Come As You Are by Emily Nagoski


Summary

Although the book’s main intended target audience is clearly women, I would recommend this book to anyone who has any interest in learning about human sexuality and how to have a better sex life. Emily takes us on a journey from the macros to the micros of sex and ultimately leaves us with many many possibilities to explore as we look for ways to improve our personal sexual perception and our sex lives. She has a very positive, gentle, non-judgemental, and down-to-earth voice and the best part is that she uses evidence-based research to back up pretty much everything she says. Her opinions are clearly labeled as such and she has no trouble in giving theories as to why certain things are the way they are. It’s a very empowering book for women, and society as a whole as Emily debunks some of the nonsense we are told through media and the stories we hear from those around us, whether it’s cultural or religious. This is a must-read for anyone who has the least bit of interest in human sexuality.

As there’s a lot I want to keep revisiting in this book, I’ve made it my mission to summarize some great points - they are meant to change the narrative we have around sex. I don’t do this for all the books I review but sometimes the books are just too good not to repeat and go over their main concepts.

main concepts summary

ANATOMY

Emily uses the same phrase over and over again until it sticks to you and that is “we are all made of the same parts, just organized differently”. She dismisses the norms we’ve come to establish in our society when it comes to sexuality and sexual behaviour and the aforementioned phrase makes it easier to clearly see that what everyone has is normal and that there is no “real” normal. We are all normal with what we have (excluding serious exceptions that require medical attention). Our idea of what normal genitals look like is a product of what we’ve seen on TV and how we’ve superimposed a cultural meaning on it. We metaphorize genitals into what they are like vs what they are. Emily clarifies once again (for those who haven’t taken an anatomy course yet) that the vagina is the reproductive canal, the vulva is the external genitalia, and the mons is the area over the pubic bone/pubis where the hair grows. Using the appropriate terminology when speaking about anatomy is a great step in the right direction

Arousal: Here Emily talks about the Dual Control Model: the Sexual Excitation System (SES) and the Sexual Inhibition System (SIS) or in other easy to remember terms: Accelerators (SES) vs Brakes (SIS).

SES: Is a sexual response accelerator that receives information/sexually relevant stimuli from the environment (what we see, hear, smell, touch, taste, imagine) and signals to the brain to “TURN ON”.

SIS: Our brakes do the same thing, take in sexually relevant threats from the environment (what we see, hear, smell, taste, touch, imagine) and signal our brain to “TURN OFF”.

The brake can be further broken down into two categories. The first one being the brake that notices threats in the environment. The second brake is more like a handbrake that sends the chronic low-level, “no thank you” signal. Where the footbrake is the fear of performance consequences, the handbrake is the fear of performance failure (for example: worrying about not having an orgasm).

All sexual function and dysfunction can be conceptualized as a balance or imbalance between the brakes and the accelerators. Often one thinks that a sexual problem means that there isn’t enough of an accelerator/stimulation effect happening but in truth, the most common cause of sexual dysfunctions is that there is too much pressure on the brakes.

In other words, having sensitive brakes is the strongest predictor of sexual problems of all kinds.

Both SES and SIS are traits. We all have them but all have different sensitivities (same parts, arranged differently). This equates to differences in the potential to be aroused (arousability).

Most people score average on the SIS/SES scale. You can take a quiz to find where you stand.

Those with a high SES and low SIS sexual response respond readily to sexually relevant stimuli but not to potential threats. This means they are easily aroused but while that may sound fun, keep in mind that it also means that they have a hard time preventing arousal which can lead to compulsive sexual behavior. 2-6 % of women identify with this category

If you have very sensitive brakes and a not-so-sensitive accelerator, you might have difficulty getting aroused, have a lack of interest, or experience problems with orgasm.

There are differences between men and women when it comes to SIS/SES however there are also many differences within each group.

