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American Academy of Clinical Sexologists
The Sexual Template and Erotology
Presented at the Asia Pacific Conference of Sexology, Mumbai, India November 23, 2004 Reproduced here with the permission of the author.
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BIBLIOGRAPHY
The sexual template is the basis for love and lust. The exploration of the template is a therapeutic tool to unlock the patients’ resistance to revealing their individual sexual desires. This information is then used to treat, augment, or restore the desire phase of the human sexual response cycle. The methodology used in restoring the desire phase is erotology. Erotology, named for the Greek god of love, Eros, is the scientific study of erotic love. It has its genesis in the English translation of Ovid’s Ars Amatoria. Eros is also known as Cupid, a winged cherub with a bow and arrow, who represents love especially on February 14, St. Valentine’s Day in the United States. There are two elements found in the sexual template - love and lust. Since most of the world practices monogamy, the ultimate goal is to find love and lust in one partner. As the present divorce rate of over fifty percent the United States illustrates, many people who fail to reach this goal, try and try again, as we can deduct from the increase in serial monogamy. As an aside I must mention one of the most egregious corruptions of the English language in the United States - the misuse of the word monogamy, which means “to be married to one person at a time”, as a synonym for fidelity. Therapists whose fail to make the distinction are often misled by patients who know it only as a form of marriage, and therefore insist that they have always been monogamous. As a result, the therapy may fail to address the issue of fidelity, an important aspect of the relationship. This desire for finding congruence of love and lust is one of the prime motivations for seeking sex therapy. I often hear from both men and women that “I love my husband/wife but the spark has gone out of our relationship.” People who love their partners and have no interest in them sexually are not going to seek sex therapy. Couples who are perfectly happy with an unconsummated marriage will perhaps come in for therapy to solve an infertility problem, but not to improve their sexual relationships. Even in predominantly Christian industrial countries the view that sex is solely for procreation is resolutely rejected by a majority of couples who practice birth control, contrary to the teachings of church or synagogue, and thereby limit the number of children the marriage will produce. In practice, the clinician often finds that the presenting problem is the lack of lust, not a lack of love. It is recreational sex, not procreational sex that brings the couple to the therapist. Pharmacological discoveries such as Viagra, Levitra and Cialis, have decreased the need for the treatment of erectile dysfunctions. In the arousal phase of the sexual response cycle Prozac is prescribed to treat premature ejaculation. Scientists continue to examine testosterone for both men and women to increase sexual desire. Medicine holds out more promise that sexual problems can be treated medically, surgically and mechanically. The search for an aphrodisiac can be found throughout history in all parts of the globe. However, to date there is no substance, powder, pill or organic supplement that produces desire in any human being. While the lay public continues to seek an instant desire producing product, it is a fruitless search. The Diagnostic and Statistical Manual (DSM) published by the American Psychiatric Association provides an understanding of the four phases of the human sexual response cycle for humans, i.e.: desire, arousal, orgasm and resolution. However the division into four phases is not quite adequate. For the male, resolution is a separate step, the refractory period, which is not found in women. During the refractory period following orgasm, the male is unable for a varying amount of time to continue his sexual activity. Males have no choice but to obey their physiological nature to recover between sexual acts. This is not true for females, which helps explain why some women are capable of multiple orgasms. According to Alfred C. Kinsey, 14% of women regularly reported having multiple orgasms during coitus. The number of women who experience multiple orgasms through all outlets is estimated to be seventy-six percent. The number of males who report multiple orgasms is about one percent. Even this figure may be attributed to those men who count interrupted orgasm, i.e. stop-start, as multiple orgasms. Understanding the human sexual response cycle is crucial in providing sex therapy. Many undereducated, self-proclaimed experts in sexology do not realize that there are two different models of the cycles. Some claim to be Masters and Johnson trained sex therapists and naively use the Masters and Johnson model of excitement, plateau, orgasm and resolution without realizing that the most important phase, desire, is missing from that model. A lack of desire is defined by the DSM as “persistently or recurrently deficient or absent sexual fantasies and desire for sexual activity”. Note the reference to fantasy, not reality in this definition, a reference to what occurs in your brain. I am convinced that the greatest sexual organ is what is found between your ears and not between your legs. The stage of desire has been defined by John Money as a ”lovemap” - by William Simon and John Gagnon as a “sexual script” and by Jack Morin as a “core erotic theme (CET)”. But none of these is adequate for an explanation of the desire phase. Money is preoccupied with the paraphilias that result in a vandalized lovemap, while Morin’s CET is better, but too focused on desire as a result of transforming unfounded emotional business from childhood and adventure into excitation and pleasure (Morin, p. 141). SImon and Gagnon emphasize intra-psychic scripts which are expressions of each person’s unique response to life experiences beginning as a small child influenced by societal scripts. While each of these definitions is academically and philosophically interesting, they are of little value in improving the sex lives of real patients who are troubled by the interruption or disruption of the human sexual response