Permission for Pleasure
A podcast to educate and equip women with the information and confidence they need to express, experience and enjoy their sexuality. Cindy Scharkey RN, BSN, brings her 35+ years of experience as a healthcare professional to open the doors to healthy conversations about sex. This is a community where you can listen and learn to give yourself permission for pleasure. Visit www.cindyscharkey.com for educational blogs and newsletter.
Permission for Pleasure
Orgasm Is A Big Brain Event
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Your brain is wired for pleasure! My conversation with Dr. Nan Wise continues as she shares her research about how your brain benefits from orgasm and pleasure and how even thinking about pleasurable stimulation lights up your brain like a Christmas tree! As she emphatically says, “Orgasm is a big brain event!” She also teaches how to lay down pleasure pathways to help those who find it difficult to orgasm. Learn about your brain-body connections and how the more you pay attention to the sensations you feel, the more you can dial them up for more pleasure.
Dr. Nan Wise is a certified sex therapist, relationship specialist, neuroscience researcher, and author of Why Good Sex Matters: Understanding the Neuroscience of Pleasure for a Smarter, Happier, and More Purpose-Filled Life.
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The pleasure crisis: Why good sex matters
Exploring your perspective of pleasure
Why vibrators work for women and how to choose one
Natural health benefits of orgasm
Sex on the brain: Your two part system
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So basic science about sex still in its infancy, unfortunately.
SPEAKER_01Hello everyone, and welcome to Permission for Pleasure. I'm Cindy Sharkey, your host, and you're joining me for part two of my discussion with world-renowned neuroscientists, sex therapist, and relationship specialist Dr. Nan Weiss. I do hope you'll go back and listen to part one if you missed it, and then rejoin us here for the second part of our discussion about pleasure. These episodes with Dr. Nan are sponsored by Uberlube, which you know is my favorite silicone lube for pleasure. Support the podcast and use the link in the show notes to try Uberlobe. Let's jump right back in with Dr. Nan and talking about your brain on pleasure. Nan, welcome back to the show.
SPEAKER_00I'm so happy to be here.
SPEAKER_01Love it. And we ended last time saying that we're going to jump into how the brain is wired for pleasure. This is your work about the command sender, right, and the generator of pleasure. So tell us a little bit about that.
SPEAKER_00Well, you know, there's a very intimate relationship in our brains between pain and pleasure. In fact, the places in the brain that we get the pleasure chemicals from, our own opioids, are wired in to be painkillers. So essentially, pleasure and pain have a very intimate relationship. As I talked about in the last episode, pleasure and pain are important signals that are wired in for us to recognize things that feel good and are good for us, things that hurt and are not good for us. So when we talk about pleasure, we'll see a lot of the same places activated in the brain as are activated in pain, which is very interesting. So we don't have quite yet the technical ability, because you know, brain science is still in its infancy. FMRI is which is functional MRI, magnetic resonance imaging, which lets us look at the working brain to see how it's working, as it's working, was only developed in the 1980s and started to be used more widely in the 90s for these sort of ways of looking at the working brain. So that's functional, which is different than the kind of brain scans you get when you go to find out what's happening in your anatomy. But to make a long story short, when we studied, the first thing that we did was we looked at where do the signals from the genitals get processed in the brain? It was 2011, Cindy, and we still hadn't had that done systematically. So my first job in grad school, when I went back for the second time, was to do a mapping study. So we mapped the projections of the various parts of the female genitalia into the place in the brain that processes sensations. And then we did that for men. So basic science about sex, still in its infancy, unfortunately, but back to when genital stimulation builds. So when somebody is stimulating their genitals and it was clitoral stimulation in my study, what you see when you analyze the data, so I'm not watching it real time. I am taking all that data after the experiment and I'm analyzing it. And what you'll see is sensory, the places in the brain that process sensations come on board, then the areas that are involved in the reward circuitry, that which is basically the seeking system. The fancy name for that is the mesolimbic dopamine system. So meso in the middle of the brain, dopamine, and it's limbic or the emotional structures. When you start to have stimulation and it starts to feel good, you start to see activations of the emotional regions and also what we call hedonic hot spots in the brain, like the hypothalamus in the areas in the orbital frontal cortex, start getting active and active, and the hypothalamus and hippocampus, all these different regions, and then they peak at orgasm, and then the activity comes down. So I did the world's first study of looking at women having orgasms that were self-stimulated, self-stimulation versus partner stimulation, where the partner was reaching into the scanner and stimulating the clitoris, no easy thing. And what we discovered was that it activates huge amounts of the brain, which is why we say that orgasm is a big brain event.
