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Book Summary: Love Worth Making by Stephen Snyder, MD

Love Worth Making (2018) is a guide to enhancing sex and intimacy within committed partnerships. Drawing from real-life examples of sex and couples therapy sessions, it shows how both daily life and trauma affect our sexual feelings. It takes an emotional approach to untangling sexual problems and offers ideas on maintaining an erotic climate in a relationship.

Who is it for?

  • Partners who love each other but are struggling to keep desire alive
  • New couples who want to learn how to sustain their sexual relationship
  • Anyone interested in the emotional side of sexual connection

Discover how to achieve long-lasting erotic connection in a committed partnership.

We live in unprecedented times when it comes to sex. Porn is everywhere. Knowledge about the latest science of sex is at our fingertips. There’s no shortage of sex advice – from different positions to high-tech sex toys to techniques that would make your grandmother blush.

But has this helped us in our committed sexual relationships? Are we satisfied in bed? Any couple that’s tried and failed to purchase their way to erotic fulfillment would probably say no. That’s because if you’re not emotionally connected to your partner, erotic novelty will wear off fast.

In the following chapters, you’ll find out how to take care of your sexual self within the emotional landscape of a relationship – and have great sex, time after time.

Book Summary: Love Worth Making by Stephen Snyder, MD

In this summary, you’ll learn

  • how simmering helps keep sexual energy alive;
  • why sexual generosity needs to be balanced by selfishness; and
  • why it’s important to stand your ground in a relationship.

Reaching true arousal is possible once you’ve learned how to nurture your sexual self.

Many therapists and sex help books will tell you that sex can be summed up as “friction plus fantasy.” But couples who have tried and failed to reignite their desire know that there’s more to it than that. There’s something else that’s missing, something more elusive: the feeling of true arousal.

Three psychological changes happen when we’re aroused. First, we feel captivated, are absorbed, and lose all sense of time. Next, we regress to a more primitive, selfish state of mind. Finally, we feel good about ourselves – like our partners can really see us. Formulas can be quite useless in the pursuit of arousal. But there are certain rules of the heart you can learn to help cultivate the ideal conditions for arousal to thrive.

The key message here is: Reaching true arousal is possible once you’ve learned how to nurture your sexual self.

Rules of the heart need to be understood more than they need to be followed. They exist in a realm of genuine connection and authenticity. Here, you’ll find your sexual self: a highly personal, erotic feeling. It’s marked not by lust, but by gratitude and awe.

The sexual self is very honest, but its vocabulary is mostly limited to “yes” or “no.” Trying to force the sexual self to turn a “no” into a “yes” will pretty much guarantee bad sex.

This is what happened to Carmen, who couldn’t feel anything during sex with her husband Scott. She got aroused when they’d kiss on the couch in the living room. But once they’d moved to the bedroom, she’d become fixated on the worry that there was something “wrong” with her – and mentally shut down.

What most people don’t realize is that they’re responsible for their own arousal. So the author suggested that Carmen do two things to set the mood for herself. First, ask Scott not to try to make her climax – she worried he’d get upset if she didn’t, which pulled her out of the moment. Second, if she felt turned on when they were on the couch, then try staying on the couch.

The next week, Carmen reported that their couch sex was more erotic. But she was still distressed. She confessed that she gave herself orgasms the “wrong way”: in the bathtub, with her clitoris under running water.

The author told her that she wasn’t doing anything wrong. But the belief that she was damaged had garnered a lot of power over the years. For her sexual self to be happy, it needed acceptance. Reassured, Carmen gave herself an orgasm for the first time with her hands a few weeks later. And during sex with Scott, she was able to hold on to her arousal – and finally climax in her husband’s arms.

Sex should never feel like work.

Another rule of the heart is that the sexual self never grows up. It’s vulnerable and selfish; it can’t hide its feelings or pretend. Once we embrace the fact that our sexual selves are like children, we can better understand our sexual dilemmas.