cycle. The patterns that shape each individuals erotic desire phase are unique. To provide therapy, the clinician must have an understanding of the unique sexual template each person possesses. Only by this understanding of the sexual template will therapists be able to provide beneficial sex therapy to patients and clients. The sexual template can be best understood as the sum of all sexual erotic desires. The first step is therapeutically determining each person’s “cathexsis”. Sigmund Freud’s “Besetzung” was translated as cathexsis in the psychiatric professional language to express “the affectional, emotional and sexual energy in determining a sexual object choice”. Although Freud translated it simply as interest, the broader use held. (Gay p. 465) The first step in defining each individual’s sexual template is to determine if the sex object choice is male, female or both. The use of cathexsis also allows the therapist to get away from political, religious and societal adjectives such as sexual orientation, sexual preference or sexual deviation. The cathexsis is in each person’s sexual template. This bypasses the etiology of homosexuality which is of no concern for the therapist. Acceptance of the patient’s cathexsis is the crucial first step in beginning to deconstruct the sexual template and then to use it to improve a person or couple’s sex life. In its simplest form the sexual template consists of physiological urges generally emanating in the limbic system or paleocortex which includes the amygadala, the hippocampus and hypothalamus which control sexual desire and mating behavior and causes humans to want to have sex either with others or by themselves through masturbation. The stirrings of the limbic system can be ignored if they arise in inappropriate settings such as work, church, meetings or places where it is impossible to satisfy these urges immediately. However if the conditions are right we can use the desire phase fantasies to start the arousal phase whereby men will get an erection and women will experience lubrication or vaginal sweating. It is the fantasy found in the sexual template that enables the rest of the human sexual response cycle. Unless an individual is devoid of any sense of creativity or has a dread of sexual fantasies because of a strict religious or family upbringing, the arousal phase will flow naturally from the person’s sexual template, i.e. the individual preferences for a particular person’s shape, age, face, etc. In addition to the physical attributes of a sex object, there are other attributes in the sexual template such as desire for tenderness, closeness, companionship, affection and other societally approved emotions. On the other hand the sexual template may contain elements which are thought to be antisocial, mentally ill, debauched, and even sinful. These elements are described as paraphilic and listed as mental disorders in DSM. Knowledge of patients’ fantasies by the clinical sexologist will enable the therapist to provide sex therapy that benefits the couple by using the human sexual response cycle itself to determine the course of the treatment. Knowing that the fantasies residing in the sexual template are the key to starting the sexual response cycle seems to be a simple solution to resolving the sexual dysfunctions of the couple. However this seemingly simple process is really the most difficult part of the therapy, because patients are usually extremely resistant to acknowledge their fantasies to their partners, their therapist and even to themselves. Even patients with a normaphilic sexual template will resist revealing its contents. Thus, what seems to be so simple and potentially so beneficial to the patient may be resolutely kept from the therapist by the patient. Why is there such resistance, considering the couple or the individual made an appointment, kept the appointment, stated the presenting problem and now refuses to discuss sexual fantasies? In an examination of this puzzle we need to go to Havelock Ellis’s discussion of the evolution of modesty in Studies in the Psychology of Sex (1898) for an answer. Modesty is defined as propriety in dress, speech or conduct in accordance with each society’s standards of morality and decorum. The disregard for society’s values can cause great social and psychological harm to the individual who crosses the societal line regarding these social mores and folkways which vary from culture to culture and time to time. When an individual’s behavior lacks modesty, others will condemn it and consider it disgusting, regardless of their own private behavior which may not be all that different. They will portray themselves as modest and therefore not disgusting in societal terms. The need to be seen as modest manifests itself in the physiologic change known as blushing, which is found in all races and societies. This reddening of the skin is an indication that the person is of high moral and social fiber. What is considered disgusting behavior is largely related to modesty. Regarding sexual behavior even in marriage, dress, nudity, coarse language and jokes, pornography and other media may be seen as socially unacceptable material. While society holds Modesty in high esteem, it is often privately ignored and disregarded by various individuals who nevertheless present themselves as moral and modest members of society. While we can discuss sexual behavior in general, we cannot generalize to the individual nor can we clearly establish a definition of “normal” sexual behavior. The best we can do in delineating what is normal is to realize that which is normal is largely determined by the society in which that activity is practiced. What is considered “normal” in the United States might be considered “abnormal” in other societies. Research does not indicate that there is a “normal” sexual activity, sexual preference or ritual for all men at all times in all societies. We can classify sexual activities, but we should not apply value judgments to these activities . They are determined by the society in which the activity takes place and also by the individuals involved. It’s not a joke to say that the common definition of sexual abnormalities has, even in the recent past, been: “any behavior that I do not do myself is abnormal, repulsive and should be repressed.” Of all varieties of human behavior, sex is the most controversial, conflict-ridden and subject to contradictory judgment. Accepting this as a given, assessments of behavior, sexual or otherwise, are generally made according to four criteria:
