Episode 05: The Four Pillars of Curated Sexual Experiences

Great sexual experiences don’t often just happen by accident – they're created and they’re practiced. In today’s episode, Dr. Alexis Anderson will teach us the four pillars of a well-thought-out sexual experience. She will walk through everything from creating the right environment, to the ongoing conversation that keeps everyone comfortable and present, all the way through to aftercare involved when the experience has concluded.  

Whether you’re new to being intentional about your sexual practice, looking to deepen your practice, or maybe you’re experiencing a new medical diagnosis that has changed your sexual practice – this episode is for you! 
 

Welcome to The Alexis Anderson Podcast. 

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Want more? Visit my website www.alexisandersondpt.com, and connect with me on Instagram (@alexisandersondpt). Thanks for listening and joining the conversation! 

 
SHOW NOTES  

0:57 – A welcome and introduction to what we are talking about today! 

1:54 – Alexis leads with a disclaimer, thanking the BDSM community for their ingenuity and work, and sharing her trust in them 

4:30 – Topic #1: Set up 

7:39 – A note on removing distractions 

8:36 – Alexis! This sounds like a LOT to prep for a sexual experience! 

9:10 – Topic #2: Communication 

17:11 – Topic #3: Continuous and enthusiastic consent 

19:26 – Topic #4: After care 

23:27 – Who these four pillars apply to 

23:42 – Alexis brings the episode to a close with a review of what we talked about 