Take a common problem the author often gets from clients. One partner – say, the husband – claims that he doesn’t know how to give his wife pleasure. No matter how hard he tries, his efforts are always met with criticism. Meanwhile, the wife counters that the problem isn’t her sensitivity – it’s his lack of passion.

Lacking “passion” is usually code for lacking something else: a type of sexual selfishness. When our partners selfishly take sexual pleasure from being with us, that’s what actually gives most of us pleasure. Our sexual selves want to be ravished and adored – not serviced out of a sense of obligation. Think about it: if getting you off seems like work for your partner, you won’t lose yourself in the moment. That’s not to say being generous in bed is a bad thing; it’s just not especially erotic on its own.

The key message here is: Sex should never feel like work.

Not surprisingly, many people say their favorite part of sex is the moment when their partner climaxes. Watching them lose control feels powerful – and power play is another thing our sexual selves love. Unfortunately, feelings of shame often get in the way of our enjoyment.

Take Jill, who was deeply ashamed of the fantasy she used to climax during sex with her husband Peter. Whenever she lost her arousal, she’d feel terrible about it, and then she’d fantasize about a wicked man locking her up. She couldn’t see him, but she knew he was always watching her. This fantasy would make Jill orgasm without fail – but it always left her feeling disturbed.

After some discussion, she and the author realized that her fantasy was all about attention. It was likely a result of feeling neglected as a child – our minds often turn trauma into sexual fantasy as a way to soften the pain. The fantasy itself wasn’t Jill’s problem; it was the fact that she punished herself in an unnatural way whenever she lost her arousal.

Sex therapy, as the author told Jill, is about embracing what already feels easy and natural; it’s not meant to put us under pressure. So, rather than force herself to climax with a fantasy that upset her, he suggested she try being kind to her sexual self if her arousal diminished.

The following week, Jill and Peter had wonderful sex – sex that didn’t feel like work. When she lost arousal, she decided not to worry and let Peter come first. Then, she gave herself an orgasm. She still used her fantasy – but now that she understood its origins, she was able to enjoy it.

Women need to feel pursued in order to feel desired.

Plenty of exceptions can be made to any generalization about male or female desire. But the author has found that the erotic differences between men and women still cause lots of problems for straight couples.

When Rob and Melissa were first married, he couldn’t keep his hands off her. But then, he stopped initiating sex. Although Rob claimed he was always ready and willing, Melissa felt like he didn’t want her anymore.

Another rule of the heart is that women want to feel desired. That’s why most women prefer if men usually do the initiating. But this didn’t seem fair to Rob. He didn’t get why Melissa couldn’t be the one to initiate.

The key message here is: Women need to feel pursued in order to feel desired.

The author decided to use an unusual example to illustrate this rule of the heart for Rob: rat foreplay.

A female rat flashes her rear end at a male rat. He runs after her for a while – until she decides he’s chased her enough and lets him have her. Much like the female rat, Melissa enjoyed being chased because it meant Rob was really interested. Finally, it all clicked for Rob.

This is a problem that plagues many marriages: once the husband feels secure, he stops chasing his wife. So, aside from describing rat foreplay, how can women get their long-term partners to pursue them?

Many sex books recommend that women make themselves less available to their husbands, or introduce some other element of uncertainty. But rather than resort to manipulation, the author suggests that a woman simply educate her male partner on her need to feel desired. Then, he can decide if he’s willing to put in the effort – and if not, he can face the consequences.

Chasing a woman all the way to the bedroom isn’t always necessary. A technique called simmering is an effective way to maintain a good erotic climate in a relationship. Simmering is when you carve out a quick moment to get excited with your partner, even if sex isn’t a practical possibility. It’s not meant to be an intense activity – think a sensual embrace that leaves you both feeling buzzed. It’s different from cuddling, which tends to neuter erotic energy.

While anyone can simmer their partner, in heterosexual relationships, it’s ideal if the man simmers the woman more often. Grabbing her passionately demonstrates his desire. And don’t worry if it’s frustrating – a little bit of sexual frustration is a good thing.

