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Volume XIV Number 6 July 1986 ISSN: 0091-3995 Sex Information and Education Council of the U.S.

A SEX ADDICT SPEAKS

Sharon R. Edwards, MA Editor

In these times of conservative politics, the Moral Majority, and even exists. Sexologist Richard K. Sharon,for example, believes AIDS, it is not surprising that the term “sexual ” has that until we can define what “normal” frequency of sexual emerged. After free , open , legalized abortion, behavior is, we cannot label people as sex addicts. New York and the feminist movement of the 6Os, the sexual problems in and gay activist R. William Wedin has traced the the early 70s were focused more upon not having enough origins of the concept of to the Bible Belt in sex-inability to have or maintain an or lack of the late 70s. Wedin believes that this condition emerged as a desire-rather than having too much. During that era, we reaction to the of the late 6Os, particularly rarely heard about professionals addressing the issue of an with respect to the consciousness raising of heterosexual inability to control one’s sexual behavior with respect to fre- women, and that gay men have recently been targeted as sex quency and/or number of partners. In fact, as a teenager grow- addicts as a result of the growing homophobiasurroundingthe ing up at that time, the predominant feeling was that you were appearance of AIDS. Helen Singer Kaplan, a well-known New abnormal if you did not have sex whenever, wherever, and York specializing in sexual problems, does not with whomever possible. believe that sexual addiction should be a distinct diagnostic But these days, in both the professional community and category due to its rare occurrence and lack of distinction from the popular media, we are hearing more and more about the any other compulsive disorders, such as gambling. In fact condition of sexual addiction. The problem itself is not a new Kaplan goes so far as to say that sexual addiction is a media term one. In the past, it has been called nymphomania or Don that has no scientific validity. Juanism. And we certainly have always had sex offenders- Who is in a position to establish how often and with whom child abusers, exhibitionists, perpetrators. But it is only in the healthy adult should have sex? or ? the past few years that uncontrolled sexuality has been identi- Society? Individuals? Eli Coleman, one of the leaders in this fied as an addictive process in which anxiety, loneliness, and field, believes that sexual behavior is on a continuum and that pain are temporarily relieved through a sexual high not so the distinction between healthy and addictive or abusive sexu- unlike that obtained from drugs or . ality is determined by whether the behavior is self-enhancing The term L’sexual addition” has created quite a stir in both or self-limiting. Patrick Carnes, one of the pioneers in sexual the field and the popular media. The term first addiction, has said that people whose sexual behavior has appeared in 1978 in the journal of , a journal seriously interfered with their lives in terms of health, occupa- unlikely to be seen by many professionals in the field of sexol- tion, or family have identified themselves as sex addicts. ogy. Before any professional recognition of this condition, In order to understand better the validity of this condition former members of (AA) founded from the perspective of someone who feels afflicted by it, I groups based upon the 12-step model of AA for treating sexual conducted the following interview with a woman who identi- addiction. A few years later, this condition did start to receive fies herself as a sex addict. Carol (fictitious name) is a lesbian in professional attention. In the early 8Os, for example, Mark her mid-forties who has sought treatment for sexual addiction. Schwartz of Tulane University,formerlywith Mastersand John- She was raised in an upper-middle-class family in the North- son, recognized that men who were arrested for incest showed east, with a Jewish/WASP parental background and no per- signs of , not to drugs or alcohol but rather manent religious affiliation. She is a very bright and attractive to sex. Schwartz hypothesized that for the sex addict, sexual woman who has had some college education and has always fantasies and urges served to reduce anxiety temporarily by been active politically. Carol’s story describes the kind of providing an illusion of power or intimacy that compensated for emotional pain experienced by a sex addict and provides feelings of worthlessness. insight into both the etiology and implications for treatment Others, however, are not convinced that t’he condition of this condition. Q: When and why did you feel that your sexual behavior was a with my sexuality. I tried to repress it. I knew that you had to problem? remain a virgin in high school. I also knew that women were A: I knew all along that my sexuality was a problem-back as expected to sleep with men. I was very uncomfortable around far as high school. I didn’t realize that I was a sex addict until I boys. stopped drinking and doing drugs. I was in Alcoholics Anon- Q: It has been suggested by those working in the field of ymous (AA) at the time. I realized that I had to stop having sex sexual addiction that many sex addicts were abused as children. or I would start drinking again. I was using sex with men to Where you abused as a child? avoid dealing with my sexual feelings about women. I decided A: I wasn’t abused physically or sexually, but emotionally. I to go to Sexual Compulsives Anonymous (SCA). was raised in a very proper , where everyone repressed Q: How did you hear about SCA? their feelings. My family was very rigid. My father was racist and A: From the guys at AA. They talked about it. I knew about it homophobic. He destroyed me. He took out all of his anger for a year before I finally decided to go. and lack of self esteem on me. He constantly threatened to Q: Have you had any other addictions? send me to reform school. A: Yes, I’ve spent my whole life juggling my addictions to stay Q: why? alive. I went to Overeaters Anonymous (OA) first for bulemia. I A: Because I disrupted this pristine family. I was an incorrigible was also drinking at the time. I thought that I wasn’t an alco- child. After my sister was born, when I was 2% years old, I tried holic if I didn’t drink alone because my mother, who was an to smash her with a lamp. I was used to being the only child alcoholic, always drank alone. Then I wassent to AA by OA. For among pampering adults. My sister and I fought constantly. years I substituted one addiction for another. I’ve been When I was 11 years old, I stabbed her in the leg with a knife. addicted to alcohol, drugs, sex, food, , cigarettes, shop- Whenever she would upset me I’d threaten to do the other leg. ping, and gambling. Q: What was your relationship with your mother like? Q: When did you first experience addictive behavior? A: I liked her. She had so much that was good about her. She A: I started overeating, drinking,and smoking cigarettes when was a totally self-sufficient woman, but my father ripped her to I was in high school. In high school I was aware that food had pieces like he did to me. He ridiculed her constantly. Neither of become a priority in my life. them had any self esteem. I don’t think she would have stayed Q: What was going on in your life at that time? with him if she had sobered up. A: My mother’s drinking had gotten worse. I couldn’t deal Q: Did your parents have any problems with their sexual behavior? A: Not that I was aware of. Q: How was the issue of sex treated in your family? A: It wasn’t. As far as I can remember, my parents didn’t express it in front of me. SICCUS REPORT Q: When and with whom did you have your first sexual experience?

Volume XIV, Number 6 July 1986 A: Graduation night in high school. I had sex in a cemetery with a friend of my girlfriend’s. She said he would be good to The S/ECUS Report is published bimonthly and distributed to break me in. SIECUS members. Q: Was it a good experience? Annual membership fees: Individual $40; Student (with valida- A: No. It hurt, and it didn’t turn me on. I didn’t have an tion) 520; Organization $90; Benefactor $150 or over. orgasm. Then I started having sex whenever possible in order Library and Institutional subscriptions: $40 annually. to have an orgasm. Outside U.S.: Canada and Mexico, add $5.00 per year to the Q: When and how did your sexual addiction first manifest above fees; other countries, add $10.00 per year. itself? Single copies of back or current issues of the S/ECUS Report may A: After college, when I wasabout 24years old and had moved be ordered for $5.88 each, prepaid. Bulk prices available. to New York. I met a guy who knew how to get women off. All inquiries should be directed to the SlECUS Publications After I had an orgasm, I wanted to have sex all the time. I felt Office at the address below. totally free sexually. I would have sex constantly. I also got into S!ECUS Report is available on microfilm from University Micro- bestiality. After this guy would have sex with me, his dog films, 300 North Zeeb Road, Ann Arbor, MI 48106. would lick my genitals. I used sex as an escape, to avoid dealing with life. My whole life revolved around having sex. The only Editor-Sharon R. Edwards Editorial Assistant--Deborah L. Tolman time I had any self worth was when someone was having sex Editorial Consultants with me. I felt that sex was all I could offer in a relationship. I Joan S. Benesch also felt powerful when I pleased someone sexually. When my Michael Carrera, EdD psychiatrist asked me what my main goal was I told him it was to Jane Quinn, ACSW have as many as possible. Robert Selverstone, PhD Q: Did you usually have several lovers or one? Ann Welbourne-Moglia, RN, PhD A: I had sex with whoever I could. Many of my lovers were Copyright 0 1986 by TheSex Information and Education Council alcoholics. I often moved in with the guys I slept with. I was of the U.S., Inc. 80 Fifth Avenue, Suite 801-2, New York, NY monogamous only when someone was paying the rent and 10011; (212) 9292300. taking care of me. I had to have sex every night. One night a Library of Congress catalog card number 72-627361. friend brought over a bunch of guys and we did and I No part of the S/ECUS Report may be reproduced in any form had sex with them for six hours straight. I hurt so much that I without written permission from the SIECUS Publications started crying. I was supposed to get paid, but I was paid in Office. cocaine rather than money.

2 SIECUS Report, July 1986 Q: Did you become a prostitute to support your drug and articles by Patrick Carnes, an addictionologist, and Eli Cole- alcohol habit? man, a sexologist. Each offers a different theoretical basis and A: No, this was the only way I could make enough money to implications for treatment. support myself. I had no skills and I couldn’t survive in New York on the amount of money from regular jobs. I started doing hotel calls and made a lot of money. Then I got into shopping and gambling. I spent my days in thedepartmentstoresand my Carnes, Patrick. “Progress in Sexual Addiction.” S/ECUS Report, 14(6), nights hooking. I was also spending a lot of money playing the July-August, 1986. Coleman, Eli. “The Continuum of Sexual Compulsivity.” Special stock market. Supplement to the TAOS Newsletter, 3(7), January-February, 1985. Q: How did you first become involved in ? Coleman, Daniel. “Some Sexual Behavior Viewed as an Addiction.” A: I fell into it. I was at a suppercluband aguyapproached me New York Times, October 16, 1984. and offered me $100 to sleep with him. I didn’t go with him at Rowland, Craig. “Reinventing the Sex Maniac.” The Advocate, January 21,1986. I the time, but six months later I called him. Then I either worked Sharon, Richard. “I Cannot Remain Silent.” Special Supplement to the as a prostitute or lived with someone. JAOS Newsletter, 3(7), January-February, 1985. Q: What happened after you sobered up in AA and decided to stop having sex? A: I stayed celibate to avoid drinking for 2% years. I knew that if I had sex I would not be able to stay sober. After I was sober and celibate for two years I thought I was cured of my sexual addiction. I started opening up to my feelings about women. At the age of 39, I “came out” and started sleeping with women. The first time I had sex with a woman I didn’t have an orgasm and that made me angry. Then I did have an orgasm and again I couldn’t stop having sex. I felt so comfortable with women. All I wanted to do was be in bed. I got into sadomasochism (S&M) Al IX/ARC : Update ‘86 and became addicted to that. Then when I got involved with the second woman, I didn’t have sex because I was afraid I On July 25 and 26, 1986, various AIDS service providers and would get out of control. But we would go to women’s porn support groups in San Francisco are holding a conference that movies and women’s discos and read porn. This was all I would will highlight recent advances in clinical management of AIDS do. I couldn’t take care of myself. I wasn’t able to deal with my patients as well as the latest research findings. A wide range of sexual addiction until I sobered up. care providers will find this conference pertinent: nurses, Q: What kind of experience did you have with SCA? social workers, mental health practitioners, health educators A: It was wonderful; it saved my life. Everyone in SCA has an and others who work in acute and/or chronic settings. Topics individual recovery plan that they create themselves. They use will include medical and epidemiological information; medi- the same 12-step method as AA. In SCA the people share their cal implications; psychological issues; groups at risk; legal experiences, strength, and hope. social, political, and educational issues. For further informa- Q: How often did you go to meetings? tion, contact: Renee Renouf Hall,AIDS/ARC: Update’B6,Staff A: I went every night that I could at first-up to 4 or 5 times a Development, Langley Porter Psychiatric Hospital, Box 32B, week for several months. The program prevented me from The Medical Center at UCSF, San Francisco, CA 94143. getting involved in obsessive relationships. I will continue going to SCA in order to stay celibate for many more years. I don’t feel that I’ve totally recovered yet. read Self-Examination Kit Q: How do you feel about the label “sex addict”? A: I think it’s an accurate term. I still would like to have sex all The American Institute for Cancer Research is distributing free the time. I’m an addict. self-examination instruction and reminder kits. These Q: What is your present condition in terms of your addictions? kits may be obtained by sending a business-sized stamped, A: I’ve been off drugs and alcohol for 51% years, off cigarettes self-addressed envelope to: American Institute for Cancer for 3% years, off caffeine for 2 years, not bulemic for 2% years, Research, Dept. BSE, Washington, DC 20069. and celibate for 2% years. Q: What are your future goals? A: I want to become self sufficient and financially independ- New journal: Call for Papers ent. I don’t feel that I can have a healthy relationship until I’m able to take care of myself. I’m also afraid of getting involved with someone who might become dependent on me. I’m just The Haworth Press, Inc., has announced the forthcoming new starting to put together my own life. I don’t feel that I can even publication, the Journal of Pastoral : Innova- date at this point or buy sex toys or . I think I tions in Clinical Research, Contemporary Practice, and Theo- would focus on it too much. logical Reflections. The first issue is scheduled for spring 1987. Q: Would you recommend SCA to others? Articles of particular interest are those that acknowledge the A: Yes, I agreed to do this interview so that others could hear social context of behavior as well asthose that reflect an empir- about the program and be helped. ical basis. Prospective authors should first request an Instruc- While this is only one example of a sex addict and each tions for Authors brochure from: Harold T. Kriesel, PhD, individual’s problem is unique, Carol’s problem of multiple Editor, Journal of Pastoral Psychotherapy, The University of addictions is often found in other sex addicts. For two different Iowa Hospitals and Clinics, 2147 Steindler Building, Iowa City, in-depth perspectives on sexual addiction see the following IA 52242.

