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Pelvic + Sexual Health

(Re)Discover Pleasurable Touch with Sensate Focus

Oct 11, 2022Amanda Angelotti, MD4 MIN
a close up photo of a woman's collarbone showing the texture of her skin

Information on sensate focus was adapted from Cornell (2019) and Masters and Johnson (1994).

If you’ve had chronic pain with sex due to conditions like vaginismus or dyspareunia, it’s essential to give yourself ample time to feel safe and open to sensual touch.

Healing from chronic pain is especially challenging because it mixes and amplifies signals between your body and brain, impacting how you experience and respond to even normal sensations. This faulty feedback loop can lead to (or worsen) pain with sex, and create fear and avoidance of sensual touch.

The good news: A pelvic floor physical therapist can treat your chronic pelvic pain with a combination of strategies that work together to break this feedback loop and improve your muscle and nerve function. These strategies often include mindfulness exercises, breathing and other stress-relief strategies, as well as the use of vaginal dilators to gradually retrain your brain to experience non-painful sensations in your pelvic floor muscles.

Incorporating sensate focus into the treatment of chronic pelvic pain improved patients’ comfort and confidence with sex.

A wonderful compliment to these treatments is a process called sensate focus. Recent studies show that incorporating sensate focus into the comprehensive treatment of chronic pelvic pain improved patients’ self-reports of comfort and confidence with sex.

What is sensate focus?

First described in the 1960s by Masters & Johnson, there is no definitive guide to sensate focus, but the expert consensus is that it uses mindfulness techniques to retrain your brain so that you stop anticipating pain with (and even decrease anxiety over) sensual touch — and start opening up to the possibility of pleasure. 

Sensate focus is all about tuning into what it feels like to touch and be touched. It’s similar to how you might focus on your breath as it moves in and out of your body during meditation. But with sensate focus, you pay careful attention to what you feel through your skin, homing in on things like texture, temperature, pressure, and speed.

A key aspect of a sensate focus is that it not be a sexual experience.

A key aspect of a sensate focus is that it not be a sexual experience. It involves collecting information about what you’re feeling, not working toward the goal of being turned on or having an orgasm. By keeping it non-sexual, you’re giving your brain space to recalibrate how it responds to touch and the anticipation of touch.

How do you practice sensate focus? 

Sensate focus is a step-by-step process that you’ll progress through over weeks or months. Through the steps, the landscape of sensual touch grows and expands to work toward sensual intercourse that is packed full of new and welcome sensations — all you need is a trusted partner of any sex or gender to practice with. 

Here are some important things to keep in mind as you go through each step:

  • Think sensual activity, not sexual activity. While the two may have a lot in common, differentiating them is key. Sexual activity refers to all that has to do with sex. With sensual activity, you focus your senses — sight, smell, touch, taste, and sound — to experience your body and your partner’s body. Sensual activity removes the pressure to perform or respond in a certain way, and can create space to break out of ingrained patterns and discover new things.
  • Stay present in the moment, noticing your sensations without judging them. My partner’s skin feels smooth here or rough there. Try not to anticipate what you’ll experience or evaluate whether it feels good. If you have expectations or judgments, especially in the moment, you’re not as present in your body.
Each time you practice, take turns touching or being touched.
  • Choose a toucher and a receiver. Each time you practice, take turns touching or being touched, which are two distinct experiences. As the toucher, try to focus on the sensations of touching your partner. As the receiver, focus on the sensations of your partner touching you.
  • Clear communication is key. Talk to each other in advance about how you’re going to practice sensate focus, and communicate during the activity, should anything make you feel uncomfortable or if you want to stop. It’s preferable, however, not to talk out loud about what you’re feeling so as not to distract your partner from their experience.
  • If you get turned on: That’s okay! But avoid turning this mindfulness practice into sex. Take a deep breath, slow things down, and focus on your sensations. 
  • If you get sleepy: Take a nap! Practice another time when you’re well rested. 

Set aside 30 to 45 minutes for each practice session, focusing on one step at a time. You can repeat a step as many or as few times as you’d like before continuing on to the next. Try these exercises when you and your partner are relaxed, rested, and feeling kind toward one another. Get naked so you can make way for lots of skin-to-skin contact, lock your door, and turn off your phone so you’re free of distractions. 

Step 1: Non-genital touching

For Step 1, breasts, chest, and genitals are strictly off-limits. Focus on the sensations of touching and being touched without incorporating the most traditional erogenous zones. 

Choose who will be the toucher first. The receiver can lie down while the toucher begins exploring various kinds of touch. Here are some ideas to consider:

  • Play with skin texture: Notice how skin textures on different parts of the body feel, both in touching and being touched. How do fingers compare to the backs of your hands, or the thighs or calves? Which parts of your skin are especially supple or sensitive?  
  • Vary tempo and pressure: Feel the difference between a soft, drawn-out touch and firm, quicker touches. Then compare a long, firm touch, to a quick, soft one. How do these variations affect your sensations?
  • See how touching with your whole hand feels compared to touching with one or two fingers, or just your fingertips.

Try to continue this for about 15 minutes to get past any initial awkwardness and into a good flow, then reverse roles. The new toucher can do their own exploration in whatever style or sequence they prefer. Remember that your goal is just to experiment with different kinds of touching and notice what they feel like, not to make your partner happy or give them a massage (but bookmark that for later!). Move on to Step 2 in another session when you feel ready.

Step 2: Genital and breast/chest touching

In Step 2, breasts, chest, and genitals are back on the table (kissing and intercourse are not). Use what you learned about touch and sensations from step one, and expand the repertoire of sensations while exploring touch of the genitals, chest, and breast. The key is to focus on the experience of touch and exploring your partner’s body, rather than trying to turn them on. However, don't forget about the rest of the body — consider briefly focusing on the genitals, then move to other parts of the body, returning again in the natural course of exploratory touching. 

