In this study we examine the role of sexual mindfulness in individuals’ sexual satisfaction, relational satisfaction, and self-esteem. Midlife U.S. men and women (N = 194 married, heterosexual individuals; 50.7% female; 94% Caucasian, age range 35–60 years) completed an online survey. More sexually mindful individuals tended to have better self-esteem, be more satisfied with their relationships and, particularly for women, be more satisfied with their sex lives. Some of these associations occurred even after controlling for trait mindfulness. These findings may also allow researchers and therapists to better address an individual’s sexual wellbeing, relational wellbeing, and self-esteem by teaching sexual mindfulness skills.

Research has suggested women’s sexual response cycle may vary more than previously thought. We asked 769 sexually active women between the ages of 18–70 to report on their sexual desire and arousal patterns during their last sexual experience. Using a latent class mixture model from retrospective sexual response data, we found six classes of desire and arousal patterns (Low, Middle Steady, High Fluctuation, Low Fluctuation, Upper Steady, High). We examined how these patterns were related to demographics, outcomes during the sexual experience, and outcomes for the global relationship. The Low sexual response class (8% of women) was significantly different from other classes in duration of the sexual experience, orgasms, and overall satisfaction with the sexual experience. Most sexual response patterns were associated with healthy relational and sexual outcomes. All classes except for the Low arousal and desire class showed associations with a neutral or positive sexual satisfaction evaluation. The non-problematic variation of women’s sexual experience is an important concept to consider as it impacts determinations of dysfunction and women’s self-evaluations. Not all women need to experience high levels of arousal throughout the sexual experience or to have desire at the outset in order to have positive sexual experiences and sexual outcomes.

Little research has evaluated the associations of mindfulness training on couple romantic and sexual well-being and no research has examined the role of sexual mindfulness within an intervention. We introduced the Sexual Mindfulness Project (SMP) that addressed sexual relationships through daily mindfulness, sexual mindfulness (remaining aware and non-judgmental during sexual experiences), communication, and problem-solving skills which was taught in a structured intervention. We examined the effects of this program with committed couples (N = 5) who attended a two-session version of this project. We use mixed methods and examined themes from participant interviews and explored how sexual mindfulness in romantic and sexual relationships may prompt feelings of connection and intimacy. Qualitative results indicated improvement in individual, romantic, and sexual well-being. In addition, as appropriate, we integrate quantitative findings of change in sexual mindfulness and the other outcomes using retrospective pre-post design. We used a retrospective pre/post test to avoid reference frame bias, as sexual mindfulness is a skill that individuals may over-estimate on a pretest as participants know little about how to evaluate their sexual mindfulness. We found that the participants’ perception of the mechanism of change included their efforts to slow down, pay attention to their own sexual experience and/or feelings, communicate more effectively, and then address those feelings or thoughts with their partner in a non-judgmental, open, and accepting way.

Mindfulness has shown positive links with conflict resolution. Additionally, couples skilled in conflict resolution report greater sexual and relationship satisfaction. However, no research has examined the moderating effect of mindfulness, specifically sexual mindfulness, between conflict resolution and sexual and relationship satisfaction. We used 1,627 couples from wave III of the Couple Relationships and Transition Experiences (CREATE) study. Sexual mindfulness moderated the association between conflict resolution and sexual satisfaction, even after controlling for attachment. Wives higher in sexual mindful awareness may rely less on conflict resolution for their sexual satisfaction. Karremans and colleagues’ (2017) model of mindfulness and romantic relationships provides a framework for testing whether, when, and how mindfulness increases positive romantic relationship processes and outcomes. Under this framework, mindfulness may provide a mechanism to help couples achieve sexual and relationship satisfaction. Mindfulness and sexual mindfulness may provide a useful mechanism for therapists, educators, social workers, and couples to enhance satisfaction within the romantic and sexual relationship even without partner buy-in.

The association of mindfulness with couples’ relational and sexual satisfaction may be mediated by forgiveness and gratitude. Although forgiveness and gratitude have individually been shown to play a role in couples’ relational and sexual satisfaction, we use an integrated model. This study included 1,360 couples recruited through a nationwide two-stage cluster stratification. Using an actor–partner interdependence model, we found significant indirect effects (β = 0.01, 0.08, p < .01), indicating that forgiveness and gratitude mediated many of the associations between couples’ mindfulness and their sexual and relational satisfaction. This may provide useful information for clinicians and therapists when addressing marital issues.