Sexual Mindfulness and the Libido of Generativity: A Psychoanalytic Perspective on Future-Oriented Desire and Couple Well-Being

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

The manuscript presents an original and novel theoretical proposal that articulates the notion of libido of generativity (LoG) as an integrating axis between erotic desire, care, and shared projects. The combination of psychoanalytic approaches and sexual mindfulness is innovative and conceptually coherent. The text succeeds in linking classical theory with applications in sexuality and couple well-being.

The proposal for a brief Relationship Guidance (RG) curriculum demonstrates a clinical applicability. Furthermore, the text presents falsifiable propositions and a sex/gender-sensitive reporting plan (SAGER), which reinforces its scientific credibility.

However, some sections are overly technical and condensed, making them difficult to read fluently. This can hinder rapid comprehension, even for specialised readers. It is recommended to simplify long sentences and clarify technical jargon.

Although the manuscript does not implement the proposed intervention, this is consistent with the Perspective format. It would be valuable for future research to test the falsifiable propositions presented, evaluating the programme's effects on sexual and partner satisfaction, as well as the proposed mechanisms. The inclusion of such future studies would strengthen the translation of the conceptual framework into verifiable practical applications.

Therefore, this manuscript is sufficiently coherent and has strong bibliographical support. It also provides an important guide for future research.

Author Response

Dear Reviewer,

We are grateful for your thoughtful and generous assessment of our manuscript. Your comments helped us improve clarity, readability, and the translational value of the paper. Below we detail the revisions undertaken in response to your observations.

1) Readability: simplification of dense/technical passages

• Sentence length and jargon. We systematically shortened long sentences and replaced highly technical wording with plain, precise terms across §§3–4.

• Clarified neuro-computational phrasing. The opaque sentence on interoceptive precision has been rewritten as:
  “Within active interoceptive inference, sexual arousal can be described as the increased weighting (‘precision’) assigned to ascending bodily signals (e.g., genital, cardiac, respiratory). This higher precision updates cortical expectations (notably in the anterior insula), amplifies the felt bodily salience, and couples with autonomic adjustments experienced as arousal.”

• Signposting. Each major section now opens with a one-sentence “map” of what the reader will find.

• Plain-language overview. We added a brief, citation-free paragraph at the end of the Introduction that summarizes the proposal in accessible terms.

2) Abbreviations: reduction and first-mention definition

• We limited acronyms to the core set (LoG, RG, FSFI, IIEF, PROMIS SexFS, CSI, CPQ) and spelled out less common ones (e.g., PRFQ, HEP, HRV) at first mention in the abstract, main text, and captions.

3) Conceptual framing: generativity ≠ procreation

• To avoid any pronatalist reading, we explicitly state that generativity does not equate to biological procreation. In figures and text, we present three outcome pathways with equal status: Procreative, Creative–Sublimative, and Community-Forming.

4) Relationship Guidance (RG) curriculum: clinical applicability

• We expanded the practice-ready description and refined Table 1 into a session-by-session matrix.

• New “In plain words” column: each session now includes a brief, practitioner-oriented description to enhance transferability.

• We aligned each session with targets (mechanisms) and outcomes, and added safeguards consistent with SAGER/Equity.

5) Figures and theory of change

• We inserted Figure 1 (LoG—Axes, Mechanisms, Outcomes Map) and Figure 2 (Theory of Change for RG) in high-resolution, with captions that include a one-line “How to read this figure” guide.

• A simplified Graphical Abstract (deriving from Figure 1) has been prepared.

6) Falsifiable propositions and future research

• Consistent with the Perspective format, §5 now begins by clarifying that we are not testing the program but specifying a theory of change.

• We present falsifiable hypotheses (mechanisms and clinical endpoints), anticipated mediations (self-compassion; reproductive mentalizing) and moderations (HEP/HRV), and outline pragmatic trial designs (including cluster-RCTs), with pre-registration and SAGER/CONSORT-Outcomes compliance.

7) Abstract and compliance

• The abstract was condensed to ~195 words, single paragraph, without citations, and with minimal acronyms defined at first mention.

8) References and cross-referencing

• We reviewed references for consistency, updated cross-citations after edits, and ensured alignment between in-text numbering and the reference list.

We appreciate your concluding evaluation that the manuscript is coherent, well-sourced, and helpful to guide future research. We hope the revisions above address your concerns and further enhance readability and practical relevance, while preserving the conceptual contribution you valued.

With many thanks for your constructive feedback,

The Authors

Reviewer 2 Report

Comments and Suggestions for Authors

The manuscipt presents the notion of “libido of generativity”. This appears to mean that sexual desire, as manifested in bodily responses, combines with desire for “caregiving, legacy, and shared projects”. A short description of the conceptual foundations of the libido of generativity is presented, and some explicit predictions are made. The role of mindfulness is then discussed. A detailed description of a “relationship guidance framework” is offered, including suggestions as how to quantify the effects of the framework.