SIECUS Report, )uly 1986 3 WHERE THE ACTION IS

Progress in Sexual Addiction: An Addiction Perspective

Patrick /. Carnes, PhD Program Consultant Sexual Dependency Unit, Golden Valley Health Center Minneapolis, Minnesota

Over the last fifteen years the new professional discipline of tionism and sent to a court-mandated group for eight sessions. addictionology has emerged from the extensive foundations The group focused on the exposing behavior, but from Larry’s laid in both research and treatment of alcohol and drug addic- point of view it was merely the tip of the iceberg. He had a tions. Led by organizations like the American Academy of 15-year collection of pornography, carefully cataloged and Addictionology and scholarly publications like the Journal of indexed. He saw prostitutes three to four times a month and Addictive Behaviors, researchers have found that different masturbated daily-sometimes five times in one day. His sexual addictive behaviors (e.g. compulsive eating, , com- relationship with his wife, Joan, had diminished largely due to pulsive gambling, smoking) have much in common. It is not her rage at his increasing sexual demands and his sexual surprising that sex has only recently been added to the list, with other women. Part of her response was to overeat so much given the guilt and shame still attached to the subject. Nor that she gained over 125 pounds. should it surprise us that the professional controversy far Larry also used marijuana and cocaine, ironic considering exceeds that of other forms of addiction. his intense hatred of his dad’s drinking problem, another form of . Afurther irony wasthat his wife bought the Defining Sexual Addiction drugs for Larry because, as she later reported, it was better to The fact remains that a significant number of people have have him stoned at home than out cruising around. identified themselves as sexual addicts: people whose sexual Larry lived in constant fear of discovery that his children, behavior had become “unstoppable” despite serious conse- wife, or church community would find out about the range of quences. These consequences include the physical (self- his activities. He hated his life and was constantly tryingto cope mutilation, , disease, unwanted ), financially to support his sexual activities and drug use. occupational (large financial losses, job losses, Venereal disease created a crisis in the marriage, and with and harassment, withdrawal of professional licenses), and the help of their physician, Larry and Joan entered a hospital familial (loss of relationships, impaired family functioning, sex- outpatient program for sexual addiction. Larry found that he ual abuse, ). In addition to those problems, was not alone in his problems. Many of the patients had the one of the most frequent mental health complaints of sexual same or similar issues. In an interview with Larry two-and-a-half addicts is suicidal ideation. years later, upon completion of his treatment, he recounted Another frequent complaint of “recovering”sex addicts is that there were three main changes in his life since he began that the mental health community does not acknowledge their treatment. First, his sexuality had shifted dramatically. No problem. They become enraged when sexologists dismiss sex- longer was he pursuing a desire that he never seemed able to ual addiction as a problem of sexual misinformation, or exces- satisfy. Now he and Joan were and enjoying sex in sive guilt due to cultural dissonance, or not a serious or different ways than they had believed possible. Second, he had widespread problem. I recently spoke at a Sexaholics Anonym- time for work and play. And third, he was no longer living in ous convention in which participants were rageful and moved constant jeopardy of being discovered or running out of to tears over statements made by professionals in a New York money. Times article. Stepping back from the intensity of their feelings, In Out of the Shadows: Understanding SexualAddiction, I I had to reflect that compared to the amount of time taken to describe a model (See Figure 1) in which the principle momen- gain acceptance for the concept of alcoholism, the progress tum for the addiction in addicts like Larry comes from a per- made in sexual addiction is remarkable. sonal belief system. This belief system captures all thecultural My purpose here is to summarize this progress from an and familial messages about sex and relationships. When these addictionologist’s point of view and to specify further chal- messages are very sex negative and are coupled with low self lenges which will require theclosecooperation of specialists in esteem, core beliefs about one’s own innate shamefulness addiction and professionals in . emerge. Shame is basically a problem of mastery (why is it other kids can do this and I can’t?). When the shame is sexual (why is it Case Study other people seem to be in control of their sexual feelings and I Consider the case of Larry, a 45-year-old manager of a com- am not?), the environment for obsessive behavior is at its puter programming department. Larry was arrested for exhibi- optimum.

4 SIECUS Report, July 1986 tal, has a twenty bed in-patient treatment program for sexual addiction called the Sexual Dependency Unit. I serve as a / Belief System l program consultant to that facility. Seventy-one percent of the patient population reports multiple addiction or compulsive behaviors. In fact, thirty-eight percent of the program’s Unmanageability Impaired Thinking patients are chemically dependent; another thirty-eight per- cent have eating disorders. Compulsive gambling, spending, caffeine use, and smoking are also frequent complaints. z Addiction Cycle J The Golden Valley Program represents, in a concrete manner, the emerging recognition among addictionologists that not only do addictionsoccur concurrently, but in mutually reinforcing ways. Clinicians often observe that the treatment of f’ I+ eoc.l,, \- one addiction will result in the flourishing of another. Patients, for example, who have both alcoholism and sexual addiction often observe that their alcohol use was a way to anesthetize their pain around their out-of-control sexual behavior. They Despair Ritualization further comment that their alcoholism was relatively easy to deal with compared to their sexual acting out. Such observations are at odds significantly with the tradi- Sexual Compulsivity J tional “disease” model of chemical dependency in which alcoholism and drug addiction are perceived as the primary “illness” and the sexual behavior as resulting from it. Unfortu- Figure 1. The addictive system. nately, there are still alcoholism treatment centers where Source; Carnes, Patrick. Out of the Shadows: Understanding Sexual patients are told that their sexual behavior will straighten out Addiction. Minneapolis, Minn.: Compcare Publications, 1983. once they get sober. Reprinted by permission. Major progress is being made, however, in terms of under- impaired Thinking standing the relationships among the various addictions. One exciting example is the research of Milkman and his colleagues Through these lenses the addict’s thinking becomes (Advances in Alcohol and Substance Abuse, 1983) on the psy- impaired, literally, to the point of loss of contact with reality. chobiological impact of interactions on addiction Addicts talk of entering an altered state parallel to the Jekyll- pathology. For their research purposes, they use a matrix Hyde shift where even common sense considerations disap- developed around three categories of addictions: the arousal pear. Denial and delusion govern their lives. One addict, for addictions (e.g., gambling, sex, stimulant drugs, and high risk example, told of following a woman into what he thought was a behaviors), the satiation addictions (e.g., overeating, depres- restaurant only to discover himself standing in the lobby of a sant drugs, and alcohol), and the fantasy addictions (e.g., psy- police station to which the woman had fled. chedelic drugs, marijuana, and mystical/artistic preoccupa- Because of the impaired thinking, an addiction cycle per- tions). Beyond their research method of categorization, the petuates itself through four phases: conceptualization of models of poly-addiction will go far in broadening traditional models of addiction. They will also assist l preoccupation in which the addict enters a trance-like ob- in answering the questions many practitioners have about session cross-tolerance effects. l ritualization that enhances the trance l sexual behavior that is often not rewarding l despair that, once again, the behavior has been repeated Family System Theory

One way to stave off the despair is to start the preoccupation Many addiction professionals are using systems theory as a over again. And the cycle becomes the recursive series of conceptual foundation for their work not only because it is an events which dominates the addict’s life. With this process integrative paradigm but also because it is a growth versus underway, the addict’s life becomes more and more unman- illness model. One of the systems identified, for example, by ageable, thus confirming the basic feelings of unworthiness most addiction specialists as key to the self-defeating patterns that are the core of the addict’s belief system. of the addiction is the family system. Note in Larry’s story how Larry’s secretive life was embedded in this process of other family members had their own addiction patterns shame, powerlessness, and despair. He wanted very much to (father’s drinking and wife’s overeating). Observe also Joan’s stop the pain, but the only things that seemed to help were his co-participation in the illness through the purchasing of Larry’s rituals of indexing his pornography, finding a prostitute, or, drugs, Even her weight gain was a statement about their when unable to pay for sex, exposing himself. Larry’s addictive sexuality. process presents a very common model familiar to addiction As part of the etiology of the addictive system, extreme professionals. Shame is a key factor in all addictions. Sexual family behavior such as extreme rigidity or chaos are common shame, especially in a sex-negative culture, is particularly to people who have dependency problems. Further, I describe virulent. in a new book now in press a survey of 300 sexual addicts and the incidence of childhood sexual abuse. Sixty-five percent of Multiple Addictions the women and forty-five percent of the men report having Other familiar factors in Larry’s case are multiple addic- been sexually abused. For a number of reasons I specify in the tions, both in the addict and his immediate family members. book, I believe that this is, in fact, underreported. Golden Valley Health Center, a suburban Minneapolis hospi- As part of treatment, the family or significant others are

