The Sensory Detective: Finding Sensory Integration Clues to Sexual Dysfunction

Non-demand touch, such as hand massage and other “sensate focus” exercises, are still recommended by many sex therapists who want to help couples struggling with sexual difficulties. Non-demand touch exercises help take the pressure off partners who are too focused or anxious about penis-vagina penetration to stay present with their own or their partner’s responses. These exercises are designed to build or restore emotional safety and sexual trust; cultivate awareness of sensual stimulation and preferences; and facilitate intimate communication through exploratory questions and answers as both partners experience giving and receiving touch.

The giver may ask questions like:
“Is this a good place to touch you?”
“Do you like this touch to be fast or slow, firm or light?”

The receiver may say things like:
“No, I don’t like my nipples touched until I am more aroused.”
“Yes, that feels good. But press just a little more firmly there.”

You may have experienced these “homeplay” exercises if you have consulted a sex therapist or clinical sexologist. If you are a sexologist or therapist yourself, you may be used to routinely including a program of sensate focus exercises in your clinical practice. However, some people experience anxiety during these exercises, or find them to be a turn-off, or otherwise counter-productive. Some people may resist doing these exercises, but are not sure why, and this resistance can add to the difficulties already experienced by the couple.

It’s time we were all more aware of sensory integration dysfunctions and their potential effects on sexual intimacy. We have to ask ourselves, “what is the impact of sensory dysfunction on sexual behavior?” A couple of years ago I coined an unofficial term for this problem, “adult sexual-sensory dysfunction” or ASSD. And though many of us are fed up with acronyms and the “alphabet soup” diagnoses, I’d like to use this term to advance a new meme and awareness. I see sensory integration dysfunction as one of the missing links in addressing and managing sexual concerns, particularly for people who also have a diagnosis of ADHD or ADD; or Asperger’s Syndrome or another autism spectrum condition; or any other pervasive developmental condition where sensory dysfunction often occurs. However, some people simply experience sensory integration problems which are not co-morbid. Children who are diagnosed with sensory disorders often receive help through “sensory diet” planned by occupational therapists. But for many adults, sensory dysfunction is seldom considered or diagnosed.

What is sensory dysfunction? Someone who has a low threshold for noise, touch, smell, taste, or sound is hypersensitive, and will avoid those things. A person who has a high threshold for various types of sensory input is hyposensitive, and will seek out these sensations. Many people combine low and high thresholds for various kinds of stimuli. For example, a person may crave super-spicy food (hyposensitive to taste) but be unable to tolerate the sound of a humming refrigerator (hypersensitive to sound). If you are hyposensitive, you will seek more of that kind of sensation. You will be a “sensory seeker.” Mosh pits and loud rock concerts are filled with hyposensitive sensation seekers. A hypersensitive person will be sensory avoidant. The person who flinches from touch is tactile avoidant. A person who cannot bear to kiss or give oral sex may have oral sensitivities. The senses of balance and body awareness are also included in sensory integration.

I have had a few clients who cannot bear to give oral sex. As children, these people hated having their face washed or their teeth brushed – any sensation around their face or mouth is unbearable. I have had a few clients who were aversive to certain types of touch. They may go through the roof with gentle stroking but enjoy a firm, non-moving grip. Even certain types of fabric – a change to flannel sheets, for example – can interrupt an otherwise promising sexual encounter.

There is growing anecdotal awareness in the BDSM and kink communities that for many people, consensual bondage, sensation play, and certain fetishes may be providing an eroticized – and much needed – adult sensory diet for people who experience some form of sensory dysfunction. As a “kink aware professional,” I feel we need much more research and understanding of the creative ways in which some adults cope with sensory dysfunction and its impact on sexual behavior and feelings.

Some sensory dysfunction websites provide checklists for sensory issues. While I do not suggest that these checklists will provide grounds for a diagnosis, they may indicate the wisdom of referring certain clients to occupational therapists for assessment. In the meantime, you can also use the results of these checklists to modify sensate focus and other homeplay strategies as needed. In the absence of abundant research on this topic, you may feel that you are “playing detective,” but please persist – this is an area which deserves diligent and careful inquiry.

© Copyright 2011 by By Amy Marsh, Sexologist & Consulting Hypnotist (EdD, DHS, CH), therapist in Albany, California. All Rights Reserved. Permission to publish granted to

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • L. Austin

    L. Austin

    September 26th, 2011 at 2:56 PM

    Never been to a clinical sexologist or anything of that nature, but me and my husband do non-demand touch exercises. However, we didn’t know what it was called, since we thought we made it up. I will say to any couples married, engaged or serious dating that this is a great technique to utilize of you aren’t very comfortable with the idea of sexual intercourse. While your partner might be a bit anxious to go to “full blown” sex, this will help you gain your trust for one another as well as sexual confidence. Not to much that it is quite pleasurable!

    This doesn’t have to be limited to sexual dysfunction, it is good to practice this even if you are sexually active with your partner.