Some things to experiment with in Step 2: 

  • Positions: The receiver could start lying face down. Then you might transition to where the toucher is sitting up with their back supported and legs slightly spread in a V shape, with the receiver sitting in between the toucher’s legs, and their back to the toucher’s chest. This way, the toucher can reach around the receiver to touch most of their body.
  • Hand-riding: In this technique, the receiver places their hand on the back of the toucher’s to follow along with their movements. The intention is not for the receiver to direct the movements, but to provide subtle, nonverbal feedback about things like speed or pressure. The receiver can show where they like a firmer touch, or where they might like to linger. If you’re the toucher, try to take this feedback not as criticism but as a suggestion for experimentation. This technique is especially useful in genital touching so that the toucher doesn’t have to guess what the receiver prefers.

Touchers: If you feel tempted by sexual touch, think back and try to repeat some of the things you learned in Step 1. Slow down. Trace along the curve of your partner’s spine, then see how that compares to the contour of their hips. Run your fingers through their hair as if you’re experiencing its texture and thickness for the first time. You could also try shifting the receiver into a new position to change things up and reconnect to your sensations.

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Receivers: If you become sexually aroused, take a deep breath in, then breathe out as you refocus on the physical sensations of your partner’s touch. If you want to keep receiving genital stimulation, your partner can continue, with or without hand-riding to guide their pressure and tempo, and then deliberately move on to other areas of the body, rather than staying focused on the genitals. If you orgasm, let it happen, but neither partner should try to make it happen.

Again, take turns touching and receiving. At any time, either partner can say, “I’d like to switch,” if they find themselves feeling bored or fatigued.

Step 3: Touching with lotion

Progress to experience the sensations of touch through lotion. The addition of your favorite lotion, baby oil, or massage oil provides a silkier, slicker texture that can really help to expand sensory awareness by enhancing the physical sensations. Warm the bottle or tube in hot water or the microwave beforehand, or the toucher can just rub it in between their hands to warm it before putting it on their partner’s body, to further enhance this touch. 

Some couples like to start Step 3 with lotion, while others prefer to start without it and then add it in for comparison. Either method is fine, but remember to focus on sensations, not giving a massage.

Note: If the partner that is receiving touch has any vulvar pain or sensitivity, consider using a gentle personal lubricant that they know will not irritate their symptoms, when practicing touch to their genitals.

Step 4: Mutual touching

This step moves away from the “your turn, my turn” cadence and allows you to use your sharpened sensory awareness skills to experience all of the sensations of touching your partner, while at the same time experiencing being touched by your partner, bringing your sensual activity to a new realm. Continue to hold off on kissing and intercourse to focus just on the additional sensual dimension of mutual touching. 

Things to try in Step 4:

  • Oral touching: This doesn’t mean oral sex. Instead, it means using your mouth and tongue the same way you’ve been using your fingertips to explore your partner’s body.
  • Location: Move from the bed to the shower or another location to see how that alters your perception and experience.

If you start feeling sexually focused, it’s fine to refocus on less sexual areas of the body, or lie down and let your partner do the touching until you’re ready to bring your attention back to tactile sensations. 

Step 5: Sensual intercourse

You know how you can have sex without intercourse, a.k.a. outercourse? This is the reverse: having intercourse without sex. What does that mean? The idea is to incorporate intercourse into how you and your partner touch each other. You’ll expand your sensory awareness into direct genital touching, while remaining focused on physical sensations rather than sexual pleasure.

To ease into it, start with non-genital touching, then gradually progress to genital and mutual touching. Don’t try to become aroused—and don’t worry if you do. Just focus on the sensations in your fingertips and the feel of your partner’s touch on your body. Use the hand-riding technique to show your partner what you like, but try not to direct their moves.

When you feel like you’re both comfortable and focused, get into a position that’s amenable to intercourse but don’t insert anything yet. Begin by exploring genital-to-genital contact the way you did in previous steps with your fingers or mouth; notice the sensations you experience with different variations of touching and rubbing. 

If you’re ready for intercourse, start with just partial penetration. Go slowly and focus on the new warmth you’re feeling. Experiment with going shallow versus going deeper, or slower versus faster. Stop moving altogether, either in partial penetration or deep inside. Hold completely still for 20 or 30 seconds. What does that feel like? Make small, subtle movements, or squeeze and relax your pelvic floor muscles. How does that change your sensations? Play with whatever feels interesting to you and your partner, and remember to keep your focus on sensations. 

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Your pelvic physical therapist (PT) can help you decide when and if sensate focus should be incorporated into your treatment for healing pelvic pain, and they’ll connect you with a trusted sex therapist or psychotherapist to help guide you through this practice. Your therapist will help you determine a program that’s right for you and safely guide you through the practice, particularly if any negative or traumatic emotions are surfaced in the process. 

Once you progress through the final step, you can enjoy this “new” way of having intercourse, and come back to it whenever you and your partner desire, as a way to vary your healthy, sensual sexual relationship.

Clinical content writer and product designer Amanda Angelotti
Amanda Angelotti, MD

One of Amanda's favorite things in life is translating complicated medical concepts into understandable-yet-sophisticated content. After earning her medical degree at UCSF, she worked on clinical product development and content at several health tech companies, including Robin Healthcare, One Medical, Iodine, and Omada Health. Amanda recently returned to freelancing so she can devote more time to her other favorite things in life, which include her daughters, sci-fi, whole milk, public transit, and live music.

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