Transcript

SPEAKER_00 0:01

Hello, and welcome to the Alexis Anderson Podcast. I'm your host, Alexis Anderson, pelvic health physiotherapist and guide for anyone navigating the messy, confusing, and often isolating world of pelvic and sexual health. This season, we're breaking down the myths, sharing real stories, and giving you evidence-informed tools to understand your body. Whether you're a patient, a clinician, or someone quietly struggling, you're in the right place. Let's take the shame out of the conversation, bring clarity where there's confusion, and make pelvic health feel human, hopeful, and actually talked about. Before we get into it, let's talk the legal stuff. While I am a physical therapist, I am not your personal physical therapist. So please remember, this content is for educational purposes only and not a substitute for personalized medical advice, diagnosis, or treatment. Now let's get started. Hello and welcome to the Alexis Anderson Podcast. I am your host, Dr. Alexis Anderson, Doctor of Physical Therapy. Great sexual experiences often don't just happen by accident. They're created and they're practiced. In this episode, I'll walk through everything from creating the right environment. This may include tools, lighting, products, and more, to the ongoing conversation that keeps everyone comfortable and present all the way through to aftercare when the experience is over. Whether you're new to being intentional about your sexual practice, looking to deepen your practice, or maybe you're experiencing a new medical diagnosis that has changed your sexual practice, this episode is for you. I will be covering four topics in today's episode. The first is setup, second is communication, third is enthusiastic and continuous consent, and fourth is aftercare. Before we dive in, I would like to give credit where credit is due. I did not come up with these concepts on my own. These concepts came from the BDSM community. And I'll tell you how I got these concepts from that community because the story is worth telling. I had a patient who came into my office who was experiencing vulvadinia. Vulvadinia is a condition where you have pain of the vulva. In her particular case, she had constant pain in her vulva. She was dating and navigating her medical condition, which was extremely challenging. She tried to get information and help from the medical community, but kept striking out. She refused to give up, and so she went outside of the medical community and she found a BDSM group that was providing educational classes. So she joined. And she came back to my office and educated me not only about her experience, but about the concepts that she had learned. I was blown away by this patient. Not only did she bestow her knowledge upon me from the BDSM community, but I was also blown away by her willingness to not give up, to get creative, and to go outside of her own comfort zone and seek this education. Now she doesn't participate in BDSM acts, but the fact that she was able to go to that community and get the information that she needed is absolutely incredible. I'm so grateful to live in San Francisco and I'm so grateful to this community. I think a lot of people look down on the BDSM community without ever listening to them or getting to know them. And that's a mistake because they have been practicing intimacy and sexual acts in some of the safest, most communicative, most consent-forward ways out there. They want everyone to be safe, they want everyone to be informed, they establish safe words, they set the scene, they communicate boundaries, and they take care of each other afterward. So even though my patient doesn't participate in BDSM type activities, she was able to take these concepts and apply them to her own situation. So I want to send a thank you to the BDSM community. I want to send a thank you to my patient. Thank you so much for being vulnerable and not only educating me in that moment about your current situation, but educating me about the BDSM community. That really sparked my interest and motivated me to get more educated about this community and their practices to help me to become a sex positive provider. And I hope by the end of this episode, you can take these four pillars and apply them to your own life and the bedroom and beyond. Let's get into it. Number one, setup. So what does setup actually look like? Well, that depends. That depends on you, your sexual partner, our partners, and your medical diagnoses or some things that you might be dealing with. For example, that may include products and tools. Some products and tools that you might want to incorporate could be things like lubricant. This is a non-negotiable. Everyone should have lubricant in their nightstand or nearby to incorporate into their sexual experience. Have any tools you may want to incorporate into your experience. This could include obvious ones like external or internal vibrators, cock rings, penis pumps, penile injection medication, dilators, a sex wedge to help to support you or your partner's body. Maybe you have a back brace or wrist brace for your hand that provides safety for your body so that you don't move it in certain ways or move it past certain ranges of motion if you're post-surgical. This may include sensory items, eye masks, bandanas, restraints, a tickler, whips, chains, your leather outfit, maybe some sexy lingerie, maybe it's some fun items. It may include some food items like whipping cream, ice cream, medical supplies, any and everything that you might need for your sexual experience. Prep, plan, have it on hand. Next, you can think about environment. For example, lighting. Do you want the lights on? Do you want the lights off? Maybe you want to dim the lights or have candles lit? Get it set before you start. Are there any scents that you would like to smell while you're participating in your sexual experience? You can light a candle that has a scent, have an incent. You could even incorporate some aromatherapy into your sexual experience. Think about music. Would you like some sound