Categories
Sexual Dysfunction

Sex, Culture Influence

Increasing complaints of inadequacy of human sexual function, it would seem that the potpourri of cultures that influence the behavior of so many might designate some area less vital to the quality of living than sexual expression to receive and to bear the burden of the social ills of human existence.

As recently as the turn of the century, after marriage rites and advent of offspring were celebrated as evidence of perpetuation of family and race, woman was considered to have done her duty, fulfilled herself, or both, depending of course upon the individual frame of reference.

In reality:
Society honored her contribution as a sexual entity only in relation to her capacity for breeding, never relative to the enhancement of the marital relationship by her sexual expression.

In contradistinction to the recognition accorded her as a breeding animal, the psychological importance of her physical presence during the act of conception was considered nonexistent. It must be acknowledged.

However, that there always have been men and women in every culture who identified their need for one another as complete human entities, each denying nothing to the other including the vital component of sexual exchange.

Unfortunately, whether from sexual fear or deprivation (both usually the result of too little knowledge), those who socially could not make peace with their sexuality were the ones to dictate and record concepts of female sexual identity.

The code of the Puritan and similar ethics permitted only communication in the negative vein of rejection. There was no acceptable discussion of what was sexually supportive of marital relationships.

So far the discussion has focused on an account of past influences from which female sexual function has inherited its baseline for functional inadequacy.

Because this influence still permeates the current “cultural” assignment of the female sexual role, its existence must be recognized before the psycho physiological components of dysfunction can be dealt with comprehensively.

Socio Cultural Influence

More often than not places woman in a position in which she must adapt, sublimate, inhibit or even distort her natural capacity to function sexually in order to fulfill her genetically assigned role. Herein lies a major source of woman’s sexual dysfunction.

The adaptation of sexual function to meet socially desirable conditions represents a system operant in most successfully interactive behavior, which in turn is the essence of a mutually enhancing sexual relationship.

However, to adapt sexual function to a philosophy of rejection is to risk impairment of the capacity for effective social interaction. To sublimate sexual function can enhance both self and that state to which the repression is committed, if the practice of sublimation lies within the coping capacity of the particular individual who adopts it.

To inhibit sexual function beyond that realistic degree which equally serves social and sexual value systems in a positive way, or to distort or maladapt sexual function until the capacity.

And to function is extinguished, is to diminish the quality of the individual and of any marital relationship to which he or she is committed.

When it is realized that this psychosocial backdrop is prevalent in histories developed from husband and wifes with complaints of female sexual inadequacy, the psycho physiological and situational aspects of female orgasmic dysfunction can be contemplated realistically.

The human female’s facility of physiological response to sexual tensions and her capacity for orgasmic release never have been fully appreciated.

Lack of comprehension may have resulted from the fact that functional evaluation was filtered through the encompassing influence of socio cultural formulations previously described in this topic.

There also has been failure to conceptualize the whole of sexual experience for both the human male and female as constituted in two totally separate systems of influence that coexist naturally.

Categories
Sexual Dysfunction

Male Orgasm Influence

Professionals many times look for a specific influence or conditioning that predetermines sexual failure, and in most instances it can be identified if the delving goes deep enough.

Instances of neither positive nor negative dominance by either biophysical or psychosocial influence structures. If a woman has never established a close juxtaposition between the biophysical and psychosocial systems of influence because she has lived in a protective vacuum, she will not have been stimulated to develop her own sexual value system and therefore will tend to neutralize most input material of sexual implication.

The case history
below is presented to emphasize the fact that there need be no dominant influence (either positive or negative) in the development of primary orgasmic dysfunction.

Mrs. B was an only child of parents in their thirties when she was born. Both parents, teachers in a small, church-oriented college, were more restrained by habit of life-style and their own relationship than by religious influence.

The child did not develop as an extension of their presumed intellectual interests but became the “doll” whom they dressed exquisitely, handled little, and disregarded emotionally (as she perceived her upbringing). There was no real source of female identification, no opportunity to establish a sexual value system.

