Book Review: Come As You Are (2021)

Come As You Are by Emily Nagoski was originally published in 2015 and revised in 2021. It's goal is to empower women in their sexuality by normalising the anatomical and psychological diversities among women. It clears up long held myths, stereotypes and assumptions regarding sex through a mix of scientific explanations and personal accounts gathered by the author from the many women she encountered in her professional and private live. The book was written to help the millions of women who are told by society that they and their bodies are dysfunctional, broken or abnormal to live with confidence and joy inside their bodies.

Emily Nagoski is a trained sex educator, has a degree in Psychology, did her masters in Counseling Psychology and earned a Ph.D. in Health Behavior with a concentration in human sexuality. She taught graduate and undergraduate classes in human sexuality, relationships and communication, stress management, and sex education. She was a lecturer and Director of Wellness Education before traveling all over the world as a full time writer and speaker.

The phrase "we are all made from the same parts, arranged in different ways" is used as the common theme throughout most of the book. It ist first introduced when discussing shared origins between female and male sexual organs. In the following chapter it is used to shed light on why peoples arousal responds differently to stress, even tough we all follow the same stress regulation cycle. Later she picks up the thread again in the context of arousal and orgasms, by explaining how we respond differently to stimulation, even though we are all made from the same parts.

The author produces scientific evidence in forms of studies to support her claims. She supplements them with fictional personal accounts, condensed out of the experiences of the many women she met during her privat live and professional career. In the Introduction she notes, that the book only contains a part of the scientific material on women's sexuality and that she curated this corpus by only including the material that she deemed to have "(...) the most immediate relevance in women's everyday lives.".

Personal Opinion

This Book was very eye opening for me and cleared up some long held myths. Especially the concepts of arousal non-concordance, the dual control model and the explanation of responsive desire made me rethink a lot of my beliefs and actions. It was one of the better books I read this year and has earned a proud place in my library. Society trying to discourage women from making their own decisions and using methods like shaming, applying pressure trough cultural norms and religion or cutting access to education, are well documented. In that sense 'Come as you are (2021)' fits nicely among previous books I read like: 'Die Erschöpfung der Frauen (2024)', 'Invisible Women (2019)' and 'Epistemic Injustice (2007)' who all touch on similar core issues. It also matches my personal experience, since I believed and propagated a lot of the stereotypes that the book tries to clear up. In addition to that I benefited from some of the mental health advice given in the book. Especially regarding self-worth, self-compassion and mindfulness.

Who Should Read This Book?

The book is relevant to anyone who is either a woman or is / wants to be in contact with women. The knowledge presented in this book can offer a path to a more joyful, confident and empathic life and reduce the hurt caused by propagating old myths and stereotypes. Even though it focuses on women, many of the concepts apply to men as well.

By the authors own acknowledgement the book focuses on cis-women. Meaning women who are born with female attributes, are assigned the label female, raised as women and are happy with that assignment. Trans, inter and non-binary people are not discussed, because according to the author, there is not sufficient data available. Though not explicitly stated, the author also seems to assume that the reader is able-bodied, non-menopausal and pain-free. The author recommends that people who are experiencing unwanted pain during sex should check with their medical provider.

Key Points and Concepts

These are the key points I isolated from the book. I have written a small summary for each concept below.

• We are all made from the same parts, arranged in different ways
• Learning, Liking, Wanting and Arousal Non-Concordance
• The dual control model: Accelerator and Breaks
• It's all about context
• Spontaneous and Responsive Desire
• Pleasure and sex worth having
• Self-compassion and non-judgemental awareness

We Are All Made from the Same Parts, Arranged in Different Ways

The book starts with the proposition that "we are all made from the same parts, arranged in different ways". To prove this, the author brings up the concept of biological homology, which she defines as "traits that have the same biological origins, though they may have different functions". She explains that only in the sixth week of pregnancy, the genitals between male and female start to diverge, and they actually stem from the equivalent fetal tissue. They are indeed made from the same parts, but arranged in different ways. So there really is no reason to define one or the other as standard. Variations in shapes, sizes, colours and textures are all normal and beautiful. Ranking what supposedly is beautiful and what not and defining an arbitrary standard makes no sense and harms people who do not fit this arbitrary norm.