The authors’ proposal that desire for sex somehow includes a desire for procreation and subsequent caregiving and the passing of a legacy to the following generation is extremely old-fashioned and completely out of touch with current thought. Nevertheless, some organizations, like the Holy Roman Catholic and Apostolic Church, still insist on the association between sex and procreation, and would probably welcome the notions presented in the present Perspective.

The most valuable part of the manuscript, according to this reviewer, is the detailed presentation of the relationship guidance framework. Among the aims of this framework is to “enhance reproductive mentalizing within a triadic scene (self – partner – child)”. Primary and secondary endpoints are specified, and outcome measures are suggested. No evidence is provided suggesting that any of the outcome measures indeed are affected by the program.

Even though the terribly old-fashioned approach to sexuality offered in this manuscript is completely outdated, it may be entirely legitimate to try to revive it.

Finally, I have two specific comments. On p.3, line 136-137, the authors write “sexual arousal emerges when interoceptive prediction errors are granted high precision….”. This is perfectly incomprehensible. Furthermore, the frequent use of unusual abbreviations make the manuscript difficult to read. Why don't you write out at least some of them in the text, saving the reader from the trouble to constantly consult the list at the end?

Author Response

Dear Reviewer,

We thank you for your frank and careful reading. Your remarks have helped us strengthen conceptual clarity, inclusivity, and readability. Below we summarise the revisions made, aligned with each of your points.

1) On the claim that our view is “old-fashioned” (sex = procreation)

What we clarified and changed. We now state explicitly—both in the Introduction and in §2—that generativity does not equate to biological procreation. Within our framework, procreation is one among three future-oriented outcome pathways, presented with equal status in text and figures: (i) Procreative; (ii) Creative–Sublimative; (iii) Community-Forming (e.g., mentorship, care work, shared social projects). Figure 1 has been redrawn to display these three branches symmetrically, and the captions were expanded to avoid any pronatalist reading.

Rationale. Our use of “reproductive mentalizing” refers to the capacity to hold in mind triadic representations (self–partner–child/symbolic offspring), not to a prescription that sex must be procreative. We also revised the curriculum description to underline non-procreative routes to generativity wherever relevant.

2) “No evidence that outcomes are affected by the program”

What we added. As this is a Perspective, we do not test the program; however, §5 now opens by making this explicit and provides a concise theory of change plus falsifiable hypotheses. We specify primary clinical endpoints(FSFI/IIEF; CSI; CPQ) and mechanistic endpoints (self-compassion; reproductive mentalizing; interoceptive awareness/accuracy, optionally with HEP/HRV), and we outline pragmatic/cluster-RCT designs with pre-registrationand CONSORT-Outcomes/SAGER compliance. We also cite the existing evidence base for the component mechanisms(e.g., mindfulness-based protocols for low desire; couple-skills interventions for communication/satisfaction), positioning our integrated model as a testable synthesis rather than a claim of proven efficacy.

3) The sentence on interoceptive “precision” was “incomprehensible”

What we rewrote (verbatim). The prior sentence has been replaced by the following plain-language formulation:

“Within active interoceptive inference, sexual arousal can be described as the increased weighting (‘precision’) assigned to ascending bodily signals (e.g., genital, cardiac, respiratory). This higher precision updates cortical expectations (notably in the anterior insula), amplifies the felt bodily salience, and couples with autonomic adjustments experienced as arousal.”

We also simplified nearby phrasing to reduce jargon and nested clauses.

4) Excessive and unusual abbreviations

What we changed. We reduced acronyms to a core set (LoG, RG, FSFI, IIEF, PROMIS SexFS, CSI, CPQ) and spelled out less common ones (PRFQ, HEP, HRV) at first mention in the abstract, main text, and figure/table captions. A consolidated Abbreviations section is provided; we also replaced several acronyms with full terms in the running text to improve flow.

5) Readability and flow

What we changed. We performed a line-by-line edit to shorten long sentences, removed stacked subordinate clauses, and added signposting at the start of major sections (“This section defines…”, “Here we align…”, etc.). At the end of the Introduction, we inserted a brief plain-language overview (no citations) to aid rapid comprehension.

6) Relationship Guidance (RG) curriculum

What we improved. We retained the component you valued most and enhanced its practice-readiness. Table 1 has been expanded with a new “In plain words” column (one-line take-home per session), explicit mapping of exercises → mechanisms → outcomes, and SAGER-consistent notes on equity/inclusion. Figure 2 (Theory of Change) now mirrors the trialable logic of the curriculum.

Closing

We appreciate your candid critique and the opportunity to clarify scope and language. The revised manuscript, we hope, addresses your concerns by (a) decoupling generativity from procreation; (b) specifying testable hypotheses and trial designs befitting a Perspective; (c) rewriting the neuro-computational sentence in accessible terms; and (d) reducing acronyms while improving readability.

Thank you again for the constructive guidance, which has materially improved the paper.