reroute their orgasmic response through vagal nerves or potentially other pathways, what would be your hunch that these guys are doing? Are they finding a way to decouple those three responses? Are they hot wiring the vagal nerve to do something else that's also possible for women? And does that shed any light on the women who would swear blind, they're having multiple climaxes, but according to your measurements aren't?

Nicole Prause, Ph.D.: It very well could be that they've trained themselves to identify and be able to disassociate the different components of that experience. And this is again where I would love to be able to do the research on them. It's getting the time and resources because that's ultimately how we're going to come to understand these things. We have to get the sensors on them. Questionnaire research is great, we need it, but it's done. Like we need to stop asking and we need to start measuring because people are not experiencing what they're reporting when we put sensors on them. And so I just think those data are a very limited utility now. I need to be able to look at the contractions and look at the time course and the brain responses. Throughout the entire kind of sexual experience, we're there it's past time to try and characterize some of those things.

Jamie Wheal: So you're basically saying we're unreliable narrators of our erotic lives.

Nicole Prause, Ph.D.: Yeah. And sometimes that's to our benefit. So I'm also a licensed psychologist and I always say if a woman tells me she has a climax, I don't say, well, but did you have the contractions? I'm like, great, good, we don't have to worry about that. I don't question the experience when it's a matter of helping someone or trying to address sexual issues. It's more as a physiologist, if I want to identify health benefits associated with climax and I'm interested in vasopressin, then I need to know if you had a climax or not because I need to know if you got the bolus of vasopressin. So it becomes important in those settings.

Jamie Wheal: All right. So I'd love to ask a couple of kind of like pan back, bigger level questions to bring this home. And I fully appreciate this about you, you're remarkably considered and deliberate in what you say and what's based on the data and where you are even in the analysis of the data and a refusal to get out there over the diving board and take a plunge. Right. But now, we get to close the book on your lab hat, to mix metaphors wildly, and we get to put on the other hat, which is basically, what are you excited... Let's just assume no limits to fundings or approvals for the next decade, where are you dying to take the field? What's sort of the true gold standard? What is the big questions that light you up that you would love to know the answers to? And let's just say without constraints, 10 more years of research, what would we know and what are your hunches about which way some of those studies would go?

Nicole Prause, Ph.D.: Yeah, my guess is this peri-orgasmic period is really something I didn't know existed, I don't think anyone knows existed and it's a potential actual discovery. It's along the lines of... I like to say when I was in school, I heard the scientists who discovered auto acoustic emissions speak, and so this is the ear doesn't just perceive sound and vibration, but also sends some sound out as a method of sharpening listening. And so you can actually measure these and some people, you can even hear their auto acoustic emissions. Crazy stuff. But the discovery process is like when he realized this was real and he had data that finally kind of made that argument well, and so we're seeing all these hints we see, he's like, oh, that GSR it's like right there and this is here.

And so in following those, if this is real, if we can continue to see that there is this really unique state and period, and there are so many different ways, we need to test and make sure that's really the case and that it's reliable and what can we do to provoke it and what can we do to enhance it, that I think there's a lot of health potential there. My guess is climax is going to be useful for sleep, probably. I like that. I do want to study and document that, but it's less interesting to me than this potential for a whole new phase of sexual response that just doesn't exist in current models. Those sexual responses that we still teach in intro to human sexuality classes, those are in the 1960s, it's time to revise them.

We should have done the test at the time. So we need to understand like what is going on in the brain and the body because something unique is happening. And I think we've seen it in profound ways in our biosignals. So we also still don't know how orgasms are triggered ultimately. There are lots of good theories. If I had, to your point, unlimited resources, I need to figure out that trigger, I want to understand how that happens, not just so I can be the monkey giving myself unlimited climaxes, but to see how to harness that. If someone struggles with that I can still give them the benefit of the sleep benefit or whatever that may be that we find is useful, that we're going to need that next step. Okay, this looks like it's helpful, well, then how do we get there, how do you know you're in that state? How do you provoke it reliably? What does it look like? How do you know it happened? Is there a way to enhance that? So all kinds of questions around provoking that high arousal state that I think is going to be most useful for health moving forward.

Jamie Wheal: And that specifically is that that higher arousal is the peri-orgasmic state that you're describing.

Nicole Prause, Ph.D.: Yeah.

Jamie Wheal: And that brings to mind, I mean, Robert Anton Wilson, and then I think I quote him in the book, but that the prolonged genital embrace is highly effective for radical brain change is secret known both East and West through the years. Right. And the Western sex magic tradition talked about eroto-comatose lucidity, the idea of by getting to that place, the peri-orgasmic, and then stretching it out with all of the neurochemical priming, whether it's transient hyperfrontality or whatever is happening to the brain anatomy, what's happening to the rest, and I think you described it as a drop in sympathetic tone. And if you can hang there and you can actually stretch that out intentionally, it is a profound place, at least as these traditions report, for both inspiration and psychological mutation and potentially relational exploration. Let's take that kind of traditional, historical, cultural like this has been going on for a long time before we set up labs to study it and your interest in it, what might we get to as those paths cross, do you think?

