madsen practice

This is what arousal looks like.

About 20 women are lying blindfolded on yoga mats in an airy structure in the Joshua Tree desert. Some are partially dressed in loungewear or lingerie; others are fully nude. Sexy indie folk music blasts from the sound system and outside, through the open double doors, the wind kicks up, rustling the fragrant desert scrub brush, pomegranate trees and ponderosa pines.

Their bodies are layered with a collage of fresh fruit, feathers, cucumber slices, smooth stones and velvety flower petals, among other things. Facilitators quietly tiptoe around the room, gently placing more and more items onto their chests, arms and legs until their skin is barely visible. One woman lies with lemon slices on her nipples, a large strawberry in her open mouth and a bouquet of long-stem pink roses, in full bloom, on her pelvis.

Facilitators adorn women’s bodies with colorful objects during an exercise about receiving pleasure and feeling beautiful.

(Joyce Lee / For The Times)

The exercise is meant to help the women connect with their bodies by stimulating them with a spectrum of sensations: the cool slickness of a polished river stone or the prick of a pineapple rind. It’s about receiving pleasure and feeling beautiful — no matter your age, body shape or perceived limitations.

“The biological clock may be finite, but your sexuality — arousal — is infinite,” says the event’s host, Pamela Madsen, scattering rose petals on one attendee’s thighs.

Pamela Madsen, Back to the Body’s founder.

(Joyce Lee / For The Times)

Welcome to Back to the Body, a sexual wellness retreat helping participants — all women — access their erotic selves. In this group, attendees are straight or bisexual and range in age from mid-30s to mid-70s. They’re mostly from around California, but some have traveled from North Carolina, Florida and Connecticut. They’ve come to overcome intimacy issues or body shame, to process trauma, to learn how to better orgasm or otherwise improve their sex lives. Some are therapists themselves looking to expand their knowledge of “sexological bodywork,” a form of body-based sex therapy that Madsen practices. Others simply want to be in community with like-minded women who are also exploring their sexual selves.

The two-night retreat, which costs $550 to $2,000 depending on accommodations on the sprawling multi-villa property, includes mindfulness exercises, journaling, expert-led seminars, group discussions and meals by a private chef. It also features a preview of a “bodywork session” that one might experience at Back to the Body’s longer, weeklong retreat: a live “pleasure demonstration” at the event’s, um, climax — but more on that later.

Madsen guides participants in a “Lotus Lift Meditation,” meant to help them clarify their intentions for their lives.

(Joyce Lee / For The Times)

An unlikely high desert sex educator, Madsen, “60-something,” is a brash, outspoken New York transplant who oscillates between frank asides (“I like to say ‘f—’ — get used to it”) and welling up with tears (“I’m sorry, I’m just getting emotional, this is important stuff”) as she proselytizes about the power of erotic energy. She believes that “when a woman reclaims her arousal, she reclaims her aliveness.” Put another way: Pleasure isn’t just a component of your life — it’s a tool for transformation.

“I’ve seen women changing, improving their lives,” Madsen says of past participants, her voice cracking with emotion. “They start taking control of their finances, they start to care about how they’re spending their time.”

Sitting on the porch of the “big house,” a midcentury modern ranch home where the retreat meals are served, attendee Mandy Manuel, 39, a sex therapist from Connecticut, says that she found love — for herself and with a partner — after attending several Back to the Body retreats.

Back to the Body’s midcentury modern ranch home.

(Joyce Lee / For The Times)

“I’ve been in a large body my whole life. And the world will tell you ‘you’re not good enough, you’re not pretty enough, you’re not deserving of sex and romance,’” she says. “I totally bought into that story. And I wanted to challenge that. So I came and it was life-changing. Just recognizing ‘Oh, wow, I can receive.’”

Manuel eventually started dating online and met her current partner a year and a half ago (and is now facilitating a Back to the Body retreat in 2026). “My standard for dating shot way up. Previously it was: ‘I’m just going to accept whoever wants me’ and now it’s ‘who do I want?’”

