Resurrecting Sex by David Schnarch: Book Summary

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Resurrecting Sex (2002) is David Schnarch’s book on sexual problems in committed relationships. This summary follows that edition: an introduction, four parts, fourteen chapters, and six appendices. Schnarch had already written Passionate Marriage. Here he applies that approach to arousal, orgasm, pain, desire, medication, and the relationship that has grown up around the problem.

The book: Resurrecting Sex by David Schnarch

Introduction

Schnarch opens with two frogs thrashing in a pail of buttermilk. They are about to drown. When they stop panicking they notice their struggling has started to turn the milk into butter, a platform they can stand on. He says we are all frogs in the buttermilk. Sexual problems feel like drowning. The struggle is also how a couple builds something they can stand on.

The book is about problems that show up in every stage of a relationship: trouble getting aroused, pain, orgasms that are hard to reach or that arrive too fast, and desire that doesn’t match. Once a problem has been around for a while, you are dealing with two people and their feelings about themselves and each other, not only a penis or a clitoris that won’t cooperate. The sexual problem shapes the relationship, and the relationship shapes the sexual problem. Getting the body to respond still matters. So does getting the relationship into a state that can support good sexual functioning.

Schnarch is explicit that tips, new positions, and sensate-focus exercises often fail with real couples, because those methods assume two cooperative patients. He describes Resurrecting Sex as a second-generation approach. Masters and Johnson defined the first generation in the 1960s. This book looks at sex, love, and intimacy as one process, and at the purposeful ways intimate relationships operate.

Part I: A Crash Course in Sex

Chapter 1: A Second Chance at Sex

Summary: Chapter 1 argues that unsatisfying sex is common, and that most people hide it because they think they are uniquely screwed up. Schnarch points to the early rush of Viagra prescriptions, and to the Internet, as what made the private misery harder to deny. He cites a wide range of studies: anywhere from 10 percent to 52 percent of men and 25 percent to 63 percent of women have sexual problems. An estimated 15 million men in the United States have significant erection problems, and another 10 million have partial difficulty. One man in three has some difficulty with erections by age 60.

He walks through two surveys in particular. A 1999 AARP and Modern Maturity mail survey of 1,384 adults ages 45 and older found that 26 percent of the men reported complete or moderate difficulty with erections, and that less than half of those men had ever sought treatment. Only 10 percent of the men and 7 percent of the women in that study had taken medication, hormones, or other treatment to enhance sexual performance. The 1992 National Health and Social Life Survey, of 1,749 women and 1,410 men ages 18 to 59, found that 43 percent of women and 31 percent of men reported a sexual problem in the prior year. In that study, 19 percent of women reported difficulty lubricating and 15 percent reported pain during sex. About a quarter of women reported difficulty reaching orgasm.

The rest of the chapter is about who “couples with sexual problems” actually are. Schnarch’s point is that the category includes young couples, long wars, couples who never had much of a sex life, abuse, affairs, illness, and premature orgasm. Believing you are defective is normal too. He asks the reader to drop the stereotype and keep the dream. He also tells you how to read the book with a partner who may not be eager: read it on your own if you have to, skip the ultimatums, and remember you are dealing with another human being. Changing yourself pressures your partner, because the relationship has to reorganize around a person who is no longer playing the old part.

Chapter 2: How Sex Works

Summary: Chapter 2 is the mechanics chapter, built around what Schnarch calls the Quantum Model. Genital response and orgasm are reflexes. Your body has response thresholds. Lubrication or erection, and then orgasm, happen when your total stimulation gets high enough to cross those thresholds. When it doesn’t, you get a sexual dysfunction. Some women have never had an orgasm because they have never reached the orgasm threshold. Some people reach it during masturbation and not with a partner. The model is meant to make those patterns understandable instead of mysterious.

Total stimulation has more than one layer. There is physical stimulation. There are also emotions, thoughts, and feelings, which can raise or wreck the total. Your partner’s feelings can change your response. Aging slows the body’s responsiveness because response thresholds rise. Schnarch is clear that aging itself does not destroy the capacity for sex, and that arousal problems and orgasm problems are not an automatic consequence of getting older. People differ a great deal in how much stimulation they need, and those thresholds change.

