IrishPsychiatrist 15

STUDY
PEGGY J KLEINPLATZ
A DANA MNARD
NICOLAS PARADIS
MEGHAN CAMPBELL
TRACY DALGLEISH
ANDREW SEGOVIA
KELLIE DAVIS
From closet to reality: optimal sexuality
among the elderly
SUMMARY
Semi-structured interviews were conducted with men and
women over the age of 60 who had been in relationships of
25 years or longer and who self-report experiencing optimal
sexuality. The findings suggest that perceptions of sexuality
change over time. Secondly, optimal sexuality flourishes in
the context of a relationship deepening with maturity.
Thirdly, optimal sex gets surprisingly better with experience
and becomes self-perpetuating. Finally, intimacy does not
necessarily mean monogamy. Aging may be an asset towards
optimal sexual development.
INTRODUCTION
Within popular culture, the predominant message is that
great sex is the exclusive province of young, attractive, able-
bodied, unmarried, heterosexual individuals. Research on the
sexuality of the elderly has focused on the multitude of sexual
problems faced by the elderly (and the hormonal treatments
available).
1,2,3
However, that those individuals who have
managed to stay partnered with the same person for decades
could be considered role models for how to make great sex
last a lifetime, is an idea that has not been considered.
The aging process in both men and women is believed to be
invariably associated with the experience of sexual
dysfunctions. According to DeLamater and Sill, the operating
paradigm within the research concerning sexual desire in
elderly populations seems to be that sexual desire decreases
by default with age as a result of lower hormone levels, illness,
medication, injury or lack of access to sexual partners.
4
The impression that sex becomes rather dismal with aging
stands alongside a few recent studies showing the potential
importance of sex in the lives of the elderly.
5,6,7
Although old, married people are generally not considered
first as a font of information about optimal sexuality, it
stands to reason that individuals and couples who have
managed to make this experience last a lifetime or who have
developed the capacity over the years to experience optimal
sexuality have much to teach the rest of us. In this study, we
set out to answer one question: what is the picture of
optimal sexuality in individuals over the age of 60 who
have been in partnered relationships for 25 years or longer?
METHODS
Semi-structured interviews were conducted by two of the
authors (i.e. a clinical psychologist and a graduate student
in psychology) over the telephone and were recorded with
informed consent. Interviews were of 45 minutes to two
hours duration. Members of the research team attempted to
cluster together conceptually related themes to describe a
picture of great sex among these participants. Several
meetings were held to discuss these themes followed by a
return to the data by each member of the team until a
picture of optimal sexuality among these participants began
to emerge. The study was approved by the Ethics Committee
at Carleton University and subsequently by the Ethics
Review Board of the University of Ottawa (both in Canada).
Participants were sought out based on their prospective
knowledge of optimal sexuality. These key informants
were individuals who self-reported having experienced
optimal sexuality in their relationships of 25 years or longer.
They were recruited through announcements posted in
community groups for older men and women. Additional
participants were recruited using a snowball technique.
As part of a broader study, a total of 64 participants were
interviewed, including 25 older individuals (14 men, 11
women). Of the 25 individuals recruited on the basis of their
age and long-term relationships, the average age was 66.6
years with a range from 60 to 82 years. The average length
of participants longest relationship was 29.0 years. Many of
the older participants (n=15) described themselves as able-
bodied but others were currently experiencing physical
disabilities or illness (n=10).
RESULTS
Five major themes emerged in the analysis of the interview
data as follows.

Optimal sexuality changes over time
Participants who reported having experienced great sex
noted that it improves with age, maturity and experience. It
changes over a lifetime, evolving constantly. An older woman
observed: Instead of rushing by the windows in a train, one
watches the scenery. Others mentioned that as sex became
greater it became slower, less goal-directed and orgasm-
focused. An older man had learned with experience that the
great relief of sexual urges is not the same as great sex.
