Download Masters and Johnson`s sex research and sex therapy

JOURNAL OF SEX RESEARCH, 46(5), 505–510, 2009
Copyright # The Society for the Scientific Study of Sexuality
ISSN: 0022-4499 print=1559-8519 online
DOI: 10.1080/00224490903051202
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Masters and Johnson’s Sex Research and
Sex Therapy Program: A Critical Appraisal
From Down Under
Sex Research and Sex Therapy: A Sociological Analysis of Masters and Johnson. By Ross Morrow. New
York: Routledge, 2008, 212 pages. Hardcover, $120.00.
Reviewed by Hollie J. Fuhrmann and Eric R. Buhi,
Department of Community and Family Health, College
of Public Health, University of South Florida, 13201
Bruce B. Downs Blvd., MDC 56, Tampa, FL 33612;
E-mail: [email protected]
In 1966, the Masters and Johnson research team
released Human Sexual Response, the groundbreaking
work outlining their four-stage model of the human sexual response cycle (Johnson & Masters, 1966). The pioneering duo, gynecologist William Howell Masters and
lay-psychologist Virginia Eshelman Johnson, released
a follow-up text in 1970, Human Sexual Inadequacy,
which established a biomedical nosology for the diagnosis and treatment of sexual dysfunctions based on their
four-stage model (Masters & Johnson, 1970). Together,
these works are credited for legitimizing and, even, igniting the burgeoning field of sex therapy, and their models
continue to provide a basis for current approaches to sex
research and sex therapy. The works of Masters and
Johnson were so positively received that both Human
Sexual Response and Human Sexual Inadequacy were
best-sellers, translated into more than 30 languages;
what’s more, a photo of the researchers glossed the
May 25, 1970 cover of TIME Magazine. In fact, there
was so much optimism about the works of Masters
and Johnson that it was widely, though perhaps naively,
believed that sexual dysfunction could be eradicated,
and the rising divorce rate might subside as a result.
That we are still reading about research on sexual
dysfunction in this and other journals suggests that the
works of Masters and Johnson did not provide the deliverance for which sex researchers, sex therapists and,
especially, those living with sexual dysfunction had
hoped. As is the case with much groundbreaking
research, answers lead to more questions, the questioning of once-accepted answers and, eventually, a so-called
Kuhnian revolution (see Kuhn, 1970). In Sex Research
and Sex Therapy: A Sociological Analysis of Masters
and Johnson, Ross Morrow (2008) reminds us that scientists’ subjective experiences via their socio-cultural positioning makes science a relativistic experience. Morrow
(2008) drives a sociological-infused paradigm shift in
sex research and sex therapy by providing ‘‘a sociological analysis and critique of the conceptual foundations
and practice of Masters and Johnson’s (1966, 1970)
sex research and therapy program, as articulated in their
seminal texts Human Sexual Response and Human
Sexual Inadequacy’’ (p. 1). A sociologist, who received
doctoral training from the University of New England,
NSW, and who currently teaches social theory and
social science at the University of Sydney and University
of Technology, Sydney, respectively, Morrow draws
heavily on his previous work in the fields of sociology,
social theory, and human sexuality. His publications in
The Australian and New Zealand Journal of Sociology
(Morrow, 1994, 1995), in the Revue Sexologique (Morrow,
1996), and contribution to the edited volume of Perspectives in Human Sexuality (Morrow, 2005) serve as
foundations for this more in-depth critical analysis.
Before moving forward with this review, we as
reviewers would like to point out that we are social
and behavioral scientists with research interests in sexual
and reproductive health, and not experts on sex research
as it pertains to sex therapy. As such, we are not adequately equipped to comment on Morrow’s text (2008)
from a medical or clinical viewpoint. We do, however,
feel that we have remarks to offer regarding Morrow’s
sociological analysis of sex research and Masters and
Johnson’s contributions. In fact, it is Morrow’s sociological analysis that uniquely contributes to the literature
on sex research, sex therapy and, more specifically, to
critiques of Masters and Johnson’s work. Morrow
(2008) states the following in his introduction:
A key theme in my overall argument is that Masters and
Johnson constructed their apparently scientific ideas
about sexual function and dysfunction with reference
to dominant Western beliefs and values about sexuality,
and that their sex therapy program operated as an institution of control. (p. 1)
In chapter 2, Morrow (2008) tackles the sociological
literature on sex, arguing that, despite a dearth of literature and the discipline’s own stance that the sociology of
sex did not emerge until the 1960s or 1970s, sociology
was ‘‘part of the discursive explosion about sexuality
that characterized Western societies from the eighteenth
century’’ (p. 8). His rewritten history of the sociology of
sex provides sufficient evidence that early sociological
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work on sex does emanate from the 18th century with
extensive references to the works of Karl Marx,
Friedrich Engels, August Comte, Herbert Spencer,
Emile Durkheim, Charles Letourneau, and Max Weber,
to name a few. So, why then has sociology overlooked
its scandalous forays into sex research prior to World
