The four dyadic types are the young unmarried dyad, the young married dyad, the experienced married dyad, and the experienced unmarried dyad.

The young unmarried dyad is seen much more frequently by the sex therapist than by the marital therapist. My impression is that young unmarrieds rarely come for marital therapy. Their sexual problems are the same as those of other patients.

The relationship of the young unmarried dyad is usually centered on sex. Whether they live together or apart (although this is much more pronounced when they are living apart), they tend to have lives separate from the relationship. Because of this, the need for extra-sexual satisfaction within the dyadic relationship is diminished, since they can obtain this elsewhere. As a result, as long as sex is good, one partner tends to tolerate behavior by the other that married partners will not. Their perception of their relationship is generally that nonsexual problems “are not a problem.”

But if sex is not good, what is the use of continuing the relationship? Just as good sex and strong separate lives can smooth over nonsexual problems, poor sex can cloud otherwise satisfactory aspects of the relationship and interfere with general “good times.” That is, after a time the young unmarried dyad comes to feel that if the sexual problem is not resolved the relationship has failed.

Thus the young unmarrieds will seek sex therapy rather than marital therapy. Usually, the therapy proceeds smoothly; there is little “sabotaging” by the non-dysfunctional partner and little fear of the outcome. The irony is that it is precisely in the young unmarried dyad that the most drastic changes in the relationship tend to occur. That is, the sexual dysfunction often has been used as an excuse or reason for immobility. The insecurities and fears associated with the failure to achieve good sex have frozen the dysfunctional partner into a practically fixed relationship. With the dysfunction cleared up, that person feels more free to move.

Although many young unmarrieds continue in the same relationship after successful sex therapy, a large proportion does move. This movement can be in two directions: the “cured” partner moves away and begins to explore other relationships, or the dyad gets married. The psychodynamics in the first alternative are evident: the formerly dysfunctional partner, his or her feelings of inferiority cleared up along with the dysfunction, now feels confident to handle sexual situations and eager to see where they might lead. No longer tied down by his or her own sense of inadequacy, or impelled to tolerate the faults of the partner because of his or her tolerance of the dysfunction, he or she elects to move.

The psychodynamics in moving toward marriage are less clear. One possibility is that these partners were planning to marry anyway and wanted to remove an important obstacle to their satisfaction before the relationship became more fixed. Another is that the dysfunctional partner did not want to “inflict” himself or herself on the other with a permanent sexual dysfunction, and a third is that one partner demanded the cure of the dysfunctional one before agreeing to marry. The most likely explanation is that marriage is seen by both partners as a challenging and serious commitment, and that the improved sexual functioning of the one partner and the more satisfactory sexual relationship for both increases their self-confidence individually and together.

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The male homosexual essentially protects himself from the retaliatory fears of castration by shifting his sexual impulses away from a heterosexual object to a homosexual object. The origin of such castrative fears lies in the oedipal situation in which the child’s sexual wish to possess the mother raises the fear of retaliatory punishment in the form of castration from the father. Why a homosexual object in the adult should seem safer than a heterosexual one, however, is not at all clear, but it seems certain from clinical experience that a confirmed homosexual is inordinately afraid of women as sexual objects. The male homosexual is literally fleeing from women. As a neurotic symptom, male homosexuality can be understood as a phobic avoidance of the female genital. Many homosexuals in fact tend to view the vagina with disgust and revulsion. Often such individuals have an intense vagina dentata fantasy, that is, the fantasy that the vagina is like a devouring mouth which can somehow consume and destroy the penis.

The castration fear can be related either to the mother or to the father. The typical family configuration in which male homosexuality is fostered generally has a domineering, overpowering, seductive, and excessively intimate mother together with an emotionally detached, hostile, aloof, and rejecting father. The son of such a mother would be expected to have a great deal of anxiety about separating from her and also to fear that she would devour him should he get too close to her or hold on to her for too long. The dependency on the mother, so essential to sustain life and to psychic growth early in the child’s experience, becomes associated with aggressive and destructive elements.

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One of the personality variables which seems central to response to erotica is guilt. Donald Mosher has developed a well validated measure of sex guilt, a “generalized expectancy for self-mediated punishment for violating or for anticipating violating standards of proper sexual conduct”, and demonstrated that high sex-guilt subjects rated erotic films as more pornographic, disgusting, and offensive, and more often saw oral-genital sex as abnormal than did low sex-guilt subjects.

Sex guilt was positively correlated (correlations usually > 0.3) with the following variables in Mosher’s study: religiosity, political conservatism, the belief that the government should enforce sex laws, the belief that homosexuals should be excluded from society, that love and sex are inextricably linked, that extra- and premarital sex are not good ideas, that abortion should be difficult to obtain or illegal, and that conservative standards of sex behavior are best. Additionally, sex guilt was positively correlated with preventing respondents from expressing their sexuality because of social disapproval, guilt feelings, and religious or other moral training.