Many comments suggested that practice is important and
helpful. The learning process continues still: You can always
go further. An older woman noted: I think experience
makes all the difference. Theoretically, the elements are the
same. But in all likelihood, it takes a fair bit of experience and
practice to get as high as you can possibly go before you die.
In addition, though, it was personal growth that enabled
exceptional sexual experiences: Young people are more
performance and theyre just too anxious. Older people have
more understanding for what it takes Sex comes with
maturity. Sex becomes better and better with time (as
described by an older man). If anything, the participants
conceptions of great sex had become increasingly demanding
over time. A 67-year-old man commented: Well, I was not as
good a lover when I was 19 to 40 as I was thereafter, and I
probably am a better lover today than when I was 40.
Optimal sexuality flourishes in the context of a
relationship deepening with time
Optimal sexuality is always contextual and seems to thrive
in ever-deepening relationships characterised by an invested
sexual interest in oneself and/or another.
8
As one participant
noted: Its just the huge warmth of being with somebody
that youve been in bed with for 40-plus years and still
feeling that immense rush of joy that, you know, what a
gift! Whereas the popular myth is that long-term
relationships breed sexual boredom, participants suggested
that the profound development of intimacy is the
prerequisite for optimal sexuality: As you get to really
experience the other person, get to know each other, get to
open up with each other, fine-tuning things sex gets
better with time, with a partner. The qualities of optimal
sexual relations identified previously, such as being present,
mutually transparent, vulnerable, safe and respectful
9
seem
to blossom with commitment to one another and to sexual
intimacy.
8
Such fundamentals as trust, caring and expressive,
empathic communication enable couples to take risks
together: Because of the attitudes and the freedom and the
ease that you have with your partner, or partners, um, you
just, uh, sort of seem to relax and go to places that you
might not have planned out but that are delightful.
Great sex becomes even more impressive with age:
I didnt know it would be that great until I got there
(older woman)
Many of the participants reported that they began
experiencing great sex when younger, or at least had caught
a glimpse of it, but over the years it had become even greater
and with more consistency and regularity rather than by
some rare fluke. They recalled great sex beginning in mid-
life, often mentioning their 50s. Over time, a higher
proportion of sexual experiences had become great and
with greater consistency. As an older man articulated it: Its
more frequent, its more common, its more often now Its
like once youre open, youre open. Even those who had
had an inkling of what lay ahead did not quite grasp it until
they got there. An older woman recalled: I always had a
sense of what great sex would look like in the moment but
it wasnt until I really got there that I first had a sense of
what the bliss looked like in the afterglow. Another older
man noted: Its like somewhere in there, I hit another gear
and saw possibilities that I didnt think about before, wasnt
aware of missing anything. But I found other, I found more
keys on the keyboard.
Great sex is self-perpetuating: memory reminiscing
anticipation
One of the themes emerging from these interviews is that
great sex leads to more great sex. Just as many therapists
observe downward spirals in our patients destructive
interaction patterns, a spiral escalating upwards becomes
self-perpetuating, too. It seems that the shared memory of
great sex leads to joint reminiscing, which in turn helps
solidify and enrich the bond between the partners, which
then brings about more anticipation of great sex. In the
words of one older woman, it begins with memories etched
on your consciousness. As another pointed out, this
reminiscing is part of how one recognises great sex. An older
man stated: It creates anchor points pleasure points
which you can bring back. These individual and shared
memories then create a platform and springboard for further
deepening and expression of optimal sexuality.
Other comments demonstrated the contrast between
social stereotypes of the elderly as asexual (or perhaps post-
sexual) versus the reality of how optimal sexuality affects
ones sense of self, improving self-esteem and body image,
thereby leading to more great sex. One older woman said: I
am incredibly sexy and I know it or, as exclaimed by an
older man, it made me feel 50 years old again!