With the differences in genitals and hormonal cycles of women, girls learning about sexually relevant stimuli are:

  1. Likely to begin in later in their development

  2. More influenced than boys; by social and environmental context

Since SES/SIS are traits like personality that we are born with ie they are mostly stable throughout our lifespans, we can try to change them. This change can be compared to changing your IQ. Although SES/SIS is more flexible than IQ, we know very little about the factors in changing them.

So we may not be able to change the mechanism but we can change what the mechanism responds to. That is, we can change the context. For example, we can change what the brakes consider a potential threat and then reduce those threats. We can change what the accelerator considers sexually relevant and then increase the sexually relevant things in our life.

CONTEXT

Our brain’s perception of sensations is context dependant. For example, ticking can be fun when we are already turned on or in a happy mood and downright annoying and frustrating when we are already angry or not in a good mood.

The brain takes in stress and then views everything as a potential threat. Our brains have separate functions: Expecting (anticipating), Eagerness (wanting), and Enjoying (liking). You can have one without the other, for example, you can want without like and any other combination.

The best context for sex, for the majority of people, will be: low stress, highly affectionate, and explicitly erotic

Emotional Context

Chronic stress, depression, and anxiety will reduce interest in sex, decrease sexual arousal, and interfere with orgasms. Stress activates our brakes. Even the women with active accelerators can experience the effects of this as the stress blocks sexual enjoyment, even though it might not interfere with the increased interest in sex. Sex, when one is stressed, will be experienced differently than sex when one is joyful.

Broken culture = Broken stress response cycle

Our stressors in this day and age are different than what we previously experienced in that we are not getting chased by lions or preditors (hopefully most of, if not, all of the time). This type of stress can be classified as acute stressors. They have a clear beginning, middle, and end. If a lion is chasing us, we have the chase, the running, the surviving, and the celebrating. This is a cycle that our bodies complete when reacting to a stressor (which was the lion in this example).

Contrary to the acute stressors, we also have chronic stressors - low intensity, longer duration. With this type of stress, we don’t take the deliberate steps that are needed to complete the cycle. Why? Because our emotion dismissing culture has shaped us to do so. This emotion dismissing culture is uncomfortable with Feels. We avoid expressing our emotions. Our way of dealing is: if it’s not in front of us, we don’t feel stressed. We equate stress management with eliminating all stressors or with “just relax”. Unfortunately, stress cannot be turned off like a light switch.
We are good at self-inhibition and we do this by stopping our own stress response cycle by relegating it to an “appropriate time”.

How do we complete the cycle?

Physical activity, sleep, affection, meditation (mindful, yoga, tai-chi), primal scream or a good cry, or sensorimotor relaxation.

Although not yet proven by research, many women speak of the benefits of rituals of self-kindness such as grooming, nail painting, make-up, getting ready for the day, etc.

Emotions are like tunnels. You have to walk all the way through the darkness to get to the light at the end.

Most people think that dealing with the stressor is the same as dealing with stress but in fact, they are very different.

Attachment & Love: in the right context, sex can attach us emotionally to new partners or reinforce emotional bonds in unstable relationships. Sex and love are closely linked to our brains - in the right context.

Staying over your own emotional center of gravity is one of the many things we can do and Emily talks about her Scientific Guide in accomplishing this. This entails owning your feelings (naming the feeling), listening to them, being responsible without being reactive, and then taking the emotions seriously without taking them personally.

  1. Name the feeling

  2. Welcome the feeling. Sit with it, as you would with a welcomed guest

  3. Take responsibility for the feeling. How can the feeling be managed? If you are experiencing anger, how can you manage the anger? If it is grief, how can you heal the loss? We have to ask ourselves “What will help?” Sometimes, we won’t be able to do much but to allow the feeling to discharge and complete its cycle.

  4. Communicate the Feeling and Need. I feel X, I think what would help is Y.

She also gives the analogy of a sleepy hedgehog. If you found a sleepy hedgehog on your couch, you wouldn’t yell at it or be angry that it’s there. You would give it a name, sit peacefully with it on your lap, figure out what it needs, and then tell your partner about the need and collaborate to help the hedgehog.

