(Aug. 2022)
Introduction
The impact of orgasmic meditation (OM) practice and its downstream influence on various psychological, physiological, and neurological metrics has been demonstrated in an accumulating wealth of scientific research findings. This report provides a comprehensive synthesis of OM literature to date, highlights comparisons and distinctions with other contemplative practices and research findings, and provides insight into the most pertinent future research directions.
What is OM?
Orgasmic Meditation (OM) is a mindfulness-based, partnered, consciousness-sexuality practice designed to create feelings of increased awareness, connection, and intimacy through finger to genital contact. Mindfulness is broadly defined as the process of bringing attention to any moment-to-moment experience (Bishop et al., 2004). OM is a partnered practice in which one person gently strokes the upper left quadrant of the partner’s clitoris for 15 minutes. Participants practicing OM are known as “stroker” and “strokee,” with the stroker using an index finger to stimulate the strokee’s clitoris. The stroker can be any gender; the strokee must have a clitoris and thus is always a cisgender female or postoperative transgender female. The sexual orientations of the stroker and strokee are unimportant; that is a matter of the participants’ preference.
Practitioners of OM follow what is referred to as a “container,” a defined sequence of deliberate and structured steps that result in reproducible experiences. Verbal interactions between the stroker and strokee are minimal and limited to descriptions of the vulva (stroker) and requests/suggestions concerning slight variations in stroke (stroker or strokee). Safety measures are in place. The stroker warns the strokee first before touching the strokee’s body and again before touching the strokee’s genitals; both participants are taught that the OM session can be ended at any time, for any reason, and with no need for explanation. OM is defined as a meditative practice separate from the act of sex. Despite its name, the aim of orgasmic meditation is not on achieving sexual climax but rather on developing heightened awareness through a focus on the physical sensations experienced during the OM session (Millar, 2015). OM practitioners report anecdotal benefits similar to other mindfulness-based practices, in addition to the well-known health benefits associated with orgasm (Lakshmin interview [Asprey, 2013]).
The aim of OM is to provide access to peak states of consciousness, akin to the marriage of flow and meditation that shifts individuals into eudaimonic well-being.
OM and Behavioral Applications
Induction of flow states: The OM experience displays similarities to flow in brain states. The primary subjective characteristic of a flow experience is that it arises when persons are performing an activity in which they are fully engaged and immersed in a feeling of energized focus, enjoying the process of the activity. People feel that they have become part of the sensory input from the external activity and, hence, feel a state of flow not only in the mind but throughout the entire body. In a similar manner, OM practice is reported to include an experience remarkably similar to that of flow states. For both stroker and strokee, the experience seems to be marked by a feeling of energy moving through the body such that participants become absorbed into the activity and the sensory stimulation process of the practice. For the strokee, sensory stimulation is specifically related to clitoral stroking. For the stroker, it is the act of stroking itself, interactions with the strokee, and participation in the flow state.
Brain scan studies of various flow-induced states have documented decreased metabolic activity in the brain’s frontal lobes. During OM sessions, decreased activity in the frontal lobes has been documented as well (Newberg et al., 2021; Newberg et al., in preparation). Hence, we recognize similar changes in neurophysiology associated with the experience of OM practice and flow states.
Since the frontal lobes also regulate neuronal flow in other areas of the brain, one may expect other similarities such as changes in the limbic system, which is involved in emotional processing as well as automated thought processes. In both OM and flow experiences, the limbic system appears to play a prominent role.
Facilitating and enhancing connection: Although the roles of the partners in an OM practice are distinct (one partner stroking and the other being stroked), both participants have claimed benefit from the practice, including improved intimate/romantic partnerships, empathy, friendships, physical health, mental health, professional life, and spiritual/religious life—regardless of age, sexuality, education, or income (Millar, 2015). OM practitioners also report deep transformative experiences during and as a result of their practice. One uniquely transformative element of OM practice is that it reliably increases experiences of connectivity and empathy.