SIECUS Report, July 1986 5 vital to the recovery process. When Golden Valley Health Cen- tive disorders. Perhaps the best brief explanation of the process ter staff conducted six-month post treatment evaluations, they is Ernst Kurtz’s classic article “Why AA Works” Uournal of discovered only one common denominator to all the patients Studies on Alcohol, 43:38-80) for those readers with no 12-step who suffered : no family members, partners, or signifi- group experience. cant others had participated in the family week of treatment. Definitional problems abound in sexual addiction. Eli Systems theory also allows a more organic approach to Coleman elaborates upon them in his companion article to this treatment. For example, comparisons between alcoholism and piece. Questions of normalcy, cross-cultural comparisons, spe- sexual addiction treatment can create misperceptions about cial populations are all familiar terrain to the addiction special- the course of treatment. A better comparison can be made by ist. In fact, Jim Orford, one of the very first to articulate a theory looking at eating disorders. There are 34 million obese and 14 of sexual dependency, comments in his recent book Excessive million morbidly obese persons in the United States. Yet, like Appetites (1985) : sexual addiction, we have been very slow to address this prob- Debate over definitions in this area is intriguingly remi- lem. In compulsive overeating, patients are not asked to give niscent of debates on the same subject when drug- up eating, but rather to learn how to eat differently. Eating taking, drinking, or gambling are under discussion. In patterns, environments, foods, and rituals shift so that they none of these areas is there agreement about the precise enhance rather than destroy the patient’s life. points on the continuum at which normal behaviour, Similarly, sexual addiction treatment helps patients reclaim heavy use, problem behaviour, excessive behaviour, their sexuality by a primary refocusing of their sexual behavior. “” or “ism” are to be distinguished one from Some have assumed that the focus of alcohol pro- another. When reading of the supposed characteristics grams has been directly translated to sex addiction programs, of the “real nymphomaniac,” one is haunted by memo- and they feared that treatment in these programs would be a ries of attempts to define the”real alcoholic”or the “real sex-negative experience. Of the four hospital based programs I compulsive gambler.” know, treatment staff work very hard to help their patients achieve the goal of sexual enhancement. Part of review criteria Current research trends are abandoning the traditional for all such programs should include treatment goals that disease oriented typologies in favor of recognizingthat natural encourage healthy and varied forms of sexual expression. systems are varied even in pathologies. To find the model “sex addict” that everyone can agree on will take us down a trail the Treatment Outcome professional addictionologist has been on before. There is not In terms of treatment outcomes, the early six-month eval- one kind of alcoholic but actually a variety of types who have uation of Golden Valley Health Center patients isencouraging. excessive use of alcohol in common. So I believe that we will This internal study of 30 patients has all the obvious limitations find similar patterns in sexual addition. of a preliminary study done on the first patient cohort to reach The risk is that addiction specialists look skeptically at sex six months. It is also not a large sample, nor is it conducted over therapists and their lack of training in addictive delusional a long period of time. Nor were the forms consistently com- thought processes and while sexual scient- pleted. But the information obtained from this preliminary ists criticize addictionologists as having inadequate knowledge study is positive. For quality of life indicators, patients reported of sexuality. Meanwhile, people who are struggling with the significant improvement in the following areas: issue are asking for help. And no progress will be made. Therein is the opportunity. Some years ago the Italian 0 Family Life 76% psychiatrist Mara Palazolli (1981) appealed for professionals to 0 Job Performance 81% work for what she termed “transdisciplinary” knowledge as l General Physical Health 80% contrasted with interdisciplinary efforts in which differentspe- 0 Self-l mage 71% cialists focused on a common problem. From her point of view For program outcomes, patients reported: “transdisciplinary” meant creating a new body of knowledge through the cooperation of different disciplines. Sexual addic- l Having no or minimal problems maintaining recovery 86% tion presents us with a great challenge and opportunity for e Recommending program to others 100% addictionologists and sexual scientists to develop the new body a Attending regular or frequent 12-step meetings 76% of knowledge that Palazolli envisioned. The last program outcome requires some explanation. References Addiction programs often rely on community support groups based on the I2 steps of Alcoholics Anonymous or as they are Milkman, H., Weiner, 5, Sunderwirth, 5. “Addiction Relapse.” Ad- translated (e.g., Overeaters Anonymous, Gamblers Anony- vances in AlcoholandSubstance Abuse, Fall/Winter 1983184,3, I-2. mous. In the case of sexual addiction, there are a number of Carnes, P. J. Out of the Shadows: Understandine Sexual Addiction. groups, such as or Sexaholics Anony- Minneapolis, MN: Compcare Publications, 1983. mous. The fact that 76 percent of Golden Valley’s patients could Kurtz, E. “Why AA Works.” journal of Studies on Alcohol, 43, 38-40. find local groups is remarkable, given that the majority of them Orford, J. Excessive Appetites: A Psychologist’s View of Addictions. New York: John Wiley & Sons, 1985, p. 106. came from all over the United States and Canada. It is a testi- Palazolli, M. “A Transdisciplinary Approach to Family Systems”(Audio- mony to the rapid expansion of resources for this problem. tape), Garden Grove, CA: Infomedix, 1981.

Conclusion

Some professionals are mistrustful of self-help groups, especially when they have had no experience with them. The Next Issue . . . September 1986 fact is they are of uneven quality. However, a good group is will feature guest editor Janet Rosenzweigon the topicof hard to beat in terms of helping addicts cope with their shame. CHILD SEXUAL ABUSE The 12steps are particularly effective with shame-based addic-

6 SIECUS Report, July 1986 MORE ON THE SUBJECT

Sexual Compulsion vs. Sexual Addiction: The Debate Continues

Eli Coleman, PhD Assistant Professor and Associate Director Human Sexuality Program, University of Minnesota Medical School Minneapolis, Minnesota

A client came in to see me a number of years ago and said he Anonymous, Sex and Love Anonymous, and Sex Abusers didn’t know how to explain his problem. After a few false starts, Anonymous. he said, “My brother is an alcoholic. While I’m not an alcoholic, Professional treatment programs have also increased in I feel and act just Ii ke my brother when he was drin king. Except, number. These treatment programs, inpatient or outpatient, I don’t drink that much. I don’t know if there is a word for it, but also differ significantly in their treatment philosophies and I feel like a ‘sexaholic’.” methods, including psychoanalytic, social-learning, family sys- Over the past few years, there has been a growing aware- tems, cognitive, behavioral, and/or biological treatments. ness that certain sex behaviors could become an agent for Some programs apply an addiction model borrowed from compulsive or addictive disorders. No consensus exists treatment of alcoholics, while others use treatment models of whether these behavior patternscould be described as psycho- obsessive-compulsive or impulse control disorders. Some use sexual, obsessive-compulsive, impulse, or addictive disorders. hormonal therapy, such as depo-provera, an anti-androgenic How to describe these behavior patterns is still under debate agent. Some treatment programs distinguish between individ- and discussion. What is clear is that a number of people are uals who are compulsive or addictive sex offenders-rapists, concerned about the excesses, the lack of control, the amount exhibitionists, incest perpetrators, etc.-and those with less of preoccupation, and the disruption of their lives by their social or criminal offenses, such as problematic pattern of sexual behavior. or multiplesexual partners. Becauseall combinations are possi- In response to these concerns, a number of self-help pro- ble, each program is unique to some degree. There is no grams and professional treatment programs have emerged, consensus on treatment method at present, nor much research along with books, articles, television coverage, and lively dis- demonstrating treatment effectiveness. cussions among sexologists and professionals in the addiction Debate Over Terminology field. The self-help groups, which are rapidly increasing in There has been much debate over terminology, reflecting number, have been designed to help people gain control over these philosophical and theoretical differences. The term sex- destructive patterns of sex behavior. Many of these groups ual addiction has received the most discussion because it was have adopted the l2-step method of Alcoholics Anonymous one of the first of this new terminology popularized by Patrick (AA) in which members are asked to take a first step and Carnes’ book The Sexual Addiction, recently retitled Out of the acknowledge that they are powerless over alcohol and that Shadows: Understanding Sexual Addiction. John Money their lives have become unmanageable. In Sex Addicts Anon- (1985), at Johns Hopkins Hospital and School of Medicine, has ymous (SAA), for example, this first step is simply changed to indicated that “Carnes is incorrect in calling sex an addiction. It “We admitted we were powerless over our sexual addiction- is the object of erotic (or the person) to which someone that our lives had become unmanageable.” The remaining becomes addicted. Analogously, hunger is not an addiction- steps from AA remain unchanged. Sex Addicts Anonymous the addiction is to food, usually carbohydrate.” In his book describes itself as “a fellowship of men and women who are Love and Love Sickness, Money (1980) states, “The person who committed to a program of spiritual recovery from a life that has fallen in love becomes addicted to the love partner- invited compulsive, uncontrolable, and harmful sexual practi- obsessed and preoccupied with the next ‘fix’ of being ces” (Twin Cities SAA, Minneapolis, Minnesota). together.” The danger of describing sex as an addiction is that it There are numerous other self-help organizations with presupposes that the individual is addicted to all forms of little or no connection to or contact with each other. These sexual behavior rather than a specific sexual object or set of groups often differ significantly in philosophy and method, sexual behaviors, and following this model, suggests absti- thus, it should not be assumed that one group operates like nence as a treatment goal. another, even within the same organization and city. Some of Others view these behavior patterns as sexual compulsions these organizations are: Sex Addicts Anonymous, Sexaholics (Quadland, 1985a, 1985b). Dr. David Barlow (1985) has des-

SIECUS Report, July 1986 7 cribed these as obsessive-compulsive disorders. Others, such ments of such conservative political views and have made as Dr. Andrew Mattison at the Clinical Institute of Human people who do not fit into a narrow, traditional sexual Relationships in San Diego have preferred a non-diagnostic lifestyle feel bad, immoral, and, now mentally ill. For exam- labeling of these behaviors and to simply describe them as ple, a young client came to me and said that he was a sexual problems of sexual control. addict. When I asked him why he thought this he told me There were some attempts in the current revision of the that he masturbated 2-Xtimesweeklyand had been tryingto Diagnostic and Statistical Manual of the American Psychiatric stop for several years. He began worrying about this behav- Association (DSM-III) to include a new category of psychosexual ior after he learned that sex could become “addictive.” His disorder called “Hyperactive Disorder.“Thisdis- behavior could be understood as addictive by some or com- order was defined as sexual desire or activity persistently so pulsive by others. Or his behavior could be defined as a con- high that it interferes with social or occupational functioning, flict between conservative sexual attitudes and a misunder- and not occuring only during the course of another Axis I standing of normal or healthy sexual behavior. I chose the disorder, such as a , a manic episode, or substance latter in treating this individual. intoxication. My understanding is that inclusion of this new cate- 5. “Too much sex can never be too much” (Anonymous). At a gory has been abandoned. recent meeting of the Society for the Scientific Study of Sex While sexual scientists debate this question of terminol- (1986), Sol Gordon commented that if you were going to be ogy, my clients seem to be most comfortable with describing compulsive about something, let it be sex. He alluded to the their problems as either compulsions or addictions. The impor- fact that this type of compulsivity is far less dangerous than tance of debating terminology, however, should not be under- other compulsivities, unless it involves criminal activities. estimated. It is critical in truly understanding the nature of 6. The use of the words addiction or compulsion to describe these problems and the methods for treatment. And, yet, ulti- certain sexual behavior patterns does not exactly fit our mately, we must acknowledge that wewill never find complete current conceptualizations of compulsions or addictions. A unanamity of thought. better term is needed to describe these behavioral prob- lems or to expand or clarify our understanding of what compulsive or addictive behaviors are. As Stanton Peele Arguments Against the Addiction Concept (1975) has argued, our conception of addiction has changed Many concerns and arguments have been made against over the years and is no longer as physiologically defined. conceptualization of sex as a potential agent for a compulsive Thus, the use of the word addiction can be expanded to in- or addictive behavior (e.g., Cushman, 1985; Sharon, 1985; Tay- clude not only behaviors which are analogous to addictions lor, 1985; Wedin, 1985a 1985b; and Levine, 1985). The following but are indeed addictions themselves (e.g., love addiction). concerns and arguments have been made by some of the By strict definition, many of the sexual behaviorsofwhich our above listed sexologists. clients complain cannot be considered compulsive because compulsion is currently defined as a compelling activity This concept can potentially be used to oppress sexual from which the person derives no pleasure. While people minorities. For example, individuals with multiple sexual who describe themselves as sexual compulsives or addicts partners or same-sex partners may be viewed as compul- commonly experience guilt and remorse over their sexual sives or addicts because they do not conform to the moral behavior, they often describe great pleasure before and values of the prevailing culture (or therapist). with the polit- during the sexual activity itself. So we clearly have some ical swing to the right in sexual morality, the dangers for definitional problems. abuse of this conceptualization is ripe. 7. Many people who are treating those with sexual compulsiv- No matter how one defines sexual compulsivity or addic- ity or addition have not been properly trained. For example, tion, there seems to be an implicit comparison to normalcy addiction professionals too often have simply borrowed of sexual behavior. Thus, the person who masturbates ten from their knowledge of treating alcohol addiction to treat times a day is compared with those who masturbate two or sexual addiction. Often they have had very littleor notrain- three times weekly. While we know that the baseline of ing in sexual science or . Conversely, sex thera- sexual behavior is extraordinarily wide, we rarely can agree pists attempting to treat these problems have had little or no on what normalcy is. Therefore, the criterion of “number of training in treating addictions, compulsive behaviors, or times” as an indicator of compulsivity or addiction has the impulse disorders. potential danger of pathologizing normalcy. 8. Free use of the words addiction and compulsion have - If we use global assessment concepts such as preoccupation, dered these terms meaningless. The way that some are out of control, unmanageability, negative consequences, or defining these terms renders the world and all people outside one’s value system, we improve upon a definition within as compulsive or addictive. An analogy is the term using only numbers as a criteria but fall into potentially neurotic, in which descriptions became so broad that no subjective, and value-laden assessments. In the hands of one could escape the label. those who hold sex-negative or highly restrictive attitudes 9. There is very little research which documents the existence about sexuality, this subjectivity can, again, pathologize of such a conceptualization. Nor is there much research normalcy. which documents the effectiveness of treatment methods There seems to be no coincidence that the growth of inter- derived from these concepts. est in sexual compulsivity or addiction has paralleled the growth of right-wing, conservative and discriminatory atti- Understanding Sexual Compulsion tudes about sexuality and the increase in the dangers of sexually transmitted diseases, such as herpes and AIDS. The It is very important in furthering our understanding of argument has been made that mental health professionals sexual compulsivity or addiction that these criticisms and con- using such conceptualizations have become simply instru- cerns be addressed. In attempting to understand the concerns

