287 Masters and Johnson

1. 287 Masters and Johnson Pepper Schwartz, PhD, 2013

2. Masters of Sex: The PBS series • The background on the team that first watched sex happen with modern monitoring equipment –rather than heard people telling about it!

3. The Invention of Sexual Therapy • William Masters, an ambitious young doctor who wanted to “complete” Kinsey. • Virginia Johnson, Social Work background, secretarial, recruitment , interviewing and “emotion work”

4. Begun at Washington University in St. Louis.. • Designed in 1954, • Research Lab set up - 1960s • WANTED TO BE THE FIRST PERSON TO SCIENTIFICALLY MEASURE THE BIOLOGY OF SEXUAL RESPONSE–…

5. But there were others before him.. • Marie Bonaparte had trouble reaching an orgasm • Decided that it was the space between the clitoris and vagina that made the difference. • In 1924 published a paper based on several hundred measurements of women to prove her thesis.. ( less than an inch distance..)“luckiest of all are mares and cows”…

6. Early Impotence treatment modes in 1950s • Albert Ellis, Arnold Lazarus, Joseph Wolpe –others • James Seamens, develops the • “start” “stop” treatment of premature ejaculation which Masters and Johnson re-invent as the “squeeze technique” for the • problem

7. But MJ research wiped others off the map.. • Startled the world with the book in 1970 • HUMAN SEXUAL RESPONSE

8. Major Accomplishments • 1.The Human Response Cycle • 2.Understanding female orgasm • 3.Synchronizing male and female love making

9. Major Accomplishments… 4.Setting a precedent for empirical observation of sexual functioning • 5.Creating a therapeutic method for sexual issues 6.Creating an alternate physical explanation versus a Freudian one for sexual issues

10. Based on new methods • FIRST RUN THROUGH– WITH MALE AND FEMALE PROSTITUTES • THEN LOOKING FOR “NORMALCY” LOOKING FOR “REGULAR “ RECRUITS” • RECRUITS HAVE VARIOUS KINDS OF SEX IN THE LAB WITH PHYSIOLOGICAL AND PSYCHOLOGICAL MEASUREMENT

11. 10,000 EPISODES OF SEXUAL ACTIVITY.. FOR SIMULATION OF INTERCOURSE: PENIS SHAPED CAMERAS FOR USE IN MASTURBATION ( Dildo Camera)

12. Masters and Johnson quote: • The penises are plastic and were devleoped with the same optics as plate glass. Cold light illumination allows observation and recording without distortion. The equipment can be adjusted for physical variations in size, weight, and vaginal development. The rate and depth of penile thrust is initiated and controlled completed by the responding individual. As tension elevates , rapidity and depth of thrust are increased voluntarily, paralleling subjective demand. “

13. The Human Sexual Response Cycle • Masters and Johnson wanted to show that men and women went through essentially the same arousal process

14. Four Phases • First- Excitement • Second-Plateau • Third- Orgasm • Fourth- Resolution

15. First Phase: Excitement • Increase in Heart Rate • “Sex Flush” • For Women: lubrication within 30 seconds of stimulation • Begin Vascocongestion ( blood supply delivery)

16. Second Phase:Plateau For women: Distension and Lengthening of the vaginal walls Outer third of the Vagina becomes engorged with blood Vaginal barrel tightens ( from engorgement and muscle tension-outer third tightens one third more..)

17. female changes • Cervix and uterus are pulled slowly back and up Muscle and blood flow cause smoothing of vaginal walls Chances in color and shape of vagina and uterus ( redish to purple) Clitoris flattens under the “hood”-becomes half it’s size…

18. Female changes • The bottom part of the vagina expands and creates a “ basin” ( giving many women the sensation that the fully erect penis is “lost” in the vagina!

19. For Men: • Additional blood flow to the Penis • Penis doubles in size • Muscle tension increases greatly • Possible tightening and drawing in of the scrotum

20. Third Phase: Orgasm • For Women: • More changes in the upper third of vagina • Strong contractions at 0.8 second intervals – Reoccurring between 3-15 times per orgasm • Uterus elevates and contracts with vaginal contractions

21. Female Orgasm • Clitoris shortens by about half ( more work by Wallen in 2006) confirms Bonaparte that distance from the vaginal opening makes a difference in orgasm ( “ distance of thumb length or less”).

22. For Men: • Penis fills with as much blood as it will in this process • Ejaculations occur in rhythmic contractions Heart and Respiration rates at peak for both men and womn

23. Resolution • For men “ Post ejaculatory sensitivity” • For women “ high clitoral sensitivity” • Breathing rate goes back to normal over a relatively short period • Some men, fewer women, sleep or need absolute immobilization

24. M and J paid new attention to the “clitoral versus vaginal”orgasm • Showed they were one and the same • Showed some variablity in how some women reached orgasm ( fantasy, nipple touch etc) • Showed that most of the nerve endings were in the clitoris and not in the vaginal barrel or cervix..

25. what was the clinical application? • The field of sex therapy began: • First- To Educate Men and Women about how their bodies work • Second-to co-ordinate male and • female arousal progression to orgasm

26. Criticism • 1. Mechanistic • Masters and Johnson didn’t seem to notice that except for masturbation, sex happens between two people: interpersonal variables and situational context were not taken into account.

27. 2.Excitement is not the lst phase • Helen Singer Kaplan: first phase should be Desire • ( Masters and Johnson assume desire and it is often problematic)

28. Distinguish Arousal and Desire ROSEMARY BASSON AT U.BRITISH COLUMBIA= A FEMALE RESPONSE CYCLE THAT IS RESPONSIVE RATHER THAN AUTOMATIC..