to be playing in the background? Maybe you want it to be silent. You can create your own sexy sensual playlist. You could have relaxation music in the background, whatever you prefer. You can think about temperature. Are you going to be too hot, too cold? Want to make sure that you and your partner, our partners, are comfortable? Will you need extra blankets? Are you or your partner on their mincies? Maybe you need a towel to put down. Will you need wipes, wet wipes, dry wipes, a towel to clean up afterwards? Do you need to alter the environment in any way? For example, maybe clean up a little bit. This may sound like a funny one, but it's real. I had a patient explain to me that she would often get out of her head during her sexual experience if she saw there were dirty clothes in the room. When she saw dirty clothes in the room, her mind started to race about the laundry that she had to get done, her to-do list, and then she was completely out of her sexual experience. So for her, tidying up the space before sexy time was really important. Environment matters. Whatever pulls you out of your sexual experience, remove it. Speaking about being pulled out of your sexual experience, remove anything that is a distraction. Your brain is your biggest sex organ. If you are not in the moment and being present, it can pull you right out of your arousal state. Getting phones out of the room is really important, and or making sure that your phone is on silent and all notifications are turned off. You're really wanting to create an uninterrupted space. And here's the thing: you don't have to have everything prepped, doesn't have to be perfect, but just planning for the experience, especially having products and tools that you will want or need on hand is super important. Sometimes you improvise. Sometimes you get creative in the moment, and that's part of the fun. There's room for spontaneity even with a plan. The goal of setup isn't rigid. It's making sure you and your partner are partners, have what you need to feel comfortable, present, and ready to enjoy your sexual experience. Now, some people say, Alexis, this sounds like a lot to prep for a sexual experience. I hear you. But think about it this way: you prep for experiences all the time in your daily life. For example, you're going to the grocery store, you prep with your grocery list, you make sure you have your bags and your trunk before you go to the store. Or let's say you're going to go for a bike ride. You make sure your tires are aired up, you have a map of where you're going to go, what time you're going to leave, what time you'd like to come back. This is no different. You're just prepping for your sexual experience to have what you need and to have a good time. Second topic is communication. This is a big one. A lot of people have a hard time talking about sex. They have a very difficult time asking for what they want. They have a difficult time asking their partners what they want. People find it difficult to ask for what they need. And I get it, it can feel super vulnerable and oftentimes can be really awkward. But here's the thing: you communicate about what you want and what you need all the time in your daily life. Maybe you just haven't brought that type of communication into the bedroom yet. Think about it like this. You and your partner are trying to figure out what you're gonna have for dinner tonight. So you ask, what do you feel like? Mexican, Italian, Vietnamese, Indian, right? You start to brainstorm, you talk about which type of food that you want. Maybe you land on pizza. Fabulous. Now you get specific. What do you want on your pizza? What type of sauce? What type of cheese? Would you like pepperoni, pineapple? You're figuring out each other's wants, each other's desires, and you're also figuring out what you don't want. But you're communicating and you land on something that works for the both of you. Sex is no different. What do you feel like doing tonight? Do you feel like cuddling? Do you feel like having oral sex? Would you like to take a shower together? Talk about the time that you have to enjoy each other. Maybe you only have 20 minutes because you have kids and they're taking a nap. Talk about that. Well, we've got 20 minutes. What would you like to do? What do you want to feel? But this quick, honest, open communication is so helpful. It takes the guesswork out and it makes all who are involved feel seen, heard, and considered. This is also a space where you might want to talk about pain or physical limitations before you get started. Maybe you just had surgery and there are some post-surgical precautions that you have to stay within. Maybe there are painful parts of your body that you'd like to avoid, or you have boundaries around. This is a good time to talk about those issues so everyone involved is informed, everyone is safe, and having a good time. And then beyond the big picture, there is in-the-moment communication. This is where I find a lot of patients have a difficult time. In the heat of the moment, oftentimes patients don't feel comfortable telling their partner to stop. They feel uncomfortable saying things like, ouch, or that hurts, right? One, they have a hard time speaking up, but then also they may not want to hurt their partner's feelings. So this is a wonderful time to talk about how you're going to communicate in that sexy moment. For example, you can use verbal communication. You can set up a safe word that indicates you'd like things to stop. You can set up a safe word that indicates you'd like things to slow down. Or a safe word that says, yes, keep going. I like that. And these can be things that you feel comfortable saying in the heat of the moment. Some folks find it easier to use a stoplight analogy. Green light, green light, that feels good. I like it, keep going. Yellow light, it doesn't really feel so good, or it's not really doing anything for me. Or yellow light, let's slow down. Red light, stop. Or red light, this is painful. Use words that you feel comfortable saying. Some folks have no