SIECUS Report, July 1986 of clients who express these types of problems, many psy- Thus, there is the increased need to return to the temporary chotherapists have tried to be cautious in not over-diagnosing relieving fix. The behavior becomes repetitive and forms a or falling into the traps the critics have pointed out. vicious cycle that simply feeds a greater need to engage in the In my own attempt to address these problems, I have behavior for its analgesic qualities. Once the behavior cautioned my clients about the problems of labeling and admit becomes compulsive, this results in further feelings of shame, our lack of knowledge regarding these problems. However, I interference in interpersonal relationships, and intimacy dys- am willing to treat people who are in psychological distress function. Thus the sexual compulsivity both results from and because they perceive their sexual behavior as having the becomes a symptom of intimacy dysfunction. elements of preoccupation, lack of control, and destructive- Sex as a potential agent for a is natu- ness to their well being or their lives. I prefer to view sexual rally alluring. The sexual response cycle causes significant behavior on a continuum, for every sexual behavior has its changes in neuroendrocrine and body chemistry. These healthy aspects and its potential for abuse or compulsion. I changes can have adrenalin or analgesic-type qualities. The prefer the term abusive behavior patterns or compulsivity “natural high” from sexual activity can ease pain, help one because there seems to be more uncertainty and potential relax. It can also mask feelings of pain such as low self esteem. harm for the use of the term addiction. Sex and be used as a “short-cut” to a semblance of positive self-esteem and a feeling of intimacy. Etiology This paradigm of the etiology has been most helpful to me The etiology of this still ill-defined set of behaviors is clinically in understanding a variety of compulsive behaviors. obviously obscure. But in a scientific fashion, I have my own The other dynamic which seems most evident in the develop- hypotheses based upon existing theoretical notions of compul- ment of sex compulsive behaviors is the background of highly sivity and addictions and descriptive data based upon my own restrictive and conservative attitudes regarding sexuality (See clinical sample. Figure 2). In response to these environments, my clients have In my clinical experience, some type of historical family not been able to conform to such restrictive attitudes (usually intimacy dysfunction, such as child abuse or neglect, can be found (See Figure 1). In response to this trauma, the client develops feelings of shame. Because of the lack of established boundaries between parent and child in the egocentric stage Highly Restrictive of childhood, the client perceives that he was the cause of Attitudes on Sexuality I the abuse-whether it was neglect, physical, psychological, f sexual or emotional abuse-and developsfeelingsof unworth- Unable to Conform iness and inadequacy (see Kaufman, 1980, for a better descrip- to Restrictions tion of this process). This feeling of shame results in low self-esteem and an interruption in normal, healthy interper- c Interpret Behavior sonal functioning, which leaves the person feeling lonely. All as Sinful or Deviant of these events and feelings cause psychological pain for the client, and in order to alleviate this pain, the client begins to Feel Guilt and Shame search for a “fix,” or an agent which has analgesic qualities to it. I For some, this agent is alcohol. For others, it could be drugs, t certain sexual behaviors, particular foods, working patterns, Keep Secrets gambling behaviors, etc. All seem to cause physical and psy- 1 chological changes which alleviate the pain and provide a Pain temporary relief. This respite from the psychological pain does not last, and the shame, low self esteem, and loneliness return. t Act Compulsively to Relieve Pain

* Family Intimacy Dysfunction or Abuse i \ Figure 2. Development of compulsive behaviors through restrictive - Sh v.2 sexual attitudes. h because they are simply sexual beings). Issues surrounding Pain + Analgesic --t Temporary - More Need masturbation, for example, have been commonly traumatic. 1 4 “Fix” Relief to “Fix” Many clients report having been severely disciplined for child- alcohol hood masturbation or carefully watched to prevent masturba- drugs food tion from occurring. Because they could not conform to such sex restrictions, they cognitively construed themselves as sinful or gambling deviant, resulting in feelings of guilt and shame. Many had etc. already developed shame-based personalities even before sex- uality had become an issue. In order to alleviate some of the guilt and shame, they became secretive about their sexual behavior to avoid punishment. This whole process, again, pro- I 1 duced psychological pain. The individual, then, acted to alle- viate the pain through compulsive behavior patterns. Also, as Figure 1. Development of compulsive behavior patterns. in most obsessive-compulsive disorders, the more the person

SIECUS Report, July 1986 9 tried to suppress the impulse, the more compelling it became. 6. Treatment programs or psychotherapists who treat sexual These hypotheses are in need of testing. And research is compulsivity or sexual addiction or problems of sexual con- now being conducted. Hopefully, in the near future, therewill trol need to be knowledgeable about human sexuality as be some answers. well as personality disorders, addictive disorders and other Recommendations forms of mental illness. And, very importantly, the psycho- therapists should hold positive and healthy attitudes about Since the concepts of sexual compulsivity and sexual their own sexuality and a wide range of sexual expression of addiction are quite new, I would like to offer a few others’ sexuality. In reviewing my hypothesized etiological recommendations: factors, conservative or restrictive attitudes about sexuality Extensive research should be conducted on the individuals may be one of the important precursors to sex compulsive be- who identify themselves or have been identified by psy- havior. If treatment simply reinforcesthese attitudes, then the chotherapists as sexually compulsive or addictive to shed therapist has contributed to the factors which lead the per- more light on the definitional problems, etiological factors, son to act compulsively. Treatment must go beyond control and treatment methodology. For example, efforts such as of problematic sexual behavior. First, one must rule out the Michael Quadland’s (1985) research on his theoretical possibility that the problem is a values conflict between an understanding of the problem, treatment methods, and individual’s own expression and societal pressures, and if outcome data are quite commendable. this is a values conflict, it should be treated accordingly. If Research should distinguish between different types of sex- not, treatment again should go beyond the control of sexual ually compulsive or addictive individuals. This could be behavior to help the individual develop positive and healthy done according to, for example, Patrick Carnes’four identi- attitudes regarding sexuality. In the process of treatment, fied levels of sexual addiction. factors which might contribute to compulsive behavior Research should also distinguish the behaviors along a con- patterns or inhibit healthy sexual expression should be tinuum of compulsivity or addictiveness. Possibly distin- explored: sexual attitudes, shame, low self esteem, lack of guishing psychological traits from psychological states personal boundaries or respect for others’ psychological might alleviate the problems of seeing people as either boundaries, sex role discomfort, confusion or , compulsive or not or additive or not. concerns about , sexual dysfunction, Until further research has been completed, we should be communication skills, dependency patterns in relation- cautious in our vocabulary, diagnoses, and definition of the ships, and means of expressing intimacy. problem. It is appropriate for us to set a framework for understanding and treating individuals who present with Conclusion concerns or problems related to preoccupation, lack of The pioneering efforts of many sexual scientists and other control, or negative consequences as a result of their sex related scientists need to be commended for their efforts at behavior patterns. We are in no position to be omnipotent approaching old problems with new solutions. The critics of in our assertions at this point, and these do not need to be these new theoretical formulations should also be com- transferred to our clients. This is not to mean that certain mended because they have raised serious and legitimate con- philosophies or treatment methods should not be defined cerns which have forced many of us to sharpen our theoretical and applied. This is the only way that the treatment thinking, to test our hypotheses through rigorous research, approach can be described and evaluated. and to avoid the potential dangers which they have outlined. 5. We need to learn about and conduct research on the efforts When I began my career as a sex therapist over ten years of the self-help organizations. Professionals tend to have ago, I always felt I was in the dark when it came to treating disdain for many self-help organizations because of their individuals with or with compulsive behavior pat- lack of professional guidance. And, yet, as we have learned terns. Giving permission to clients to be sexual beings without from those who have been members of Alcoholics Anon- feeling guilty and psychoeducative methods of sex therapy ymous (AA), while not effective with everyone, this self- were not helpful; nor were behavior modification or psycho- help group may be just as effective as chemical dependency dynamic methods. The newer approaches which combine treatment programs, many of which have incorporated the methodologies seem to offer more promising results. Yet, we philosophy and understanding of alcoholism from AA. One need to document these methodologies and carefully conduct of the main concerns I have with the application of the AA outcome studies based upon our work. model to sexual compulsivity or addiction is that by borrow- In an effort to increase communication among profession- ing so much philosophy from AA,control,abstinence,and a als working in this area and to provideaforum for presentation program of spiritual recovery is emphasized, and I don’t of theoretical formulations and research data, the Program in think this is enough. People can live without alcohol; on the Human Sexuality at the University of Minnesota Medical other hand, sexuality is an important and healthy aspect of School will be sponsoring a conference in the spring of 1987. life. Most groups with which I am familiar help participants This should be a good vehicle for an intensive look at the separate “addictive” forms of sexual expression and “non- problem of sexual behavior which develops into obsessive, addictive” forms. Therefore, their intention is not to purge compulsive, impulsive, or addictive forms. We eagerly await sexuality from its members. Without leadership or people more scholarly work in this important area of human sexuality. with longer terms of “sobriety,” these groups often lack positive messages about sexuality. Those who have suffered References pain as a result of their sexuality might be reluctant to give permission to other individuals to enjoy sexuality. There Barlow, D. Interview in D. Coleman, “Some Sexual Behavior Viewed needs to be modeling of healthy sexual expression beyond as an Addiction.” New York Times, October 16, 1984. the control of destructive or abusive patterns of sexual Carnes, P. The Sexual Addiction. Minneapolis, MN: Compcare behavior. Publications, 1983.

10 SIECUS Report, July 1986 Cushman, L. P. “A Sexologist’s Concern.” Special Supplement to the TAOS Newsletter, 3(7), January-February, 1985. Gordon, S. “Sex Is Politics-Whether We Like It or Not.” Pres- entation at the Annual Meeting of the Eastern Region of Sexual Addiction Treatment Programs the Society for the Scientific Study of Sex, Philadelphia, PA, April 12, 1986. Kaufman, C. Shame: The Power of Caring. Cambridge: Shenk- man, 1980. Levine, M. “AIDS and Sexual Behavior: A Panel Discussion.” Pres- OUTPATIENT/SUPPORT GROUPS entation at the Annual Meeting of the Eastern Region ofthesociety for the Scientific Study of Sex, Philadelphia, PA, April 20, 1985. COSA: A support group for family members of sex Money, j. Love and Love Sickness: The Science of Sex, Gender addicts Difference and Pair-Bonding. Baltimore, MD: Johns Hopkins Twin Cities COSA University Press, 1980. Money, J. “Love as Addiction.” Special Supplement to the TAOS P.O. Box 14537 Newsletter, 3,(7), January-February, 1985. Minneapolis, MN 55414 Peele, S. Love and Addiction. New York: Signet, 1975. Quadland, M. “Overcoming Sexual Compulsion.” New York Native, November 7-20, 1983. Sex and Love Addicts Anonymous Quadland, M. “Compulsive Sexual Behavior: Definition of a On the West Coast: Problem and an Approach to Treatment. journal of Sex and On the East Coast: Marital Therapy, 11(2), 1985. SLAA SLAA Sharon, R. K. “1 -Cannot Remain Silent.” Special Supplement P.O. Box 529 P.O. Box 99429 to the TAOS Newsletter. 3(7). lanuarv-Februarv, 1985. Newton, San Francisco, Taylor, C. L. “A Social Science Perspective’of Sexual Addiction.“Specia/ MA 02258 Supplement to the TAOS Newsletter, 3(7), January-February, 1985. CA 94109 Wedin, R. W. “The Sexual Compulsion Movement.” Christopher Street, Issue 88, 1985. Wedin, R. W. “AIDS and Sexual Behavior: A Panel Discussion.” : A recovery program based on Presentation at the Annual Meeting of the Eastern Region of the principles of Alcoholics Anonymous; a group start kit the Society for the Scientific Study of Sex, Philadelphia, PA, is available for $5 from: April 20, 1985. Sexaholics Anonymous P.O. Box 300 Simi Valley, CA 93062 -DO YOU KNOW THAT.. . I In the New York metropolitan area call: (212) 570-7292

Note: SA also has S-Anon support groups for families of SSSS Student Research Grants sex addicts.

