IN SESSION

   The Graphic Sex Project brings a dose of creativity to sex therapy. 

Creating a graph taps into imagination, logic and playfulness to open up new avenues in the therapeutic exploration of sexual issues and dysfunction, creating a way for  individuals to think about their sex lives from a new perspective. 

 The process is straightforward, but remarkably illuminating.  A handful of cubes, used to tell a sexual story. What sexual activity does each color represent? What comes first?   For how long? More cubes in one color mean more time on that activity… fewer cubes is less time. What comes next? Are there climaxes? Where do they happen? Mark them with dots. Each creation becomes a springboard for productive therapeutic discovery. 

 As a therapeutic tool, in individual session or in a workshop setting, the Graphic Sex Project can help clients tap into artistic self-expression to better understand their sexual desires and the way in which their current sexual activities do or do not meet those desires. It is a tool to help clients explore their sexuality from a new perspective, bringing in new areas of cognition than are usually brought to bear on the subject of sex. It helps clients turn the complexities of their sex life into manageable stories, making difficult topics easier to share with partners and therapists alike. The simple cubes and bright colors connects the exercise and resulting conversations in the context of joyfulness and play. For clients that have some difficulty with talking about sex, the process of creating a graph can help them attach words to desires, and creates a visual representation of current sexual dilemmas, as well as future ideals, past traumas, fantasies or realities.

What people say: 

 “It was really fun to really think about what it is that gets you off, and what you enjoy. Pinning down what is ideal. So now I know.”

 “It was great. It really made me really think about what I really want during sex, and then what I actually get. We’ll see how this goes -- I’m sending the text now!”

 “It was interesting to think about sex in a linear way, because I don’t ever think about sex like that. A lot of times it get thought about in a jumbled bits and pieces memory, and not a this, that, then this then that sort of thing, so it’s a really interesting way to think about it.”

A Unique Glimpse

Every graph is a unique glimpse into the diversity of human sexual behavior. Below are some representative graphs that people have made at installation events, and agreed to release the rights to the image for the project.

Graphs of a single line are very easy to interpret the sequence of events and the proportions. Notice the 3 blue blocks: “alone again.” There's an avenue for discussion.

12% of the graphs use the word “foreplay.” The  graph below is the only instance of “afterplay.” That’s an interesting commentary on the prioritizing of the male orgasm and the acceptance of heterosexual model that sex is over after the male finishes.

Some of the graphs show a more longitudinal approach to the participants sexual story. This participant commented, “This seems boring, but this is like me 'coming out' as uninterested in sex with others. I've always maintained the facade of wanting sex with others.” He felt that making the graph was an affirmation of his asexuality.

WHY IS SEX SO HARD TO TALK ABOUT?

Nearly everyone struggles with talking about sex. They may feel their sexual practices or desires are shameful or embarrassing, or worry that they are the only one to feel like this, or that they are somehow “weird.” They may be uncomfortable simply saying some words out loud, making it hard to discuss. Our sexuality is such an important part of our lives, but it’s a topic which clients, and even therapists, may steer clear of. 

The cultural milieu that we all share discourages open and honest conversation about sex. We’ve created an unrealistic expectation of perfect sex, coupled with a narrow definition of physical beauty and what is “sexy.” In movies and television, sex is always exquisitely sensual and fulfilling, unless it is plot-driving “bad sex” -- also narrowly-defined. In movies, bad sex cues the entrance of the new love interest… and creates that cultural storyline that sex will always be great with your “one true love.” This sets up unrealistic expectations for sex in a long-term relationship.

 Sex in media has an agenda that is in many way antithetical to our personal sex life -- to entertain, to touch some longing in us in order to bring us back or entice us to buy. Many ads strive to deliberately make us feel inadequate and then give us a “solution” in the form of buying their product. Their purpose is rarely to showcase the range of normal sexuality or make us feel sexually normal. Porn also creates unrealistic expectations of how sex is supposed to be. Women’s sexual pleasure in porn is a low priority. A recent survey of online porn found that only 18.3% of women, compared to 78.0% of men, were depicted as reaching a climax. The studies authors noted “As a result, representations of male and female orgasm in mainstream pornography may serve to perpetuate unrealistic beliefs and expectations in relation to female orgasm and male sexual performance” (Seguin, et al, 2017).