Identifying sex knots gives couples the chance to reconnect and try a new approach.

Many people assume that the male sexual response is automatic. And while it’s true that most men get aroused quickly if they see an attractive body, a man’s erotic feelings are more complicated within the context of a relationship.

David was sent to the author’s office alone by his wife, Gwen. The problem was that, like Rob, he’d stopped initiating sex. But it wasn’t out of cluelessness or protest. Instead, he felt like there was some mysterious force blocking him.

He was still physically attracted to Gwen, and he’d usually plan to initiate sex when they both got home from work. But, according to David, by nighttime, Gwen would typically be complaining about something. Tired from a long day, he’d end up mentally shutting her out.

In fact, the trouble began when David and Gwen first moved in together. What happened next was an example of a sex knot: a situation that arises when our sexual selves don’t respond the way we want them to – and we react in ways that make it worse.

The key message here is: Identifying sex knots gives couples the chance to reconnect and try a new approach.

Gwen and David’s sex knot went like this: When they started living together, Gwen started criticizing David more. This made him feel unaccepted – but he responded by feigning confidence and waiting for his hurt feelings to pass. Then, as the disapproval grew constant, he began to withdraw. This made Gwen angry, so she criticized him more. As a result, David withdrew even further – which made Gwen assume David didn’t desire her anymore.

Remember how women especially need to feel desired? Well, a man’s sexual self is nurtured when he feels confident and welcomed. Unfortunately, when a woman no longer feels desired, she’ll stop giving her partner signs that he’s welcome. When David landed in the author’s office, he and Gwen were tightly bound in the worst stage of their sex knot: He didn’t feel welcome with Gwen, so he didn’t desire her anymore. Realizing this, Gwen flipped out and got upset with him. Then he really didn’t desire her anymore.

When women criticize, it’s often because they feel ignored and therefore lonely. So if David wanted Gwen to stop criticizing him, the author recommended that he stop running away and listen to her.

David agreed – and their relationship improved. He found that he and Gwen had a lot to talk about, and she didn’t harp on David’s shortcomings. But he still wasn’t initiating sex. In the following chapters, we’ll find out why.

When each partner stands their ground, they can deal with the uncertainty of change in their relationship.

Finally, Gwen met the author without David and provided some background to their story. When they first met, David was brimming with enthusiasm. He always made Gwen feel special. But once they started living together, his attitude toward her shifted from rapt to aloof.

Gwen wondered whether David might have attention deficit hyperactivity disorder, or ADHD. People with this condition have a hard time concentrating on things that aren’t immediately exciting. The next time David visited the author alone, they went through an ADHD checklist. His inattentive symptoms secured the diagnosis.

Once David started treatment for ADHD, he became happier and more eager to reconnect with his wife – but now Gwen seemed depressed. Sometimes this happens with couples. One partner changes in a positive way, and then the other grows distant – either because there’s been too much change, or because there hasn’t been enough.

The key message here is: When each partner stands their ground, they can deal with the uncertainty of change in their relationship.

When Gwen and David visited the author together, she thanked him for helping David – but lamented that he still wasn’t attentive in the ways she needed. Even on medication, he didn’t seem capable of showing love in the little details, like cleaning up after himself. She was tired of feeling like his mother.

And yet, the author had hope. Gwen and David were beginning to stand their ground. They advocated for their own needs in front of their partner. At that point, the author asked them about sex. David confessed that their foreplay always felt a bit rushed. Gwen admitted that she hurried through it because she was worried he’d lose focus.

David reassured Gwen that he wasn’t going anywhere – all he wanted to do was enjoy her, if she’d let him. But Gwen wasn’t sure if she could; she was scared to open herself up to disappointment again.

The author observed that David had learned how to differentiate. That is, he’d developed a strong sense of himself as an individual and could handle conflict without leaning on Gwen for approval. Maybe now it was Gwen’s turn to learn how to do that.

