Modern women are amazing. We have high-powered careers, smart kids, terrific partners, lots of exciting friends, beautiful homes, and financial savvy. We seem to know how to manage big money, big responsibilities, and big orgasms with the partners of our choice, and all on our own terms. The exterior is a high-gloss, showy, and impressive pattern with markers of success that women appear to handle effortlessly and with the utmost finesse. But there’s so much more to the story.

The women who come into my office dispel the myth of the she-has-it-all woman on a daily basis. Beneath this shining exterior, many women are feeling far from successful and are living in asensual, sexless relationships, wishing desperately that they actually had the lives we all assume they’re leading.

As a sexuality counselor and midwife, this is the side of the story that I see most often. It is in the privacy of my office that the true state of matrimonial unions and the modern American woman’s psyche are fully disclosed. I commonly encounter exhausted, furious, overextended wives and mothers who, for all intents and purposes, are tortured by a metastasized lack of pleasure in anything, especially sex. Many face nearly constant battles with their mates because they have disparate appetites for sex, are bored by sex, never liked it in the first place, or can’t identify with the idea of its general importance and its relationship to healthy living.

What these women—and possibly you—are missing is not just sex, but pleasure in general. They live lives focused on “getting the job done”—whatever the job is—and rarely, if ever, take time to enjoy the moment they’re in or the pleasures at hand. They also aren’t feeling as emotionally healthy and empowered in life as they seem to be to the casual observer, nor do they always speak the truth to some of their closest confidantes.

In order to experience pleasure—in all its forms—our emotional health needs to be sturdy and well integrated into our beings. Genuine self-esteem, spiritual satisfaction, health-seeking behaviors, resilience, creativity, and compassion ignite and sustain our interest in, capability to, and enthusiasm for leading a life filled with pleasure and the sensuality and sexuality associated with it.

When seeds of anti-pleasure are sown either early in life by well-intentioned parents or if our emotional well-being isn’t sturdy for whatever reason, our relationships with pleasurable activities—sexual and otherwise—can be anemic. If further cultivated by the demands of career, family, and a drive for accomplishment, then integrating pleasure becomes the pastime and pursuit of only vacationers and underachievers.

Pleasure—in and out of bed—has gotten a bad reputation among career-minded, married, and mothering women, and their intimate relationships are showing the wear.

The old but persistent voices of disapproving parents, shabby self-images, complicated sexual histories, limited sexual knowledge, and fatigue can all deter adult women from embracing pleasure with open arms. And if a woman becomes a mother, maternal obligations and responsibilities become her get-out-of-jail-free card, effectively absolving her from paying attention to her overall pleasure quotient in life.

Women in these binds have often unknowingly misappropriated their commitments to themselves and their intimate partners, giving priority instead to their professional worlds and their children. They have lost track of the pleasure they once had, including the pleasure they had with their sexual mates. They become sexually sedate and don’t even notice what’s missing. Then, sex ends up being just one more thing on their to-do lists. After years of subterranean sexuality, they acclimate to a pleasureless and sexless life, and when anyone brings this to their attention, the tension becomes untenable or all hell breaks loose.

A woman’s self-appointed mandates, tasks, jobs, or obligations have more to do with choice than she often realizes—and for the most part they have almost nothing to do with the maintenance of genuine emotional wellness. They’re also frequently a by-product of an anemic relationship with life’s pleasures. As a sexuality counselor and a woman who believes that flirting with hedonism is one of the best and most important parts of life, what I look for is just how unhealthy, unpleasant, and therefore unsexy the life of that woman is. There is nothing sexy about being busy every single moment of your day and telling people you like it this way.

There’s also no way to find any form of pleasure if you have low self-esteem or are experiencing a spiritual crisis, hating your body, feeling like you just can’t come back into who you are, or losing all of your creative juices.

And let’s not even start on the drain your lifestyle has on your compassion and empathy over the long haul. Living this sort of life completely squelches one of the greatest sources of pleasure—and one of the strongest aphrodisiacs of all—being present in the moment and giving your undivided attention to yourself or your mate.

We’re all works in progress, forever seeking new truths and greater self-insight to make life sweeter. But gaining insight doesn’t always have to be painful, protracted, and somber.