SPEAKER_01Okay, well, tell me though, was there any difference in what you saw mapped in the brain when a woman was stimulating herself versus being stimulated by a partner?
SPEAKER_00Well, that's a great question. And the short answer is during stimulation, the people who were self-stimulating who were actually controlling their own stimulation, they went up faster. But when it came to the orgasm, it didn't look any different. Now bear in mind, this is a small N, meaning there weren't a lot of subjects in this study.
SPEAKER_01You only had a few people that were donating their orgasms to you. Is that what you're trying to tell me?
SPEAKER_00Well, I probably could have gotten a lot more because it was so cool that women were so motivated to come donate an orgasm to science. But back to this whole idea of what's going on in the brain, it's a lot of activity. Yes. And what I like to tell people, and even without even getting into the whole idea of orgasm, is that our brains, brain minds are kind of like pharmacies. And how we think, what we focus on, changes the chemistry of our brains. What is the placebo effect? The placebo effect is when how your thinking or believing stimulates that pain-relieving system that's built in the descending pain-relieving system, which is releasing opioids, which is why people feel better with the placebo effect. And how we think, what we're thinking about, what we're focusing on, changes the chemistry of our brains. So one of the good things about kind of understanding that is if you want to feel better, move your body. Because when you move your body, you're changing the chemistry of your brains and connect with other people. Jak Pansept, who is the guy I talked about last episode, who mapped out these seven circuits fear, rage, panic, grief, seeking, which is the motivation, and then play, care, and lust. When he mapped out the systems, what he really learned was that we could probably focus on therapies that help people tap into positive feelings. So eliciting positive feelings, it's not going to be instead of feeling your feelings, we're going to feel the pain anyway. But if we take our attention and we focus on positive ways that we can be accepting of ourselves, loving of ourselves, patient with ourselves, it all back to that relationship with self. At the end of the day, what makes us happy is not our achievements, because you know what happens? It becomes the next thing. It's not the hot tubs that make us happy, although it's good to have a hot tub, because then we have the hedonic habituation, which is the, you know, like you get the buzz up first from getting something new, but then you're basically your system goes back because the buzz up is a learning signal. That's dopamine goes up to say, oh, there's something good here. Okay, you can learn something, but then it goes back down. And there's really nothing you're learning at the end of the day that's satisfying in the way that instead of focusing on our goals to get this, like I'll be happy when I get the PhD, or I'm happy, I'll be happy when fill, you know, fill in the blank. I got a good partner, I got this, that, or the other thing. Happiness comes more from people focusing on being in the present if they focus on those ways, like being loving, being positive, being communicative, whatever they however they need to be to make better connections, present time with themselves and each other. That's where sustainable happiness comes from.
SPEAKER_01And you even said in the book, I'm going to quote you, that to bring it full circle with pleasure is anyone has the capacity to become an extraordinary lover if they engage their brains and bodies, harnessing their full potential to experience pleasure. And this positive outlook comes into play as well.