In a recent study, Prause et al. (2021b) investigated whether OM would increase feelings of closeness in both romantic and non-romantic couples. Each participant was required to have performed OM at least 10 times previously, and each couple was required to have practiced it together at least once prior to the study. One hundred twenty-five couples reported their feelings of closeness before and after OM. Approximately half of the couples’ relationships were romantic and the other half’s were non-romantic. Prause et al. found that closeness after OM increased on average across the study participants. Interestingly, non-romantic couples reported increased closeness (“self-other overlap”) more than romantic couples.
OM increased self-awareness in both men and women, which in turn had a positive impact on their intimate and romantic partnerships. Women reported that OM increased connection, sensation, awareness of others, and self-confidence, while improving communication and their sex life. Men reported that OM increased intimate connection, confidence, awareness of others, physical sensations, and sexual awareness as well as knowledge about sex and women. They also reported improved sex life and communication in partnerships. Findings of this study support the conclusion “that this partnered, largely non-verbal practice is associated with increased feelings of closeness in the moment, including for individuals who are not in a romantic relationship” (Prause et al, 2021),
Research suggests that closer relationships result in greater intentions to help the partner (Cialdini et al., 1997), higher average relationship well-being (Bohns et al., 2013), greater compassion (Oveis et al., 2010), positive trait attributions to the other (Davis et al., 1996), and lower feelings of loneliness (Vaux, 1988). Increasing relationship closeness in the moment improved couple’s problem resolutions (Campbell et al., 2008), increased helping (Neuberg et al., 1997), improved physiological reactivity to stressors (Carlisle et al., 2012), lower perceived stress (Cwir et al., 2011), increased empathy for another person (Myers et al., 2013), improved self-control (Egan et al., 2012), and promoted positive emotions (Ramsey & Gentzler, 2015).
Impact of OM on sleep: Two independent and highly influential contributors to quality of life are sleep quality and sexual activity. Researchers (Griggs & Thiel, in review 2022) chose OM to investigate the relationship between sexual stimulation and sleep. These researchers conducted a 30-day observational study in 36 OM practitioners. During this period, participants tracked their sleep each night by using the Sleep Premium app and, on the following morning, completed a brief questionnaire about the previous day, answering the following questions: whether they had practiced OM that day, how many times was OM practiced, whether they had been stroker or strokee, whether they had engaged in physical exercise, and (for female participants) whether sexual climax had occurred. In addition, the participants completed a 15-item Tumescence Survey developed by the Institute of OM Foundation, in which higher scores indicate more psychological distress, dissociation, and craving for addictive substances.
A total of 1026 nights’ worth of data was obtained from the participants. There was a large range in the number of times participants practiced OM during the study period. Three participants only practiced OM two times during the 30-day period, whereas one participant practiced OM 87 times. Most OM sessions did not result in sexual climax in the female participants; four participants did not climax at all, whereas two participants reached sexual climax during OM sessions.
In the study analysis, OM was found to decrease sleep duration, quality, and onset rate. OM also decreased participant’s tumescence scores. The authors conclude that OM decreases sleep quality and duration, while it leads participants to a higher state of well-being. The authors note that this could indicate that OM has mood-elevating benefits.
OM as an access to eudaimonic well-being. “Eudaimonic well-being” describes a particular contentment or happiness stemming from self-actualization and having a meaningful purpose in life. Huta (2013) and Ryff (2018) have both published characteristics of eudaimonic traits.
Recently two researchers (Griggs & Regan, in preparation 2022) conducted a qualitative study of journal entries written by OM practitioners following OM practice. The researchers’ first hypothesis was that themes from Huta’s definition of eudaimonic well-being, such as connections, aliveness, presence, and competence, would be applicable themes connected to OM. Their second hypothesis was that OM allows practitioners to access characteristics of Ryff’s model of eudaimonic well-being, particularly autonomy, personal growth, positive relations with others, and self-acceptance.
The researchers assessed 1506 free-form journal entries written by 55 experienced OM practitioners (25 strokers and 30 strokees). Both summative content analysis and latent content analysis were performed. Data for strokers and strokees were first analyzed separately to identify common themes within groups. Following this, latent content analysis was performed on data from both participant groups.