As a result, many people hold private anxiety that their sexuality is in some way either embarrassing or unacceptable. Do they have sex too much or too little?  Their arousal is too difficult or too easy… Their proclivities are too weird or too vanilla… Therapists are human too, and have their own sexual difficulties or hangups. Many therapists do not have the background in sexual issues, and a client may bring up issues that challenge them or make them uncomfortable. We all know that sex can bring pleasure and joy, but it is mediated by our upbringing and cultural influences of fear, guilt and inadequacy.  The origins of our hang-ups come from so early in our development, are so often non-verbal and hard to reach, through the cognitive process of talk therapy.

SHAME

Much of the preceding can be summed up in one word: shame. All of us are susceptible to sexual shame in some form or another, especially anyone who is part of a marginalized or minority group. Religious doctrines that stigmatize sexual behavior permeate our society even for the non-religious. For women, societal messages shame the way women dress or act, and sort women into good girl/bad girl and frigid/slut dichotomies. Men are subjected to societal pressure to perform, to be tough and not show emotion. Many of us were explicitly discouraged from exploring bodily pleasure at a young age. Performance issues, insecurity about our orgasmic response or our desires, poor body image -- our shame is deeply entrenched. 

A creative and expressive activity can offer a backdoor into a person’s sexual landscape, by-passing shame and establishing a framework to approach difficult work.  The tactile and visual task of the GSP cubes, using pretty little blocks in bright primary colors, connect sex to the playfulness and joyfulness of toys, creating positive associations. In a review of shame theory, Marie Wilson addressed “the toxic, pervasive and yet often hidden psychological impact of shame on wellbeing” (Metzl, pg 76).  She found that art-making is a powerful way to address shame. With the GSP, the individual creates a portrait of their sexuality that is extremely approachable in its cubic abstraction. 

According to Einat Metzl in her comprehensive book “When Art Therapy Meets Sex Therapy, “Allowing the art process to lead enables the client to expose and conceal, pacing the explorations according to her/his own needs, and both process and creative product offer a place to face, gain distance and perspective, connect, and illuminate meanings.”  

Is the Graphic Sex Project Art Therapy?

Not really. And the creator, Jennifer Beman, is an artist, not a therapist.  But bringing art and healing together is as old as humanity itself. In the 1940s, the therapeutic use of art was defined and developed into a distinct discipline, and today art therapists use a variety of mediums to create a visual and tactile bridge into thoughts, feelings and ideas that are difficult to express verbally.  Art therapists use a wide variety of mediums, including paints, pastels, collage and clay, to give their clients a way to express the ineffable, and then guide them in their own exploration of insights. The Graphic Sex Project is similar, and yet distinct. With only one set of expression tools -- plastic cubes -- the range of abstraction and metaphor that can be communicated is smaller, the guidelines of how to use the cubes are more explicit.  There are, however, enough parallels to use art therapy as an partial homologue for use of the Graphic Sex Project by clinicians according to their own therapy style and judgement.

Making a graph shares many of the rationales of actual art therapy, and could even be considered one potential medium in an array of other art therapy approaches. Art therapists consider the characteristics of a range of materials, tailoring the media choice to the individuals needs. Art materials range from the fluid (watercolors or chalk pastels) to the resistive - materials that resist alteration. Fluid materials are “hypothesized to access unconscious processes, mediated on a preverbal level by the right hemisphere of the brain and thus aid in the integration of long-term memory” (Morley & Duncan, 2007). On this continuum, the 1 centimeter plastic blocks are a resistive medium. They would also be considered highly-structured, or boundary-determined media, “hypothesized to provide a safe, controlled and nonthreatening art therapy experience” (Hinz, Wiley Handbook, page 136). A relatively small work area is provided to “to limit or contain the ideas or affects expressed” (Hinz, 2006).  Within the framework of these theories, the Graphic Sex Project is unlikely to elicit overly strong or damaging emotional response during the creation of the graph, possibly making it safer for therapists and educators not formally trained in art therapy techniques. It should be noted that the plastic blocks are a novel medium for art therapy, without empirical research as yet to support their use.

However, in Lariza Fenner’s essay, “Constructing the Self: Three-Dimensional Form,” there is something to support the use of the Graphic Sex Project as a tool to help clients access and expand their individual sexual narratives. Referring to any sculptural process, she says that when viewing their creation, “a level of awareness about the individual’s method of ordering experience may be internalized… may also initiate a dialogue among differing self-constructs, which may eventually lead to understanding why one may be more or less prominent” (Fenner, pg 155).  “Assembling, shaping, re-shaping, and reflecting are, in sculpture, all aspects of the media that lend to constant redefinition of space and personal narrative” (Fenner, page 154).