SPEAKER_00Right, and the experiencing pleasure is not waiting to have an orgasm, it's not focusing on the orgasm. 90% of my practice with men is about men having performance anxiety or difficulties because their penises are not cooperating, and then 90% of my practice with women is either they're not having desire or they're not enjoying sex. So, really, the whole point isn't as Beverly Whipple used to say, goal-directed is not gonna be pleasure. When people truly have ongoing long-term sexual pleasure in life, it comes from connection. It's not from how many orgasms, whether they have orgasms at all, whether they become skillful lovers with their hands, it's about the connection, being present to yourself and the partner. And that's why I think we need to expand what we mean by sex. Because, you know, like you talked about scripts, the biggest problem with our North American sex scripts, Peggy Kleinplatz, who's one of my favorite sex therapists and authors, she wrote a textbook on sex therapy that was so amazing. She said that, you know, having a penile vaginal sex, heterosexual, penile vaginal sex with orgasms, preferably together, is the worst, you know, recipe for people having really crappy sex. Because, you know, we need to think about sex as pleasure in our bodies with each other, thinking about sex as grown-up play. Grown up and it doesn't have grown up play. Yeah, grown up play.
SPEAKER_01I think I've heard you say neurons that fire together, wire together, right?
SPEAKER_00Exactly. That's Heb's law in neuroscience. Learning is when neurons start connecting by firing together. That's learning, it's changes in the neurons talking to each other. And when women have trouble experiencing orgasms in the first place, primary anorgasmia, when they've never had an orgasm, it's largely because they haven't had enough experience laying down the pleasure pathways.
SPEAKER_01I misunderstood that. You meant neurons that fire together, wire together, not related to partners.
SPEAKER_00Well, I think it could be looked at as partners too. There's different ways to look at that. Our nervous systems are going to change when we're connecting with other people. Tell me more about what you thought. I'd love to. I can't remember.
SPEAKER_01I think I I think I just read it in your book and it stuck in my head, but then I didn't remember which part it was related to. So if you're saying, so tell me the truth, you know, you're my brain expert about neurons firing together and then wiring together.
SPEAKER_00Right. So when neurons, which are simply cells in the nervous system, when they communicate, they communicate with each other. And when the signal from one stimulates the other, it starts to create changes in those areas called the synapses, which is the space between the neurons, between the cells, and it creates physical changes that wire the neurons in a way together, in the sense that then there is that pathway. When you think about it, it can work for good, meaning like laying down the pleasure. When people practice, when women practice masturbating, the signals strengthen between the genitals and the area, I call it the brain's crotch, the paracentral lobule. It's actually tucked in in between the hemispheres, that those connections become strengthened so that the sensations then are strengthened. That's the laying down the pleasure pathways. Okay. But I can tell you how it can work badly too. When we keep thinking the same thoughts over and over again.
SPEAKER_01Ruminating, you mean?
SPEAKER_00Ruminating, exactly. What we're doing is we're creating circuits where these neurons that are firing together, wired together, and then it becomes like the needle in the groove. It goes deep and it becomes very hard to get out of that. So that's an example of a non-pleasure pathway strengthened by the rumination.
SPEAKER_01Okay, so that is fascinating and also hopeful in the sense of you're saying if we lay down these pleasure pathways, then we can not so much rewire, but create the pathways that are firing and relating with our brain and body in a healthier way.
SPEAKER_00And we can rewire. When we talk about neuronal or neuroplasticity, which is a big term these days, what we're just talking about, which is what neurons do anyway, is they connect. And plasticity is just neuronal learning. These connections that these pathways that are practiced repeatedly become habitual. So what is a habit? Habits are behaviors that were at one point required attention, perhaps, and then they become automatic. That's one way to look at a habit. Many of us have emotional habits, like when we eat, when we're anxious, emotional eating, people who do a lot of drinking alcohol, that's an emotional habit. It's a habit. You reach for the drink or the bag of Doritos. I don't know why I'm in on the Dorito case. They engineered that stuff to be unsatisfying, where you just want more, more, more. So the seeking system, which is what we think of as reward system, is not about feeling satisfaction or even liking. It's about craving, wanting, wanting, wanting. That's why social media can be so addictive. That's why people can get drawn in down the rabbit hole because it just is not really satisfying, it's just elicits more craving. So that's the seeking system. It makes you motivated to crave, but what you're motivated and craving isn't stuff that's going to be satisfying and good for you. So that's why I'm a big fan of healthy hedonism and a big practitioner of it myself. I'm really, I have to practice what I preach because I need to, because left to my own devices, I tend to have a lot of anxiety. That's like, and a lot of people do. Nature's not dumb. People who worried were people who tended to put their genes into the gene pool. They live long enough because they made sure they had food, shelter, and all of that, and there's too much of a good thing. There is such a thing as too much of a good thing.