Five common themes were identified in the stroker group: connected with partner, took control of the process, conscious of the act and process, post-OM experiences, and struggled with the OM process. Four common themes were identified in the strokee group: opened oneself to the sensation, lost oneself, a sense of security, and felt freed. No common themes were shared between strokers and strokes. Nevertheless, the authors note that “while strokers and strokees have different experiences inside the OM they each, through their own avenue, are developing skills and obtaining states of being that indicate OM does indeed create access to eudaimonic well-being” (Griggs & Regan, in preparation 2022).
Reports on mystical experiences: Using a validated, quantitative measure of mystical experience, the Mystical Experience Questionnaire (MEQ30), Siegel and Emmert-Aronson (2019) conducted a two-part study to assess whether and to what extent participants would report mystical experiences during OM, and also how much such experiences would be correlated between partners. The MEQ is used to measure four different facets of the mystical experience: mystical (feelings of oneness); transcendence (loss of boundaries of time and space); ineffability (inability to put the experience into words); and positive mood.The questionnaire has been used previously to measure mystical experiences generated by hallucinogenic agents such as psilocybin.
In the first part of the study, 780 OM practitioners were asked individually to complete the MEQ30 with a single powerful OM session in mind. Respondents reported having had moderate to strong mystical experiences, with 62% of respondents reporting a “complete mystical experience.” Women experienced higher levels of mysticism than men. In the second part, the authors asked experienced OM couples to complete the MEQ30 immediately after their next OM session. One hundred twelve respondents (56 couples) reported on average having had moderate mystical experiences, with 23% reporting a “complete mystical experience.” When couples were asked to respond to questions about the same OM session, both partners reported a similar intensity of mystical experience. Session intensity was not dependent on being in a particular position.
Findings of the study suggest that OM can trigger a substantial mystical experience in both partners—one comparable in strength to that induced by a moderate dose of psilocybin, which has also been reported to result in mystical experiences and has shown promise in the treatment of mood and substance disorders. Future research is planned to investigate neural activity in OM practitioners and in persons who experience other forms of mystical experience.
OM vs Sex: OM is taught as a practice distinct from sex. In a study conducted to see whether people who engage in OM actually maintain that distinction (Siegel et al., 2022), researchers conducted an online convenience sample survey including qualitative open-ended text questions and quantitative Likert-style questions. The 30-item questionnaire, which was distributed via email listservs to practitioners of OM, included questions designed to explore similarities and differences between OM, seated meditation, fondling, and sex. Siegel et al.’s report includes an analysis of 220 OM practitioners’ responses to the quantitative questions.
OM practitioners view OM sessions as significantly more similar to meditation than to sex or fondling. This viewpoint is consistent regardless of the manner in which the question was asked (e.g., agree with “OM is not sex” or disagree with “OM is sex”) or whether OM was compared to a specific or multiple behaviors. As practitioners complete more OM sessions, the distinction between OM and sex or fondling becomes more pronounced, suggesting that the novelty of genital touching in meditation diminishes over time, as practitioners get used to the focus of OM.
Siegel et al. conclude, “The results of this study have implications for OM practice and for how it is approached and regulated. As previous studies have shown, sociocultural and historical contexts play a large role in what constitutes sex. In the wake of current public controversy over sex and consent, a practice whose practitioners report benefits in relationships, friendships, health, professional life, and spiritual life (Millar, 2015), has teachings around sexuality and consent, and yet is rated as clearly distinct from sex possesses clear benefits and a role in the broader conversation of health, wellness, and positive sexuality” (Siegel et al., 2022, p. 9).
Arousal evaluated by galvanic skin response. Studies of meditation often assume homogeneity in the nature of arousal that is experienced. If this assumption is incorrect, however, the effects of meditation may be mischaracterized. To illustrate this possibility, Siegle and Prause (2022) used the example of OM, a meditative-sexual experience that one might intuit would produce uniformly high arousal. Galvanic skin response (GSR) was recorded from 100 participants as a measure of general arousal during a single OM session. The experiences were not homogeneous, with some participants demonstrating increased arousal and others lowered arousal. In fact, phasic GSR patterns suggested that a similar number of individuals experienced increased arousal as those who experienced decreased arousal during OM. The researchers state that their findings suggest “that even for the most intuitive examples, averaging reactivity across people may be a poor decision. Rather, it is possible that the same form of meditation could confer benefits to different individuals, or the same individuals on different days, through different mechanisms.”