All decisions in her behalf included the theoretically objective presentation of two alternatives, but parental, primarily mother’s preference was emphasized. Mrs. B had no recollection of making a definitive decision of her own until her sophomore year at college, when she chose for a husband a relatively older man (he was in graduate school and seven years her senior). With this one decision she again relinquished all opportunity for self-determination.

They married upon his graduation at the end of her junior year in college. His assumption of total authority in marriage appeared more by default than demand and continued through 11 years of marriage, during which two children were born.

During the first years of the marriage, Mrs. B maintained a complacent attitude toward her sexual role within the marriage. However, in the last six years of the marriage she developed an intense desire to realize full sexual expression for herself and greater sexual pleasure for her husband.

Husband behavior
In this latter period her husband’s behavior, though warm and protective, was highly restrained in sexual as well as other facets of the marital relationship. He participated in the Foundation’s program with complete willingness, although with little concept of what or how anything in the marriage could be changed.

Reared by an older aunt and uncle he had learned little, by direction or observation, of the potential for human interaction on a personal level. However, he fortunately had not been given any primarily negative indoctrination.

Mrs. B’s enthusiasm for an effective sexual relationship within the marriage was and still is defined as real, but she has been unable to overcome anesthesia to any sensory perception that she can relate to erotic arousal. She has been unable to establish sensory reference within which to develop and relate her well-defined affection and regard for her husband.

The two contributing systems of influence on sexual function:
Remained in displaced positioning one from the other. To date she has demonstrated-insufficient emotional or intellectual capacity to establish a symbiotic state between her two systems of influence.

It is with mixed clinical reaction that the cotherapists regard the positive reaction of Mr. B to therapy. His response was one of delighted enthusiasm to the concept of interaction marked by both physical and verbal communication.

His feeling for his wife was intensified and he has become completely comfortable in a demonstrative marital role. While both partners feel that the alteration in the quality of the marital relationship is of significant proportion, the therapy has in fact failed to achieve the aim of reversal of the presenting distress.

This case represents a strikingly intense degree of negative conditioning, yet there was little of content in the history that could be termed specifically negative in its rejection of sexual expression.

This case also represents an example of the possible clinical warning system revealed by a negative reaction to the use of a moisturizing lotion as a medium of physical exchange. Mrs. B found its use “distracting” and of little meaning to the exchange with her partner.

While Mr. B found it to be the crucial contribution to establishing his initial ability to touch and feel with comfort and receptivity.

Categories
Secondary Impotence

Impotence Influence

An illustration of the repressive influence of religious orthodoxy upon the potential effectiveness of sexual functioning can be provided by relating the history of one of the five couples with both husband and wife products of different religious orthodoxies.

Impotence and Religion

Mr. and Mrs. D were married in their early twenties. He was the product of a fundamentalist Protestant background, she of equally strict Roman Catholic orientation. The man had the additional disadvantage of being an only child, while the wife was one of three siblings. The marriage was established over the firm and often expressed objections of both families.

Impotence and Sex Information

Prior to marriage the wife had no previous heterosexual, masturbatory, or homosexual history, and knew nothing of male or female sexual expression. She had been taught that the only reason for sexual functioning was for conceptive purposes.

Similarly, the husband had no exposure to sex information other than the vague directions of the peer group.

He had never seen a woman undressed either in fact or in pictures.

Dressing and toilet privacy had been the ironclad rule of the home. He also had been taught that sexual functioning could be condoned only if conception was desired.

His sexual history consisted of masturbation during his teenage years with only occasional frequency, and two prostitute exposures. He was totally unsuccessful in each exposure because he was presumed a sexually experienced man by both women.

Sex with Prostitute

During the first episode the prostitute took the unsuspecting virginal male to a vacant field and suggested they have intercourse while she leaned against a stone fence. Since he had no concept of female anatomy, of where to insert the penis, he failed miserably in this sexually demanding opportunity.

His graphic memory of the incident is of running away from a laughing woman.

Condom

The second prostitute provided a condom and demanded its use. He had no concept of how to use the condom. While the prostitute was demonstrating the technique, he ejaculated. He dressed and again fled the scene in confusion.

