Part lll Personal Relationships and Development & Clinical Observations

1. The Psychology of SexPart IIIPsych 405Dr. D. WardellDepartment of PsychologyUniversity of Alberta

5. “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

6. Part lllPersonal Relationships and Development & Clinical Observations The Kinsey surveys

7. More recent ones... The NHSLS survey... Some results: who, what, where, when and how often “The Marriage Effect” Comparing Canadian surveys Canadian attitudes

8. Sexual Dysfunction Sexual functioning Masters and Johnson Model EPOR Helen Kaplan’s Model DEO Rosemary Basson et al. Beyond DEO

9. Sexual Dysfunction Sexual dysfunctions: • desire • arousal • orgasm • pain NORC Base rates: Men: 31% Women 43% Julia Heiman

10. Sexual Dysfunction • Desire:hypoactive sexual desire and sexual aversion Dx issues: • “dysfunction” vs. problem • medical factors

11. Sexual Dysfunction • Arousal: SADF and SADM Dx issues: • “erectile insufficiency” for men • vaginal lubrication for women • the relevance of negative emotional states (anxiety) • the relevance of the autonomic nervous system. (PNS/SNS)

12. Sexual Dysfunction • Orgasmic: orgasmic dysfunction and “premature ejaculation” Dx issues: • the ejaculation for men • the “satisfaction” for women

13. Sexual Dysfunction “Premature ejaculation” Dx issues:comparative and personal criteria

14. Sexual Dysfunction • Pain: dyspareunia and vaginismus Also: “Sexual dysfunction NOS”

15. Sexual Dysfunction Summary DSM LTR Men: 10%? Women: 15-20%? NORC BR12 Men: 31% Women: 43% Diagnosis, reconsidered: We need to “acknowledge the highly contextual nature of women’s sexuality.” - Rosemary Basson

16. Sexual Dysfunction Therapies: Masters & Johnson Evaluative research definition of success success and spontaneous remission Modern modifications relationships and individualized assessment

17. Summary The general population is • Not very sexually active... • Satisfied with their sex life, but... • Reporting lots of problems! How to understand this? The complexity of human sexuality

18. Neurobiology of Male Sexuality 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. Neurobiology of Female Sexuality 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. Similarities and differences

20. 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 Meredith Chivers

21. Some Topics 1. Contraception and Abortion ▪ Natural and unnatural methods ▪ Rates and results ▪ Consequences: “post-abortion syndrome”? “Our Sexual Society” Some myths about “your sexual self”

22. 2. Masturbation Other species Human history The Future of Solitary Sex John Money

23. 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)

24. Marriage and Divorce:Research at “The Love Lab” The three types of regulated marriage 1. Validating 2. Volatile 3. Conflict-avoiding “Balance Theory”: 5 to 1 Are all happy marriages alike?

25. Marriage and Divorce:Research at “The Love Lab” • The Four Horsemen of the Apocalypse • Complaining • Contempt • Defensiveness • Stonewalling

26. 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”

27. 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

28. 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 “Obsessional following is a pathology of attachment.” - John Meloy

29. Obsession and Stalking:research and practice Preoccupied: Poor self-image ... Fearful: ...compounded by negativity Dismissive: Narcissism and hostility

30. Gender: Men, Women and the Trangendered 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

31. 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”.

32. 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. genes 2. prenatal hormones 3. physical appearance 4. learning “A faint signal that somehow gets amplified.” - Deborah Blum

33. 3. Childhhod Gender Identity Disorder Diagnosis: discordance, distress and the desire to change Prognosis: e.g. “the sissy boy syndrome” • gender • sexual orientation

34. 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 • i.e “Classic / Homosexual TS” • “Gender atypicality” among men • Note: “autogynephilia” • i.e “Non-classic / Heterosexual TS”

35. 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

36. 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

37. Sexual Orientation The surveys: Kinsey and beyond • same-sex sexual behavior? 37%, 13%  20%? • same-sex sexual desire? 50%, 28%  about 40%? • same-sex romantic attraction? males: 3 - 4% females: 1 – 2 %

38. Sexual Orientation The modern results: • behavior? 9%, 4%  maybe 10%? (not 20%) • desire? 8%, 8%  maybe 10%? (not 40%) • attraction? males: 2.8% females: 1.4 %

39. Sexual Orientation Development of Sexual Orientation: • Psychodynamic Theory (“Psychoanalytic”) ... and its problems • Learning Theory (“Socialization”) ... and its problems • Biology (e.g. prenatal androgenization) ... and its problems

40. Concordance rates and other curiosities “The paradox of gay genes” Other theories: “Availability” and “EBE” Theories

41. Two Types of Theory Anne Fausto-Sterling (right) and partner Simon LeVay ...biological and beyond...

42. 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”

43. Sexual Orientation and the Social Context Same-sex sexual behavior ... a sin ... a crime ... evidence of an attribute Cross-cultural variations Developmental discontinuities

44. Sexual Orientation and the DSM What is wrong with any sexual orientation? • Theoretical criterion (disease, defect) and DSM I • Social criterion (difference, deviance) and DSM II • Personal criterion (distress, dysphoria) and DSM III • Maladaptation (dysfunction, disorder) and DSM IV

45. Sexual Orientation and the DSM • A Diagnosis:“Sexual disorder NOS” • discordance • distress • and the desire for change A Therapy:three possibilities • Sex life  sexual orientation • “Conversion” and “reparative” therapy • The alternative ... reducing the distress ... and the debate

46. Sexual Orientation and Other Species Same sex sexual behavior in other species

47. Sexual Orientation and Other Species Homosexuality in other species

48. 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

49. The Lovemap • Three premises: • Whatever your sexual orientation, you can be in love with people who do not share it. • Whatever your sex, you can be in love with people of either sex. • 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.” - Lisa Diamond

50. Special Cases Bisexuality, for men and women “The perpetual quagmire of sexual theory” • Men • Descriptive features • - behavior, desire, attraction • Developmental history