SPEAKER_01Well, you are a wealth of information, Nan. I have a couple questions back to your study with women and men. I think you talked about this in the book, but I'd love to hear you speak to, and we're going to pivot kind of back to this. If people thought about their genitals being stimulated, what happened in their brain?
SPEAKER_00Thank you for leading me down this direction because it's so important. I threw in a whole bunch of different conditions in the experiment because I was very interested in what happens if we just think about a body part. Because I'm being a hypnotherapist, somebody who's into, you know, how the mind and brain work together, I was always fascinated. So what we did was we created a condition that the women did. The men also did something similar, but I wasn't in charge of the male data, and that hasn't been analyzed yet. So I can't speak to that. But what we found was when we had our participants think about having the vagina penetrated with a dildo. And then we alternated that with a condition where we had them imagine having a pelvic exam with a speculum. Okay, two completely different things. Okay. But both involving penetration, and most women do not experience a pelvic exam as erotic or pleasure. They experience it or pleasurable. And I asked my participants just to be sure about whether they experienced the idea of the imagery of a pelvic exam as pleasurable. Nobody did. But what I found was much to our amazement, but I can't say it was always really so surprising to me because I understand, you know, if you think about a lemon, your mouth can water, you know, there's this brain-body connection. The women in the condition of thinking about the dildo, the places in the brain that would be lit up by an orgasm. So we're talking about these emotional centers, these places in the brain that are stimulated by other kinds of pleasures, sex, drugs, rock and roll, you know, the pleasure circuitry got lit up like a Christmas tree. Just thinking about pleasurable stimulation. Pleasurable. Yeah, because the context we wanted to give them, you know, like think about having a dildo versus a pelvic exam, you know, inserted. And it was very clear. They said the imagery in both cases, when I asked them after the scan, how vivid was the imagery? The imagery was vivid in the case of the pelvic exam. They imagined it, but did not light up the pleasure centers in the brain like the dildo did. So, what does that tell us? The mind is the most important sex organ of all. And the mind and the brain are the same thing. The body has as many neurotransmitters as the brain. This arbitrary distinction between mind and body is kind of ridiculous.
SPEAKER_01And certainly brain and mind because it's not the is not the body sending more signals to the brain than the brain is actually sending to the body. I've heard some science about that. Is it true?
SPEAKER_00Well, you know what? That's a good question. I'm not sure how to answer it, but I think when you look at the central nervous system, and that includes the spinal cord, that's body. The spinal cord is part of the body, right? It's central nervous system, but there's so Much communication going on all the time between the heart and the brain. Now, you read the body keep score, you mentioned that before. He talks a lot about when I've heard lectures, you know, I do trainings with people about trauma, that there's something called heart math, which is a biofeedback device with cardiac variability. And I took courses with him. The communication between the heart and the prefrontal cortex is a big part of why there is such a connection between our emotions and how we feel with our heart. You know, you get pain in your heart when you're hurt, when you're hurting emotionally. So, you know, there's this intimate to even think about there being any kind of distinction between the brain and the body because there's constant communication all over the place. So back to the women who were able to light up their brain with their mind. Light up their brains, right? You know, there are some people who report being able to create orgasms without any physical stimulation. Beverly and Beverly Whipple and Barry Kama Sarak, who are mentors, they studied women like that in the 80s with Gina Ogden. God bless her, she's no longer with us. They did a study of um women who could have imagery-induced orgasm. It wasn't a brain study, but they showed that when women were listening to these imagery-induced orgasmic experiences, it showed up in terms of making them less sensitive to pain, which is what orgasm does. It's because those pain alleviating regions are also parts of that whole pleasure system.