Sex that “advances the plot”, brings the parties closer together vs sex that is gratuitous (sex for the sake of you can). To have more and better sex, give yourself a compelling reason to have sex. Something important to move toward.

Cultural Context - to be sex-positive in a negative world

We all grow up hearing contradictory messages about sex and the awareness of these messages leads us then to choose whether or not we want to believe them.

Self-criticizing increases stress. Healing begins when we let go of self-criticism.

Healthy at every size (HEAS): Health is not predicted by weight. We can be healthy and beautiful at any size we are. We must enjoy living in our bodies today and treat ourselves with self-kindness and compassion. What results from this: a better sex life.

AROUSAL-NON CONCORDANCE

Genital responses do not necessarily match a person’s experience of arousal.

Women have greater arousal non-corcordance than men. There is a 50% overlap between what a male’s genitals respond to as “sexually relevant” and what the brain responds to as “sexually appealing”. For women, the overlap is at 10%. Why is this? Well, women are different. Sexually relevant (expecting) is not the same thing as sexually appealing (enjoying). For most women, the overlap is context dependant. The best way to tell if a woman is aroused is to listen to her words.

DESIRE - AROUSAL in context

Arousal begins when the accelerators are activated and the pressure is eased off the brakes. Desire comes when arousal meets context.

There are two types of desires:
1. Spontaneous - most mentioned in our culture because most men share this (oh how convenient). 15% of women have a spontaneous desire style - ie you want sex out of the blue.

2. Responsive - 30% of women experience responsive desire style. That is, sex is desired when there is something pretty or erotic is already happening.

Sex is not a drive. A drive is needed to survive. A drive is pushed by an unpleasant internal state that ends when return is made to baseline. Sex is not hunger, it’s an “incentive motivation system”. Incentive as in thrive. Pulled by the attractive external stimulus (incentive). It ends when the incentive is obtained. Think curiosity.

Sex might sometimes feel like a drive. This is because the mind is focused on obtaining a goal. If you can’t reach the goal, the mind is angered and frustrated. This is the emotional brain. It has a little monitor whose job is to reduce discrepancies. The monitor motivates us to pursue novelty, ambiguity, pleasure, etc. To increase sexual desire in relationships, increase novelty, pleasure, ambiguity, and intensity (do something that increases your heart rate).

It’s not how you feel, it’s how you feel about how you feel.

ORGASM

Orgasm happens in our brains, not our genitals. 30% of women are orgasmic from vaginal penetration alone whereas 70% are sometimes, rarely, or never orgasmic from penetration alone. The most common way for women to orgasm is through clitoral stimulation. The orgasm is not an evolutionary adaptation for survival, it’s a fantastic bonus. For better orgasms, turn off the offs and turn on the ons, more gradually.

META-EMOTIONS

It’s not how you feel. It’s how you feel about how you feel.

Welcome your sexuality as it is - right now, despite your expectations.

Develop no judging, “emotional coaching” meta-emotions to facilitate letting go of old, absurd cultural standards.

Recognize feelings are normal and a part of life. Give yourself permission to be and feel whatever you are and feel so your body can complete the cycle, move on through the tunnel and come out at the end of the light.

My key Takeaways

  1. Arousal can be broken down into the Accelerators and Brakes system. Accelerators are stimuli that turn us on and brakes are the stimuli that turn us off. Though we cannot change these, we can change the context of this mechanism

  2. Sex is connected to the brain, this is after all, where orgasm happens. Stress plays an important role in this and to remedy this, practice healthy ways of “completing” your emotional cycle. See above in summary.

  3. Avoid using the phrase “sex drive”. Instead, use phrases like “desire style”. You can either have a spontaneous or responsive desire style and both are normal and okay.

  4. It’s not how you feel, it’s how you feel about how you feel.

I would recommend this book to

  • Anyone interested in learning about human sexuality - particularly from a women’s perspective

  • Lots of helpful information even if you don’t identify as a woman.

  • My past self :)