The cases carry the model. Amanda, 55, has lost desire and has more trouble with orgasm, and she hides it from Cole. Lloyd is losing erections and having orgasms sooner. Mariel has intermittent pain during intercourse. Gordon has to start aiming and supporting his penis, and he and Clare are not close enough to talk about what that means. Sharon and Reggie show what happens when physical technique is used to avoid emotional contact. Amy’s intermittent orgasm problem turns on what she is doing with her own feelings, not on Fred changing his hands. The chapter’s practical conclusion is to maximize total stimulation: body responsiveness, physical stimulation, and the mental and emotional part together.

Chapter 3: What Is Happening When You Can’t Get Aroused?

Summary: Chapter 3 separates physical arousal from subjective arousal. Wendy and Jonah have been together ten years. Jonah has had erection difficulty throughout the marriage. Wendy is having more trouble getting aroused, and her mind wanders during sex, which she hides so she won’t add to his load. Schnarch uses them to show that one partner’s problem spreads. He also shows the reverse: some people have genital response without feeling turned on, and some feel desire while their genitals lag.

Almost all men and women have arousal problems at some point. For men, the problems include difficulty getting and keeping erections. Arousal problems usually show up early in an encounter. Desire sits next to subjective arousal. Sixteen percent of the men in the NHSLS study reported a desire problem, and Schnarch says that figure badly undercounts what he sees clinically. He also describes sexual aversion, the less common pattern of dread, including sobbing and full-blown avoidance.

Pain is treated as its own category, related to arousal and still distinct. Women’s pain can be at the entrance to the vagina or deeper. Sexual pain is less common in men. The NHSLS figure he gives is 3 percent. Repeated pain can train the body into more pain, including vaginismus, and some women develop a phobic reaction on top of that. Causes are organized with the Quantum Model: anything that limits the body’s response, anything that cuts the quality or quantity of stimulation, and psychological factors. He covers aging, illness, menopause, declining testosterone, medication side effects, and recreational drugs, including the way smoking works against the stimulation you get from kissing. Touching without feeling is common, and he does not treat it as a simple communication problem. Phil and Mary’s story is the long example: a repeated pattern in which his fear of being emotionally controlled, and her deference, keep both of them from relaxing into sex. Commonsense “support” makes the pattern worse. They turn it when Phil stays present if he loses his erection, and Mary stops deferring at every turn.

Chapter 4: Do You Have Difficulty with Orgasms?

Summary: Chapter 4 treats orgasm as a psychobiomechanical event. Schnarch quotes Alfred Kinsey’s comparison of orgasm to a sneeze, then says the reactions people build around that twitch are anything but simple. Orgasm is a matter of total stimulation exceeding the orgasm threshold. Not having one is only part of the picture. Reaching orgasm too quickly is a male problem, and Schnarch calls it the most frequent sexual problem men have.

Men and women are more alike here than the stereotypes say. Both can have trouble reaching orgasm. Both can learn to broaden the ways they get there. Many women do not reach orgasm during intercourse. At least half of all women have intermittent problems. In the NHSLS study, one man in a dozen reports difficulty reaching orgasm, and some men, like some women, don’t admit the difficulty. Not having an orgasm does not have to be a catastrophe.

He sorts the patterns. Some people have never had an orgasm at all. Some had them and then lost them in a pervasive way, after illness, medication, menopause, or surgery. He notes that removal of the cervix during hysterectomy can matter, and he uses Conner to show a man whose medication was the overlooked cause. Some difficulties are occasional. Some are situation-specific, including trouble with a particular partner. Orgasms are interpersonal events even when you are alone, because your mental world is in the room. The chapter’s cases, including Rhonda and Candice and Regina, turn on addressing the layers of the problem instead of hunting for one cause.

Chapter 5: Twenty-two Ways to Resurrect Sex

Summary: Chapter 5 is the working list. Schnarch groups the twenty-two suggestions into optimizing the body’s ability to respond, optimizing physical stimulation, and optimizing thoughts, feelings, and emotions. He does not want you to grab the diagnosis you prefer. Men in particular, he says, often want a purely physical explanation so the problem isn’t “my fault.” Women sometimes want the same bulletproof excuse to stop having sex. Don’t assume a disease or a drug is the culprit just because it causes problems for other people, and don’t assume that feelings automatically mean you have to dredge up childhood.

