We’ve just received the incredible news that a study on our retreats has been published in The Journal of Sexual and Relationship Therapy. This is huge! We’re beyond excited. We also know that for most, sitting down with a 40 page academic article written in mind-bending scientific lingo isn’t their idea of a great time. It can also be confusing, with lots of scientific terms and statistical explanations. Here we break down some of the most important points for you, and explain the science in a way that’s easy to understand and digest. If you want any further information, feel free to reach out to us at firstname.lastname@example.org .
Betsy Crane, Kaci Mial, and Elise Becher
What’s this study all about? What did it seek to find out?
The research question that guided this study was: How do Back to the Body™ retreat participants perceive the effects of sexological bodywork within the context of a sensual retreat on their sexual lives?
What were the results of the study?
Surveys of participants from past retreats reported moderate to very positive changes across all the constructs that were tested: arousal, sexual self-image, sisterhood; body image; feelings about their genitals, sexual assertiveness, and sexual satisfaction.
The surveys of participants completed during the retreats revealed significant increases in genital self-image, body image, sexual self-image, and sexual satisfaction; however, sexual assertiveness decreased in these participants.
In interviews with scientists, five major themes were found: feeling safe, connecting to self and others, feeling acceptance and permission, exploring arousal and pleasure, and transformative life changes.
To understand more about how these results were measured, what statistics back them up, how the themes were found, and to understand the exact quantity of positive changes found, read on.
Why is this study so significant and newsworthy?
There is a huge gap in the literature surrounding sexualty and in clinical sexology and sexual medicine around sexual pleasure (Jones, 2019). This study focuses on what women’s pleasure means to them in their terms and on their terms, which is revolutionary in the current context of sex research.
The use of hands-on work within the field of sexuality is controversial, in part due to ethical concerns and legality issues (Haines, 2007). However, it’s been researched in other countries such as Denmark (Ventegodt & Struck, 2009) and Israel (Hoch, 1986). Despite this controversy, engaging the body along with the mind and emotions is a powerful form of education and healing. This is the first study within the United States to examine the effects of this type of education, and could have far-reaching impacts in academic and clinical realms.
For more information on the groundbreaking nature of this particular study, read our “Why?” article, which explains in detail just why this particular type of science is so needed.
What’s up with Sexological Bodywork? Is this a thing, at more than just Back to the Body? Since when?
In the modern era of clinical and therapeutic use, the legendary sex educators and researchers Masters and Johnson used sexual surrogates to help their clients (Masters & Johnson, 1970; Rosenbaum et al., 2014). Many others have followed in their footsteps, including the iconic Betty Dodson, recently featured in Goop (Dodson & Ross, 2020; Meyers, 2015).
Sexological Bodywork, the focus of this particular study, was created by Joseph Kramer (Morin, 2007). According to the Association of Certified Sexological Bodyworkers (ACSB), Sexological Bodywork is “somatic education that assists individuals, couples, and groups to deepen their experience and awareness of their body, eroticism, and sexuality” (Association of Certified Sexological Bodyworkers, n.d.-a, para. 1).
Our retreats at Back to the Body™ utilize Sexological Bodywork within our unique framework (the Back to the Body Method™)in order to create our special recipe for hands-on healing. We’ve taken a tradition that is as old as time, combined it with modern clinical practices, and added our own signature spice and plentiful life wisdom, and created a special version of this particular practice. Back to the Body™ retreats were the only retreats studied in this science, and we’re very proud to be representing this body of work.
How about the ethics part of this? It’s controversial for a reason, right?
The study goes into great detail about the ethical, legal, and clinical controversies around hands-on sexual health and sex education. You know which side of the arguments we believe in here at Back to the Body™. If you want to know more about why we support this, read the study, or read our ethics guide here!
Why Back to the Body™?
As we mentioned above, there are many people doing this type of work out there. Our retreats were chosen to be studied specifically because of our weeklong intensive format, which follows the same consistent pattern. We have a formula, and we use it repeatedly because we know the elements that make for magic. It turns out, that formula is important for science, because they’re able to study something that is consistent across time and can be reliably replicated.
What does the study design mean?
This study is an exploratory mixed methods design. Mixed methods means it is a mix of qualitative and quantitative research. The exploratory part means that the first phase of data collection is qualitative, and is followed by a phase of quantitative data collection, with a final phase of integration or linking of data from the two separate strands. This is an especially sound scientific approach because it takes advantage of both types of data collection, each which have their own strengths and weaknesses.
OK, but what is quantitative data? What’s qualitative data? How are they different?