It would be helpful if the four criteria listed were mutually reinforcing, but that is not always true. Something may be statistically common, medically healthy, morally sound and illegal. Thus the legality of a particular sexual activity is not always dependent upon any of the other three criteria. The application of such value judgments of sexual behavior in a heterogeneous pluralistic society has resulted in much confusion. The meaning of a statistical norm has often been distorted. Medical judgment has often lacked scientific support. Morality has been confused with tradition. Statutes and ordinances have frozen many dubious factual claims and moral conclusions into law, thereby making a common behavior that is healthy, but perhaps ethically unacceptable to some, illegal for all. Not infrequently an original determination that a particular sex act is unhealthy or uncommon turns out to be incorrect and no longer applicable, but the moral and legal judgments based on it persist. Socio-cultural factors affect sexual experience and expression and result in resistance to therapy. While sex is a function rooted in our biological nature, its experience and expression are largely determined by socio-cultural and social-psychological factors. The principal socio-cultural factors involved in modest behavior determine the meanings of experience. These include socioeconomic and social class, the family structure, and religious and other moral and moralistic teachings. The culture in which an individual was raised and/or currently lives largely determines how this or her sexuality is experienced, what the experience means and what causes sexual desire or not. Cultural influences also affect what is considered normal sexual behavior and what is not, the purpose of sexual activity (for enjoyment, for status and power, for procreation, etc.), the respective roles of women and men, norms with respect to homosexual behaviors and identities, norms with respect to participation in non-marital, extramarital and postmarital sexual behavior, norms and expectations regarding sexual behaviors at each stage of life and sexual positions, duration and sites of sexual contacts. The therapeutic model often used to unlock patient resistance, to reveal their individual sexual template is the P-LI-SS-IT model developed by Jack Annon of the University of Hawaii in 1972. The “P” in the model stands for permission for the patient to safely reveal his sexual template. Once permission is given and accepted, the clinical sexologist moves on to “LI”, which stands for limited information. The following are areas to be discussed with the patient to further decrease resistance and enable the patient to view the sexual fantasies as with the norm of sexual behavior. Next the clinical sexologist begins to provide the SS (specific suggestions) part of the model which utilizes erotology to enable the patient and partner to find those areas of mutuality in each other’s sexual template. According to Masters and Johnson, the couple or marital unit is the patient. The therapist can safely provide information from each sexual template to the other partner. The active participation removes the feelings that the other will find their fantasies disgusting as they are specific suggestions from the therapist regarding the variety of sexual activities that are within the norm of unusual, non-coercive sexual behaviors. The final stage IT intensive therapy is usually provided for those patients who have an underlying pathology. This is usually not a specific sexual problem, and therefore a referral to an appropriate mental health specialist is warranted.
Andrae, S. (2000) The Secrets of Love and Lust. London: Abacus.
Annon, J. (1972) Brief Treatment of Sexual Problems. Honolulu: Enabling Systems.
Barasli, D. and Lipton, J. (2000) The Myth of Monogamy. New York: W.H. Freeman and company.
Ellis, H. (1936) Studies in the Psychology of Sex. New York: Random House (four volumes).
Gay, P. (1989) Freud: A Life for Our Time. New York: Anchor Books.
Masters, W. and Johnson, V. (1970) Human Sexual Inadequacy. Boston: Little and Brown.
Money, J. (1986) Lovemaps. New York: Irvington.
Money, J. (1994) Reinterpreting the Unspeakable. New York: Continuum.
Morin, J. (1995) The Erotic Mind. New York: Harper Collins.
Reik, T. (1957) Of Love and Lust. New York: Farrar, Strauss and company.
Simon, W., Gagnon, J.H. (1973) Sexual Conduct: The Social Sources of Human Sexuality, Chicago: Aldine.
CONFIDENTIAL Dr. Wm. Granzig SEXUAL PROBLEM HISTORY 1. Description of current problem. (Why are you here?)_____________________
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2. Onset and course of problem: a. Onset (How old were you when it started, did it appear gradually or was it sudden, were there any precipitating events, did it happen at the same time something else started?) __________________________________________________________ __________________________________________________________ b. Course (Did it change over time: increase, decrease or fluctuate in severity, frequency or intensity?) __________________________________________________________ __________________________________________________________ __________________________________________________________ 3. What is your opinion about the cause of this problem, and why does it continue? ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ 4. Past treatment and outcome: a. Have you had a medical evaluation: (when? what was the treatment? What were the results? Are you currently on any medication for this problem? ___________________________________________________________ ___________________________________________________________ ___________________________________________________________
b. Have you had any other professional help including sex therapy? (Often? What sort of treatment? What were the results?) ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ c. Self-treatment. (Explain) ___________________________________________________________
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5. What do you expect to get out of your consultations with me? (Be specific. What do you want to do that you cannot do now? Or stop doing?)
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