The suggestions, in his order:

Have a complete medical evaluation.
Don’t push for the diagnosis you prefer.
Remember that sexual problems always involve mind and body.
Do what you can to maximize your physical health.
Pay attention to subtle changes in your physical response, but don’t get overly preoccupied with them.
Expect to change your sexual style as you get older.
Don’t assume you connect emotionally with your partner during sex.
Increase the quality and quantity of your stimulation.
Do whatever works.
Increase contact with your partner during sex: “follow your connection.”
Establish a more collaborative alliance with your partner, in bed and out of it.
Explore new dimensions and depths of your sexual connection.
Work out your issues with your partner.
Develop a better relationship with yourself.
Operate from the best in you.
Don’t get lost in psychodynamic interpretations.
Don’t turn yourself into a stereotype.
Discover the meaning of your sexual problem.
See yourself through the window of your sexual relationship.
Changing your relationship involves recognizing new truths.
Changing your sexual relationship involves deeper emotional connection.
Changing your sexual behavior involves changing your identity.

A few of these carry arguments that run through the rest of the book. Genital prime and sexual prime are different. Your genitals reach peak responsiveness in adolescence. People don’t reach their sexual prime until their forties, fifties, or beyond. If your sexual style never changes, your rising response thresholds will eventually outrun “what you usually do,” and dysfunctions get more likely. Suggestion 22 is the identity point: your sexual style is tied to who you think you are. A partner’s request for something different implies dissatisfaction with the status quo. Changing what you do changes how both of you see yourselves.

Part II: How Sexual Relationships Work

Chapter 6: Changing Is Often Difficult—and Worth It

Summary: Part II turns the camera around. The sexual relationship is now the subject, and sexual functioning is one of the forces that shapes it. Anxiety is the constant. Schnarch sets this against two familiar approaches. Traditional psychology explains the present by childhood injury and ends up treating the relationship as pathology. Masters and Johnson treated anxiety mainly as performance anxiety and guilt, and their strategy was to reduce anxiety as much as possible. Constructing the Sexual Crucible, and the Passionate Marriage and Sexual Crucible approaches this book uses, take a wider view. Couples are anxious about facing the relationship, about changing sexual behavior, and about being known. Reducing anxiety is not the whole strategy, because that is not how relationships work.

The dominant patterns of a relationship, he writes, are more likely caused by things that are going right than by things that are going wrong. People regulate anxiety and get a sense of identity through the relationship they are in now. Accommodation works only when it lowers both partners’ anxiety. Two-choice dilemmas show up because you want connection and you want a self, and those clash. Depending on your partner’s validation to feel okay eventually damages the marriage. Gridlock is common. He offers a picture of borrowed functioning, one partner borrowing stability from the other, and of the “test and fold” process conflict-avoidant couples use. Peter and Judy are the example: he hints at sex, she gets nervous, he backs off, and both conclude that change is impossible. Schnarch’s heading for this is “The Good and Bad News: Nothing’s Going Wrong.” The same process in a high-conflict couple looks like “test and attack,” which is Alexia and Martin. If you treat the opening act as the end of the story, you are more likely to give up.

Chapter 7: Hold On to Yourself!

Summary: Chapter 7 names the skill the rest of the book depends on. The critical factor in making progress is not the size of the problem, how long it has lasted, or how bad it has gotten. It is your ability to hold on to yourself and do what needs to be done. Schnarch has seen people with decades-long problems shift in weeks, days, or overnight, when someone did a thing they had ruled out as too scary. He recommends a giant step rather than baby steps, a willingness to tolerate discomfort, and action that creates realistic hope. Bravery counts, and bravery requires anxiety.

Holding on to yourself has four activities. Stay clear about who you are when your partner or the situation challenges you. Calm yourself down, soothe your own anxiety, and lick your own bruises. Remain nonreactive when your partner gets anxious or provocative. Tolerate discomfort so you can grow. Some ways of self-soothing work better than others. Give the dilemma a meaning. Don’t overreact to your partner’s overreaction. He uses Linda and Charles as one solution story, and he argues for a collaborative alliance and for repair attempts. Success is not the absence of anxiety. It is staying a self while you reach toward your partner.