SPEAKER_01Wow. Let's pause there because you go through the big brain event and what happens with orgasm. You just touched on it right there with pain relievers, but let's list the other ones because I think people don't know how healthy it is for them to orgasm and how good it is for their body and their brain. So it gives your brain oxygen. It let's list some of these off. You talked about the cascade of nourishing neurotransmitters.
SPEAKER_00Yeah, neuropeptides. And you don't even have to go all the way to have an orgasm to get some of these benefits. I looked at basically the first 10 seconds. Actually, it was I had to do that for my published paper. I had to increase it to 20 seconds. The first 20 seconds of stimulation, and then everybody stimulated for various amounts of time. Not people aren't going to have an orgasm in the same amount of time or it won't last. So that was one of my big methodological challenges. And I saw over the course of stimulation more and more involvement, enrollment of sensory regions, the regions that take in sensation, sense, sensation integration. So sensations land in one place and then they get processed in other places in the brain, in the temporal regions, temporal and parietal regions. And then what would happen was there would be more and more activity in the limbic regions, which are the emotional, the limbic, the hippocampus. The hippocampus, I'm a big fan of the hippocampus, the hippocampus and amygdala, as well as the nucleus accumbens, are areas that are very much involved with paying attention to things that feel good or things that hurt. So we know it makes sense that we're gonna remember things. The hippocampus is very much involved in memory. We're going to want to encode memory of events that are painful or really pleasurable, encoding intensity, like the amygdala will be activated when people are really afraid and also when people have orgasms. The amygdala is going like this to the hippocampus. Pay attention, this is important.
SPEAKER_01She's got her elbow up like she's elbowing somebody, like, hey, hey, pay attention.
SPEAKER_00And then the nucleus succumbents, which is ground zero for sex, drugs, and rock and roll, gets stimulated. So this starts over the course of stimulation and seems to peak at orgasm. So it's not like orgasm is a switch and all everything happens. We still don't understand what's the actual switch of going over into orgasm. It might be a matter of just having uh, you know, enough intensity that does that. We haven't sussed that out yet. Well, and I think it could be very individual in a lot of ways. It could be very individual, but there's something that happens where that stimulation gets to a point. Barry Kamaserek has a theory about when the stimulation gets to the point where if it goes beyond that, it would be painful. But who knows? You know, it's just great to be able to, it's he talks about inhibition and excitation. That's his thing. But what's really, you know, what's the takeaway here? If you're going to be able to, through just what you put your attention on, change your chemistry enough where you can light up your pleasure places in the brain. That teaches us that we can use these pharmacies, the built-in, you know, brain pharmacies, for harnessing our attention on sensations and actually increasing our ability to be present to them. Hence the, you know, the more you pay attention to the sensations, the more you can dial them up.
SPEAKER_01Okay. The more you pay attention to the sensations, the more you can dial them up.
SPEAKER_00And I teach people, I've created an exercise about touch and imagine touch. So people who have trouble getting like signals to be able to really be in, you know, having a lot of pleasure, I have them touch the generals and then think about touching the generals so that you can begin to pair the ability to focus your attention on sensations with actual stimulation. So I'm all about trying to help people learn how to work the wiring. And it's not about having the orgasm, it's about being present to the sensations.
SPEAKER_01Yes, and you also did a little bit of research about the nipple stimulation and pathways. How does that work for people?
SPEAKER_00Well, in the last episode, I was telling you about how my first project in grad school was mapping the connection between the genitals and the brain. And we put in the nipples as one of the regions to be able to stimulate to see where the signal went. Because you know, anecdotally, any woman, women will tell you that nipple stimulation, and men will say that too, can be very erotic. Or even bring them to orgasm. And you know what? They're when you think about it, nature's not dumb. Because when you get pleasure from nipples, that may be increasing the likelihood of your being able to, you know, nurse a baby. And women sometimes have a hard time recognizing it's not always pleasurable. I nurse two kids. Sometimes, you know, they would be it would be the nipples could be sensitive. Of course. But but it also can give you pleasure. It's like you can feel the letdown and the cascading of all of the prolactin and what's it, oxytocin prolactin for milk. You feel that, you know, and that's very reinforcing. So what we found, and I know this is a I went rather circuitously to the punchline here, but lo and behold, guess where the nipples map on? To the genital sensory cortex and ground zero of the brain's crotch. We had thought maybe that was mediated by oxytocin. So if you had nipple stimulation, you released oxytocin and then oxytocin caused contractions of the vagina, right? But nah, it wasn't mediated by oxytocin because it happened too quickly.