“Finally, sculptural processes are inherently cognitive and can facilitate a form of literacy (Rawson, 1997). This literacy enables the creator and observer to think in three dimensions and create abstractions from physical reality, and fosters cognitive growth. A person can hold the percepts of physical space in their minds eye and reiterate them through the process of modeling. In doing so, reality is abstracted and presented in sculptural form. Abstraction is a cognitive capacity that has been shown time and again to foster cognitive growth (Efland, 2002) and … can be used as a conduit of meaning from one human, and one modality, to another” (Fenner, pg 156).

Display of Graphs

With the opportunity to add their graph to the growing gallery of graphs online, individuals can celebrate their sexuality, laying claim to its own unique space in the panorama of human sexual behavior. In the aggregate, each graph is so different, and yet at the same time there are many similarities across the demographic spectrum. Take two steps back and they are all little collections of colored cubes, each as worthy and acceptable as the next. Seeing one’s own graph in the context of the gallery is an affirming exercise in publicly renouncing societal shame.

Adding a graph to the collection is a purely voluntary choice, and should be offered without pressure.

ABOUT THE PROJECT

In 2016, I started thinking about making a documentary about women’s perspectives on their own orgasms. I suspected that my own experience of years of feelings of inadequacy about my sexual climax were widespread among women.  The female orgasm is more various and more ambiguous than the male orgasm, and leads some women to question their experience. Women sometimes wonder IF they are experiencing orgasm at all, something few men have ever done, benefiting from an obvious tell at ejaculation.  In order to research the possibility of a documentary, I began organizing a monthly discussion group called Women Uncorked, to bring women together to talk about sex. I wanted to practice talking openly about sex, and hear what other women had to say about their sexual climaxes.

I started thinking about sex A LOT. Not just having sex, but about the politics of sex -- things like the so-called orgasm gap (Frederick, et al, 2017) and why men have more reliable orgasms than women (at least, among heterosexuals).  I started thinking about why we don’t talk about it, and how many women don’t feel free to talk about sex even with their closest friends. I started thinking about the taboos and the admonitions of “too much information - TMI” that any personal mention of our actual personal experience is met with. As I developed the group, I thought women would need some ice breakers to get in the right frame of mind to start talking. I came up with the idea of little colored cubes to stand in for our sexual behavior, as a way to get the conversation going.  Women liked making the graphs, and the revelations they found in the process did lead to great conversations. But what I found eventually was that the “ice-breaker” really wasn’t necessary. Women are very eager to talk about sex given the space, the opportunity, and the permission. Conversation flowed very freely without taking the time to make the graphs.

I began thinking of other places I could bring what was now the Graphic Sex Project. I also wanted to begin to include the graphs of men.  I began to realize the potential of the project. It brought to mind for me the powerful installation by Jamie McCartney called the Great Wall of Vagina, featuring 400 plaster casts of vulvas on 10 large panels. His goal was to educate people on what normal women really look like, and how diverse women’s genitalia really is. He says, “For many women their genital appearance is a source of anxiety, and I was in a unique position to do something about that.” I saw that I could do the same for sex that McCartney did with genitalia: showcase the diversity of the human sexual experience in a way that deliberately makes the sexual non-sexual. Viewing the gallery of graphs takes people deeper into human sexual behavior in a visual way that is approachable, playful and non-threatening, and without shame, using humor and spectacle to educate.

The GSP has been taken to over 20 events as an interactive installation, as well as formed the core of several workshops, which generated all the graphs you see in this manual. Previously-made graphs are displayed for people to explore, provoking thought and opening conversations, and people are invited to make their own. A specially-designed lightbox allows people to take a picture of their creation to keep, to send to partners, and to add their graph to the collection if they chose. Over 700 graphs have been collected so far.  The graphs are also available on the GraphicSexProject website.

STORYTELLING AND 

HOW THE GRAPHS REFLECT OUR CULTURE

THE CLASSIC STORY ARC

Storytelling is a uniquely human activity, common to every culture on earth. The constructivist view is that we create our realities: that what we make of our experience constitutes all we can know of the world we live in. 