The Society for the Scientific Study of Sex awards at least one Sexual Addicts Anonymous annual student research grant of $500. Research conducted by Twin Cities Sexual Addicts Anonymous masters or doctoral students is eligible. Those interested P.O. Box 3038 should submit a IO-page abstract by September 15, 1986 to: Minneapolis, MN 55403 Cynthia E. Jayne, PhD, Society for the Scientific Study of Sex, P.O. Box 29795, Philadelphia, PA 19117.

INPATIENT PROGRAMS Family Resource Movement Conference Sexual Dependency Unit at Golden Valley Health Center: On September 12-14, 1986, the Family Resource Coalition is intensive, 4-week, structured inpatient program that sponsoring a national conference to bring together peopleand incorporates 12 steps of AA and Alanon programs involved in prevention-oriented, community-based Golden Valley Health Center efforts to strengthen families. Over 80 workshops, seminars Sexual Dependency Unit and forums will cover a variety of multidisciplinary topics. CEU 4101 Golden Valley Road credits will be available. For more information, contact: the Golden Valley, Minnesota 55422 Family Resource Coalition, 230 North Michigan Avenue, #1625, (612) 588-2771 Chicago, IL 60601; (312) 726-4750.

Sexual Addictions Treatment Program at JoEllen Smith Progress in Impotence Psychiatric Hospital: intensive 30-day inpatient and 2-week outpatient regimen applying behavior mod- On September 19-20, 1986, the University of California, San ification and cognitive therapy Diego, Medical Center is sponsoring a conference entitled Contact: Stephen Southern (584) 363-7588 Sexual Addictions Treatment Program Progress in Impotence: Diagnosis and Therapy. It will be held Clinics for Marital & Sex Therapy at the Hotel Intercontinental in San Diego, California. For JoEllen Smith Psychiatric Hospital further information contact: Edith Bookstein, Conference New Orleans, LA Management Associates, P.O. Box 2586, La Jolla, CA 92038; (619) 454-3212.

SIECUS Report, July 1986 11 INDEX TO VOLUME XIV September 1985 - July 1986

Articles - Titles Francoeur, Robert T. Reproductive Technologies: New Alternatives and New Ethics. No. 1, p. 1. AIDS: Avoiding Witch-Hunts. Vern L. Bullough. No. 3, p. 1. Krim, Mathilde.American Foundation forAIDS Research Statement on AIDS; Prevention and Prospects for Control. Thomas A. Peterman the A/DS Crisis in the United States. No. 3, p. 7. and William W. Darrow. No. 5, p. 11. Lynn, Barry W. The New Pornography Commission: Slouching Toward American Foundation forA/DS Research Statement on theA/DS Crisis Censorship. No. 5, p.1. in the United States. Mathilde Krim. No. 3, p. 7. Moglia, Ronald. The She// Game. No. 5, p. 15. Confronting the Myth of : The Networking Project for Dis- Moglia, Ronald. Sexual Abuse and Disability. No. 4, p. 9. abled Women and Girls. Harilyn Rousso. No. 4, p. 4. Moglia, Ronald. Sexual Science and Public Policy. No. 3, p. 8. Ethical Guidelines for Ethics Committees. Elizabeth Rice Allgeier. No. Mosher, Donald L. Misinformation on Pornography: A Lobby 4, p. 11. Disguised as an Educational Organization. No. 5, p. 7. The Kinsey Institute: From 1947 to the Present. Elizabeth Rice Allgeier. Peterman, Thomas and Darrow, William. AIDS: Prevention and No. 1, p. 6. Prospects for Control. No. 5, p. 11. Misinformation of Pornography: A Lobby Disguised as an Educa- Roman, Bea. The Shanti Project: Support Services for People tional Organization. Donald L. Mosher. No. 5, p. 7. with AlDS and Their Loved Ones. No. 3, p. 3. The New Pornography Commission: Slouching Toward Censorship. Rousso, Harilyn, Confronting the Myth of Asexuality: The Net- Barry W. Lynn. No. 5, p. 1. working Project for Disabled Women and Girls. No. 4, p. 4. Progress in Sexual Addiction: An Addiction Perspective. Patrick Skerker, Pamela. Sexuality Education in a Psychiatric Day Treatment Carnes. No. 6, p. 4. Setting. No. 4, p. 7. Reproductive Technologies: New Alternatives and New Ethics. Robert Welbourne-Moglia, Ann. Statement to the U.S. Commission on Por- T. Francoeur. No. 1, p. 1. nography, Houston Texas, September 12, 1985. No. 2, p. 8. The Safe Sex She// Game. Ronald Moglia. No. 5, p. 15. A Sex Addict Speaks. Sharon R. Edwards. No. 6, p. 1. Sexual Abuse and Disability. Ronald Moglia. No. 4, p. 9. Sexual Compulsion vs. Sexual Addiction: The Debate Continues. Eli Audio-Visual Materials Reviewed Coleman. No. 6, p. 7. Sexual Science and Public Policy. Ronald Moglia. No. 3, p. 8. AIDS Alert. No. 6, p. 18. Sexuality and Disability: Looking Backward and Forward. Pamela AIDS: What Everyone Needs to Know. No. 6, p. 17. Boyle, No. 4, p.1. Alone Together: New Ministries for Sing/es. No. 1, p. 22. Sexuality Education in a Psychiatric Day Treatment Setting. Pamela M. Another Ha/f. No. 1, p. 22. Skerker. No. 4, p. 7. Are You Listening: People Who Have Struggled with Abortion. The Shanti Project: Support Services for People with AIDS and Their No. 1, p. 23. Loved Ones. Bea Roman. No. 3, p. 3. The Attendant. No. 4, p. 21. S/ECUS Position Statement on AIDS. No. 3, p. IO. Better Safe Than Sorry I//. No. 3, p. 17. S/ECUS Position Statement on Censorship of Sexually Explicit Ma- BARN, The Body Awareness Resource Network. No. 4, p. 22. terials, No. 5, p. IO. Can We Talk? No. 1, p. 23. A Silver Lining in an Ominous Cloud. Sharon R. Edwards. No. 3, p. 6. Chance of a Lifetime. No. 6, p. 17. Statement to the U.S. Commission on Pornography, Houston Texas, Choosing Children. No. 2, p. 14. September 72, 7985. Ann Welbourne-Moglia. No. 2, p. 8. Communicating with Dr. jessie Potter. No. 6, p. 19. Summer 1986 Graduate Studies in Human Sexuality andSex Education. For Our Lives. No. 3, p. 17. No. 4, p. 14. In Due Time. No. 1, p. 23. What the United States Can Learn About Prevention of Teenage Love Skills. NO. 5, p. 22. Pregnancy From Other Developed Countries. Joy Dryfoos. No. Men Who Molest/Children Who Survive. No. 4, p. 21. 2, p. 1. A Million Teenagers. No. 5, p. 22. More Than Friends. No. 2, p. 13. A Night Out. No. 2, p. 13. Now I Can Tell You My Secret. No. 3, p. 18. Persona/ Decisions. No. 6, p. 19. Postponing Sexual Involvement: An Education Series for Young Teens. Articles - Authors No. 5, p. 23. Setting Limits. No. 2, p. 13. Allgeier, Elizabeth Rice. Ethical Guidelines for Ethics Committees. Sex and Decisions: Remember Tomorrow. No. 1, p. 23. No. 4, p. 11. Sex and Pregnancy. No. 1, p. 24. Allgeier, Elizabeth Rice. The Kinsey Institute: From 1947 to the Silent Pioneers. No. 1, p. 22. Present. No. 1, p. 6. Stale Roles and Tight Buns: images of Men in Advertising. No. 3, p. 17. Boyle, Pamela. Sexuality and Disability: looking Backward and Sudden Changes: Post Hysterectomy Snydrome. No. 4, p. 22. Forward. No. 4, p. 1. Taking a Sexual History. No. 6, p. 18. Bullough, Vern L. AIDS: Avoiding Witch-Hunts. No. 3, p. 1. Talking Helps. No. 2, p. 14. Carnes, Patrick. Progress in Sexual Addiction: An Addiction Per- Terrific Sex. No. 6, p. 18. spective. No. 6, p. 4. VD: More Bugs, More Problems. No. 6, p. 18. Coleman, Eli. Sexual Compulsion vs. Sexual Addiction: The Debate Weirded Out and Blown Away. No. 5, p. 23. Continues. No. 6, p. 7. What Sex Am 1. No. 2, p. 13. Edwards, Sharon R. A Sex Addict Speaks. No. 6, p. 1. Where Did I Come From? No. 5, p. 23. Edwards, Sharon R. A Silver Lining in an Ominous Cloud. No. 3, p. 6. Young Fathers/Teenage Love. No. 6, p. 19.