Intimacy and monogamy
Perhaps the most surprising findings involved multiple
partnerships among the elderly. In seeking the wisdom of
old, married couples, we specifically sought out
participants over the age of 60 who had been with the same
partner for at least 25 years, but found that about half
(13/25) were openly non-monogamous. None of them were
cheating on their partners, that is, involved in clandestine
affairs. All of these 13 participants had some variety of
consensual non-monogamy built into their primary
partnerships. This mutual agreement was confirmed by their
spouses on those occasions when both members of a couple
had volunteered to be interviewed; in those cases, we
From closet to reality: optimal sexuality among the elderly
16 IrishPsychiatrist
interviewed each partner separately and found their accounts
were virtually identical. Most of the participants had married
with the expectation of monogamy but chose to expand their
options over the years. In interviewing a husband and wife
(separately) who had been married to each other for 46
years, each said: Great sex began 12 years agowhen we
went poly. Yet even for non-monogamous individuals, the
greatest sex almost always occurred with the primary partner.
DISCUSSION
For those who fear aging will entail the inevitable loss of
sexuality, it is heartening to discover that personal and
relationship development over the course of a lifetime can
help open the door to optimal sexuality.
None of the participants in this study felt that his/her
facility for optimal sexuality was a natural talent that had
sprung fully formed in youth. On the contrary, these
participants believed that the quality of their sex lives had
changed over time as well as perceptions of what sex might
be or could become. For individuals so inclined, the heights
of sexual relations could grow given maturity, experience
and deep emotional intimacy. Furthermore, the pinnacle
thus far of their sexual experiences far exceeded their
hopes and expectations. On the basis of this study, it is not
clear if all people are capable of optimal sexuality or would
even wish to experience it; however, it is clear that among
those who now live it, the capacity for optimal sexuality was
acquired, thus allowing for the prospect that others who
might value optimal sexuality could cultivate the ability, too.
Curiously, even among those we had sought out
specifically because they were old, married people few had
a conventional sex life, or at least what the research
literature had suggested was predominant. This may reflect
a sampling error or may suggest a further link between
rejecting traditional sexual norms and optimal sexuality.
Several also had debilitating illnesses or injuries or had
partners with injuries or illnesses that prevented them from
experiencing normative sexual functioning. Many
participants emphasised the need to let go of conventional
sex scripts, re-vision sexuality and expand conceptions of
sex itself. Their new, broadened range of meanings was
surely to their advantage in continuing their sexual
adventures as they grew older in the face of diminishing
physical capacities. As mental health professionals, we may
learn from them to focus on heightened pleasure rather than
sexual performance in helping our patients at any point in
the life cycle.
The sexuality of older individuals has been marginalised
both within the research literature and the general
population. However, results of this study indicate that
aging is no impediment to the experience of optimal
sexuality and may actually be an asset. These participants
have demonstrated that sexual intimacy can provide a
journey of ongoing and growing discovery and mutual
exploration, constantly rediscovering oneself and ones
partner(s), physically and emotionally naked together.
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PEGGY J KLEINPLATZ, PHD, FACULTY OF MEDICINE AND SCHOOL
OF PSYCHOLOGY, UNIVERSITY OF OTTAWA, CANADA
A DANA MNARD, MA, SCHOOL OF PSYCHOLOGY, UNIVERSITY OF
OTTAWA, CANADA
NICOLAS PARADIS, BA, FACULTY OF EDUCATION, UNIVERSITY OF
OTTAWA, CANADA
MEGHAN CAMPBELL, PSYD, INDEPENDENT PRACTICE
TRACY DALGLEISH, BA, SCHOOL OF PSYCHOLOGY, UNIVERSITY OF
OTTAWA, CANADA
ANDREW SEGOVIA, BA, SCHOOL OF PSYCHOLOGY, DEPT OF
HUMAN KINETICS, UNIVERSITY OF OTTAWA, CANADA
KELLIE DAVIS, BSC, FACULTY OF MEDICINE, UNIVERSITY OF
OTTAWA, CANADA
From closet to reality: optimal sexuality among the elderly
18 IrishPsychiatrist