Sexual wellness is a long-established sector of the medical establishment that, today, encompasses everything from contraception and safe sex practices to organic lube, tantric breathwork, couples counseling and the latest Magic Wand Rechargeable vibrator. It adds up to big business: the global sexual wellness market is projected to reach $48.2 billion by 2030, according to Global Industry Analysts Inc.

A participant in the “art of adoration” exercise.

(Joyce Lee / For The Times)

Somatic (or body-based) sex therapy, a subset of sexual wellness, is also not new in the medical field. Individuals struggling with sexual issues have for decades turned to sexual surrogates, or trained professionals who specialize in “experiential learning” and who work in tandem with a client’s sex therapist when talk therapy isn’t enough.

Whereas sexual surrogacy is interactive, mimicking partnership, sexological bodywork employs “one-way touch.” In Back to the Body’s private, one-on-one bodywork sessions that means certified sexological bodyworkers, trained in Madsen’s approach, are always clothed and focus attention on the consenting client without reciprocity. A session may involve breathwork, intimacy coaching, sensual touch, sound and movement, including dance. It’s a “body first” approach to healing, in which physical sensations inform thoughts, as opposed to talk therapy.

But hands-on sex education is controversial.

“I don’t endorse it with my clients,” says UCLA emeritus professor Dr. Gail E. Wyatt, a licensed clinical psychologist and board-certified sex therapist, “because I don’t trust [that] the individuals who are assigned [to touch clients] have the boundaries to see this as a professional act and not as an opportunity. Vulnerable individuals may end up in a situation where they’re being taken advantage of.”

Madsen acknowledges that sexological bodywork is edgy but stands by the modality.

“We cannot heal, expand or awaken our sexuality through words alone,” she says. “We must touch the body to hear it speak — and that terrifies people.”

The retreat includes journaling exercises as well as mindfullness activities and group discussions.

(Joyce Lee / For The Times)

Sexological bodyworkers are not doctors and there’s no national certification for the profession. Practitioners do, however, adhere to a code of ethics upheld by the Los Angeles-based Assn. of Certified Sexological Bodyworkers. While sexological bodywork falls into a legal gray area, the state of California first recognized it as a profession involving sex education in 2003 when it approved training at San Francisco’s the Institute for Advanced Study of Human Sexuality (the school closed in 2018 and no additional state-approved schools have emerged). Nonetheless, somatic sex education appears to be growing: two Back to the Body practitioners offer sexual wellness retreats through their own companies: Court Vox leads one for queer men through his the BodyVox and Cosmo Meens leads one for straight men through his Himeros Project.

“There’s a great need for education about sensuality and the body that we don’t get in school or at home, typically speaking,” says Regena Thomashauer, author of “Pussy: A Reclamation,” which explains that we live in a culture that teaches women to turn off their power.

To be clear, Madsen stresses, arousal is not just about orgasming, or even physical pleasure, but about agency. Erotic energy — desire — is a powerful, “life-changing tool” every woman has access to, she says — it connects you to your passion and creativity, to your intuition and voice.

“When women are in touch with their arousal, they start being able to see themselves, they start being able to express themselves, Madsen says. “They find their voice, they’re able to speak their desires.”

Addressing the group in the living room, Madesn elaborates on the empowering, if political, nature of Back to the Body’s work.

Madsen believes that “when a woman reclaims her arousal, she reclaims her aliveness.”

(Joyce Lee / For The Times)

“Women have only had the right to vote for just over 100 years,” she says. “You [often] couldn’t have a checking account or credit card until 1974 without a man. Why is this work important? Because we’ve been taught not to trust ourselves, not to trust our bodies. That we are vehicles for birth, that we are vehicles for sex, vehicles for entertainment, vehicles for service — we are not sovereign. What does this work do? It creates sovereign women.”

What’s more, Madsen says, it takes time for women to reach a state of arousal — and many women experience premature penetration during sex.

She breaks into song: “I want a man with a slow hand …” she croons, belting out the Pointer Sisters’ early ‘80s pop hit. Laughter erupts around the room.

A private chef, pictured in the background, prepares farm-to-table meals for participants.

