Sex, Mortality & Meaning: A Sex Therapist’s Reflection on Being Alive
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As a sex therapist, I reside with people at some of the most vulnerable intersections of life—shame and desire, fear and longing, body and identity. But there’s one thread that quietly weaves through almost every conversation, even if it's rarely spoken directly:
We are all going to die.
And somehow, this matters deeply to how we live, love, and have sex.
Sex and Mortality: Two Sides of the Same Coin
Sex is about life—about embodiment, connection, creativity, and often even the potential for reproduction. Mortality is its mirror—reminding us that this life, and these bodies, are finite.
The ancient Greeks had a word for this dual awareness: eros and thanatos—the life force and the death drive. Freud later adopted the concept to explain our internal conflicts between creation and destruction. I am in entirely in agreement with Freud’s psychosexual analyses.
But, I digress….
In therapy, I see the fear of mortality play out in more human, tender terms:
The client who feels panic after sex because intimacy reminds them how alone they feel.
The aging couple trying to reawaken their sensual connection after a health scare.
The widow asking, “Can I ever desire again—and what does that say about my love for the person I lost?”
The person afraid to fully embrace their sexuality because it makes them feel exposed, mortal, fragile.
Underneath it all is the question: If I let myself really live—really feel—what happens when I lose it?
Mortality as a Mirror for Desire
When we become aware of our mortality, something shifts. Some people shut down. Others awaken. I know what this feels like. Many begin to ask deeper questions:
Am I living in alignment with who I am?
Am I loving the way I want to love?
Have I been playing safe with my sexuality… and my life?
Mortality forces us to confront the uncomfortable truth that time is limited. And this confrontation can become a powerful motivator for erotic aliveness.
Desire, then, isn’t just about sex—it’s about the desire to feel fully, to connect deeply, to live authentically. And paradoxically, it’s our awareness of death that makes that desire burn brighter.
Sexuality in the Face of Aging and Loss
Aging brings its own kind of existential awakening. Bodies change. Hormones shift. Some sexual functions may decline. Others evolve. Many clients—especially those in midlife or older—tell me they feel grief. Not just about their bodies, but about the time they feel they’ve lost, or the parts of themselves they never explored.
I often hear:
“I wish I had allowed myself more pleasure when I was younger.”
“I spent years performing instead of enjoying.”
“I never really felt safe enough to ask for what I wanted.”
These reflections are laced with mourning—but also with clarity.
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When mortality becomes real—through aging, illness, or loss—it can shake us awake. It reminds us that it’s never too late to claim joy, to speak honestly, to choose connection.
Therapy as a Space to Confront Mortality and Meaning
Sex therapy is not just about solving problems in the bedroom. It’s about creating space for people to explore who they are, what they want, and why it matters—before it’s too late.
In this way, sex therapy becomes an existential process. It asks:
What do you want your erotic life to mean?
What parts of yourself have you buried out of fear or conformity?
How would you live if you accepted your mortality not as a threat, but as a guide?
These are not easy questions. But they are essential ones.
Mortality as an Invitation to Live
We often think of death as something far away, abstract. But it’s always here—quietly shaping the choices we make, the risks we avoid, the intimacy we crave.
In my work, I’ve seen people reclaim their sexuality after decades of silence. I’ve seen couples find new ways to connect after grief. I’ve seen individuals find the courage to live more fully, love more honestly, and ask for what they’ve always needed.
None of this erases the reality of mortality. But it transforms it—from something to fear into something that reminds us:
You are here now.
You are alive now.
You are still free to choose how you live, how you love, and how you touch.
And that is where real erotic power begins.
An added benefit is that once we come to peace with understanding that we only have some much time and energy left, we begin to be more selective about how (& with whom) we spend our time and enjoy it more fully.
Are you ready to explore what your sexuality means in the face of life’s fragility?
Therapy can help. Reach out to start a conversation—about desire, mortality, and the art of living fully.
As a generation Xer born in the 1970s, the reality of mortality is increasingly apparent. However, once you embrace your mortality, you no longer fear it and the world opens up to you.