Sex guilt was negatively correlated with number of sexual partners, intercourse frequency, oral-genital activity, and the belief that sex is fun.

Sex guilt, then, may be seen as a central psychological variable in predicting sex attitudes and sex behavior. Love and others used Mosher’s Forced Choice Guilt Inventory to predict the time spent viewing erotic slides. They found that “the viewing time of the low sex guilt group increased linearly as a function of increasing pornographic content. There was no significant increase in viewing time for high sex guilt subjects. Subjects with a moderate degree of sex guilt displayed a curvilinear pattern”. The three groups were referred to as the profligate, the priggish, and the prudent.

Ray and Walker reported that low sex-guilt female subjects rated masturbation, coitus, and petting stimuli as more sexually arousing, better, more pleasant, safer, and more appealing than did high sex-guilt subjects.

Based on the above, one would expect censorship, condemnation of material on the basis of its explicit sexual content, to enhance viewing of the material on the part of low but not high sex-guilt subjects. Schill and others conducted such an experiment and found that when material was labeled as “porno junk,” viewing time was highest for both high and low sex-guilt subjects. When the experimenter used the phrase, “I really enjoyed that porno stuff”, high sex-guilt subjects viewed it for an average of 2.55 minutes relative to the low guilt subjects who viewed it for an average of 0.79 minutes.

It would seem from these data that the “banned-in-Boston” effect served to increase viewing time for both groups, but the approval condition affected only the high guilt subjects’ viewing. In retrospect this is an intuitively satisfying outcome but clearly raises the question of the value of censorship to inhibit behavior. Fromkin and Brock and Zellinger and others have applied commodity theory analysis to the effects of restrictions on pornography and have found results which confirm “the commodity theory prediction that the imposition of age restrictions upon pornographic materials increases their desirability”. They conclude that “making erotic materials more difficult to obtain, harassing and punishing pornographers and purveyors of pornography, and restricting certain materials . . . may increase interest in the materials and render them more desirable than would have been the case without the restriction, harassment, or difficulty”.

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In the Victorian era, marriage was the only acceptable social role for women. Unmarried women were called “spinsters.” They were ridiculed and blamed for remaining single. When a girl preferred an active and independent life, she was called a “tomboy,” “amazon,” or monstrosity. To be feminine meant to become a hybrid of infantile dependence and motherly protectiveness. Women were expected to practice and enjoy the three great “feminine” K’s— K?che, Kirche, Kinder (kitchen, church, and children).

In Freud’s time masculinity and femininity could have been described as follows:

When you say ‘masculine’ you mean as a rule ‘active,’ and when you say ‘feminine’ you mean passive. . . . The male sexual cell is active and mobile; it seeks out the female one, while the latter is stationary and waits passively. This behavior of the elementary organism of sex is more or less a model of the behavior of the individuals of each sex in sexual intercourse. The male pursues the female for the purpose of sexual unity, seizes her and pushes his way into her (Freud).

Freud did not invent penis envy but discovered this culturally determined phenomenon. The more restrictions were imposed on girls, the more frequently they wished to escape their yoke.

Penis envy was never a general feeling common to all women at all times; certainly the Tschambuli or Arapesh women never had the reason for such an envy. In Arapesh, men and women shared household and child-rearing responsibilities, and among the Tschambuli, women were the dominant sex. (Murdock)

Freud’s observations of penis envy in women who were reared in an atmosphere of discrimination and subjugation must be interpreted in light of another hypothesis brought forward by Freud, namely, the tendency of the child to identify with the “strong aggressor.” In patriarchal families, the father was the absolute ruler, and the male and female children were proud to identify with the father rather than with the mother. It is small wonder that

Freud noticed the preference for a masculine, father-based superego (Fenichel; Freud).

One therefore must interpret penis envy in girls not as an envy directed to the male organ of their playmates or brothers, but rather as a wish for the possession of the father’s penis and with it, father power. Penis envy does not seem to be a general and universal element of female psychology but must be interpreted as the feminine protest against male domination. The penis, as a cherished symbol of power, was envied by women not because of its sexual significance, for vaginas undoubtedly can procure as much and often more sensual pleasure than penises; it was the penis as the power symbol which elicited the justifiable envy (Homey; Kelman; Millet; Unger and Denmark).

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Compared to earlier years, men in their thirties are less preoccupied with sexual thoughts and fantasies but are still highly responsive to sexual stimuli. In the forties and fifties, sexual expression among males becomes less intense genitally, and men of this age group often require more psychic stimulation for effective sexual functioning (Kaplan and Sager).