Learning, Liking, Wanting and Arousal Non-Concordance

According to the book, the three intertwined but separable mechanisms (Learning, Liking and Wanting) form the universal mammalian hardware that processes all our emotional/motivational systems. This includes stress responses (fear, aggression, and shutdown), disgust, all forms of pleasure from physical to artistic, love and social connection, and of course sex. In the book Emily calls the system comprised of these three functions the Emotional One Ring that mediates everything.

The function of the Learning> part is to continually scan our environment as well as our thoughts and try to predict, based on our past experience, what might happen next. Over the years we implicitly associate things with each other. With time we might learn for example, that getting kissed softly on the neck is sex related, because the kissing and sex mostly happen together. Then if we get kissed on our neck at a future time, our Learning system goes: "Ah, a kiss on the neck, this is sex related!", and our body reacts accordingly. The Learning system does not judge if something feels good or bad, neither does it care about the context something happens in. It just goes "this is sex related".

The Liking part is the subjective evaluation of an experience as either "this is nice" or "this is not nice". This is where the context of a situation comes into play. If the context is safe and we feel relaxed, then we might go "this feels good". If the context is unsafe, we feel stressed or even threatened, then we might go "this does not feel nice at all".

Finally Wanting is what motivates us to "get moving". Depending on the evaluation of Liking and the context it occurs in, it makes us move either toward or away from something. If Wanting is activated with a stress response mechanism we search safety. If it is activated with the attachment mechanism, we seek affection and when Wanting is activated with our sexual accelerator, we pursue sexual stimulation.

The core insight here is, that Learning and Liking are two independent processes. Because Learning is automatic and non-discriminant regarding the context of a situation, our body might react to sex related stimulation even if we don't like or want it. This phenomenon, when your body reacts differently to how you feel, is called arousal non-concordance and is completely normal. For women the reaction of the body only matches her subjective arousal 10% of the time. For men it is closer to 50%. So when a vulva gets wet, that says nothing about enjoyment or pleasure. The only thing it means, is that the Learning system went: "oh this is sex related" and the body reacted to this learned behaviour. Nothing else.

Not making this distinction leads to very problematic and dangerous assumptions like:

• She says she does not like it, but since she gets wet that means she is actually enjoying it.
• If I don't get wet during sex, something is wrong with me.

So the only safe indicator if a person enjoys something is to ask her and not to guess based on her body's reaction.

The Dual Control Model: Accelerator and Breaks

Emily introduces what she calls the 'Dual Control Model'. It is a model that incorporates the Emotional One Ring and helps to explain why people respond differently to sexual stimuli. It consists of two parallel paths called the Accelerator and the Breaks, both of them influencing our state of arousal. The accelerator models Sexual Excitation (all the reasons why we should be aroused right now) and the breaks model Sexual Inhibition (all the reasons why we should not be aroused right now). Subconsciously every sensation and all our thoughts along with the context get processed (Learning, Liking) and either activate our breaks or accelerator (Wanting). Every person has this accelerator and breaks, but what activates the breaks and accelerator is individual and highly context dependant. For most people stress hits the breaks, for some it's the opposite and for some others it depends on the circumstances. Some people might also have very sensitive breaks and an insensitive accelerator, or vice versa.

It’s All About Context

Since what activates the breaks or the accelerator is highly context dependent, context can change how something feels. A classic example of this is tickling. Tickling might feel nice during a playful sexy fight on the couch, but not so much in the middle of a heated argument. Another, more extreme, example might be doing something with or without consent. Same action, vastly different context. So just knowing what hits the accelerator or the breaks is not enough, you always have to pay attention to the context first. By altering the context we can therefore influence how we react to sexual stimuli and ultimately change our state of arousal. Making sure the context of a situation is safe, consensual, trusting and stress free can go a long way in disengaging our breaks. For most people it is difficult to enjoy sexual interactions when everyday worries, stress from work, health or financial problems are bearing down on us. But when you are in a context where you feel safe and relaxed, then pleasure can happen.