Part III: Medical Options

Chapter 8: Sex Devices and Surgical Procedures

Summary: Chapter 8 starts the medical section with a warning about how people use it. Devices, drugs, and surgery always land in a relationship. A fast change, from a pill or an operation or an illness, can be delightful or unsettling. Some clients want a bionic solution so they can ignore the marriage, or a fix they can use without telling their partner. Schnarch would rather talk about that motive than scold it.

He then reviews actual options: vibrators and dildos, condoms, sleeves, and French ticklers, constriction and vacuum devices, and how to buy sexual paraphernalia. On the surgical side he covers vascular surgery and penile implants, complications, and the issues that determine whether someone is satisfied afterward. Other procedures, including breast surgery, show up as changes that alter how a person feels in their body and in the relationship. The through-line is that a device can help the body and still leave the alliance untouched.

Chapter 9: Sex Drugs: Better Loving Through Chemistry?

Summary: Chapter 9 applies the Quantum Model to medication. Viagra and the other drugs of that era try to lower response thresholds and amplify the body’s response to stimulation. They do not, by themselves, raise your total level of stimulation, your pleasure, or your satisfaction. That would take a drug that worked on the brain. The drugs of this book aim at the genitals. Schnarch says the available medications don’t differ much in how many users report improvement. They differ in delivery: ease, speed, and comfort. Ease of use is a large part of why people choose one.

He covers injectable drugs, drugs that are inserted, and recreational drugs. Then he explains why Viagra made such a splash, who the potential markets were, how it is taken, how it works, what the clinical research showed, and side effects. He also takes up women and sex-enhancing drugs. Men’s and women’s genitals are similar and different, and he reports that the initial research on these drugs for women was not encouraging. The mind-set he wants is the same as the rest of the book. Don’t split mind from body, and don’t turn the bedroom into a chemistry lab.

Chapter 10: Can Medical Options Improve Your Marriage?

Summary: Chapter 10 answers its title with a condition. The question is not what Viagra will do to us. It is how we will use it. When the best in you drives the use, and the expectations are realistic, these products can help a great deal. When fear, insecurity, and the need to be impressive drive the use, or the refusal, people are more likely to be unhappy with the result. You don’t need Viagra to find peace and emotional connection in lovemaking, and there is no guarantee Viagra will give you that.

Reliable performance can let some couples relax enough to make contact they couldn’t make before. Harder and stiffer is not necessarily more intimate. Schnarch also describes psychological dependence on the drug. About 70 percent of men get better erections with Viagra. About a third of those who try it get no benefit. He calls that group the unlucky 30 percent. When the easy medical solution drops out, couples get pushed into causes they had hoped to skip. Harry and Patty are the case: Viagra doesn’t improve his erections, and questions they had kept down come up, including whether she will stay and whether counseling is on the table. Viagra is not a tranquilizer. If you are highly anxious and pumping adrenaline, it is less likely to do what you want. The chapter closes on realistic expectations and on how to deal with your partner’s reaction, including turning the instability into growth.

Part IV: Couples in Search of Solutions

Chapter 11: Solutions for Arousal Disorders

Summary: Chapter 11 pulls the earlier parts into a plan for arousal problems. Schnarch wants a goal-directed, stepwise approach, and he wants you to pursue sexual potential rather than only fix a dysfunction. Optimize the body’s ability to respond: a medical checkup, physical measurement of genital response when that is useful, a medication review, hormone replacement, testosterone for women and for men, and care about how testosterone is taken. Oral sex-enhancing medications, penile injections, and implants are back on the table here as tools, not as the whole treatment. Sexual pain, dyspareunia, gets its own section, and so does the practical problem of actually implementing a medical solution with a partner.

Then optimize physical stimulation. He talks about sexual technique, opening to your connection, and leaning into your partner’s touch. Betty and Harry, Byron and Vern, and Vivian and Armand are the stories. The last move is thoughts, feelings, and emotions. Masturbation is treated as a tool. He explains how desire and arousal interrelate, how to work with a desire discrepancy, and how couples create desire and hope instead of waiting to feel like it.

