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The Psychology of Sex Part III Psych 405 Dr. D. Wardell Department of Psychology University of Alberta 2 3 4 “And the end of all our exploring will be to arrive where we started and know the place for the first time” -T.S. Elliot 5 Part lll Personal Relationships and Development & Clinical Observations The Kinsey surveys 6 More recent ones... The NHSLS survey... Some results: who, what, where, when and how often “The Marriage Effect” Comparing Canadian surveys Canadian attitudes 7 Sexual Dysfunction Sexual functioning Masters and Johnson Model EPOR Helen Kaplan’s Model DEO Rosemary Basson et al. Beyond DEO 8 Sexual Dysfunction Sexual dysfunctions: 1. 2. 3. 4. desire arousal orgasm pain NORC Base rates: Men: 31% Women 43% Julia Heiman 9 Sexual Dysfunction 1. Desire: hypoactive sexual desire and sexual aversion BR NORC Dx Men: 5 16% (0 - 3%) Women: 2233% (10% ) Dx issues: 10 “dysfunction” vs. problem medical factors Sexual Dysfunction 2. Arousal: SADF and SADM BR NORC Dx Men: 5 10% (0 - 5%) Women: 1419% (6%) Dx issues: 11 “erectile insufficiency” for men vaginal lubrication for women the relevance of negative emotional states (anxiety) the relevance of the autonomic nervous system. (PNS/SNS) Sexual Dysfunction 3. Orgasmic: orgasmic dysfunction and “premature ejaculation” BR NORC Dx Men: 0 8% (0 - 3%) Women: 7 25% (10%) Dx issues: the ejaculation for men the “satisfaction” for women 12 Sexual Dysfunction “Premature ejaculation” BR Men: Women: NORC Dx 21 30% (5%) ? (?) Dx issues: comparative and personal criteria 13 Sexual Dysfunction 4. Pain: dyspareunia and vaginismus BR Men: Women: NORC Dx 03% (0%) ? 15% (3 - 18%) Also: “Sexual dysfunction NOS” 14 Sexual Dysfunction Summary NORC BR12 Men: 31% Women: 43% DSM LTR Men: 10%? Women: 15-20%? Diagnosis, reconsidered: We need to “acknowledge the highly contextual nature of women’s sexuality.” 15 - Rosemary Basson Sexual Dysfunction Therapies: Masters & Johnson Evaluative research definition of success success and spontaneous remission Modern modifications relationships and individualized assessment 16 Summary The general population is 1. Not very sexually active... 2. Satisfied with their sex life, but... 3. Reporting lots of problems! How to understand this? The complexity of human sexuality 17 Neurobiology of Male Sexuality 1. Peripheral nervous system: Autonomic aspect Parasympathetic and Sympathetic components e.g. “Erection Generating Centre” 2. Central nervous system: Brain stem: PGN (Paragiganto Nucleus) Hypothalamus: Medial Preoptic Area and Paraventricular Nucleus Neocortex Dopamine, Testosterone, Viagra, et al. 18 Neurobiology of Female Sexuality 1. Peripheral nervous system: Autonomic aspect Parasympathetic and Sympathetic components e.g. “Erection Generating Centre” 2. Central nervous system: Brain stem: PGN (Paragiganto Nucleus) Hypothalamus: Medial Preoptic Area and Paraventricular Nucleus Neocortex Dopamine, Testosterone, Viagra, et al. 19 Similarities and differences Comparing Sexual Arousal Between the Sexes Genital and Subjective Measures Correlations for men Category-specificity for men For women, “a rudderless system of reflexive physiological arousal.” - Meredith Chivers Implications 20 Meredith Chivers “Our Sexual Society” Some myths about “your sexual self” Some Topics 1. Contraception and Abortion ▪ Natural and unnatural methods ▪ Rates and results ▪ Consequences: “post-abortion syndrome”? 21 2. Masturbation Other species Human history The Future of Solitary Sex 22 John Money Excerpt from US patent 745,264 by Albert V. Todd, filed on May 29, 1903; depicting a lockable belt with a tube for inserting the penis. It uses spikes, electric shocks and an alarm bell as punishment for erections (designed to prevent masturbation and nocturnal ejaculation) 23 3. Marriage and Divorce: Research at “The Love Lab” Are all happy marriages alike? The three types of regulated marriage 1. Validating 2. Volatile 3. Conflict-avoiding “Balance Theory”: 5 to 1 24 3. Marriage and Divorce: Research at “The Love Lab” The Four Horsemen of the Apocalypse 1. Complaining 2. Contempt 3. Defensiveness 4. Stonewalling 25 3. Marriage and Divorce: Research at “The Love Lab” The cascade: DPA: “Diffuse physiological arousal” FAE: “Fundamental attribution error” The implications for marital therapy Early marital therapies Later marital therapies “Minimal Marital Therapy” 26 4. Erotica and Pornography: History of research and debate Modern research results Experimental research