Sex film viewing—not hypersexual concerns—associated with greater sexual arousal before engaging in OM: One hundred twenty-five adult couples (250 participants) who reported having practiced OM at least 10 times in the past were recruited through social media, OM listservs, and word of mouth. Information was collected on these participants’ levels of sensation seeking, touch avoidance, pathology symptoms, and sexual assault history.
Hypersexual concerns were assessed by queries concerning participants’ own concerns about their ability to control their own sexual behavior and their frequency of viewing sexual films. Sexual arousal (before and after OM) was measured using self-reports on sexual arousal and skin conductance responses from the participant who received stimulation (strokee).
The researchers found that participants’ personal hypersexual concerns were not related to reports of sexual arousal. Frequent viewing of sexual films, however, was related to more sexual arousal before engaging in OM. There was also an association between strokers who watched more sex films and their stroked partners’ higher skin conductance responses. The researchers conclude that “sex film viewing may increase sexual responsiveness in individuals and their partners” (Prause & Siegle, 2022).
The Call: Some women recognize their innate, volitional ability to attract attention from other persons. The hypothesis in this project was that all women have this ability, known as the Call. To test this hypothesis, the Institute of OM Foundation developed a 20-item questionnaire with scores ranging from -60 to +60 and assessed it in 2017 women in the US. Other data collected from this population included demographic information as well as responses to a 10-item big five personality scale, the Sexual Self-Esteem Subscale (from the Sexuality Scale), and the Cloninger Self-Transcendence Scale. The latter two scales were used to validate the Call questionnaire.
Scores above zero on the Call questionnaire, indicating experience and/or use of the Call, were only identified in a small percentage of respondents (25%). Among these women, the Call positively correlated with the personality traits of extraversion and openness.
The researchers (Delorme & Van Vleck, in review) demonstrated the instrument’s validity, reliability, and internal consistency (Cronbach’s alpha 0.89), and validated the Call Questionnaire by demonstrating a higher than 0.4 correlation with both the Sexual Self-Esteem Subscale and Cloninger Self-Transcendence Scale. Based on these findings, the authors conclude that “the Call questionnaire is a short, valid, and reliable instrument for evaluating women’s perceived innate ability to attract others.”
OM and Clinical Applications
Trauma and adverse childhood experiences: Partnered sexual interactions can provoke distressing emotional experiences for individuals with a history of childhood adversity. These in turn can impede sexual arousal. Some clinicians theorize that such histories impair the ability to feel close to any person, leading to difficulty connecting with intimate partners and sexual dissatisfaction. In contrast, it is possible that alleged deficits in closeness are due to contextual factors, such as the risk and unpredictability inherent in many sexual encounters. To test this hypothesis, Prause et al. (2021a) examined whether the same sexual deficits are present during OM, given it follows a predictable structure, has safety features, and induces a feeling of closeness in most OM practitioners. One hundred twenty-five experienced practitioners in OM, with varying levels of childhood adversity, rated their positive and negative emotions before and after OM. Participants reported higher positive emotions (happy, amused, sexually aroused) and lower negative emotions (anxiety, anger) after OM. Interestingly, those participants who had experienced greater childhood adversity, especially sexual abuse, reported higher sexual arousal than participants who had experienced less childhood adversity. The study findings suggest that the effects of adverse childhood on perceived closeness and sexual arousal can be mitigated contextually (Prause et al., 2021a).
Theoretical mechanisms for treating depression: Depression is a vastly complex condition with numerous causes. OM is multivalent in that it engages multiple sensory, physiological, and cognitive channels at once. In women, some aspect of physical stimulation seems to produce antidepressant effects. The simplest assumption is that, like exercise, OM produces a type of neural activity that results in a lift in mood. Practiced repeatedly, OM may mechanistically function like an antidepressant. Additionally, the induction of blissful experiences and “unitary” states, in which people sense that they are part of something larger than themselves, has been found to imbue individuals with a unique sense of meaning.