The author suggested that Gwen sit with her feeling of fear and see how it went. Gwen agreed – and that day marked an important shift for her. She realized that disappointment was just a feeling; it didn’t mean it was the end of the world. She also learned that suffering together could sometimes lead to happiness – if each partner stood their ground.

Erotic feelings return when partners feel deserving of each other’s love.

Sarina and Jo, a lesbian couple in their fifties, had met with the author at the beginning of their relationship, and he’d helped them work through a small problem. Now, many years later, after they’d married and had children, they returned.

They were finally empty nesters – and Sarina had lost all interest in sex.

According to Jo, this was merely a new stage of Sarina’s passive-aggressive sex drive. If they planned a weekend away, for example, Sarina would pick a fight the day they were supposed to leave. Then, she’d be uninterested in sex the whole trip.

Sometimes couples will experience a small disruption in their erotic lives and just need a quick tune-up. Therapists refer to this as treating an immediate cause. But often there’s a deeply rooted remote cause that will continue to stir up trouble until it’s healed. This was the case for Sarina and Jo.

The key message here is: Erotic feelings return when partners feel deserving of each other’s love.

Remote causes manifest when people unconsciously try to get their partners to join them in a reenactment: a drama from their childhood that they don’t fully understand.

Sarina, who’d experienced neglect from her parents, was reenacting that neglect with Jo. When Jo expressed love for Sarina, Sarina would respond with coldness – as if she were trying to convince Jo that she was unlovable. Meanwhile, Jo’s mother had been cold to her, so Jo was reenacting that dynamic. The remote cause was that both women never really knew they deserved to feel wanted.

So the author suggested a mindfulness technique called sensate focus, in which they’d get naked and take turns touching each other. There would be no expectation of giving or taking pleasure – they weren’t required to feel anything they didn’t really feel.

A coin toss decided that Sarina would lie in bed and Jo would touch her first. She began at Sarina’s feet. Sarina realized she felt a deep sadness. Jo kissed Sarina’s toes, as if to urge Sarina to lift her feet and follow the feeling. Sarina let herself be carried by the current of sadness – trusting that Jo would keep her afloat. Jo, meanwhile, was getting slightly aroused. When it passed, she felt calm and happy.

Sarina worried that Jo was getting tired. Jo whispered, “Just stay with it, Sarina.” Hearing her name made Sarina feel emotional. She could feel Jo’s love and attention intensely. Eventually, Sarina’s river of sadness flowed into a big lake. She imagined rolling in the lush grass beside the lake with Jo. Sarina sensed Jo’s arousal, found herself aroused as well, and gave herself to Jo.

Good sex in a relationship is all about paying attention, without judgment, to the erotic moment. You do this when you’re a good parent to your sexual self – offering it patience, kindness, and acceptance.


If your sexual self is rebelling, don’t force it to do something it doesn’t want to do; instead, practice acceptance. During sex with a partner, you’re still responsible for creating the conditions for your own arousal. Sex should also never be a chore. If you’re too focused on giving your partner pleasure and not enjoying yourself, they won’t feel your passion. Great sex happens when partners connect from a place of mutual selfishness. And if you hit a rough patch in your relationship, try to sit with feelings of sadness or disappointment rather than panic. When you do this, you can approach your partner from a calm, confident place and stand your ground.

And here’s some more actionable advice: Don’t give ANTs your emotional attention.

One reason why people stop enjoying sex is because negative, obsessive thoughts about themselves take over. These automatic negative thoughts, or ANTs, capture their attention and make it difficult to stay in the present erotic moment.

Many sex advice books recommend replacing ANTs with affirmations – but the author doesn’t think that’s the most effective method. Instead, he advises clients to identify ANTs when they pop up, acknowledge them, and move on.

About the author

Stephen Snyder, MD is a sex and couples therapist, psychiatrist, and writer in New York City. He’s an Associate Clinical Professor of Psychiatry at the Icahn School of Medicine at Mt. Sinai Hospital, and has served as Chairman of the Consumer Book Award Committee for the Society for Sex Therapy and Research (SSTAR). He writes for Psychology Today and the Huffington Post.

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