12 SIECUS Report, July 1986 Bibliographies Safe Sex in the Age of AIDS. Institute for the Advanced Study of Human Sexuality. No. 6, p. 23. Acquired immune Deficiency Syndrome: An AnnotatedBibliography Safestud: The Safe Sex Chronicles of Max Enander. Max Enander. No. 6, of Print and Audio-Visual Materials for Sale. Leigh Hallingby, - p. 20. camp. No. 3, p. 13. Sex Roles and Psychopathology. Cathy Spatz Widom, ed. No. 2, p. 20. Sexuality and Disability: A Bibliography of Resources Available for Sex Therapy: A Practical Guide. Keith Lawton. No. 3, p. 19. Purchase. Leigh Hallingby and Marianne Clasel, camps. No. 4, Sexuality and Handicap: Problems of Motor Handicapped People. p. 15. B.H.H. Dechesne, C. Pons, and A.M.C.M. Schellen, eds. Sexuality and Family Life Education: An Annotated Bibliography of No. 4, p. 23. Curricula for Sale. Leigh Hallingby, camp. No. 1, p. 9. Sexuality and Its Discontents: Meaning, Myths and Modern Sexuality. Jeffrey Weeks, No. 6, p. 22. The Silent Wound. Peggy Boyd. No. 3, p. 23. Solutions. Leslie Cameron-Bandler. No. 6, p. 21. Test-Tube Women: What Future for Motherhood! Rita Arditti, Books Reviewed - Titles Renate Duelli Klein, and Shelley Minden, eds. No. 1, p. 15. Treatment interventions in Human Sexuality. C. C. Nadelson Abortion: Moral and Legal Perspectives. Jay L. Garfield and and D. B. Marcotte, eds. No. 1, p. 17. Patricia Hennessey, eds. No. 2, p. 21. Western Sexuality: Practice and Precept in Past and Present AIDS in the American Mind. Dennis AJtman. No. 3, p. 19. Times. Philippe Aries and Andre Bejin. No. 2, p. 24. Are You Still My Mother! Are You Sti// My Family? Gloria Cuss Back. No. 1, p. 19. Anxious Pleasures: The Sexual Lives of an Amazonian People. No. 5, p. 21. Behavioral intervention in the Sexual Problems of Mentally Handi- Books Reviewed - Authors capped individuals in Residential and Home Settings. Lynda K. Mitchell. No. 4, p. 23. Abel, Ernest L. Psychoactive Drugs. No. 3, p. 20. Bisexual and Homosexual Identities: Critical Theoretical Issues. John P. Andrews, Lori B. New Conceptions: A Consumer’s Guide to DeCecco and Michael C. Shively, eds. No. 1, p. 16. the Newest Fertility Treatments. No. 1, p. 15. Child Sexual Abuse: New Theory and Research. David Finkelhor. Altman, Dennis. A/DS in the American Mind. No. 3, p. 19. No. 2, p. 17. Arditti, Rita; Klein, RenateDuelli; andMinden,Shelley, eds. Test-Tube Connections Between Sex and Aggression. Dolf Zillman. No. 1, p. 18. Women: What Future for Motherhood? No. 1, p. 15. The Eternal Garden: Seasons of Our Sexuality. Sally Wendkos Olds. Aries, Philippe and Bejin, Andre, eds. Western Sexuality: Practice and No. 2, p. 16. Precept in Past and Present Times. No. 2, p. 24. 45-AndSingle Again. Mildred Hope Witkin, with Burton Lehrenbaum. Back, Gloria Guss. Are You Still My Mother! Are You Still My Family! No. 5, p. 20. No. 1, p. 19. GirlTalk: A// the Stuff Your Sister Never Told You. Carol Weston. No. 5, Baylesi Michael. Reproductive Ethics. No. 1, p. 15. p. 21. Benedict, Helen. Recovery: How to Survive . and Social Work. Robert Schoenberg and Richard S. No. 1, p. 16. Goldberg. No. 1, p. 19. Boyd, Peggy. The Silent Wound. No. 3, p. 23. Hot Living: Erotic Stories About Safer Sex. John Preston, ed. No. 6, Brandt, Allan M. No Magic Bullet: A Social History of Venereal p. 20. Disease in the United States Since 7880. No. 2, p. 19. How to Make Love to the Same Person for the Rest of Your Life (and Cameron-Bandler, Leslie. Solutions. No. 6, p. 21. Still Love /t!). Dagmar O’Connor. No. 3, p. 21. Corea, Gena. The Mother Machine: Reproductive Technologies from Human Sexuality Across the Life Span: implications for Nursing Artificial to Artificial Wombs. NO. 5, p. 19. Practice. Loretta P. Higgins and Joellen W. Hawkins. No. 2, p. 22. DeCecco, John P. and Shively, Michael G., eds. Bisexual and incurably Romantic. Bernard Stehle. No. 1, p. 21. Homosexua/ Identities: Critical Theoretical Issues. No. 1, innocent Ecstasy: How Christianity Gave America an Ethic p. 16. of Sexual Pleasure. Peter Cardella. No. 3, p. 21. Dechesne, B.H.H., Pans, C., and Schellen, A.M.C.M., eds. Sexuality I Wish My Parents Understood: A Report on the Teenage and Handicap: Problems of Motor Handicapped People. No. 4, Female. Lesley J. Nonkin. No. 5, p. 21. p. 23. Lesbian Sex. JoAnn Loulan. No. 2, p. 19. Dittes, James E. The Ma/e Predicament. No. 2, p. 15. Lesbian and Gay Issues: A Resource Manual for Social Workers. Hilda Enander, Max. Safestud: The Safesex Chronic/es of Max Enander. No. 6, Hidalgo, Travis L. Peterson, and Natalie Jane Woodman, eds. No. 2, p. 20. p. 23. Finkelhor, David. Child Sexual Abuse. No. 2, p. 17. Lifting the Curse of Menstruation: A Feminist Appraisal of Fromer, Margot Joan. : What Is It, Why It Happens, the influence on Women’s Lives. Sharon Golub, ed. No. How You Can Deal With It. No. 2, P. 23. 1, p. 18. Cardella, Peter, innocent Ecstasy: How ‘Christianity Gave America an Making Babies: The New Science and Ethics of Conception. Peter Ethic of Sexual Pleasure. No. 3, p. 21. Singer and Deane Wells. No. 1, p. 15. Garfield, Jay L. and Hennessey, Patricia. Abortion: Moral and Legal The Male Predicament. James E. Dittes. No. 2, p. 15. Perspectives. No. 2, p. 21. Menopause: What It Is, Why It Happens, How You Can Deal Golub, Sharon, ed. Lifting the Curse of Menstruation: A Feminist With It. Margot Joan Fromer. No. 2, p. 23. Appraisal of the /nf/uence of Menstruation on Women’s Lives. The Mother Machine: Reproductive Technologies from Artificial No. 1, p. 18. insemination to Artificial Wombs. Gena Corea. No. 5, p. 19. Gregor, Thomas. Anxious Pleasures: The Sexual Lives of an New Conceptions: A Consumer’s Guide to the Newest Fertility Treat- Amazonian People. No. 5, p. 21. ment. Lori B. Andrews. No. 1, p. 15. Higgins, Loretta and Hawkins, Joellen W. Human Sexuality No Magic Bullet: A Social Historv of Venereal Disease in the United Across the Lifespan: Implications for Nursing Practice. States Since 7880. Allan M. Brandt. No. 2, p. 19. No. 2, p. 22. Parents Talk Love: The Catholic Family Handbook About Sexuality. Hildago, Hilda; Peterson, Travis L.; and Woodman, Natalie Susan K. Sullivan and Matthew A. Kawiak. No. 2, p. 15. Jane. Lesbian and Gay Issues: A Resource Manual for Pleasure and Danger: Exploring Female Sexuality. Carol Vance, ed. Social Workers. No. 2, p. 23. No. 1, p. 20. Howells, Keith, ed. The of . No. 2, p. 18. Psychoactive Drugs and Sex. Ernest L. Abel. No. 3, p. 20. Institute for the Advanced Study of Human Sexuality. Safe Sex in the The Psychology of Sexual Diversity. Kevin Howells. No. 2, p. 18. Age of AIDS. No. 6, p. 23. Recovery: How to Survive Sexual Assault. Helen Benedict. Lawton, Keith, Sex Therapy: A Practical Guide. No. 3, p. 19. No. 1, p. 16. Loulan, JoAnn. Lesbian Sex. No. 2, p. 19. Reproductive fthics. Michael Bayles. No. 1, p. 15. McGill, Michael E. The McGill Report on Ma/e Intimacy. No. 2, p. 18.

SIECUS Report, July 1986 13 Mitchell, Lynda. Behavioral intervention in the Sexual Problems of Mentally Handicapped Individuals in Residential and Home Settings, No. 4, p. 23. Nadelson, C.C. and Marcotte, D.B. eds. Treatment interventions in THIS StJMMER AMERICANS WANT Human Sexuality. No. 1, p. 17. A SAFE VACATION Nonkin, Lesley 1. I Wish My Parents Understood: A Report on the Teenage Female. No. 5, p. 21. Olds, Sally Wendkos. The [ternal Garden: Seasons of Our If you are planning a summer vacation, you might decide Sexuality. No. 2, p. 16. to write your will before you travel. Preston, John. Hot Living: Erotic Stories About Safe Sex. No. 6, p. 20. Schoenberg, Robert and Goldberg, Richard S. Homosexuality We hope you will remember to include SlECUS in your and Social Work. No. 1, p. 19. will and estate plans, so that, no matter where your trav- Singer, Peter and Wells, Deane. Making Babies: The New els take you, the issues you care about will continue to Science and fthics of Conception. No. 1, p. 15. Stehle, Bernard. incurably Romantic. No. 1, p. 21. have your support. Sullivan, Susan K. and Kawiak, Matthew A. Parents Talk Love: The For further information, please contact: Catholic family Handbook About Sexuality. No. 2, p. 15. Vance, Carol, ed. Pleasure and Danger: Exploring Female Sexuality. No. 1, p. 20. Raul Companioni Weeks, Jeffrey. Sexuality and Its Discontents: Meaning, Myths and SIECUS Modern Sexuality. No. 6, p. 22. 80 Fifth Avenue Weston, Carol. Girltalk: All the Stuff Your Sister Never Told You. No. 5, p. 21. New York, New York 10011 Widom, Cathy Spatz. Sex Roles and Psychopathology. No. 2, p. 20. Witkin, Mildred Hope with Burton Lehrenbaum. 45-AndSingle Again. HAVE A SAFE AND PLEASURABLE TRIP! No. 5, p. 20. Zillman, Dolf. Connections Between Sex and Aggression. No. 1, p. 18.

DO YOU KNOW THAT.. . I

Resources to Write for . . . School-Based Health Clinics: An Emerging Approach to Improving Adolescent Health and Addressing Teenage Preg- nancy (April 1985) is a 24-page report, authored by Douglas The National Association of State Boards of Education has two Kirby, based on a 1984 conference. An overview of existing programs is given, as well as suggestions for implementation of 1985 publications recommended for supporters of sexuality new programs. Addresses of 17 U.S. school-based clinics are education in the schools. Creating Family life Education Pro- grams in the Public Schools: A Guide for State Education Poli- included. Order from: Center for Population Options, 1012 14th Street, N.W., Suite 1200, Washington, D.C. 20005 for $3.00 cymakers (32 pages, $4.00), by Susan N. Wilson, encourages action on the issue of children’s need for increased education (incl. p/h). Bulk rates available. about sexuality and interpersonal relationships. It includessec- tions on assessing the need for family life education, assuming Especially for You (1983) is comprised of two books: Curricu- state leadership, defining the policy, building support for the lum Guidelines/Teacher’s Manual (II5 pages), and Student policy, listening and responding to the opposition, using the Workbook (85 pages). Judith L. Keller and Diane Fletcher media constructively, and tapping a national support network. authored this program for pre-adolescents (ages g-12), which Creating and implementing Family life Education in New Jer- has been implemented in Virginia. The curriculum addresses sey (92 pages, $lO.OO), written by Lana Muraskin and Paul A. Jar- human reproduction, physical growth and development, emo- gowsky, is a study of the development and implementation of tional development, and parenthood, including pregnancy the state’s family life education mandatethat took effect in 1983. prevention. Sample classroom materials for students and par- Findings of case studies undertaken in six local school districts ents, a bibliography, and audio-visual and visual aids informa- throughout New Jersey are presented. Both publications can be tion are also contained in the teacher’s manual. It is priced at ordered from: NASBE, 701 North Fairfax Street, Suite340,Alex- $17.50 (+$3.00 p/h). The student workbook, which is imagina- andria, VA 22314. Prices include p/h. tively illustrated and organized, is priced at $4.00 (+$.75 p/h); bulk rates are available. Order from: EFY Publications, 1107 Creative Child Press has produced a series of children’s books Colonial Avenue, Norfolk, VA 23507. for sexual abuse prevention education.Therearefour coloring books (1985) written by Robin Lenett and DanaBarthelme: Kids Fathering and Men’s Issues Films (1985), is a 17-page filmo- Have Rights Too!, My Body is My Own!, Sometimes It’s OK to graphy compiled by David Civeans, who plans to update it on a Tell Secrets!, and What You Should Do When.. . . Also available regular basis. In this annotated compilation, 50 films are listed are a coloring book and an activity book, both published in along with names and addresses of their distributors. Single 1984, entitled It’s OK TO Say No! Each book is priced at $1.95 copies are available for $5.00 from: Nurturing Press, 187Caselii and can be ordered from: Playmore and Waldman Publishing Avenue, San Francisco, CA 94114. Bulk rates are available on Corp., 200 Fifth Avenue, New York, NY 10010. request.