Male declines in sexual capacity often result in frustration over ability to perform sexually. This often leads to avoidance of sexual functioning which, in a marriage, can lead to feelings of neglect by the wife. This perceived neglect may be interpreted by the wife as evidence of her waning attractiveness. If this coincides with menopause, it can reinforce the societal stereotype of the menopausal female as unattractive and unfeminine. Negative behavioral changes by the wife then can precipitate negative responses by the husband.

In an effort to reverse age-related changes, frustration also may lead the male to seek out erotic stimuli in the form of new sexual partners. This frustration and fear of failure to perform adequately also may lead to an attempt to recapture the sexual functioning of earlier years. Interestingly, the strong motivation to perform combined with a new partner can result in short-term improvement.

It is not clear whether monotony precedes or follows changes in sexual functioning. Masters and Johnson suggest that monotony in the marital relationship is one of the primary causes of loss of responsiveness in middle-aged men. Many middle-aged males’ familiarity with their wives combined with lack of interest by the wives themselves (as well as generally greater female appearance changes with aging) may lead to waning interest by these men. Often these declines in interest are reinforced by the older female’s negative attitudes towards sex. On the other hand, changes in ability to perform sexually and accompanying decrements in sexual responsiveness may require more erotic stimulation. By definition, the newer the sexual partner is, the more stimulation value is possible.

Although there is no definitive experimental evidence with humans, the cultural stereotype suggests that males are more directed toward variety and novelty than are females. There is some indirect evidence in male/female differences in the sexes versus relationships. These differences are probably tied in part to the fact that men concentrate more on sex, and women emphasize relationships. A very high percentage of male homosexual relationships can be characterized as transitory; these changing attachments presumably reflect a desire for sexual (genital) satisfaction, an important part of which is the new sexual partner. Female homosexual relationships, on the other hand, tend to be more stable and less physical. Heterosexual relationships fall somewhere in between, and sexual monotony as a reason for marital failure is cited much more frequently by males than by females.

If it is true that males are more interested in variety than females are, this difference may have arisen because males traditionally have operated in a more complex and changing environment. Whether this is because of temperamental differences or whether it resulted in temperamental differences is an open question. But if it is true, the double standard has allowed males to experiment sexually with a variety of partners and has imposed severe sanctions on females for similar actions (McCary). It is possible that years of socially approved sexual experimentation among males have cultivated their desire and need for novelty.

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For example, reactions to the semirigid penile implant were favorable at a Seattle hospital. Eighty-three percent of the men who responded were satisfied. Most felt that their expectations had been met, and most said they would choose to have the operation if they had to make the choice again, However, five men specifically stated that they would not repeat the procedure—two because their partners did not like the results, one because he suffered prolonged and severe pain and the two others because the results didn’t measure up to their expectations.

Doctors at the Mayo Clinic asked their inflatable prosthesis patients to report their reaction. Sixty-one patients answered.

About half of all respondents reported that they were very satisfied with the implant; another 15 were fairly satisfied. According to the patients, their partners felt approximately the same way.

Eight patients complained of mechanical problems. When these were fixed, the patients were satisfied with their erections and with sexual intercourse.

After the repairs were made, the total results indicated that almost 90 percent of the inflatable implant patients were satisfied.

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Static stretching calls for gradually lengthening through a muscle’s full range of movement until resistance—or discomfort—is felt. To maintain flexibility, an optimal session should last from ten to twenty minutes, with each stretch held for at least ten seconds. Then work up to holding each for twenty and then thirty seconds. To increase flexibility, stay in the stretch for one or two minutes.

Tight hamstrings are a major cause of poor back flexibility and back pain, which can lead to a diminished sex life. To relax the hamstrings, do the following two exercises daily. The morning stretch should be performed just after waking up. Sit on the edge of the bed with your feet flat on the floor and your knees at a 90 degree angle.

Keeping your knees together, bend forward at the waist, letting your chest touch your knees. Hold the position for ten seconds. Repeat five times. If you need a greater stretch, push your feet out farther from the bed.

The second stretch is the straight-legged hang. To do it, stand with your feet flat on the floor and your knees locked. Bend over from your waist and try to touch your fingers to the floor without straining. Without flexing your knees or bouncing, hold the position for one minute. Remember: if at any time you feel pain stop the stretch.

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Along with giving up tobacco, you should drink only moderately—especially if you are a heavy or regular drinker. Heavy consumption of alcohol can ruin potency in the short term. And in the long run, too much alcohol can shrink a man’s testicles, reduce or remove sexual desire and render him impotent.

If you drink only occasionally, analyze your habits. If your erection fails on the days that you drink, try eliminating all alcohol on the days when you know you want to enjoy sex.

Individual tolerance varies quite a bit. One man may be able to drink four stiff ones without being affected, while another may find that just two drinks wreck his potency. And when alcohol is combined with other drugs, it can have an even greater effect on your potency—and endanger your general health.

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