Nicole Prause, Ph.D.: So my sense is whenever we talk about these kind of data, people always typically will say, well, no kidding, to your point, it's like, that's edging. Or, well, yeah, I know that's the BDSM mind-altered state, they have a specific term, it's not coming top of mind. I absolutely agree. I think this is already known, but we can't use it until we can say the point to it and say here it is, this is what's happening when you say you're in this creative exploratory state. And in some sense, it's right now relegated to mysticism or say unusually typical sexual communities, ones were there tend to be fewer practitioners. And I always like to joke, I say, how do you make our research matter to Mike Pence, and my apologies to Mr. Pence, if this is not accurate for him, but a conservative guy?

Jamie Wheal: You make it about his mother.

Nicole Prause, Ph.D.: So I say like, you're never going to convince Mike Pence that you need to have more orgasms and that they should fund women's orgasm research. He doesn't care. He does not care. But if you say I can identify this unique brain state that you can experience through climax that happens to facilitate somnolence, it's going to help our nation improve their health, reduce healthcare costs, now you're talking Mike Pence's language and you might actually get him to masturbate.

Jamie Wheal: Rub one out and call me in the morning.

Nicole Prause, Ph.D.: So I see it a bit as like we're under no myth, we don't think we're discovering something new in the sense of like, oh, this has never been known before from a cultural perspective, it's that it's not scientifically known. We have some sense people report these things, but people report all kinds of things including things that are definitely not true. And so it's a matter of saying what is that thing? And by giving it a name and giving people a thing to point at, we can say this is useful and this is not fringe and it's not religious and we can make it concretized in a way that it becomes useful and something we can prescribe and talk about in treatments and interventions. So that's really my interest scientifically in it as I realize for whatever speculation and promise it might hold that at some level, you're going to get the buy-in and get interest in folks when you can point to it. You can say, I understand what's happening, we can document it, we can show you what that is and why it's going on.

Jamie Wheal: Beautiful. Okay. So now we're at the other end of that 10, you can even make it 20 years, and we're out of your lab and all of the laser focus that you're devoting here to basically mechanisms of action, exactly what you said, this is it's in the cultural soup, it's garbled, it's distorted, it's contested, it's all those things, but if we can get to the science, then we can really help people take this home, take this to heart. It can bridge cultural divides, religiosity, different belief systems, it can help people I'm imagining, is that fair to say?

Nicole Prause, Ph.D.: Absolutely. That's the goal.

Jamie Wheal: All right. So now I'm going to ask you to be a little vulnerable, step outside your white lab coat, so 20 years from now, what is the world of human sexuality that you want to have played a part in helping bring forth? What is the world that you would speak to your 20 something daughter or a granddaughter? Right. What is the world of human sexuality that you would wish for them? Describe that?

Nicole Prause, Ph.D.: Yeah. I wish sexuality was more useful. That is, as it is, I think of sex or when I talk to patients in this space, it's like when they go to have sex, they put on a serious face, they can't talk too much because they got to do the thing, and however they think they need to interact to be a good lover or whatever that may be. I think, God, that is such a limited perspective on what sex and sexuality is. It's not in the past just for reproduction. I think we're beyond that. It's important for our most romantic relationships. That's great, don't dispute that. But we're not yet to the point of saying, and that response is useful, it's useful in the world.

If I am having trouble concentrating on a work issue, maybe I want to be able to have a climax so I can focus if that's going to be something that helps me stay on task. I want to be able to talk to folks about how can this be something that you use in your life not to reproduce, certainly, not to connect with your partner, but because it's useful for something you want. I want to be able to fall asleep and not toss and turn for hours. Man, have I got your solution, and this is when you do it to maximize the... And so I just feel like... Now as a therapist, I worked in behavioral medicine, it's crazy, the sleep assessments and interventions, they ask nothing about sexuality or that interaction. And on the treatment end, none of these mention masturbation. I was like, what are we doing?

This is the most likely used thing. Almost anyone, if you ask them about it, there has been one questionnaire that asked about it and people are like, yes, I use masturbation to help me sleep. No kidding. I want us to be able to have that conversation and right now we can't. And I think one way to do it is to have the data to say, look, this is grounded, this is not goofiness. I realize it sounds goofy, I realize the protocols are bizarre that are going to get us there, the stuff we need to do along that way, but it's worth it. There are all these things that our body can do that we're not taking advantage of. And it's just because we have this very limited way of thinking about what the sexual response is and what it does. And we absolutely could use that endogenous response to enhance, facilitate, I think a variety of aspects of our lives, both treatment-oriented and just enhancement

Jamie Wheal: Beautiful. So it sounds like shining a light on the benefits of sexual fitness as an adjunct to the human experience and as a tool for both healing and connecting and easing the ailments and hardships that inevitably come our way.

Nicole Prause: That's what I meant.

Jamie Wheal: Beautiful.

Nicole Prause: Well said.

Jamie Wheal: Well, Nicole, thank you. It's great to connect again and I'm super stoked. Congratulations on your appointment to UCLA and your return to the ivory tower. I hope this time you're not Rapunzel and stuck up there and that you get to have a nice back door to your own up as well, and keep pioneering all of the work that you're doing. And thank you for taking it head-on, you've been a lightning rod in the field, and as your academic discipline intersects with the culture and even the culture wars. And I'm really glad to see that you've kept your head up and your heart open, and you're continuing to pursue all of your research goals undeterred and with increasing support. So super glad you're out there and thank you so much for making the time.

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