I believe that the stories we tell ourselves are the mechanism by which we create the meaning of our lives. In animals, a memory may be little more than conditioning operating on behavior: in humans, a memory becomes a story element, imbued with meaning that adds to a narrative in which we are each the protagonist. A story requires several parts to make it coherent and the requirements of those parts guide our internal storytelling and both shape and constrain our meaning. Stories are necessary to construct a meaningful reality, and the scaffold has structural requirements that give it stability. A story requires a point of view and a value judgement, and both those things are entirely subjective. Given any objective reality consisting of characters, a series of actions or events, and some consequences, multiple stories could be constructed with differing perspectives and drawing different subjective meaning from the raw material of the objective reality. 

Humans are immersed in storytelling from our earliest moments. We read books to our children, tell them stories of our lives or stories of what is happening in the moment. They watch movies and television shows and read books and learn the structure of stories, and at their heart they all have the same basic elements. Characters are introduced, a scene is set, a problem to solve is presented, the hero confronts the problem, value judgments are made, the conflict is resolved or not resolved. We make meaning of lives by turning all the parts of our lives into little stories with ourselves as protagonist. Some of these stories are positive and help us navigate our goals and decisions. Some of these stories are destructive. By taking a critical look at the stories we make about our lives, we can re-evaluate whether these stories are useful to us, or whether better stories created from the same story elements might be more true, or at least just as true. According to Neimeyer, 

“The constructivist lens asserts that reality is socially and individually constructed, and therefore the creator of the sculptural object is the narrator of their subjective experience. The art therapist may be present to witness various aspects of the process while endeavoring to withhold assertions of objective truth or absolute interpretation. It is the challenge of the therapist to help the client expand upon these individual narratives and possibly gain more flexible and expanded storylines. (Neimeyer, 1997; Neimeyer & Raskin, 2001). “

Being aware of how our learned story structures shape our reality is one step toward developing our stories in a way that is more beneficial to our life trajectory, and may also help us to break out of a too rigid story structure that merely conforms to a societal script without truly serving our needs.  

The same can be applied to sex. The way a sexual episode unfolds and flows is a single story, and the script has been handed to each of us by our cultural conditioning - our parents, our friends, our partners, the media. Sexual scripts can be remarkably static for a person. They may never question that the script could be anything other than kiss, foreplay, intercourse, orgasm, cuddle. An example of how this looks can be seen in the graphs.

Here’s a common graph type among 20-somethings - fully one-third of participants 18 to 29 created a graph like this. It follows the classic dramatic story arc, with rising tension to a climactic peak, and an immediate falling intensity to a resolution.  It has the simple storyline progression.

Compare this to the dramatic story arc laid out by the German playwright and novelist Gustav Freytag in 1853: 

Many people instinctively make a graph, and have sex, in a way that fits the way they have always heard stories. But just because it’s good for storytelling doesn’t necessarily mean it’s good for sex!  Has this person internalized a cultural story of how sex should play out without really listening to the flow of their own body and their own desires?

In most of the graphs that people have made contain a classic arc, rarely is the climax labeled according to the person experiencing it.  When I see one, my first question and point of discussion is “whose orgasm is that?”

Here's another

Notice the orgasms at the peak. 

Graphs like these illustrate one reason for the so-called “orgasm gap.” In January of 2017, a study was released that showed that straight women have fewer orgasms per sexual encounter than any other group -- straight men, homosexual or bi men, and gay or bisexual women (Frederick, et al., 2017).  Part of the reason for the orgasm gap is the cultural assumption among heterosexuals that penis-in-vagina intercourse is the only thing that counts as real sex, and all that other activities, which are incidentally more likely to produce orgasms for women, is relegated to optional foreplay. Men are encouraged to “last longer” to give women a chance to orgasm during intercourse, when statistically, only about 8 percent of women reliably have orgasms during penile-vaginal intercourse, without additional stimulation (Lloyd, 2005).  When couples structure the flow of their sexual activity around this cultural script, they create a story where foreplay leads to intercourse leads to male orgasm, followed by falling action, with a male refractory period that leaves the female orgasm out of the story entirely

When women produce graphs like this, I try to encourage them to think about how, even whether,  their needs are being met, and how they can claim their own storyline that isn’t defined by their male partner’s orgasm.

Possible questions to ask:

• Whose orgasm happens at the peak?

• If you were to mark each person’s climax, what would that look like?

• Are you having a climax?

• How could the blocks be rearranged to make opportunity for your climax, before your partner’s climax or after?

• Is there really a single peak?

• Could any of those colors be subdivided into more finely detailed activities that would create more potential for your climax?