in the lab Attitudes & behavior Correlational research in real life Attitudes & behavior “The Confluence Model”: Personality as a moderator variable “You can’t hang a coat on a hook if the hook isn’t there.” Problems with erotica and pornography Cyber sex: research and clinical cases 27 5. Obsession and Stalking: research and clinical practice The research on unrequited love Two typical scenarios Results of rejection Stalking: research and clinical cases 1. Simple obsessionals 2. “Love” obsessionals 3. “Erotomania” Attachment Theory 28 “Obsessional following is a pathology of attachment.” - John Meloy 5. Obsession and Stalking: research and practice Self Others + - + Secure “Preoccupied” - Dismissive Fearful Preoccupied: Poor self-image ... Fearful: ...compounded by negativity Dismissive: Narcissism and hostility 29 Gender: Men, Women and the Trangendered 1. The biology of sexual differentiation and the Intersexual Syndromes ▪ True Hermaphrodite ▪ Male Pseudohermaphrodite (e.g. AIS) ▪ Female Pseudohermaphrodite (e.g. CAH) The Lesson of the Intersexed 30 Gender: Men, Women and the Trangendered Other cases: genital traumatization 1. The case of David Reimer 2. X, “...living as a male since 1998” David Reimer, suicide May 4, 2004 Summary: Gender awareness and ambiguous genitalia... Gender awareness and traumatized genitalia... Gender: genes, genitalia, and “the gender that is performed”. 31 2. The Psychology of Gender and the Transgendered Experience The historical importance of gender identity and the emergence of the “third gender” Development of the “gendermap”: “The Relay Race”: 1. 2. 3. 4. genes prenatal hormones physical appearance learning “A faint signal that somehow gets amplified.” 32 - Deborah Blum 3. Childhhod Gender Identity Disorder Diagnosis: discordance, distress and the desire to change Prognosis: e.g. “the sissy boy syndrome” gender sexual orientation 33 4. Adult Gender Identity Disorder Diagnosis: discordance, distress and the desire for change A. Women FTM, masculinity and gynephilia “Gender atypicality” among women B. Men MTF, femininity and androphilia “Gender atypicality” among men Note: “autogynephilia” 34 i.e “Classic / Homosexual TS” i.e “Non-classic / Heterosexual TS” 4. Adult Gender Identity Disorder Therapy: ... three possibilities 1. Body mind ... the transsexual surgical solution ... and the debate 2. Mind body ... modifying gender identity ... and the debate 3. The alternative ... reducing the distress ... and the debate 35 Sexual Orientation Definition: heterosexual, homosexual and bisexual androphilic, gynephilic and “bisexual”/biphilic What is “sexual orientation”? “Erotosexual attraction only to someone who has the same external body morphology as your own” - John Money 36 Sexual Orientation The surveys: Kinsey and beyond 1. same-sex sexual behavior? 37%, 13% 20%? 2. same-sex sexual desire? 50%, 28% about 40%? 3. same-sex romantic attraction? males: 3 - 4% females: 1 – 2 % 37 Sexual Orientation The modern results: 1. behavior? 9%, 4% maybe 10%? (not 20%) 2. desire? 8%, 8% maybe 10%? (not 40%) 3. attraction? males: 2.8% females: 1.4 % 38 Sexual Orientation Development of Sexual Orientation: A. Psychodynamic Theory (“Psychoanalytic”) ... and its problems B. Learning Theory (“Socialization”) ... and its problems C. Biology (e.g. prenatal androgenization) ... and its problems 39 Concordance rates and other curiosities “The paradox of gay genes” 40 Other theories: “Availability” and “EBE” Theories Two Types of Theory Anne Fausto-Sterling (right) and partner Simon LeVay ...biological and beyond... 41 Two Types of Theory 1. Androcentric: “bottom-up” theories Sexual desire and arousal romantic attraction sexual orientation e.g. “Inversion Model” 2. Gynecentric: “top-down” theories Relationships and intimacy sexual desire and arousal sexual orientation e.g. “Intimate Careers Model” 42 Sexual Orientation and the Social Context Same-sex sexual behavior ... a sin ... a crime ... evidence of an attribute Cross-cultural variations Developmental discontinuities 43 Sexual Orientation and the DSM What is wrong with any sexual orientation? 