Quantitative data is numbers-based, countable, or measurable. Qualitative data is interpretation-based, descriptive, and relating to language. Quantitative data tells us how many, how much, or how often in calculations. Qualitative data can help us to understand why, how, or what happened behind certain behaviors. When it comes to psychological research, in order to get the numbers part, researchers usually administer what are called scales, and ask participants to rate certain questions on a scale of numbers. They can then use statistical analyses to get mathematical measurements like percentages. This method is great because it gives us solid data to stand behind; it’s not mushy or vague. On the other hand, a lot of nuance is lost in this kind of number counting. As anyone who’s had good sex or a profound experience of love can attest, numbers certainly can’t capture all that it entails. During the qualitative part, researchers sit down with participants and ask them questions, or ask them to fill in surveys that allow them to speak in their own words about the intricacies of their inner experience. This helps fill in the gaps between the cold, hard numbers with rich, chewy descriptions.
How many people participated in this?
For the quantitative aspect of the research (the surveys and numbers part), there were 48 participants from past retreats and 35 participants were surveyed while actively participating in a retreat. Having current participants in the pool is significant in that it eliminates biases related to justifying prior choices which are a common phenomenon that can distort accuracy. For the qualitative part (the interviews), there were 21 participants.
How exactly was this data gathered?
In order to see the extent of change, researchers used what is called a pre and post-test survey method. This means they asked participants what they felt before the retreat, and then after it. So when we see a percentage of improvement, what we’re seeing is the difference in the score they provided before attending a retreat and the score they provided post-retreat.
What do the statistical tests mean that were used to measure this stuff?
There were different statistical methods used for current participants and past participants. The stats used to measure current participants’ data are more complex, so we’ll start there. In this case, researchers used what’s called a paired samples t-test to look for statistical validity. This compares scores on the pre-test with scores on the post-test in each individual, to look and see if there’s a difference that we can truly say is significant within each person. When we analyze things in these ways, we’re looking for changes that would be extremely unlikely to have occurred by chance. Stuff changes at random in huge amounts, and everything exists on a bell curve. When we look for statistical significance, what we’re looking for is something that has below a 5% chance of being able to occur at random. This is the only stuff scientists care about. Everything else can be chalked up to the world being full of chaos and humans trying to make sense out of it, seeing patterns where there really aren’t any. These statistical tests let us know what is really unlikely to be happening at random, but is changing for certain due to the effect of what’s being studied.
Effect size is another thing researchers looked at. This is the magnitude of the difference between groups, in this case the women’s experiences before and after retreats. When we say we saw a certain percentage of change, this is what we’re talking about. This was calculated using a measure called Cohen’s d. For those that want to get geeky, Cohen's d is used for comparing two groups. It takes the difference between two means and expresses it in standard deviation units. It tells you how many standard deviations lie between the two means. A standard deviation is a way of standardizing change away from the mean, the mathematical center. Since everything works on a bell curve, standard deviations aren’t each the same; each standard deviation out from average is harder and harder to reach and has a smaller and smaller likelihood of occurrence. Cohen’s D helps us understand just how significantly something has changed, taking all of this into account.
For past participants, researchers simply asked participants to rate how much they perceived each construct had changed, and they reported either “Very negative to moderately negative”, “Slightly negative”, “No change”, “Slightly positive”, or “Moderately to very positive”. When we see percentages for these numbers, we’re seeing simply the percentage of participants who voted in that category. For instance, when we see 75% next to moderately to very positive changes in regards to arousal, that means that 75% of people reported that they felt that way.
Alright, now that we know all of this, let’s review our results with this in mind. What exactly were the stats behind all of these results we read at the beginning?
Past participants reported moderate to very positive changes across all the constructs that were tested: 75% of them said they experienced this change in terms of arousal, sexual self-image, and sisterhood; 72% reported this shift for body image; 71% checked this box for their feelings about genitals and sexual assertiveness, and 66% for sexual satisfaction.
The surveys of current participants revealed statistically significant increases in genital self-image (with an effect size of 0.72), body image (with an effect size of 0.60), sexual self-image (with an effect size of 0.57), and sexual satisfaction (with an effect size of 0.52), however, sexual assertiveness decreased (with an effect size of −1.64).
We’ll write more about these constructs and what they mean in a separate article. For now, we want to focus on making sure you get how they were measured and the significance of the change. But don’t worry, there’s more to come on everything from genital self-esteem to sisterhood!
What about the qualitative portion? How was that conducted?
Qualitative data collected for this research came from open-ended questions on the survey of past participants and individual interviews. The survey asked respondents to share comments about effects they perceived related to each of the constructs they had first assessed on the quantitative portion. Participants also completed semi-structured interviews via Zoom. For the semi-structured interviews, researchers created an interview guide with 15 open-ended questions to guide the conversation, surrounding similar topics.