The authors of the orgasm frequency study concluded that women were more likely to experience climax when a greater variety of activities were included in a sexual episode. They found that:

“women who orgasmed more frequently were more likely to: receive more oral sex, have longer duration of last sex, be more satisfied with their relationship, ask for what they want in bed, praise their partner for something they did in bed, call/email to tease about doing something sexual, wear sexy lingerie, try new sexual positions, anal stimulation, act out fantasies, incorporate sexy talk, and express love during sex. Women were more likely to orgasm if their last sexual encounter included deep kissing, manual genital stimulation, and/or oral sex in addition to vaginal intercourse.

To help clients think about ways they could increase their orgasm frequency with a greater variety of behaviors, suggest they assign more activities to additional colors. What would they like to add? Could they add them to their graph in the place and proportions they think they might like? Ask them to add a dot or dots to indicate where they think they might reach a sexual peak and differentiate their partner’s climax with a different color of dot. This is not to imply that the story they have told with their graph is inadequate in any way, but to explore with them how they can add more detail to the story they have told, and possibly future stories as well.

Compare a classic story arc graph to one like this, with greater range of activity, multiple peaks and valleys, multiple orgasms as well!

Using the Graphic Sex Project materials can help open up conversations with clients and make a real cognitive shift in their approach to sex.  It can help them:

• Develop an awareness of the cultural sexual script 
• Question how the cultural script might not be meeting their needs
• Think about sexual alternatives
• Feel empowered to advocate for their own climatic storyline
• Build a visual representation of a potentially more rewarding sexual experience
• Create words to express what they want
• Visualize how those activities could be incorporated into their repertoire
• Make a fun visual aid to share with their partner
• Open up conversations with their sexual partner(s)

INTUITION AND GRAPH INTERPRETATION

The graphs people make offer a two-prong therapeutic approach, both latent and manifest. The manifest meanings are the words they use, the order and proportions they put them in, that form a springboard for in-depth discussions of their sexual needs and desires and how they are being met.  In the words of Einat Metzl referring to the process of art therapy, “These rich meanings often come up in the reflective dialogue that follows the experience of art making, after the ‘flow’ of engagement has reached a place of (temporary?) saturation and a space to acknowledge, analyze or question more deeply arises intuitively in both client(s) and therapist.”

But there is also the intuitive interpretation that the therapist can explore in the latent meanings. Pay attention, first, to the way the individual approached the exercise and how they used the medium. Is their relation to the blocks more kinesthetic - dumping them out and beginning immediately to move them around, or sensual - running their fingers through them, listening to them shake in the bag? This initial approach to the task is useful to move an individual’s focus to the physical realm. It might be illuminating in couples therapy to observe the different ways the two partners relate to the blocks.  And second, once the graph is created, the creative decisions they make regarding how the blocks lay on the page may hold additional therapeutic insight.  Consider these two graphs:

Without empirical data it is difficult to say how these two graphs relate to these two individual’s sexuality, and whether the metaphors they bring to mind are correlated with their actual sexual experiences. The one on the left appears extremely verbal, with the words entirely filling the space available, and forming the visual structure of flowing movement. It is tempting to suppose that this person is also highly verbal in her sexual expression at every phase of an encounter.  Compare to the graph on the right, where the words are extremely small, and squeezed close to the blocks, leaving vast acreage of unused white space. It might not be stretch to suppose that the individual is uncomfortable with words during sex. Further, and drawing from a discussion in evaluating art creation on the Expressive Therapy Continuum developed by Kagan and Lusebrink in the 1970s, Lusebrink noted that “very small forms, minimal or no color to define forms, and constricted use of space indicate a restrictive affective involvement” (Wiley, 2016). 

THE FLOW OF A REPRESENTATIVE

INDIVIDUAL THERAPY SESSION

Here is one way the use of the GSP materials might play out in session.

Sonya has been seeing Alex for several months about her anxiety and her relationships with men, among other issues. The subject of her sex life has come up several times, but she has not been very forthcoming about it, and seems embarrassed by the topic. She appears to want to talk about it, but her answers are short and often include, “I don’t know.” When asked about her sexual climaxes, she responds breezily affirmative, but trails off on the details. Alex decides to suggest she try an exercise to think about sex from a different perspective and she is enthusiastic about the idea.

Alex gives her a bag of cubes, a template paper, and a board to build her graph on, as well as a selection of pens, and some dots. He tells her to think of how sex plays out in a positive sexual encounter. “There may be many stories you could tell, but just think of one. It could be a recent experience, or just generally a common way it seems to happen for you.”  He tells her to think of it broken down into component parts, and assign each part a color. Make a legend to define what each color means. Then lay out in order and proportions, what happens. More of a color would mean more time spent on that. Mark where climaxes happen with dots if you would like. 

