Cecilia Ford, who has been a psychologist in private practice in New York City since 1987, has addressed emotional issues for Women’s Voices in many articles over the years.

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Fear of sexual inadequacy is almost universal. Few people have never worried at one time or another if they will measure up sexually or please their partner. In past eras, these fears and worries were exacerbated by the secrecy and shame that surrounded sexuality in most Western societies. Now, according to author Rachel Hills, who has just published a book called The Sex Myth: The Gap Between Our Fantasies and Reality, our fears are intensified by the opposite problem.

These days, according to Hills, openness and sexual freedom have created new pressures that come with their own traps. She writes (our)

“. . . culture . . . tells us that we must be sexy, sexually active, and skilled in bed in order to be adequate human beings—and teaches us that the truth of who we are can be found in our sex lives. . . We have moved from a culture that told us that we were dirty if we did have sex to one that tells us that we are defective if we do not have it enough.”

Recently, Hills wrote a column in The New York Times about the difficulties she suffered in her 20s as a young woman who was not following the “new rules” of beginning to be sexually active early. As someone who waited until she was 26 to lose her virginity, she was a full 10 years behind many of her peers, and wondered for much of that time if there was something “wrong” with her.

In hindsight, she realizes now that she was and is fine, and that no one’s sex life needs to follow a “script.” But Hills asserts that the problem of sexual “orthodoxy” does not stop at the rules of virginity vs. freedom. In fact, she writes, there is quite a bit of “regulation” underlying this freedom, and these unwritten rules can cause many of us anxiety and stress.

The pressure to be “normal” persists, despite the new age of sexual freedom and it continues throughout the life cycle. Within each age group and sexual lifestyle, “norms” exist that exert influence of our perceptions of how to behave, like the peer pressure Hills felt to lose her virginity early. The central thesis of The Sex Myth is that once we become sexually active, it is assumed that the sexual freedom now afforded us has removed all barriers to pleasure, and that any “normal” person must be having lots and lots of great, orgasmic sex.

It is no longer prescribed that we must be married to a partner of the opposite sex but it is assumed that if you are normal, you are “hot.” Even what defines “hot” isn’t what it once was. Women today may not be entirely aware of how radically these norms have changed, or how fierce they once were. For example, just as the concept of virginity before marriage once reigned, so did the ideas of simultaneous orgasm and its evil twin, the vaginal orgasm. Many physicians, and Freudian analysts in particular, used to believe that women were capable of two kinds of orgasm: clitoral, and vaginal. Women who required direct clitoral stimulation to reach climax were considered psychologically “immature.” It was not until Masters and Johnson did their research into what actually occurs in the body during sexual activity that it was discovered that there is only one kind of female orgasm.

Worse, women who could not achieve orgasm with a partner during intercourse were labeled “frigid” and were often referred to psychoanalysts to help them discover the roots of their “immaturity” and/or “hostility toward men.” During this ignominious chapter in the history of psychotherapy, it was rarely suggested, even by female analysts, that the male partner, let alone technique, had any role in these issues.

Masters and Johnson, (who quite literally shed light on these issues) educated us and invented techniques to help dysfunctional couples and individuals (many of which are still in use today), completely revolutionized our understanding of sexual responsiveness (for an excellent and entertaining exposition of their early work watch the first two seasons of Masters of Sex on Showtime, which I reviewed here.) However, their research did not shed much light on the issue of sexual desire.

In her book, Hills asserts that there is a cultural prejudice that pressures both sexes into feelings that we should be having, and if not having, at least we should be wanting passionate sex as a major part of our lives. As the popularity of Viagra demonstrates, and the attention surrounding the announcement of a new drug to treat low desire in women, lack of desire is a widespread issue for both men and women. Yet people consistently overestimate how frequently their peers are having sex by a wide margin. Would our tepid sex lives bother us as much if we knew they were, well, normal? Or if we understood that the idea that one size fits all is, where sex is concerned, a myth?

Married people, in particular, operate under a set of constraints that cause unnecessary conflicts. While the rule of fidelity, obviously, is still mostly inflexible, others standards are sometimes applied with destructive rigidity. Among the “sex myths” that I have encountered that trouble couples in my practice, the “good sex” myth is especially pernicious. According to Hills, this myth dictates:

“The sex you are having must be of a particular type. Good sex is exciting and spontaneous, a product of passion rather than duty or routine. It is novel and inventive (never boring). . .”

A corollary to this is the orgasm myth. Of course, the aim of sex like this is a fabulous orgasm. Recent studies have shown that women’s sexuality is not as neatly linear as men’s, but more circular, and a “successful” sexual encounter does not necessarily begin with desire or end with orgasm for both parties. Many women I have treated are not necessarily orgasmic during partnered sex but are not unhappy with that situation. Yet, as Hills writes, the “sex myth” dictates  “orgasms that occur during partnered sex are superior to those that occur during masturbation.”

Masturbation in general is a huge area of controversy for married couples. Some people believe that if you are happy sexually with your partner, it should be “unnecessary.” The point of the “sex myth” is what is or isn’t necessary is entirely individual. In couples I have treated, the anxiety over masturbation has become intense often when a husband has developed what a wife perceives to be an overdependence on Internet porn, which she finds hurtful or distasteful. Especially troublesome is when this is something he has kept hidden from her so it has taken on the aspect of a secret, split-off part of himself. The husband’s behavior, insofar as it has become something hidden and “outside” the marriage is a barrier to intimacy. Often exploring the meaning of the behavior and restoring the intimacy can allow couples to heal.

In my experience, some couples successfully bring use of “marital aids,” including the use of pornography, into their relationship in a way that enhances their sex life. This depends entirely on the individual couple. If both parties are able to feel comfortable, it can become an asset and a “safe” way to experiment.

Hills has written a valuable book. She points out that though we are lucky enough to live in an era of ever increasing sexual freedom, even so we are managing to restrict ourselves by imposing norms and expectations that while not as restrictive as some of the ones that may preceded them, are still causing stress, anxiety, and even unnecessary dysfunction. And yet our sexual selves are as individual as anything else about us, if not more so. As with everything else, the older and wiser we become, the more free we should feel to be ourselves.