These two sexual episodes provided only anxiety-filled examples of sexual failure. Since he had no background from which to develop objectivity when considering his “sexual disasters,” inevitably the cultural misconception of lack of masculinity was the unfortunate residual of his experiences.

There was failure to consummate the marriage on the wedding night and for nine months thereafter. After consummation sexual function continued on a sporadic basis with no continuity. The wife refused contraception until after advent of the third child.

Sexual success was never of quality or quantity sufficient to relieve the husband of his fears of performance or to free the wife from the belief that either there was something wrong with her physically or that she was totally inadequate as a woman in attracting any man.

Sexual Difficulty

They rarely discussed their sexual difficulties, as both husband and wife were afraid of hurting one another, and each was certain that their unsatisfactory pattern of sexual dysfunction was all that could be expected from indulgence in sexual expression at times when conception was not the prime motivation.

With no appreciation of the naturalness of sexual functioning and with no concept of an honorable role for sexual response, the psychosocial pressures engendered from their negatively oriented sexual value systems left them with no positive means of mutual communication.

The failure of this marriage started with the wedding ceremony. There was no means of communication available for these two young people. Trained by theological demand to uninformed immaturity in matters of sexual connotation, both marital partners had no concept of how to cope when their sexual dysfunction was manifest. Their first approach to professional support was to agree to seek pastoral counseling.

Here their individual counselors were as handicapped by orthodoxy as were their supplicants. There were no suggestions made that possibly could have alleviated the sexual dysfunction. When sexual matters were raised, either no discussion was allowed, or every effort was made to belittle the importance of the sexual problem.

Without professional support, the marital partners were again released to their own devices. Each partner was intimidated, frustrated, and embarrassed for lack of sexual knowledge. The sexual dysfunction dominated the entire marriage.

The husband was never as effective professionally as he might have been otherwise. He withdrew from social functioning as much as possible. The wife was in a constant state of emotional turmoil, which had the usual rebound effect upon the children. By the time this husband and wife arrived at the Foundation, she was well on the way to earning the title of “shrew.”

Psycho-Sexual Performance

The couple was first seen after a decade of marriage. As expected from individuals so handicapped in communication, each partner had established an extramarital coital connection while individually searching for some security of personal identity and effectiveness of sexual performance.

The wife had been successful in establishing her own security of psycho-sexual performance; the husband, as would be anticipated in this instance, had not. After ten years of traumatic marriage, both individuals gravely questioned their religious beliefs. Although no longer channel visioned, the wife continued church attendance, the husband rejected all church affiliations.

There can be no feeling for naturalness of sexual expression when there is no background of sexual comprehension. There can be no appreciation that sexual functioning is indeed a natural physical phenomenon, when material of sexual content is considered overwhelmingly embarrassing, personally degrading, and often is theologically prohibited.

In essence, when an individual’s sexual value system has no positive connotation, how little the chance for truly effective sexual expression.

The fact that most men and woman survive the handicap of strict religious’ orthodoxy to function with some semblance of sexual effectiveness does not mean that these men and women are truly equipped to enjoy the uninhibited freedom of sexual exchange.

Their physical response patterns, developing in spite of their orthodox religious negation of an honorable role for sexual function, are immature, constrained, and, at times, even furtive.

Sexual function is stylized, unimaginative, depersonalized, and indeed productive only of biological reproduction. A derogatory affect upon the total personality is the tragic residual of conditioned inability to accept or handle objectively meaningful material of sexual content.

Categories
Erectile Dysfunction

Influence to Penis

There is a recorded history of one man whose failed attempt at initial coitus developed while he was partially under the influence of drugs.

Two men (the exception mentioned above) failed in their first attempts at vaginal penetration under the influence of excessive alcohol consumption. In none of the 12 individual patterns among these 13 men is there specific evidence to support psychodynamic concepts of the dominant mother and the meek and docile father or the inadequate mother and the supremely dominant father.

The one common factor:

The men had restrictive input from an immature or even negatively disposed sexual value system. The psychosocial system certainly exerted overwhelmingly dominant influence on the biophysical component.