problem in this department. They love talking during their sexual experience. They love sexy talk. So if that's you, lean into that. Or if that's something that you like to get into, experiment. Yes, that feels good. More of that. Over here, down there, up a little, over to the right, over to the left. So you're giving your partner guidance during your sexual experience. If you don't feel comfortable talking, sometimes people use sounds. Sounds that indicate that you're feeling good, sounds that indicate that you're not feeling so good. This was really fun. I had a couple in my office and they talked about the different sounds that made them feel comfortable during their sexual experience. It was great. They were a married couple, they'd been married for over 25 years, and they were vulnerable and open enough to share their sounds with me and their partner. They talked about some of the sounds that they would make if they were feeling good. What was funny is that then they talked about the sounds that they wanted to make when things were not feeling good. And one of the partners started to make the sound, and his husband thought, oh my gosh, I thought when you made that sound that you liked it. And it was just really a funny moment because they had been married for so long and they never had this conversation. And this entire time, his partner, his husband, was thinking that by him making the sound, he was really enjoying himself, only to find out that when he made that sound, he actually wasn't. So it was kind of a funny moment and it was a good thing for them to experience together. And it was good for me to see that as well. For some, talking or using sounds may not be something that they feel comfortable with. So you can incorporate nonverbal communication. You can do this through touch, for example. I have some patients that when they pat their partner three times, one, two, three, that's an indication that they are not doing well. One, two, three, doesn't feel good. We need to stop. Other times they may rub their partner, indicating, yes, that feels good, keep going. I like that. You can use your nails to scratch your partner a little bit to indicate, yes, that feels good, keep going. Maybe you use a hand signal that indicates what you're feeling. You can use eye contact or lack thereof. If you're in continuous eye contact, you're present, you're involved, it means that you're into it. If you look away or you stop looking at your partner, maybe that can indicate that you want things to stop or to slow down, or vice versa. Maybe if you don't look at your partner, that's an indication that you're really present, you're using all of your senses, and you're in the moment. However, you'd like to communicate is up to you. It's what makes you and your partner feel good. We've talked about verbal communication, using words, we've talked about using sounds, we've talked about nonverbal communication, using hand signals, tactile cues, rubbing, touching, patting, tapping your partner. It's also important to talk about if people go silent. For some, when they go silent, that could be an indication that they're not having a good time and they're actually experiencing a stress response. Silence is something that you want to talk about with your partner before walking into a sexual experience with them, especially if you have had trauma. You can let your partner know that when you go silent, that is an indication that you are not comfortable and you want things to stop. On the flip side, I have had some patients that say, Well, if I'm silent, that means I'm having a good time. So don't interrupt me. This just goes to show that these conversations are super important so that all who are involved feel safe and feel seen. I'll use an example to illustrate how to implement what we've talked about so far. I had a patient who had low back pain and sciaticus symptoms, and he was nervous about engaging in sexual activity with his partner for fear of re-induring himself. So he prepped. He got a sex wedge to support his back and his partner's body. He figured out the positions that he did not want to participate in that might aggravate his symptoms. He talked to his partner ahead of time about how he was going to communicate if something started to hurt, what he would say, and what signals he would use, so that in the moment his partner would understand and they could adjust without it being a big, stressful issue. That's communication doing its job. The key is to establish your communication agreement before your sexual experience begins, whether it's with a brand new partner, our partners, or someone you've been with for years. What do we each want? What are our limitations? How are we going to signal to each other during our sexual experience? Getting on the same page beforehand means that you can actually be present once you're in it. Topic three, continuous and enthusiastic consent. Okay, this is one that I really want you to hear. Consent is not just checking a box. It's not just asking your partner once at the beginning if they want to do something or if they like it or if that feels good. Continuous, enthusiastic consent is checking in with your partner or partners throughout the entire experience. Consent is sexy. Consent is essential. A lot of people struggle with this. It's not something that we are taught, unfortunately. Hopefully, that is changing, especially now. Everyone is in charge of their own body, everyone should feel safe in their body, and everyone should respect everyone else's body. But a lot of people don't feel comfortable asking for consent or checking in with their partners during their sexual experience. But consent can be sexy and it can be fun. So what does it look like? You can ask your partner, are you having fun? Does that feel good? I'd like to kiss you. What do you think about that? Can I kiss you? Can I hold your hand? Would you like to hold my hand? Are you okay? Do you like that? It sounds simple, but so many people don't feel comfortable with it. And consent is a must. Here's the