War II? Others have suggested that sociologists prescribe to the Repressive Hypothesis regarding their
own history with sex and that the study was too quickly
co-opted by the fields of biomedicine and psychoanalysis
due to Masters and Johnson’s medicalization of sexual
function (Morrow, 2008). Morrow (2008), however,
argues that it was the remaking of sociology in terms
of the ‘‘classical canon’’ by the labor of Talcott Parsons,
Robert Merton, and C. Wright Mills that worked to
effectively marginalize the society of sex. Morrow
(2008) explains:
The remaking of sociology’s history in terms of the
canon gave many sociologists a sense that because the
canonical text did not deal very much with topics like
sexuality, ‘‘race’’ and gender, that these topics were also
unimportant for contemporary sociology. In effect, the
process of canon making narrowed sociology’s intellectual scope by excluding and discrediting what was not
canonical. (p. 35)
In chapter 3, Morrow (2008) examines essentialism
and social constructionism as the two dominant theoretical perspectives that have shaped sexual discourses in
Western societies, including sociological discourses. He
succinctly and accurately articulates the philosophical
underpinnings and central disagreements between essentialists and social constructionists, and he succeeds in
not limiting his discussion to sex research and sex therapy. While Morrow is critical of both theoretical
strains—because sexuality is not innate, static, bounded,
ahistorical or reducible to a physiological response—he
disavows essentialism and draws on the position of
Trigg (1989) favoring a social constructionist approach
tempered by realist philosophy. Morrow (2008) claims:
This modified form of social constructionism has no
need to deny that epistemological access to reality is
possible and so it avoids the problems associated with
a useless and incoherent Kantian notion of things-inthemselves as well as the problem of relativism. It also
insists on maintaining the distinction between reality
and how people conceive of it in order to escape that
absurdity of those constructionist claims which confuse
the two and end up stating, for example, that theories
somehow literally create their own worlds. (p. 71)
After establishing a topical and theoretical sociological approach to sex research and sex therapy, Morrow
(2008), in chapters 4 through 7, uses his tools to critically analyze Masters and Johnson’s seminal texts.
From a sociological standpoint, Morrow systematically
506
describes and dismantles Masters and Johnson’s
laboratory research, their four-stage model of the
human sexual response cycle, the classification of sexual
dysfunction and, finally, their sex therapy program. To
do so, Morrow provides the first synthesis of the existing critical literature on Masters and Johnson accompanied by his own sociological insights—the crux being
that Masters and Johnson’s work was ethnocentric,
essentialist, and dominated by Western values regarding sexuality. Because their four-stage model narrowly
defined sexual function as a man and a woman reaching female orgasm or male ejaculation through coitus,
all other sexual functions would be classified as ‘‘unsuccessful’’ or ‘‘sexual dysfunction.’’ Yet, contemporary
and cross-cultural research indicates there are multiple
and varying discourses and realities concerning sex, sexual function–dysfunction, and what Masters and Johnson failed to incorporate—sexual desire. Through
Morrow’s analysis, it is easy to see how Masters and
Johnson’s coital obsession and subsequent classification
of primary and secondary impotence as sexual dysfunction has led us to our current sociological environment
where erectile dysfunction is a medically recognized disease generating millions of dollars in revenue for big
pharma each year. After all, ‘‘hardness matters,’’ and
Viagra1 is ‘‘delivering the hardness men want’’ (see
www.viagra.com).
Finally, in chapter 8 (Morrow, 2008, p. 179), Morrow
closes his analysis by delineating the following implications for contemporary sex therapy: (a) Sex therapists
should be critical of Masters and Johnson’s model ‘‘as a
universal norm of healthy sexual functioning,’’ (b) Masters and Johnson’s classification of sexual dysfunction is
so problematic that it should be reconstructed, (c) sex
therapy needs to expand its focus on the individual
patient to take into consideration how the broader sociocultural environment impacts sexual functioning, (d) to
avoid being agents of social control, sex therapists must
be ‘‘more reflexive and sociologically aware’’, (e) more
rigorous treatment outcome studies are needed for sex
therapy to advance, and (f) sex therapists need to critically evaluate the commoditization of their services.
Unlike the writing style of Masters and Johnson,
Morrow’s (2008) sociological analysis is not ‘‘taxing,
turgid, and often imprecise’’ (p. 162). Rather, it is a
highly accessible, intriguing, and quick read—even for
those who are not astute in the fields of sex research
and sex therapy—that makes significant contributions
to the sociology of sex. First and perhaps foremost,
Morrow rewrites the history of the sociology of sex by
resurrecting texts from the 18th century onward to
demonstrate that sexual inquiries have long been a part
of the sociological tradition, despite canonical misrepresentation. Second, in the first text to do so, Morrow
skillfully synthesizes the critiques of Masters and
Johnson’s methods and results and provides his own
sociological analysis.