The interesting observation remains that, although there obviously are instances when primary impotence almost seems preordained by prior environmental influence, there frequently is a psychosexually traumatic episode directly associated with the first coital experience that establishes a negative psychosocial influence pattern or even a life-style of sexual dysfunction for the traumatized man.

Penis and Emotional Influence

The male with a meaningful, well-established homosexual orientation in his teenage years may be expected to experience varying strengths of conditioning against active heterosexual involvement. Similarly, a negative sexual value system can be anticipated from blind adherence to any form of religions orthodoxy.

Particularly does orthodox orientation develop as a psychosexual handicap when the wife-to-be has matured in similar religious environment. Aside from prescribed religious orthodoxy, there is little evidence that familial influence, so frequently held the primary suspect in the multiple etiologies of sexual dysfunctions, carries much statistical weight.

Certainly in the histories of primarily impotent males there are recorded instances of compulsively neurotic maternal influence, including forms of direct mother-son sexual encounter. But little is known of unopposed maternal dominance or direct mother-son sexual encounter relative to the anticipated percentage of resultant primary impotence.

What is known of the individual psychosocial characteristics of young men who are bent and occasionally broken almost beyond repair by the oppressive conditioning of unopposed maternal dominance, orthodox theological control, or homosexual orientation that another youth in similar circumstances might consider serious, but not of lasting moment?

Most men so traumatized in their teens or early twenties survive the stresses of their initial opportunity for heterosexual coition, whether or not successful, and move into a continuum of effective sexual functioning with facility and pleasure. As time passes they at least partially neutralize the negative psychosocial influences that have accrued as a combination of their environmental backgrounds and the trauma of their initial coital failures.

Penis and Social Influence

One cannot propose that environmental influence inflicts upon young males such a depth of psychosocial insecurity that statistically they must find themselves inadequate to react to the tension-filled demand of the initial coital occasion. For to make such an assumption would be to negate the influence of their biophysical system.

As an auxiliary to the Foundation’s basic research concepts of evaluating sexual functioning in our culture, investigators continually record histories of young men sexually traumatized beyond any reasonably acceptable measure, indeed well beyond the scope of the acute episodes described here.

These men may have failed to:

Perform successfully during their initial coital exposure and for a considerable period of time thereafter may have continued sexually inadequate. Yet they have recovered from their experiences with sexual dysfunction without specific psychotherapeutic support.

As far as can be, ascertained from corroborative histories of husband and wife, have led effectively functional heterosexual lives. Regardless of the depth of the specific trauma resultant from a prejudicial sexual value system, ultimately it is the interdigital response patterns of the psychosocial and the biophysical systems and the individual characteristics of the men directly involved that predicate sexual survival or failure.

Of these characteristics we know so little. It is relatively easy for the cotherapist retrospectively to identify etiological influence in states of sexual dysfunction, but to generalize from such specific retroflection is statistically unsupportable and psycho dynamically unacceptable.

In brief, the etiology of primary impotence has a multiplicity of factors. In most of these instances, the unexplained sensitivity of the particular male to psychosocial influence adjudicates the specific failures of the virginal experience with sexual function into subsequently high levels of concern for performance.

Sexual Peers

Most of his peers would not perform inadequately under similarly combined pressures of prior environmental handicapping or the immediacy of sexual trauma. At present it not only is statistically inadequate but also psychotherapeutically inappropriate to attempt definitive correlation of etiological factors for primary impotence.

From an investigative point of view, it is infinitely healthier to admit that we really have no concept of the specific psychodynamic factors that render the young man failing in his first coital connection susceptible to continuing failure at sexual performance.

The approaches to reconstitution of male sexual function from secondary impotence are essentially similar to therapeutic considerations of primary impotence. Therefore, the erectile treatment techniques and program statistics for both primary and secondary impotence will be presented in a separate discussion considering the subject from a composite point of view.

Since there have been more unmarried men referred for primary impotence than for any of the other three distresses in the continuum of male sexual dysfunction (premature ejaculation, incompetent ejaculation, and secondary impotence), a discussion of use of replacement partners, or partner surrogates, in cooperation with authority will be presented as an integral part of this chapter.