14 SIECUS Report, July 1986 I I )DO YOU KNOW THAT 8I 1

National Conference on AIDS in the What Is Abortion? Safety of Abortion, Economics of Abortion, Black Community and Women Who Have Abortions are four fact sheets pub- lished in 1985 by the National Abortion Federation. They con- tain up-to-date accurate information about abortion On July 18, 1986, the National Coalition of Black Lesbians and procedures, public health facts, economic issues, and the Gays are sponsoring a conference that will address the public demographics of women who have abortions. The cost is information and education needs of the black community on $12.5O/lot of 50 (same title) plus $3.00 p/h; bulk rates available. the subject of AIDS. The conference will be held at the Order from: National Abortion Federation, 900 Pennsylvania Washington, DC, Convention Center. For more information Avenue, SE., Washington, DC 20003. contact: Gil Gerald, National Coalition of Black Lesbians and Gays, 930 F Street, NW, Suite 514, Washington, DC 20004; (202) Discovery Dolls are soft sculpture, anatomically accurate dolls 737-5276. similar in style to Cabbage Patch Kids. Standard features include: machine washability and dryability; a name and birth certificate; one complete outfit of clothes including under- Child Sexual Abuse: Offenders, wear; for males, , bras, and sanitary napkins Victims & Survivors for adult females, and Velcro detachable pubic and underarm hair. Because each doll is handmade, many other features can A Nicholas Groth, a national expert in the assessment and be customized, including three choices of flesh color, eye treatment of both juvenile and adult sex offenders, is offering color, clothing, child or adult age, birthmarks, and disabilities. two workshops addressing the issue of sexual offense. One These sturdy, highly appealing dolls are available for $75.00 seminar will consider the dynamics of the offender as well as each (+p/h and tax) from Monique Felder, 167-44 145th theimpactonthevictim,andtheotherwillfocusoncombating Avenue, Springfield Gardens, NY 11434; (718) 712-2057. child sexual abuse. They aredesigned for professionals in men- tal health, criminal justice, crisis centers, social and protective The Educator’s Guide to Preventing Child Sexual Abuse (1986, services and other human services. The workshops will be edited by Mary Nelson and Kay Clark, is a 210-page collection given in August through October around the country. For of 19 original articles by leading professionals in the field of more information contact: Dorothy Molis, 29 Linwood Street, child sexual abuse prevention. Topics include: a history of the Webster, MA 01570; (617) 943-2381 or 943-3581. prevention movement, guidelines for prevention education, and descriptions of successful prevention programs. Many aspects of child sexual abuse are explored, such as: family Resources to Write for . . . relations, community involvement, the school’s role, legal problems, the role of the media and advertising, training par- ents and teachers, children’s developmental stages, cultural considerations, disabled children, and theory and research Frontiers in Fertility (1985) by Betty Rothbart is a 67-page report issues. A comprehensive annotated bibliography is included. on the “Symposium on Human Fertility Regulation: Techno- The price for single copies of this paperbound edition is $19.95 logical Frontiers and Their Implications,” convened by the (+15% p/h); bulk rates are available. Order from: Network Planned Parenthood Federation of America in December 1984. Publications, 1700 Mission St., P.O. Box 1830, Santa Cruz, CA This book explores the medical, legal, and ethical issues arising 95061-1830. from new reproductive technologies. Topics covered include: alternatives in conception, gender selection, fetal diagnosis and fetal therapy, maternal substance abuse, forced Cesarean Position Opening section, late abortion, and treatment of the seriously ill neo- nate. Order publication No. 1676 from: Marketing Depart- The Department of Psychiatry and Human Behavior at Jefferson Medical College announces a position for a Psychia- ment, PPFA, 810 Seventh Avenue, New York, NY 10019. Price: trist as Director of Program in Human Sexuality. $8.95 (+$I.50 p/h). The Program in Human Sexuality is a Clinical Service with a research component focusing on the evaluation and treat- Straight Talk-Sexuality Education for Parents and Kids 4-7 ment of sexual dysfunctions and infertility problems. It also (1985), by Marilyn Ratner and Susan Chamlin, is a 48-page has an active educational program encompassing all levels, in- booklet designed to facilitate communication within the fam- cluding undergraduate medical students, psychiatric residents, ily. It contains sexuality questions and issues raised by parents, and psychology interns. The position carries administrative, academic, and clinical responsibilities. in groups and workshops, about their children’s sexuality. An 8-page pullout section of activities and projects for 4-7 year For more information please contact: olds and their parents is also included. This resource is available Karl Doghramji, M.D. (215) 928-8285 for $4.95 (+$.80 p/h) from: Education Department, Planned Arlene Goldman,K.A. (215) 928-8420 Parenthood of Westchester, 88 East Post Road, White Plains, NY 10601.

SIECUS Report, july 1986 15 Resources to Write for . . .

The Dynamics of Relationships (1985) by Patricia Kramer is a The Book (1986) by Philip A. Belcastro is a 132- family life education textbook and curriculum for students and page book that describes I3 methods of birth control in lay- teachers. The teacher’s manual contains the complete stu- men’s terms and cites advantages and disadvantages for each dent’s text material, plus additional teacher guidelines, activi- method. There is also a section on future methods of birth ties and recommended print and audio-visual resources. control, some of which are now beingtested for FDA approval. Students using this text need to be at a high reading level. To order send $8.75 per copy to: Jones and Bartlett Publishers, Piloting of this course began in Washington, D.C. high schools Inc., 20 Park Plaza, Boston, MA 02116; (617) 426-5246. for one year in the fall of 1985. Prices of the manuals are: Teacher’s Manual (433 pp.), $23.95; Student’s Manual Part I, The Third Sex: The New Professional Woman (1986) is a 282- $10.95; Student’s Manual Part II $4.95 (with Part I, $14.95). page book by Patricia A. McBroom that focuses on changing Include 10% for p/h. Discounts are available on bulk orders. gender roles. It is based upon the testimony of 44 professional Contact: Equal Partners, 11348 Connecticut Avenue, Kensing- women in finance in New York and San Francisco and offers a ton, MD 20895, (301) 933-1489. view of the personalities and lifestyles of these women. This book is available for $16.95 from: William Morrow & Co., 105 Madison Ave., New York, NY 10016. The Youthful Sex Offender: The Rationale and Goals of Early Intervention and Treatment (1985), by Fay Honey Knopp, is a 31-page booklet that includes: guidelines for assessment of It’s Up to You: Self-Help for Men with Erection Problems (1985) behavior and risk, methods of treatment, and recommenda- by Warwick Williams is a 165-page, self-help book that gives tions for state planning. It is directed primarily at decision detailed guidance and advice and step-by-step exercises to makers. To order send $5.00 per copy to: Safer Society Press, help restore men’s potency. It also covers a variety of treatment 3049 East Genesee Street, Syracuse, NY 13224. Bulk rates are methods, and contains a glossary of technical terms and an available. index. This book is available for $15.00 from: Williams and Wilkins, 428 E. Preston St., Baltimore, MD 21202.

The National Family life Education Network has four new Alternate lifestyles: A Guide to Research Collections on Inten- pamphlets: Tell Someone! What to do if someone touches you tional Communities, Nudism, and Sexual Freedom (1985) by and you don’t like it (grades 5-6); Adult’s Guide to Tell Some- Jefferson P. Selth is a 133-page bibliography that describes in one!; Talking With Your Young Child About Sex; and Talking detail 36 special collections in the U.S. that are rich in published With Your Son About Birth Control. Tell Someone! is priced at and unpublished research materials in the fields of intentional $.50 for l-24 copies; each of the others is $.25 for l-24 copies communities (communes), nudism, and sexual behavior, espe- (+15% p/h); bulk rates are available on request. Order from: cially sexual freedom. This book is available for $29.95 from: National Family Life Education Network, ETR Associates, 1700 Greenwood Press, 88 Post Road West, Box 5007, Westport, CT Mission Street, Dept. P., P.O. Box 8506, Santa Cruz, CA 95061- 06881; (203) 226-3571. 8506. The Redundant Male: Is Sex Irrelevant in the Modern World? (1984) by Jeremy Cherfas and John Gribbin is al96-page book Control of Sexually Transmitted Diseases (110 pages; $7.00) is a that explains the biology of sex and sexuality and challenges 1985 publication produced by the World Health Organization patriarchal beliefs about the dominance of the male. This book that emphasizes that control programs must be based on a highlights new areas of technological ability and suggests that multidisciplinary approach involving coordinated action by the technology for asexual reproduction is not far off. Jt is health personnel at all levels and by the health education, available for $7.95 (paperback) from Random House, New information, and welfare services. Attention is given to initial York, NY. planning steps, intervention strategies, support components, and various aspects of program implementation. Erotic Power: An Exploration of Dominance and Submission (1985) by Gini Graham Scott is a 250-page book that describes and of Young People (170 the growing dominance and submission (D&S) movement. pages; $9.50), and Sex and Family Planning: How WeTeach the Through interviews and eyewitness accounts, the author offers Young (42 pages; $2.50) are two 1984 publications of the World an overview of D&S, which includes both sadomasochism Health Organization based upon a study on family planning (S&M) and bondage and discipline (B&D). This book is avail- and sex education of young people, with an emphasis on able in paperback for $9.95 from: Citadel Press, 120 Enterprise identifying the various strategies used in different countries for Ave., Secaucus, NJ 07094; (212) 736-1141 or (201) 866-0490. providing such services. Single and bulk copies are obtainable in the U.S. by sending the above amounts per copy plus $1.25 Handbook of Feminist Therapy (1985) edited by Lynne Bravo for the first publication and $.I5 for each additional publication Rosewater and Lenore E. A. Walker is a 352-page anthology that to cover postage and handling to: WHO Publications Center covers psychotherapy, assertiveness training, heterosexual and USA, 49 Sheridan Ave., Albany, NY 12210; (518) 436-9686. Pay- homosexual relationships, sex therapy, and pornography, as ment may be made with American Express, Visa, and well as other therapeutic issues. This clothbound book is avail- Mastercard. able for $34.95 from Springer Publishing Co., New York, NY.

16 SIECUS Report, July 1986 I 1 1AUDIO-VISUAL REVIEWS

Members of the Audio-Visual Review AIDS patient, who is a former drug broaching thesu bject of safer sex before Panel for this issue were: Rita Cotter/y, abuser, and his wife. becoming sexually involved is handled graduate assistant, SIECUS Information On the plus side, this film gives much with a sense of humor and the dialogue Service and Mary 5. Calderone Library, good informtion and dispels several that ensues is a good example for com- and doctoral candidate, Human Sexual- myths about AIDS. On the minus side, it munication on this topic. An erotic bath ity Program, New York University; Mari- has a scarey, alarmist quality, promul- together precedes their love-making anne Glasel, RN, MS, education co- gated largely by the type of background scene. ordinator for Cancer Prevention and music selected and the heavy use of the The second segment is an anonymous Sexual Health Care, Memorial-Sloan color red in the graphics. Sometimes the sexual encounter between two leather- Kettering Cancer Center, and student, visuals do not match the commentary clad men in an S & M bar. Beingshown in Human Sexuality Program, New York well, such as a close-up of the pelvic area the bar is another GMHC-produced University; Leigh Haflingby, MSW, MS, of a person wearing jeans shown video called “Grey Hideaway” in which Manager, S/ECUS Information Service during a reference to the lining of the a group of men are engaging in safer sex, and Mary S. Calderone Library; William sex organs. The narrator states that chil- including with a . The Li, intern, Department of Education, dren of high risk group members are two men rough house and use some Planned Parenthood Federation of also at risk, without specifying that this S & M devices, taking time out to wash America; Maria Matthews health educa- means children born to or breastfeed- their genitals and roll on a condom be- tor, Planned Parenthood of Bergen ing from women who already have fore having anal intercourse. County, Hackensack, NJ; Alex Sareyan, AIDS. It was clear only from the study In the third and very moving vignette, president, Mental Health Materials Cen- guide and not from the film that the two men who seem to be involved in a ter; Linda Schwarz, Department of Edu- persons with AIDS and the woman being long-term relationship make love out- cation, Planned Parenthood Federation interviewed with him were husband and doors by the swimming pool in their of America; and George Marsha// Wor- wife rather than patient and health backyard. One is a tanned jogger and thington, international health and professional. the other, who is rather pale, is obviously development consultant, New York, NY. Some members of the panel felt the a person with AIDS, indicated by refer- The reviews were written by Leigh Hal- negatives outweighed the positives and ences to his beginningto get hisstrength lingby. would therefore not recommend this back after being in the hospital for pneu- film for use without any audience. Oth- monia. Their love-making is playful and ers felt that it gave enough good infor- in part they act out a fantasy of a marshall mation that they would use it with giving orders to a cowboy. The scene AIDS: What Everyone Needs to Know. audiences from early teens up. ET, LT, A ends poignantly with one singing to the 1986,16 mm or video, 18 min. Purchase, other the verse from the old cowboy $350 (16 mm), $250 (video); rental, $40. song that says, “I will miss your bright Churchill Films, 662 North Robertson eyes and sweet smile.” Boulevard, Los Angeles, CA 90069; (800) One could quarrel with small points in 334-1830. Chance of a lifetime. 1986, video, 43 Chance of a Lifetime such as not includ- min. Available for purchase for $50 to ing some older actors and not showing This film surveys the facts and debunks professionals doing AIDS prevention how to remove a condom. However, the the myths about AIDS. Through the use education. AIDS Prevention Program, choice of situations is excellent, as are of animation the film explains how the Gay Men’s Health Crisis, Box 274, 132 the acting and the production values, immune system works and how the West 24th Street, New York, NY 10011; and the video is highly recommended AIDS virus destroys the system’s ability (212) 807-7517. for the intended audience. Some panel to fight off diseases. Symptoms and members also felt that, if it were to be- related diseases are presented. AIDS: This superb video is designed to be part come more widely available, it would be What Everyone Needs to Know also des- of safer sex workshops for gay and bisex- an excellent film to use in Sexual Attitude cribes how the virus is and is not trans- ual men. It begins with a brief written Reassessment workshops for mitted, why casual contact with AIDS statement of guidelines for safer sex and regarding gay male relationships and patients is not dangerous, who is at high- then consists of three vignettes. The first lovemaking. Chance of a Lifetime suc- est risk, and how to protect oneself from involves two men, one black and one ceeds mightily not just in educating the virus. Woven through the factual white, on their fourth date, making love about safer sex, but also in eroticizing material are clips of an interview with an for the first time. The anxiety regarding it. A.