Once Sonya understands what she is to do, she gets to work. She dumps the bag out and begins sorting the colors into piles. Then she starts moving cubes to her work space, and here is what she creates:

Given her age, it is not surprising that Sonya makes a graph where vaginal intercourse culminates in an unclaimed orgasm. She doesn’t specifically label the orgasm as her own.  Many young women see sex as structured around the male orgasm and have internalized the cultural myth that ideal sex culminates in a man and woman climax together. Many women think they are supposed to have a vaginal orgasm from vaginal intercourse.  In fact, only about 10% of women can climax from vaginal intercourse alone with no other stimulation (citation needed).

The clumpy-ness of Sonya’s graph may represent separation in her sexual style. It is a 5 act play with clear breaks between the acts and no overlap. It suggests Sonya sees sex in a very goal-oriented manner, with each element to be completed before moving on to the next, box checked. 

Alex asks who is having an orgasm at the end of vaginal intercourse indicated by the orange cubes. Sonya says she likes it best when they both climax together.  This is a good opportunity to educate Sonya about the female response cycle and how most women need clitoral stimulation to climax. Is Sonya also stimulating her clitoris during the intercourse? Alex asks her if she would like to add some blocks to the red part to indicate that. Doing that helps Sonya create words to go with that action. She sees them incorporated into the intercourse and starts thinking about how that could happen in real life. She might think about how some of those green cubes could be mixed into the red cubes, creating a visual touchstone in her mind to pull out in her next encounter.

Alex asks about the foreplay, a large block of indeterminate green. Sonya’s use of the word “foreplay” (things that happen before) serves to prioritize intercourse -- the activity most likely to lead to male orgasm, but not female orgasm -- over other activities that are more likely to lead to female orgasm.  Calling it foreplay also gave her a safe, vague and sanitized word, rather than something more explicit.

“What happens in this foreplay?” Alex asks.  Alex is giving Sonya permission to use more explicit language and Sonya talks about the other things that commonly happen.  Now the conversation about sex is wide open. Sonya breaks apart the green block and adds more colors to stand for the multiple activities going on. She adds giving and receiving oral, manual stimulation, digital insertion, kissing, nipple stimulation… each new color grounds a desire in words thought, said, written and read, making them more accessible to her in more sexually charged times.  Alex tells her that research has shown that the more activities that are included in a sexual encounter, the more likely women are to report a satisfying climax. Sonya tries to come up with a few more!

Alex asks about the cuddles. This is an important time of bonding, affirmation and self-care. Women are more likely than men to feel regret about a sexual encounter and often it flows out of what happens in this indeterminate block of yellow on Sonya’s graph. Alex asks her to elaborate on what she likes to hear and say. What in this moment makes the whole encounter better? Knowing what she wants here is one step toward getting it, or being aware that she is not getting it. The consent block is intriguingly large too, and could yield some interesting insights into what Sonya wants to get out of a sexual encounter, and what leads to her consent.

It might be interesting at this point to direct Sonya to make another graph of the “cuddle” section with more detail.

Conclusion, Sonya’s session

The GSP exercise was a successful way to break into the conversation about sex, across a barrier of embarrassment or shyness. It gave Sonya permission to talk very explicitly, with a starting point of connection to very non-sexual objects. The colors of the cubes were a bridge to refer to things without saying the words out loud -- Sonya started saying “pink” instead of cunnilingus, and then slowly became more comfortable with that word.  With more comfort with the words, she may feel more comfortable asking for those things in a sexual situation.

Sonya now has a different map in her head, with more detailed desires, and the words to match them are more readily accessible to her. She also has more knowledge about how her desires differ from a cultural script that she had internalized but was not serving her needs.

COUPLE THERAPY

The Graphic Sex Project can be very useful at different phases in couple’s journey in therapy. Some couples therapists have a hard time discussing the topic of sex, although sexual issues is the number one reason people seek treatment (citation). When couples present with a relationship issue, communication is already blocked - what better way to break through than blocks? The GSP cubes can be useful as an early diagnostic tool to see the sexual perspectives of the two individuals, where they have common ground and where they differ in the moment of the actual sexual encounter. It can also be brought out at various times over the course of therapeutic work when movement seems stuck. 