Individual reports of OM also suggest that the practice often uncovers painful buried psychological trauma. OM appears to increase vulnerability and thus may help individuals get in touch with ways in which they are resilient, similar to the type of “cleansing” experienced through psychedelics. This corresponds to emerging evidence that adaptive stressors may hold promise as antidepressants. The right amount of stress applied in the right way can strengthen one’s emotional resilience. Too much stress has deleterious consequences; however, OM may apply the “right” amount of stress, leaving people feeling capable and empowered. Potentially, OM may release practitioners from the “straitjacket” of depression by pushing them into a new territory in which they can take a chance.
Taking on new, courageous, and daring efforts can be functionally therapeutic, as many depressed people who have been helped by OM previously felt a tremendous sense of isolation. The nature of OM counteracts that isolation, forming a sense of connection between partners, resulting in therapeutic benefits.
OM combines powerful and innate biological mechanisms with mindfulness. Events that can draw an individual into the present moment have been shown to produce powerful antidepressant effects. Paradoxically, even if what pulls someone into the present moment is “bad,” these events can galvanize action and a sense of agency. OM may activate these pathways out of depression, utilizing an incredibly powerful part of our biology and combining it with a mindfulness approach to being in the present by carefully attending, stroke by stroke, to the practice. Research is currently underway to provide scientific data to support these theoretical mechanisms.
Neurophysiological Correlates of OM
Alterations in functional connectivity (functional MRI) in OM practitioners: A number of studies have explored the neurophysiological correlates of various meditation practices. In a study published last year, Newberg and colleagues (Newberg et al., 2021) measured changes in cerebral blood flow and functional connectivity during OM. The purpose of the study was to use resting blood oxygen level–dependent (BOLD) functional magnetic resonance imaging (fMRI) to evaluate changes in functional connectivity associated with the practice of OM. fMRI was acquired in 20 couples (20 men and 20 women) experienced in OM shortly following two conditions: a standard 15-minute OM session and a neutral condition in which the man stroked the woman’s upper leg for 15 minutes. The order in which both conditions were practiced was randomized, with half of the couples engaging in OM first and half of the couples engaging in the neutral condition first. After each practice condition had been completed, participants underwent fMRI. Resting BOLD image acquisition was performed to assess changes in functional connectivity associated with OM. Analysis was performed to evaluate brain regions hypothesized to be affected by OM practice.
A number of significant changes in functional connectivity were observed following the OM session, compared to data obtained following the period of neutral condition. Specifically, there were significant changes in functional connectivity in the left superior temporal region, inferior frontal cortex, right insula, anterior cingulate gyrus, and cerebellum. There were also changes specific to male and female participants. Overall, the findings suggest a complex pattern of functional connectivity changes that results from this unique meditation practice. The changes are somewhat comparable to findings in other types of meditation-based practices, but the practice of OM appears to have a distinct pattern of brain connectivity. Furthermore, it is interesting, but not unexpected, that both male and female participants demonstrated significant differences in functional connectivity during OM practice, but these differences were also distinct from each other, implying that both male and female participants experience effects, albeit different effects (Newberg et al., 2021).
Alterations in cerebral glucose metabolism (PET) in OM practitioners: In another report from the same study (immediately above), Newberg and colleagues (in preparation) describe changes in cerebral glucose metabolism during OM. 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) imaging was used to evaluate cerebral metabolism contemporaneously in 20 couples during OM sessions. Half-way through the 15-minute session, the research team quietly entered the room to inject FDG tracer into the participants for PET scanning and then exited, allowing couples to complete the session. After the session had been completed, OM practitioners rested for an additional 15 minutes and then were escorted into the scanner one at a time. FDG PET scans were obtained and a selected group of 20 regions of interest were analyzed. Differences in cerebral glucose metabolism were found when data obtained following OM practice were compared with data obtained following a neutral session in which the same participants substituted clitoral stimulation with stroking of the upper leg.