So in summary to get aroused and have good sex, we need to "turn on the ons and turn off the offs". It functions like a car. To drive you need to first disengage the breaks and then step on the accelerator. The challenge is to know what hits your personal breaks or accelerator and then shape the context of your sexual activities accordingly. The book offers a few resources to assist with that:

• Sexual Temperament Questionnaire to to learn about the sensitivity of your breaks and accelerator [Link].
• Sexy Contexts to figure out which contexts hit your breaks or your accelerator. Then using the Sexual Cues Assessment to help you change the context to a more beneficial one [Link].
• Turning Off the Offs to help you create a practical plan for easing off of your breaks in your everyday life [Link].

Spontaneous and Responsive Desire

There are two ways how desire for sex can occur, spontaneous and responsive. Some people feel desire out of the blue, for example when walking down the street as a spontaneous thought. That is spontaneous desire. For them desire happens in anticipation to pleasure. Others might first require some sexy actions like cuddling, massaging, kissing, etc. which then leads to desire. For them desire happens as a response to pleasure. Both are completely normal. Sadly our society has decided, that spontaneous desire should be declared the norm and that it is the kind of desire that should arise naturally in a healthy relationship and can be expected of a partner. This puts a lot of pressure on people whose desire works in a responsive way and labels them as abnormal or broken.

Emily summarised the desire process as "pleasure, first, then desire". By this she means, that first there needs to be either anticipation for pleasure or actual felt pleasure for desire to arise. In the books first edition she used to call it: "arousal first, then desire". But this lead to misconceptions and questions like: "Arousal first, then desire. Is that not the same as just having sex with someone and they wont be able to help themselves and just like it?". The problem was, that Emily meant 'arousal' in the scientific sense (excitation of relevant pathways in the central nervous system), but some readers understood this in a more literal and genital-focused way (arousal equals genital response and desire equals pleasure and consent). Together with arousal non-concordance this misconception would reinforce the dangerous rape myth: "If sex happens as a women, she won't help herself liking it". So in the second edition of the book Emily deviates from the scientific wording to make this point clearer by stating it as "pleasure first, then desire". And pleasure only happens in a positive context, if we feels safe and there is consent. After that, desire might follow.

Pleasure and Sex Worth Having

Emily proposes, that the only metric that should guide us through our sexuality is pleasure. If what we are doing is giving us pleasure, then we are doing it right. If we want to to increase our pleasure beyond that, we have to decide what amount of time and effort we want to invest. They found that Extraordinary Lovers, people who according to themselves have an exceptionally good sex life, are investing a lot of time and effort into learning, trying out new things and into deepening the connection with their own bodies as well as with other people. Emily recommends the book Magnificent Sex by Peggy Kleinplatz to anyone who wants to dive deeper into this topic.

Self-Compassion and Non-Judgemental Awareness

A lot of us practice self-judgement. We criticise ourselves for not doing enough, not being good enough not working hard enough. We are afraid to stop doing this because we think "If I stop beating myself up, I'll get complacent and lazy, and then I'll never change!". Instead we should practice self-compassion, the opposite of self-judgement. There are three parts to it:

• Self-kindness: is our ability to treat ourselves gently and with caring.
• Common humanity: is viewing our suffering as something that connects us with others, rather than separates us.
• Mindfulness: is being nonjudgmental about whatever is happening in the present moment.

One of the simplest and most beneficial things you can do for you emotional health is to practice non-judgemental awareness. It is the practice of being mindful and aware of your own emotions and acknowledging them in a nonjudgemental way. That means neutrally noticing your internal states without labelling them as good or bad, right or wrong or thinking about what you should be feeling. Nonjudging also means letting go of old and bogus cultural standards and instead turning toward what's true for you and grieving what was or could have been with kindness and without self-criticism. This also opens up the way to a satisfying sex live. By accepting your sexuality just the way it is right now, not how others, or even yourself, say it should be. Just accept it as it is right now, without judgement.