1. Theoretical criterion (disease, defect) and DSM I 2. Social criterion (difference, deviance) and DSM II 3. Personal criterion (distress, dysphoria) and DSM III 4. Maladaptation (dysfunction, disorder) and DSM IV 44 Sexual Orientation and the DSM A Diagnosis: “Sexual disorder NOS” discordance distress and the desire for change A Therapy: three possibilities 1. Sex life sexual orientation 2. “Conversion” and “reparative” therapy 3. The alternative ... reducing the distress ... and the debate 45 Sexual Orientation and Other Species Same sex sexual behavior in other species 46 Sexual Orientation and Other Species Homosexuality in other species 47 The Lovemap Where do sexual interests come from? The importance of personal experience and interpersonal relationships Two Types of theory again... “For men, sex leads to intimacy... for women, intimacy leads to sex.” - Donald Symons, The Evolution of Human Sexuality “What does sexual orientation orient?” - Lisa Diamond 48 The Lovemap Three premises: 1. Whatever your sexual orientation, you can be in love with people who do not share it. 2. Whatever your sex, you can be in love with people of either sex. 3. Your sexual desire for someone can start with your love for them whatever your sexual orientation. Is the lovemap fixed and firm or flexible and fluid? “Romance can override sexual orientation.” 49 - Lisa Diamond Special Cases Bisexuality, for men and women “The perpetual quagmire of sexual theory” 1. Men Descriptive features - behavior, desire, attraction Developmental history 50 Special Cases Bisexuality, for men and women “The perpetual quagmire of sexual theory” 2. Women Descriptive features - behavior, desire, attraction Developmental history 51 Special Cases Asexuality, for men and women “The decoupling of sexual orientation from sexual desire” Descriptive features - behavior, desire, attraction Developmental history The absence of sexual orientation? A new kind of sexual orientation? 52 David Jay Paraphilias “To study the abnormal is the best way to study the normal” - William James A. Description Sociological and Pathological Paradigms Diagnostic criteris Definition: “...reiteratively responsive to and dependent on atypical or forbidden stimulus imagery, in fantasy or practice, for the initiation and maintenance of erotosexual arousal and achievement or facilitation of orgasm.” Note: paraphilias and phobias, as opposed to “fetishes” and “irrational fears” 53 Paraphilias Examples: voyeurism exhibitionism fetishes fetishistic transvestism pedophilia zoophilia frotteurism sexual sadism and masochism and others . . . 54 Marquis de Sade Paraphilias B. Explanation Normality and Pathological approaches Theories: (and what is wrong with them) 1. Psychodynamic Theory management of impulses 2. Learning Theory A. Classical conditioning: stimulus association problems: extinction and real life? B. Operant conditioning: reinforcement problems: extinction and real life? 3. Cognition: “arousal transference/misattribution” problems: self-correction and real life? 55 Paraphilias What is wrong with many theories for paraphilias? There is “a certain naiveté about learning theories of paraphilias.” - Simon LeVay Asking the right question: Not: Why is he interested in that? But: Why isn’t he interested in anything but that? “The Vandalized Lovemap” 56 Paraphilias Modern perspectives: 1. Erotic activity preferences (“Courtship Disorders”) e.g. Penance, possession, payment activities (John Money) 2. Erotic target preferences (“Fetishes”) e.g. Substitute objects, people, self (John Money) 57 Kurt Freund Paraphilias Sources of “Vandalized Lovemaps” 1. Physical factors 2. Psychological factors “Paraphilias represent the desperation of relatively lowranking individuals who have normal sex drives but lack the wherewithal to court successfully.” - David Barash, Making Sense of Sex e.g. Developmental conflicts 58 Paraphilias C. Treatment Affirmative and Clinical approaches The limitations of behavior therapies e.g. aversion Tx, punishment, condemnation Modern approaches to treatment e.g. retraining, restructuring, relapse Biomedical approaches and anti-androgens 59 “The Paraphilia-Related Disorders” Approaches: “Sexual addiction”? 12 steps (Carnes) “Sexual compulsion”? Psychotherapy (Coleman) “Sexual impulse control problem”? Medication (Kafka) 60 The Darker Side of Sex Some Statistics The Research and Theories about Rape ▪ Radical Feminist Theory: aggression (power and anger) ▪ Psychological Theory: sex (“narcissistic reactance”) ▪ Research with forensic & non-forensic samples and their victims 61 The Darker Side of Sex 1. The Perpetrator: The heterogeneity of sexual assault Prognosis and treatment 62 Olson Ridgway Bundy Bernardo The Darker Side of Sex 2. The Victim The heterogeneity of victim prognosis Dilemmas 1. Report it? blaming the victim 2. Prevent it? the issue of consent 63 The End! Concluding Comments Essays Final Exam 64