(Joyce Lee / For The Times)

Madsen is a former kindergarten teacher turned fertility activist who grew up in Great Neck, Long Island, married at 19 and spent 45 years living in the Bronx where she raised two sons with her husband of more than four decades. She’s appeared on “The Oprah Winfrey Show,” “60 Minutes,” CNN and other media talking about sex or fertility issues before authoring the 2011 memoir “Shameless: How I Ditched the Diet, Got Naked, Found True Pleasure … and Somehow Got Home in Time To Cook Dinner.”

In the book, Madsen documents her search for “sexual, personal and spiritual wholeness.” As part of that journey, she became certified as a sexological bodyworker in 2007 through the Institute for Advanced Study of Human Sexuality. She founded Back to the Body in 2011, adding her own spin on sexological bodywork. While most practitioners offered one-off sessions, she says, she launched multi-day immersive retreats, stressing the importance of being “away from the noise of the world.”

Back to the Body had no physical home initially and held retreats virtually or around the U.S. and internationally.

Several Back to the Body participants have gifted the retreat with artworks, now scattered around the property.

(Joyce Lee / For The Times)

“But then we found this place,” Madsen says while touring the Joshua Tree property, onto which she moved in July 2024. She strides across the land, more of a swagger, wearing a white flowy dress, white cowboy hat and cowboy boots, her long black hair cascading down her back and her curvaceous bosom occasionally spilling out of her dress.

“This is the house that women built,” she says, sweeping one hand across the horizon and tucking a runaway boob back into her dress with her other. “I couldn’t have afforded this place without help — investments and donations — from participants. This work changed their lives, and they wanted to give back.”

Previous attendees also gifted artworks or ephemera now scattered around the property: large crystals around the pool or a granite statue, outside the main house, of a woman bracing against the wind.

Late in the afternoon, the women settle into the community room for a 45-minute demonstration of what a bodywork session might look like. Madsen, dressed in aqua lingerie, is the client in this scenario; practitioner Cosmo Meens, a buff and barefoot 45-year-old with thigh tattoos and a salt-and-pepper beard, is her certified sexological bodyworker. There is sexy music; there is playful slow dancing; there is laughter. “Louder!” Madsen says of the music, laying down on what looks like a massage table. There is also a shelf of accouterments nearby — coconut oil, a vibrator, a feather — to stimulate pleasure or bring her to orgasm.

The women sit in a circle around the demonstration table, rapt.

Afterward, Madsen sits up, hair mussed and cheeks flushed. There’s a short question-and-answer session. Then Madsen hard-sells the weeklong retreat, which runs from $8,000 to $18,000, depending on programming, accommodations and location (some retreats are international). There are just 30 spots left for 2026, she tells the crowd; and for those who register today, there’s a $1,000 discount.

15 of the 20 women sign up.

Participants during the “Lotus Lift Meditation.”

(Joyce Lee / For The Times)

To some, the marketing pitch might have a transactional feel: Is this cutting-edge somatic sex education or the commodification of the orgasm, of pleasure?

“It’s inaccessible,” says Betsy Crane, a retired professor of human sexuality at Widener University, who sees value in the retreat’s work but balks at the pricetag. “I understand why they have to charge as much as they do — it’s staff intensive, they include food, nice venues — but it’s not affordable for most women, that’s the inequality of the world that we live in. If it were more accepted, it could become less expensive because it could be available locally.”

Madsen says the price is in line with today’s economy.

“Travel is expensive, experiences are expensive,” she says. “What I know is: that I’m not getting wealthy, that it’s hard to keep the ship running. That women get done in a week here what costs them 15 years in talk therapy.”

The end goal? Madsen hopes her retreat will change the world “one vulva at a time.”

Sitting on the porch, Deb Morris, 63, a retired business owner who lives outside of Denver, says she’s been on more than a dozen Back to the Body retreats over the past decade. (Do the math.) But the investment of time and money has been “life changing.”

Attendees enjoy downtime between retreat activities.

(Joyce Lee / For The Times)

“How I show up at 63 is so much more vibrant and committed to life,” she says. “I stay in, sexually — my beingness, how I dress, staying healthy in the gym, having a more vibrant friend group. All of those things definitely have been affected by doing this work from my mid-50s to my mid-60s.”

She looks out at the view, a vast desert landscape. Then adds: “I feel alive.”