  • Jada


    September 26th, 2011 at 4:36 PM

    I would have to think that in a relationship where there is some form of sexual dysfunction that trust would be one of the first things to go. And when one partner can’t trust another then there are bound to be some deep issues there that will definitely require the guidance of a skilled therapist.

  • Molly S

    Molly S

    September 27th, 2011 at 3:51 PM

    When I found out that my husband had cheated on me I did not want him anywhere near me, not to even look at me and especially touch me, even if by accident. It took a long time and a very long healing process to get to the point where him touching me did not make me feel sick. We eventually divorced even after doing some therapy, but we are trying to at least be friends again. There were just too many things that the body and the mond could not let go of, and I knew that without that resolution I was stuck in a marriage that I was no longer going to be able to be committed to.

  • Rene Tait

    Rene Tait

    September 27th, 2011 at 10:51 PM

    Things on our mind can reflect on our body and this is what leads to the hyposensitivity and hypersensitivity in certain people.To fix issues such as these,not only is talkin about and thinking about it necessary but practicing to overcome the same is important as well.

    Consulting an expert and then doing the ‘homework’ with your partner seems like a very healthy and effective way of working on the problem.

  • Tim Molony

    Tim Molony

    December 25th, 2011 at 6:02 PM

    I am 45 years old and through the process of recovering my own son from autism over the past several years I have become aware of my own spectrum issues that were never diagnosed because I was not far enough along on the spectrum. It has opened up a world of understanding…not only for me but also about what my son goes through every day.

    Something I have always dealt with is hyposensitivity to touch. When it came to sex, something I am very passionate about, I always felt like a freak. I could have sex for hours with out having an orgasm. Only when I was truly relaxed and felt “safe” with someone did I orgasm. I once went two years, having twenty partners and never once reaching orgasm with any of them. I felt like a freak…I did not understand. Occasionally I would find a woman who liked to give and receive forceful play, pinching, biting, slapping…nothing too rough but enough to bring slight pain and discomfort. I always found this a great turn on…because it grounded me and brought me to a very present place with who I was with. Still I felt like a freak and was shy about it and never spoke to anyone about the way I felt. Only now am I learning. This article is the first I have read and I am so happy to find that I am not so rare.

    I have never liked “quickies” because I need time to warm up, relax and get to know the other person. Foreplay and exploration has always felt good but I never knew how to approach my hyposensitivity with someone I was just getting to know…I never connected all the dots. Occasionally I would find someone I clicked with and the sex was amazing…but mostly I suffered in silence. This article gives me much hope and I will now explore this.

    I recently met someone and I was feeling relaxed. When I asked her to pinch and bite me past the point she thought appropriate (for herself) she laughingly called my desire for this “strange” and called me “inhuman”…this while we were naked in bed. Though I found her incredibly insensitive I did not take it personally because I already felt like a freak…I am my own harshest critic…her words did not hurt but have led me to this article in a search for understanding of my own sexuality. I am thankful…

  • C Randolph

    C Randolph

    January 23rd, 2012 at 2:11 AM

    My partner, a wonderfully kind man and on the spectrum, has what seems to be multiple sensory issues that are effecting our sex life and overall issues related to intimacy. These issues are quite varied and sometimes difficult for me to understand. For example. He can go hours wanting to have sexual intercourse. He has no concept regarding the amount of time. He can loose his erection by hearing a noice, my making a body move or shift and stll contines with intercourse by sticking his penis back inside me. He rarely has orgasms and does not sem to care. He doesn’t like to tongue kiss and no cunniglingus as he feels like he is choking. He will touch me, however, while doing this he looses his erection. Sometimes, things work out fine and other times I just feel annoyed and frustrated. The hardest part for me is my feelings of disconnection and feeling a need for being desired. While theoreticly know he does desire me; I struggle with how all the pieces fit together. I have not found any information which helps me understand things and he does seem to understand either.

  • Poppy


    November 12th, 2012 at 10:10 AM

    My partner is 50 years old, I believe he has a mild form of Aspies (undiagnosed) He can get an erection but when it comes to penetration he tends to lose it which is frustrating. He doesn’t seem to consider this a problem though. He likes a degree of bondage, blindfolds, pressure and constriction.
    Is this common in Aspies?

  • Karla


    October 29th, 2014 at 4:13 PM

    I am glad I ran into this post. I am an Occupational Therapist, and I’ve always been interested in human sexuality. I had a hard time finding an article about sensory integration/SPD and sexuality. I think the lack of literature in this topic definitely helps me direct my goals for future research. Thanks for everyone who has shared their experience.
    I’m sorry you’ve encountered insensitive people, or you have gone through life feeling strange and different. Sexuality is so subjective, despite cultural and media influences to define what it “should” be.
    I recommend a book by Dr. Jack Morin, The Erotic Mind. Whatever your sexuality looks like, feels like, it is your experience and there is no right or wrong way to engage in sex (assuming, of course, that it is between consenting individuals).
    Anyway, thank you for sharing your experiences! I found them insightful and definitely helpful for my PhD plans.

  • Claudia


    April 5th, 2017 at 4:39 AM

    Thank you for these informative comments2ZkA

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