SPEAKER_01Fascinating. So all of these pathways to pleasure and paying attention to pleasure, and then helping those neurons to fire together and wire together. Listeners, I hope you're hearing this and just the power and hopefulness of experiencing more pleasure with intention, right? I mean, this is what man's research has proven is that you can use your brain-body system intentionally, paying attention to what is true and how it works together to allow yourself to experience more pleasure.
SPEAKER_00You nailed that, Cindy. You said that beautifully. Intention and attention. Not only is it okay to have pleasure, it's necessary. It's not a luxury, it's necessity for really a well-balanced life. And think about how much better we are as people when we can enjoy things, when we can experience pleasure, we're gonna be better friends, we're gonna be better citizens, more pleasure, less fear, you know, and only being afraid of what we really what's really threatening. And when we recognize that we have such capacity, when we think something's possible, it becomes very probable. So if we can get over this whole puritanical thing that makes us, you know, very ambivalent, and then think about women. Why do we have an orgasm gap? Because we're taught to be objects, not people embodied. We're taught to be objects in the heterosexual patriarchy of the male gaze. So you wonder like we're not in our bodies, we're not experiencing embodied pleasure as women. And you know, men get taught that they have to be performers, that their penises have to be a certain way and they have to last a certain amount of time in there. And that's it's hobbling their ability to just be present to their partners and to their experiences. I feel terrible for both men and women who've been cultured in these ways that take us out of our connection with self and each other.
SPEAKER_01Yes, and we can work to change that narrative. And that's some of why I'm so grateful for your work, Nan, and for you coming on to share about your work and the neuroscience behind pleasure and why it's good for us and why we want to pursue it and how we can do that. So thank you for joining us and bringing the science down to us regular people speak, so to say.
SPEAKER_00So that I hope I was able to do that, you know, because sometimes it becomes like these. Well, it actually the stuff kind of boils down to be simple and straightforward if we don't get caught up in these big, big words.
SPEAKER_01Well, thanks for being with us, Nan. Tell people how they can find you and learn more about your book and your work in the world.
SPEAKER_00Well, thank you for your work, Cindy. Thank you for your dedication all these years to promoting healthy pleasures and women's health and all of that. So, for a good time, call Dr. Nan. It's a uh I can be very easily reached via my website, askdrnan.com, with the doctor spelled out with all the letters. So it's askdrn. I offer free consultations by phone or Zoom for anybody who has questions for me. You can just sign up on my website. I encourage people to read my book. I'm just so happy about having had the experience of writing that book because when people read the book, they often reach out just to thank me, which just makes me feel so happy that you know that they gave them ideas about how to promote their own well-being. And it has a lot of practical tips in there. Yeah, it certainly does. Uh-huh. Yeah. And if anybody's interested in donating an orgasm to science or not donating an orgasm to science, they can reach me right on my website.
SPEAKER_01Great. And we'll link to that in the show notes. And we do want to thank Uber Lube for sponsoring this episode. You know they're my favorite silky smooth silicone lube. Don't forget to check out your link for that in the show notes. And Nan, we like to ask guests on this show what's delighting you right now? What's bringing you pleasure day today? Will you want to share something?
SPEAKER_00What's bringing me pleasure are my three grandsons. Looking at pictures of them, they send me pictures. We see them often enough. So having, you know, feeling like I've kind of done my job and my kids have had kids, and watching my kids love having such a good time being parents gives me tremendous pleasure.
SPEAKER_01That's so fun, so sweet. And community, I want to encourage you to think about how you can prioritize pleasure, how you can give yourself more permission. More permission for pleasure.