29. 3.Emotions, moods are not studied • A- Situational Aspects • B- Personal Background • C- Fantasy and Arousal Differences • D- Cultural Differences • E – Past Experience

30. 4.Not tested on a random sample • 4. THE MODEL DEFINES NORMALITY AND A “HUMAN” ( UNIVERSAL) RESPONSE CYCLE IT BUT IT WAS NOT TESTED ON A NORMAL OR RANDOM SAMPLE.. • ( BE LIKE LEARNING ABOUT SINGING FROM ONLY STUDYING OPERA SINGERS..)

31. PEOPLE WHO COULD PERFORM UNDER THESE CONDITIONS (WIRED, LIGHTED) • WERE HARDLY “ AVERGAGE”

32. ALSO THEY WERE SELECTED ON PERFORMANCE CRITERA ( “MUST BE A POSITIVE HISTORY OF MASTURBATION AND COITAL ORGASM”)

33. IN FACT, THEY WENT THROUGH ‘TRAINING” TO GAIN CONFIDENCE AND GET USED TO SCIENTIFIC INSTRUMENTS

34. THEY WERE ALSO CHOSEN ON ARTICULATION- HAD TO BE ABLE TO BE SEXUALLY RESPONSIVE AND BE ABLE TO COMMUNICATE ALL THE DETAILS OF SEXUAL REACTION..

35. 5. Class and other SES variables not taken into account.. • BUT THERE WAS EVIDENCE THAT THERE ARE DIFFERENCES ( GIVEN DIFFERENT VALUES, HABITS, SOCIALIZATION)

36. 6.”Success” narrowly defined • 6. THE DEFINITION OF SUCCESSFUL, SATISFYING SEX WAS ATTAINMENT OF ORGASM- IT WAS DEEMED A FAILURE IF IT DIDN’T HAPPEN, EVEN IF THE WOMEN INVOLVED FELT IT WAS A GOOD EXPERIENCE. • IT PRESUMES THAT ORGASM IS ALWAYS THE GOAL OF SEXUAL INTERACTION- BUT THIS ISN’T ALWAYS TRUE- ESP FOR WOMEN.

37. 7. Exaggerates the similarity of male and female response. • 7. M AND J WANTED TO SHOW THAT MALE AND FEMALE SEXUALITY WERE MOSTLY THE SAME-( EXCEPT FOR SPEED OF ORGASM) • THEY DOWNPLAYED THE EMOTIONAL ASPECTS OF LOVE MAKING—WHICH WERE ESPECIALLY NECESSARY FOR FEMALE AROUSAL.. • ( THEY DID NOT LOOK FOR EMOTIONAL REASONS FOR WHY “STIMULATION WAS NOT EFFECTIVE”

38. A BACKLASH TO MASTERS AND JOHNSON • PROTEST AGAINST THE “MEDICALIZATION OF SEXUALITY” • FELT THIS GAVE DOCTORS A NEW AREA TO • “PATHOLOGIZE” • SICKNESS AND HEALTH CENTERED AS OPPOSED TO RELATIONSHIP OR SELF ORIENTED.

39. WERE THE STANDARDS RAISED UNREALISTICALLY? • JAMA ARTICLE CREATING THE “ FEMALE SEXUAL DYSFUNCTION” SOCIETY- SAYING THAT 41% OF ALL WOMEN HAD SOME KIND OF SEXUAL DYSFUNCTION..

40. SPECIFIC CONTROVERIES..

41. 1. Against “The Perfect Penis” The commercialization of “ED” • The idea of a specific amount of time that the penis must be in the vagina ( average = about three minutes..) • That the penis must always be” rock hard” • That the penis should be “propped up” by Viagra and other methods of penile medicine..

42. Have medical definitions over simplified sex? • On male sexuality: • Masters and Johnson had less emphasis on psychological aspects of male sexual performance. • Impotence treated purely as an hydraulics problem rather than complex psycho-sexual issue

43. Men’s penises are seen as simple compared to women’s sexual equipment- is that true?

44. Male sexual “requirements” • Presumption: Men are ready, willing and eager to get as much sex as they can get • Every sexual experience of every man can and should be ecstatic and explosive • It is the responsibility of the man to guide his partner to pleasure and orgasm ( David Schnarsh has taken this on)

45. Sexual competence is serious business and should always proceed through the sexual response cycle to orgasm • And most importantly a man cannot be sexually competent unless he has an erection and it should be –at any age- rock hard.

46. Sex is seen as technical, not creative by M and J • Mechanical judgments as opposed to measure by couple satisfaction. • Puts a lot of pressure on men • Creates a lot of room for disappointment • When the penis is less than “perfect”- it sets the stage for problems to keep reoccurring.. • ( ie “pre-mature ejaculation”)

47. Critics feel that the penis has been pathologized so that it can be “treated” • Now that there is an industry to help penises.. • Lots of prescriptions given. • Viagra, Cealis, Levitra, Penis pumps..implants etc. • Will it be the same for women?

48. Is too much expected of women in bed? • Yes • No • I can handle anything!

49. Simultaneous Orgasm • After Masters and Johnson there was this attempt to have perfectly synchronized orgasms.. • Also there was a desire to be able to give a woman multiple orgasms ( once we knew they had them) –whether they wanted them or not..

50. Additions to the DSM ( illness classificatory system) • “inability to experience the normative response cycle represents a disability in the important area of sexual function” • Inability to lubricate-swelling response is a female arousal disorder • Involuntary spasm of the musculature of the outer third of the vagina– vaginismus • Inability to achieve orgasm in the vagina ( inhibited male orgasm disorder)