What’s the difference between open-ended and closed-ended questions and why does this matter?
Open-ended questions are those that provide respondents with a question prompt and provide them a space in which to construct their own response. Closed-ended questions, alternatively, provide a question prompt and ask respondents to choose from a list of possible responses. The reason this matters so hugely in sex research is that researchers have found that women’s definitions of good sex vary hugely from what sex researchers (who happen to have mostly been male) assume that good sex is for women. Some researchers, such as Breanne Fahs and Rebecca Plante, in their article, On ‘Good Sex’ and Other Dangerous Ideas: Women Narrate Their Joyous and Happy Sexual Encounters, offer an open-ended space in which women can describe states of positive emotionality and physical pleasure (Fahs & Plante, 2017). Spaces like this, in which women are given free reign to author the story of their experiences, may, in fact, be the closest we can come to making visible the truth of women’s sexual experience. And when we do, we find that the way women conceive of good sexual experiences is very different from what sex researchers have assumed. The fact that we’ve relied for so long on male sex researcher’s definitions of good sex is a tragedy. This study changes that by allowing women to define pleasure on their own terms. It’s radical and revolutionary. It’s necessary and it’s fabulous.
Now that we know how these themes were discovered, what were they again?
There were five major themes that researchers found: feeling safe, connecting to self and others, feeling acceptance and permission, exploring arousal and pleasure, and transformative life changes.
We’ll write more about these themes and the beautiful descriptions women gave in a separate article. For now, we want to focus on making sure you understand the brass tacks of the science.
How are these themes discovered scientifically? It isn’t just the researcher’s or Pamela’s imagination or sense of things, right?
Nope! There are whole computer programs designed to analyze transcripts and language and look for patterns and themes in scientific interviews. There are also complex content analysis methods in science designed to help researchers carry out this identification. Once themes are identified, interviews are coded line by line to look for those themes, and then analyzed accordingly. They are then tested for something called inter-rater reliability, which means that many researchers come to the same conclusion; the coding system is working reliably between different people and isn’t subject to any one person’s personal opinion too much. It’s verifiable across individuals.
How might this study influence sex therapists, sexual medicine practitioners, and sex educators?
Stigma and misinformation get in the way of accessibility, and they get in the way of science. Lack of good science gets in the way of accessibility, and you get a loop that leads to less goodness. This study breaks that loop. It’ll help lend evidence and credence to this work for an audience that might not understand how to talk to their clients about this, or even know for sure if it would help if they did recommend it. Spread the word!
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Dodson, B., & Ross, C. (2020). Bodysex. https://dodsonandross.com/bodysex
Fahs, B., & Plante, R. (2017). On ‘Good Sex’ and Other Dangerous Ideas: Women Narrate Their Joyous and Happy Sexual Encounters. Journal of Gender Studies, 26(1), 33–44. https://doi.org/10.1080/09589236.2016.1246999
Haines, S. (2007). Healing sex: A mind-body approach to healing sexual trauma. Cleis Press.
Hoch, Z. (1986). Vaginal erotic sensitivity by sexological examination. Acta Obstetricia et Gynecologica Scandinavica, 65(7), 767–773. https://doi.org/10.3109/00016348609161498
Jones, A. (2019). Sex is not a problem: The erasure of pleasure in sexual science research. Sexualities, 22(4), 643–668. https://doi.org/10.1177/1363460718760210
Masters, W. H., & Johnson, V. E. (1970). Human sexual inadequacy. Little, Brown & Co.
Meyers, L. (2015). Answering the call for more research on sexual pleasure: A mixed method case study of the Betty Dodson Bodysex workshops [Doctoral dissertation]. Widener University, Chester, PA.
Morin, J. (2007). Psychotherapy and sexological bodywork. Youtube. https://www.youtube.com/watch?v=v3D0MADgOgY&list=PL9AC7BEBF12180D2E
Rosenbaum, T., Aloni, R., & Heruti, R. (2014). Surrogate partner therapy: Ethical considerations in sexual medicine. The Journal of Sexual Medicine, 11(2), 321–329. https://doi.org/10.1111/jsm.12402
Ventegodt, S., & Struck, P. (2009). Five tools for manual sexological examination: Efficient treatment of genital and pelvic pains and sexual dysfunctions without side effects. Journal of Alternative Medicine Research, 1(3), 247–256. http://livskvalitet.org/pdf/39_259_JAMR-2009_volume_Issue_3_-_ FP_Version.pdf