The process of graph making forces the individual to look at their sexual experience from a different perspective, and then to see their partner’s perspective as well. The labeled cubes give them words to use, and tactile objects to move around and change stories on paper before they attempt to change those stories in real life. The tactile and visual feedback creates memories that can then be easier to access in the complex emotional moments of an actual sexual experience. 

Married Couple 1

The graphs of a married couple 1   The ensuing conversation focused on how overwhelmed the wife felt about all her responsibilities which put sex low on the to-do list. They talked about how the nature of foot-rubs allowed her to start thinking slowly about her body. They discussed how he was thinking about sex while she was thinking about chores and how those 2 things could be combined and shared. They had a fun exchange about what “surprise” meant.  The two graphs gave them a lot to talk about.

Married Couple 2

The graphs of a married couple 2  It’s interesting how they laid their graphs out in a similar manner, crowding their graphs and their legends and leaving much white space unused.  In Lisa Hinz’s groundbreaking work, “Expressive Therapies Continuum: A Framework for Using Art in Therapy,” she writes, “Using very little space and creating tiny figures would be indicative of greater perceptual information processing and lower affective expression, as in major depressive disorder (Gantt & Tabone, 1998; Hammer, 1997).”  The images do evoke a rigid and non-emotional approach to sex. The wife’s graph seems to be communicating how she uses sex to smooth marital tensions. Similarly, his graph begins with massage - perhaps his own tension smoothing technique. It would be interesting to ask how these two graphs overlapped, and what is going on before his green begins. 

Married Couple 3

The graphs of a married couple 3   Again, it is interesting how similarly they lay out their graphs, and the use of space. They both seem to recognize that she needs a lot of time before hand to develop the right mood - mentions of sex throughout the day and what he calls negotiation and warming her up. Good for them to recognize anticipation is important part of arousal! They both have some form of hygiene, that, when asked, they both said was the wife’s preference. The wife’s preference is for sex to last at least twice as long as the husband prefers, though it’s hard to gauge exactly where the time begins on his graphs.

 COUPLES THERAPY 

Depending on the couple’s work underway, the therapist might want to use the GSP in a number of different ways. The technique is very flexible and adaptable to the work being done, and hinges upon what type of story the couple decides to tell. For instance, they may be interested in telling a story of a sexual episode that is both typical and positive.  

Here’s what that means: Sexual partners tend to have typical flows of sexual activities. There may be many ways sex can happen, but most have them have happened pretty much that way before, more or less. Sex begins in a certain way, then A happens, then B, then C and so on. That’s one story. As a couple, they may have basically one story, or they may have a few, or they may have many. Rarely, they may have sex that plays out in a totally different way that they’ve never done before. Good for them!  But for this exercise, they should each separately think of one that happens at least from time to time, that they like.

Other stories might be what they wish would happen, what used to happen and doesn’t anymore, what happened once that was good and they wish would happen more, what happened once and was very bad, what happened the last time they had sex, what happens that they don’t like.

With the type of story in mind as decided upon, each will work separately to imagine their story, break it down into its component parts and assign each a color, making a legend on their work area. Then, using those colors, they should create a timeline of this sexual story. What happens first? What happens next? Use more blocks to show proportion. More of one color means more time spent on that activity.  Ask them to also write down about how long this sexual episode lasted. 

As they work, be aware of how they interact with the cubes, using your intuition to determine how this might correlate to their sexuality. Is one partner more kinesthetic and the other more sensual? Do they approach the task differently? Does one start with words and add cubes and the other the opposite?

When they are done, give them about 10 minutes (with a notice at the 5 minute mark that they have 5 more minutes), have them exchange graphs. One way to start could be by each telling aloud the story of the other person’s graph -- just saying in words what they are seeing. This is a form of reflecting - an effective technique in active listening where they are each communicating that they understand what the other person has communicated with their graph. It demonstrates whether they are each able to show acceptance.

Questions for further discussion in session

How are the graphs the same?

How are the graphs different?

What is in your partner’s graph that you also like?

What is in your partner’s graph that you don’t like as much? 

Talk about how often sex plays out as these graphs describe. Does one happen more than the other? Why is that?

TIME

The length of time people like to have sex to take is a sexual preference. Do the two individuals have different time preferences?  How does the length of time effect the sex? Sometimes they may do the exact same things, same order and proportion, but one in 10 minutes -- the other much longer!

WORDS

Do they use different words for similar activities? For some people, one word can be a turn-off and another word a turn-on … for the same activity!  It’s good to be aware of each other’s words. 