Chapter 12: So You Want to Have an Orgasm

Summary: Chapter 12 treats the first orgasm as a boundary you don’t cross backward. Every orgasm also has its own point of no return. Intermittent orgasm problems are still among the most common complaints. The solution he gives is the same whether you want a first orgasm, an easier one, a slower one, or a more enjoyable one: get total stimulation well above the orgasm threshold. He postpones the “how does more stimulation help a man last longer?” question to Chapter 13.

Three things are involved. Remove physiological complications. Increase stimulation, and build more relaxed, varied, non-goal-oriented sex. Change your sexual style so the realities you are having are more meaningful. The chapter then handles illness and injury, including the indirect ways illness hits a sex life, and physical stimulation. Directed masturbation is one of the concrete methods. He talks about how you know when to stop a practice, about orgasm triggers, and about the moment the orgasm actually arrives. The tone stays practical. The threshold model is the map, and the relationship is still in the room.

Chapter 13: Synchronize Your Pelvis and Your Inner Mental World

Summary: Chapter 13 is about getting the body and the mental world to fire together. Fantasies can be used to trigger orgasm. Cindy’s story is one account of how a private mental world organizes sex. Some trigger fantasies are disturbing. Schnarch asks whether you can change them, and he treats that as a process of digesting your life, not as a simple swap of one picture for another. Voluntary control and self-mastery are the aim.

The second half is rapid orgasm. He argues against plodding and for a sexual pace that can include “slow, delicious torture,” meaning deliberately built arousal rather than a race or a stall. Peace and better sex go together. He lays out a hypersensitivity theory of rapid orgasm and says the commonsense solutions don’t help. His alternative is a broad, two-part approach: short-range steps and a long-range change in how you have sex. Short-range steps include reducing anxiety and, in some cases, off-label use of SSRI antidepressants. The long-range solution is the differentiation work of the book, so the pelvis and the inner world are in the same encounter.

Chapter 14: What Will It Take to Change Things?

Summary: The last chapter says anxiety can be a turn-on, and he gives examples of anxiety arousal so readers can tell the difference between anxiety that shuts sex down and anxiety that is part of sexual intensity. He asks where sexual abuse fits. The approach is for couples in which one or both partners have been physically, emotionally, or sexually abused. It is not reserved for “good marriages” or people who are already in good emotional shape. If your partner has been abused, be compassionate and don’t go so far into safety that you become naïve or saintly. Neither of those makes you trustworthy or sexually interesting.

Then he names differentiation. He says everything in the book has been about it, under the phrase “holding on to yourself.” Your relationship is largely not determined by negative past experiences. Those experiences color how you see things. The stronger forces are normal sexual anxiety, emotional gridlock, and two-choice dilemmas, which are built into intimate relationships. The more people depend on each other to regulate anxiety and identity, the darker the relationship gets. The more they hold on to themselves, the better the example. Differentiation controls how you act with others and how you function alone.

He is blunt about the emotional aftermath. Meeting yourself can be a shock. When people relax, they often become sad. The future you want is not in your past. You have sexual problems for real, immediate reasons, so it is not too late to turn them around. You differentiate in the present by making a new response that fits now. Marriage, he writes, holds your partner’s happiness hostage, and the ransom is your own growth. One partner’s sexual problem always lands on the other. The choice is never simply “do you want to resolve this?” It includes “do you want to let this fall on your partner?” Often the honest answer to both is no, and that is where compassion comes in. The chapter ends on creating hope and finding peace.

Appendixes

The back of the book is reference material, not another theory chapter.

Appendix A, Referral Information and Resources, points readers toward places to get help, including Schnarch’s Marriage and Family Health Center in Evergreen, Colorado, and other organizations such as Planned Parenthood.

Appendix B, Medical Conditions and Diseases Creating Sexual Problems, is a list of illnesses that interfere with sex.

Appendix C, Drugs Associated with Sexual Dysfunctions, and Appendix D, Drug and Medication Sexual Side Effects, catalog medications that can impair sexual response.

Appendix E, Side Effects of Drugs That Indirectly Diminish Sex, covers drugs whose side effects get in the way even when the drug is not aimed at sexual function.

Appendix F, Organic Conditions Causing Diminished Desire, lists medical conditions that lower desire.

Taken together, the appendices match the book’s argument. Rule out and treat what medicine can treat. Then do the relationship work the pill will not do for you.