In women, significant decreases in cerebral glucose metabolism were found during OM in the left inferior frontal, inferior parietal, insula, middle temporal, and orbitofrontal regions, as well as in the right angular gyrus, anterior cingulate and parahippocampus (compared to findings during the neutral session). In men there were significant decreases in the left middle frontal, paracentral, precentral, and postcentral regions as well as the right middle frontal and paracentral regions. Imaging also revealed significantly increased metabolism in the men’s cerebellum and right postcentral and superior temporal regions. Overall, these findings suggest a complex pattern of cerebral metabolism that results from this unique meditation practice. The metabolic changes are somewhat comparable to findings in other types of meditation-based practices, but the current practice appears to represent a unique pattern of brain activity. It is interesting that there were significant differences in metabolism in both men and women during OM, but those differences were also distinct from each other, implying that male and female OM practitioners experience distinctly unique effects.
Potential use of OM for people suffering from emotional trauma based on current imaging data: A number of neuroimaging findings support OM as a possible intervention according to Dr. Andrew Newberg. In the aforementioned FDG PET study, Newman and colleagues documented physiological changes in several emotion-related centers of the brain, including the limbic system and dopamine areas related to emotional responses. Changes in cerebral metabolism were also identified in cortical areas involving attention, cognitive processing, and regulation of emotions. Likewise, fMRI revealed changes in functional connectivity during OM practice. Several limbic and cortical areas, including the amygdala, parahippocampus, insula, and various frontal lobe structures were affected. In addition, differences in patterns of brain metabolism were identified when long-term OM practitioners were compared to non-practitioners; significant changes were identified in the cerebellum, frontal lobe, limbic region, dopamine areas, social areas, and brainstem. Altogether these neuroimaging findings indicate the possibility that consistent OM practice may be useful in adjusting brain patterns of activity to aid in the regulation of emotions and treatment of anxiety, depression, and trauma disorders. Newman suggests that clinical trials involving large populations should be undertaken.
Current and Future Directions:
Understanding the role of OM in relationships and depression: To evaluate the potential utility of integrative breathwork (IB) and orgasmic meditation (OM) as novel interventions for major depression disorder, 120 individuals (60 couples) in committed, cohabitating relationships will be randomized in a 1:1:1 allocation ratio (20 couples per group) to IB training, OM training, or a wait-list control condition. Enrollment and randomization will occur on a couple-by-couple basis. Eligibility criteria require that 1) participants are between the ages of 21 and 65 years; 2) at least one member of the couple is a biological female (a requirement for OM); 3) one member of the couple meets the DSM-5 criteria for major depressive disorder, lasting at least 30 days in duration with an Inventory of Depressive Symptomatology—Self Report (IDS-SR) score of 26 or greater; and 4) both members of the couple are willing to complete at least one IB/OM training session per week for the first 4 weeks of the study. Participants taking medication for their depression will be asked to maintain a stable dose of these medications for 8 weeks prior to screening and will be asked not to make changes to their medication regimen during the study. Similarly, participants receiving psychotherapy will be required to continue therapy with the same therapist for the duration of the study.
OM and dopamine as it relates to Parkinson’s disease: The overall goal of this study will be to build on the initial success of the OM and FDG PET study by Newman et al. (in preparation) and determine whether OM practice may support dopaminergic function in patients with Parkinson’s disease (PD). This PET-MRI study will use fluorodopa PET (FDOPA) to measure dopamine function, serum markers to measure inflammation and oxidative stress, and neurological measures to assess clinical symptoms in patients with PD who are given OM training and then practice daily for several months. The purpose of this study is to evaluate OM practice over a period of 3 months. Patients with PD will be evaluated with FDOPA PET-MRI initially and again after 3 months of either daily OM practice or being placed in a waitlist control group. There are two primary aims of this study. The first aim is to evaluate the neurophysiological effects of OM in patients with PD by using a combination of FDOPA PET and fMRI. An initial pilot study of up to 10 controls (which may be split into 5 controls and 5 PD patients) will be performed first to confirm feasibility and determine the size of the effect on the dopamine system of performing OM. The second aim is to correlate clinical improvement in PD with dopaminergic changes that may occur as a result of practicing OM.
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