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While Morrow (2008) gives the reader a taste of
sociological analysis, his critique does not quite satiate
our socio-cultural hunger. Perhaps because so much of
the previous work critiquing Masters and Johnson has
focused on methodological errors, Morrow, too, seems
overly concerned with Masters and Johnson’s methods
and results, with limited attention to the specific sociological connections. For example, Morrow devotes a great
deal of time to describing Masters and Johnson’s sample
selection, experimenter, and gender biases. Yet, when
Morrow points out that Masters and Johnson’s endeavor was, in part, driven by a desire to address the breakdown of marriages in the United States, this concurrent
sociological picture is scantily painted. How was the
institution of marriage socially constructed in the
United States at the time of Masters and Johnson’s
research? What were the social, political, and economic
responses to the breakdown of American marriages?
Moreover, although Morrow does not purport to do
so, we suggest that a more comprehensive sociological
analysis might incorporate a discussion of the impact
of Masters and Johnson’s biases on contemporary sex
research and sex therapy. For example, what are the
connections between the Viagra phenomenon and
Masters and Johnson’s work? Nonetheless, Morrow’s
sociological analysis provides sex researchers and sex
therapists an appetizer for critically examining sexual
function and dysfunction, beyond the individual. For
sociologists, Morrow provides an alternative disciplinary discourse that regards the work of Masters and
Johnson. For researchers and practitioners alike, Sex
Research and Sex Therapy: A Sociological Analysis of
Masters and Johnson is a worthwhile reference book.
References
Johnson, V. E., & Masters, W. H. (1966). Sexual human response.
Boston: Little Brown & Co.
Kuhn, T. S. (1970). The structure of scientific revolutions (2nd ed.).
Chicago: University of Chicago Press.
Masters, W. H., & Johnson, V. E. (1970). Human sexual inadequacy.
Boston: Little Brown & Co.
Morrow, R. (1994). The sexological construction of sexual dysfunction. The Australian and New Zealand Journal of Sociology,
30(1), 20–35.
Morrow, R. (1995). Sexuality as discourse—Beyond Foucault’s
constructionism. The Australian and New Zealand Journal of
Sociology, 31(1), 15–31.
Morrow, R. (1996). A critique of Masters’ and Johnson’s concept
and classification of sexual dysfunction. Revue Sexologique, 4,
159–180.
Morrow, R. (2005). Sexual dysfunction and sex therapy. In G. Hawkes
& J. Scott (Eds.), Perspectives in Human Sexuality (pp. 187–202).
Melbourne, Australia: Oxford University Press.
Morrow, R. (2008). Sex research and sex therapy: A sociological
analysis of Masters and Johnson. New York: Routledge.
Trigg, R. (1989). Reality at risk. New York: Harvester Wheatsheaf.
The Enigma of Masters and Johnson
Masters of Sex. The Life and Times of William
Masters and Virginia Johnson, The Couple Who Taught
America How to Love. By Thomas Maier. New York:
Basic Books, 2009, 411 pages. Cloth, $27.50.
Reviewed by John Bancroft, 4 Blenheim Rd.,
Horspath, Oxfordshire, OX33 1 RY, United Kingdom;
E-mail: [email protected]
It is high time that we had a biography of Masters
and Johnson. They are undoubtedly the most important
people in the field of sex research since Alfred Kinsey,
and we have four biographies of Kinsey! Also, while
Masters and Johnson’s work is well-known, we have
known very little about them as people. This biography
fills that gap, though a number of mysteries remain.
The first phase of their sex research focused on
getting paid volunteers to perform sexually in their
laboratory setting. Most of these volunteers were
recruited from university staff. Women were either interacting with a partner, or on their own, stimulating themselves, in some cases with an intra-vaginal tube to allow
filming of internal changes during their response cycle.
For men, there was no comparable internal monitoring,
but blood pressure and heart rate, respiration, and skin
and nipple changes were observed in both men and
women. Over the 12 years of this research, they observed
thousands of orgasms. Interestingly, the first phase of
this research was carried out in a university setting, with
very little of the details being known by others outside
the team. When they did become known, there was sufficient negative reaction to drive Masters and Johnson
out of the university setting into privately funded facilities. It is striking, at this time when sex was still a taboo
topic in many parts of society, that they were able to
recruit so many participants—many of whom came
back repeatedly for more of these monitored sexual
experiences. This raises questions about participation
bias that are difficult to answer, but caution is clearly
required when generalizing from their results. Ironically,
it is unlikely that one would be able to carry out such
research today because of the restrictions of research
ethics not relevant at that time.
William Masters had already established himself as a
highly regarded academic gynecologist and obstetrician,
with particular skills in treating infertility. His personality is difficult to grasp, as it is paradoxical in several
respects. Why, early in his career, he set himself the goal
of explaining human sexual response remains an
enigma.
Virginia Johnson is less enigmatic in this respect. She
emerges from this biography as an ‘‘alternative’’ young
women clearly comfortable about sex, but with two
failed marriages, neither of which, it would seem, were
important to her; and two children, about whom we
hear very little until the last part of the biography. She
enters the scene when Masters is setting up his sex
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