ORDER

Are there some things that happen in the same order for both? Sometimes people like one thing later in the sexual episode that they don’t like when it happens in the beginning.  Where do the orgasms happen? How does the order of climaxes change things? Who likes to be the last to climax? The first? 

PROPORTIONS

Are there things you both have in your graphs, but in different proportions?  Are there things you would like to spend more time on? Less?

A nice variation! Red is “stuff we do.” Blue is “stuff we don’t do that I know about.” He is communicating a desire for more variety in a very non-threatening and funny way that his wife responded to without defensiveness. They had a lively conversation naming the things that in the blue category, and imagining what might all the other colors be.

After making graphs separately, some couples might benefit from making another one together. The team-building process of creation, with everything an abstraction, may help them both consider each other’s needs in a new way, and then increase their motivation to make a similar story happen during their next sexual encounter. Taking a picture of their graphs gives them a visual aid that they can refer back to for future conversations on their own.

Continuing work with couples and graphs There are other possible exercises that could be beneficial, in the form of alternative stories they can tell and learn from.  For instance, they may want to explore their fantasies. Sharing with each other their internal fantasy life can be a new way of connecting. Prepare them to stay judgement-free. Many people have a rich fantasy life of things that they would never consider doing in real life. People may also have fantasies that they would like to explore, but fear and shame keep them from sharing them. The mind is a very imaginative sex organ. The distance afforded by the abstract blocks can make a fantasy both easier to share and easier to accept for their partner. 

Here are some questions specific to the fantasy graphs: 

• Is your fantasy something you would like to actually happen? Or pretend is happening?
• Are there things in your partner’s fantasy that you would try? 
• Are there things you aren’t willing to do?
• Can you think of any ways to accommodate a partner’s fantasy in a way that works for you?

With more comfort using the cubes, more difficult topics can be approached. Making a graph of what happens when the sex is bad is much more difficult for individuals and their partners. But it’s also a difficult thing to talk about. Telling a person that you don’t like something that happens between you sexually is very challenging without arousing that person’s defensiveness and sending the conversation down a path of accusations and hard feelings. Reactivity is engaged, which prevents each from really hearing the other.  The cubes can help unlock this difficult dynamic of feeling unheard on the one hand, and feeling unable to articulate on the other. According to Einat Metzl, writing about art therapy in general in the context of sex therapy, “most couples are drawn by the novelty and authentic expression of their partner, and are then able to remain more open and connected as meanings are explored.” Remind them that each of us has unique preferences. One way to handle discomfort is simple repeat back what their partner says in their own words. That way, they feel heard and it give each a chance to process and absorb, rather than react. 

QUESTION to ask: Is this a story that you don’t like that your partner does? How willing are you to do it sometimes just for them? Is there a way to make it work better for you? Is there a way to trade?

SOURCES

Gussak, D., & Rosal, M. L. (2016). The Wiley handbook of art therapy. Chichester, UK: Wiley Blackwell.

Rawson, P. (1997). Sculpture. Philadelphia, PA: University of Pennsylvania Press.

Efland, A.D. (2002). Art and cognition: Integrating the visual arts in the curriculum. New York, NY: Teachers College Press.

Neimeyer, R.A. (1995). Constructivist theories: Features, foundations and future directions. In R.A. Neimeyer & M.J. Mahoney (Eds.), Constructivism in psychotherapy (pp. 39-67). Washington, DC: American Psychological Association.

Neimeyer, R.A., & Raskin, J.D. (2001). Varieties of constructivism in psychotherapy. In K.S. Dobson (Ed.), Handbook of cognitive-behavioral therapies. New York, NY: The Guilford Press.

Séguin, L. J., Rodrigue, C., & Lavigne, J. (2017). Consuming Ecstasy: Representations of Male and Female Orgasm in Mainstream Pornography. The Journal of Sex Research, 1-9. doi:10.1080/00224499.2017.1332152

 Frederick, D. A., John, H. K. S., Garcia, J. R., & Lloyd, E. A. (2017, February 17). Differences in orgasm frequency among gay, lesbian, bisexual, and heterosexual men and women in a U.S. national sample. Archives of Sexual Behavior. doi:10.1007/s10508-017-0939-z

 Elisabeth Lloyd, PhD, a science historian at Indiana University, Bloomington, and author of “The Case of the Female Orgasm: Bias in the Science of Evolution” (Harvard University Press, 2005).