reframe I want to offer you. Consent isn't a buzzkill. It isn't clinical or unsexy. It's what you do in everyday life already. For example, you're at a party with your friends or your partner and you do a vibe check, right? Let's check out this party. Let's see how it goes. You walk into the party, you ask, is this our scene? Is this what we want to be doing? Are these the people that we want to be doing these things with? Do we like the music? Do we like the food? Do you want to stay? Do you want to go? You're continuously checking in. You do this naturally. You're just bringing that same energy, that same conversation into the bedroom. Continuous enthusiastic consent isn't just important, it's mandatory. It's what we owe to each other. When all people are genuinely, actively okay with what's happening the whole way through, the experience is better for everyone. And that's the goal. The last topic is aftercare, taking care of each other after your sexual experience. I find this genuinely fascinating because every person is so different. After your sexual experience, after experiencing pleasure, your orgasm, people land in really different spaces, and none of them are wrong. Some people want to roll over and go straight to sleep. They feel good. They feel cozy. They just want to drift off into dreamland. I feel yummy. I'm done. Lights out. Call it a night. Some people get a burst of energy. They're wide awake. They want to move. They want to talk. They want to do something. Some people want to highlight real. They're like, that was amazing. That was incredible. I loved it when we did this. I loved it when I saw this. I loved it when you whispered this in my ear. They just want to go through that whole sexual experience again and they want to share it with you and they want to talk about all the good stuff. Some people just want silence. They want to be held. They want to cuddle. They really just want to sit in that experience for a little while longer. Really savor it, take it all in. None of these are right or wrong. But what can go wrong is if you don't know your partner's aftercare style, you can misread it completely. If your partner rolls over and falls asleep, and maybe you wanted to be held and cuddled, you might think they were bored or that they're being distant or that they didn't enjoy it. Maybe you think you did something wrong. And that may not be true at all. They might just be the type of person that feels really good and yummy after their climax and wants to just roll over and fall asleep. This is why having the conversation about aftercare before or outside your sexual experience is so helpful. It takes the guesswork out. It means no hurt feelings, no misread signals. Both people understand and can show up for each other in a way that actually lands. So, what does aftercare actually include? It can include physical aftercare, water, snacks, your body just did something, you might need to replenish and hydrate. That may include warmth, having some blankets, sharing body heat, hygiene, if that's part of your window. Maybe someone wants to take a shower or wipe themselves off with wipes. This can also include emotional aftercare, cuddling, being held, talking, sharing, looking into each other's eyes, being quiet, just being present, being together without words, holding each other, listening to music, whatever the case may be. It's your aftercare, it's your partner's aftercare. It's important to talk about it. It may include solo aftercare. If you're on your own, having solo sex, or if your partner leaves, you can still take care of yourself and make sure that your needs are met. Check in with yourself about how you're feeling, what you need, and give that to yourself. The key question to ask yourself and your partner, what do you usually need after your sexual experience? It's simple. Just ask. It opens the door to a conversation that makes everything after the experience feel safer and more connected for all who are involved. So let's bring it all together. Here's what we covered today. Setup. Prep the scene like you'd prep for anything else in your life. Have what you need, create the environment that lets you both be present, prepared, and comfortable. Communication. Talk about what you want before, during, and in the moment. Think about the food analogy. Make it as normal as figuring out where you're going and what you want for dinner. Because it is. Continuous and enthusiastic consent. Check in the whole way through. Establish your communication system before you start. Verbal, nonverbal, stoplights, taps, whatever works for you. Silence is not a yes, except for when it is. And consent is mandatory the whole way through. Aftercare, talk about what everyone needs after your sexual experience. No assumptions, no hurt feelings, just people taking care of each other. These four pillars apply to anyone. They apply to any and all bodies, any relationship type, any experience. You don't have to be doing anything extreme. You just have to be willing to communicate, check in, and take care of each other. I hope this was helpful. I hope it gave you something to bring home and into the bedroom. I want to give a sincere thanks to the BDSM community and to the city of San Francisco. Thank you for listening. If you found this to be helpful, please share, like, subscribe, and comment. Thank you for your time. Thank you for spending it with me. And I'll see you in the next episode. Thank you so much for joining me in today's episode of the Alexis Anderson Podcast. I hope you learned something that brings you more clarity, validation, and compassion for your body and your journey. If this episode supported you or you think you could help someone else, please share it, leave a review, or send it to someone who might need to hear it. And if you're a clinician or a patient looking for more resources, tools, or support, you'll find everything linked in the show notes. Remember, you're not alone, you're not broken, and treatment exists that treats you as a whole person. I'll see you in the next episode.