Audience Level Indicators: C-Children (elementary grades), ET-Early teens (junior high), LT-Late teens (senior high), A-College, general adult public, P-Parents, PR-Professionals.

SIECUS Report, July 1986 17 Taking a Sexual History. 1986, video, 18 VD: More Bugs, More Problems. 1985, Terrific Sex. 1985, video, 60 min. Avail- min. Purchase, $250. Sunrose Associates, 16 mm or video, 20 min. Purchase $440 able for sale and rental in home video 18 Cogswell Avenue, Cambridge, MA (16 mm), $390 (video); rental, $44. Alfred stores. 02140; (617) 575-3863. Higgins Productions, 9100 Sunset Boule- vard, Los Angeles, CA 90069; (213) 272- This video, oriented toward the home 6500. market, begins with an upbeat introduc- Taking a Sexual History by Marian Clas- tion in which Dr. Ruth Westheimer says gow, adjunct assistant professor, Boston This update of an earlier film entitled that terrific sex comes from a good rela- University School of Medicine, is a “YD: Old Bugs, New Problems” covers tionship, depends on openness, and videotaped lecture that addresses a gonorrhea, syphilis, herpes, chlamydia, should be fun. She then goes on to give group of health professionals. This AIDS, candidiasis, crabs, scabies, warts, 18 commandments for terrific sex rang- resource presents a good, broad defini- and trichomoniasis. Much of the infor- ing from “Don’t make love on your first tion of sexuality and a rationale for ask- mation is conveyed by people talking on date” to “Don’t fake orgasm” to “Stay ing questions regarding sexuality during the telephone in a simulated STD hotline within the guidelines of your personal health care evaluations. The highlight of situation, and what they are saying is beliefs.” Some commandments involve thevideo is the presentation oftheGlas- clearly oriented toward young people. Dr. Ruth giving her thoughts on such gow Short Form Assessment of Sexual Unfortunately, the panel found this to topics as masturbation, , posi- Health, with accompanying instruction be a lackluster film plagued by poor act- tions for intercourse, orgasm, afterplay, on how to integrate the most essential ing and a thrown-together quality. It and fantasy. Two involve her conducting questions about sexual functioning into does not mention oral or as a simulated therapy sessions-one with a a review of systems. Also included is a cause of STDs and covers neither proper woman who cannot have orgasm with a question and answer session with the condom usage nor talking to one’s partner and one with a man who is a audience about the barriers to discuss- partner about having an STD. For these rapid ejaculator. ing sexuality in a health care setting. reasons a few panel members said that With minor exceptions, Dr. Ruth does The Glasgow Short Form (printed in its they would not recommend it for any an excellent jobof coveringthe basicsof entirety in the accompanying study audience. Others said they would use it giving and receiving sexual pleasure in a guide) is brief, consisting of two ques- for adolescents in conjunction with con- holistic, permission-giving, and helpful tions each for males and females, three siderable supplementary discussion from way from which the vast majority of for both sexes, and six to clarify prob- a facilitator. ET, LT heterosexuals (her target audience in lems. Examples of the questions are: Do this video) could clearly benefit. Many you have any problems having or main- people might prefer to watch Terrific taining an erection? Do you have any Sex in segments rather than all at once, pain during vaginal penetration? How although the producers have done a has your present illness affected your Choices: good job of varying a basic “talking sexual functioning? The panel’s major In Sexuality with heads” format by having Dr. Ruth give concern with the form is that although some of her commandments while jog- Ms. Glasgow defined sexuality broadly Physical Disability ging, gardening, riding a bicycle, swing- in terms of who we are as men and ing on a swing, driving a sports car, and (16 mm & Video/Color/60 Mins.) women, her questions focus totally on walking in the rain. Because the video Produced for: genital sexual functioning. She com- does not seem to lend itself particularly Institute of Rehabilitation Medicine pletely omits the potential effects of New York University Medical Center well to repeated viewing, rental is hospitalization/illness/treatment on Joan L. Bardach Ph.D., Project Director recommended for consumers, although sex role and . Questions Frank Padrone Ph.D., CeDirector professionals may wish to purchase it. A such as: “How has your mastectomy affected your feelings about yourself as a Choices is a film which can be used ne and time again in rehabilitation woman?” or “How does your not being ADS Alert. 1985, video, 23 min. Pur- cilities human sexuality programs and able to work now make you feel about chase, $149.95. Health Alert Division, any group where issues of sexual in- yourself as a man/woman?” are not raction and adjustment-to a disability Creative Media Group, 123 Fourth asked. e being discussed. If both parts cannot Street, N.W., Charlottesville, VA 22901; Ms. Glasgow is a warm, appealing 3 purchased, Part 1 is a tremendously (804) 296-6138. presenter, and despite the lecture for- ,od discussion starter and should not mat, the video holds interest and atten- s missed. This video begins with a nine-minute tion. It does not have a heterosexist bias. urn Boyle, Coordinator: introduction by Dr. Richard Keeling, Id Disabilities Program of the Margaret Taking a Sexual History is definitely chairperson of a national AIDS task lnger Center of Planned Parenthood. NYC. recommended for professional audien- force, in which he explains why “we all ces but cannot and should not stand on need to know about AIDS.” Following its own. It needs to be part of a session the introduction, which seems to be covering both how to raise questions oriented toward adult adiences, is an about other non-physiological aspects animated section which is actually a of sexuality and also how to handle ‘ercury Productions filmstrip or videotape. In it Dr. Good- information from patients regarding 7 West 45 Street, NYC 10036 health, a Gumby-like character, answers sexual concerns and problems once it 12) 869-4073 questions from an audience of cartoon has been elicited. PR characters based on the male and female

18 SIECUS Report, July 1986 sex symbols. He describes what AIDS is, proper names for the genital parts of the his own tale of arrest and conviction how it is caused and transmitted, what body. Examples used for illustration (subsequently overturned) for perform- the symptoms are, and how people can include vignettes of everyday situations ing an abortion. This film is highly reduce the risk of getting AIDS. Dr. involving wife and husband, parent and recommended for all audiences from Keeling concludes the video with a brief child, grandparent and grandchildren, early teens up. ET, LT, A, P, PR statement that puts responsibility for doctor and patient, and employer and avoiding transmission of AIDS in the employee. Particularly helpful are the hands of the individual. instances in which a miscommunication Young Fathers/Teenage Love. 1984, 12 The panel liked AlDS Alert for the is followed by successful communica- min., video. Purchase, $245; rental, $30. most part, feeling that it is informative tion by the same people on the same Educational Cable Consortium, 24 without being alarmist. The cartoon topic. Beechwood Road, Summit, NJ 07901; characters are, in fact, specifically Dr. Potter does not hesitate to point (201) 277-2870, or New Dimension Films, designed by their creator, Charles Chic out that there is always a risk of rejection 85895 Lorane Highway, Eugene, OR Thompson, to be anxiety-reducing, and involved in reaching out to communi- 94705; (503) 484-7125. they seem successful in that regard. cate with someone. Yet no viewer could Also, the use of video format for the walk away from this film without realiz- This short film, taken from an NBC animated filmstrip is a relatively inex- ing that the ability to communicate is documentary, looks at the lives of two pensive way to keep down the price of empowering and enriching and well teenage boys who became fathers. A the finished product. On the negative worth the effort. C, ET, LT, A, P, PR young white man from Salt Lake City, side, however, the format is not particu- Utah, lives with his fiance, baby, and larly interesting or engaging and some very supportive parents. He goes to audiences may be bored by it. Other Personal Decisions. 1986, 16 mm or school, works from 8 p.m. to 4 a.m., and criticisms from panel members included video, 30 min. Purchase, $395 (16 mm), is exhausted. A young black man from disliking a reference to the HTLV-III $295 (video); rental, $50. Cinema Guild, Philadelphia is no longer involved with antibody test as a diagnostic tool for 1697 Broadway, New York, NY 10019; his child’s mother, but isvery attached to AIDS and finding the narrator to be (212) 246-5522. the baby. He had dropped out of school, condescending. but has returned, because the baby has AlDS Alert is recommended for In this fine film, produced for the given his life a sense of purpose. audiences from early teens through Planned Parenthood Federation of The panel found some important adults, with the suggestion that educa- America, seven real-life stories are pluses in this brief documentary. It pre- tors omit the doctor’s introduction. ET, woven around the central thesis that the sents a positive image of teenage boys LT, A decision to have an abortion is a strictly (something many audio-visuals do not personal one. The participants include: do), showing them making sacrifices for Communicating, with Dr. Jessie Potter. a waitress who, after a brutal in the their babies, with whom they are 1986, 16 mm or video, 28 min. Purchase, 1950’s, suffered the indignities and medi- actively involved. It is a good length for $475 (16mm), $430 (video); rental, $75.00. cal complications of an illegal abortion; educators working with groups of ado- Sterling Productions, 1609 Sherman, a 16-year-old high school student not lescents or parents, because it allows Suite 201,. Evanston, IL 60201; (312) ready for motherhood; a couple who plenty of time for discussion, of which it 475-4445. were looking forward to the birth of should generate plenty. One minus is their second child until they discovered that, although abortion is mentioned as After the Audio-Visual Review Panel saw through amniocentesis that the fetus an alternative, contraception is not dis- Dr. Potter’s previous film, “The Touch was seriously deformed; an obstetrician cussed; so this subject should be raised Film . . . ,” one member summed up our who found herself pregnant as a result of during the discussion period. ET, LT, P reaction when she said, “Every person contraceptive failure in her first year of on earth should be required to see this medical school; an abused wife and film.” Our recommendation regarding mother of three who discovered during “Communicating. . .” is the same. Once the course of separating from her hus- Memo to New Readers again Dr. Potter-in her wise, warm, and band that she was pregnant again, and a witty way-has managed to take a uni- Catholic college student who had to go The S/ECUS Report is published bi- versal issue and make it into a beautiful from door to door in her neighborhood monthly and distributed to SIECUS film filled with sound advice and won- to borrow money for the abortion. members. If you are not already a derful examples to which everyone can The women in Personal Decisions member and you wish to have con- relate. represent an excellent mix of age, eth- tinued access, through the SiECUS Some of Dr. Potter’s many points are: nicity, socio-economic status, religion, Report and other organizational pub- we should identify feelings and talk about and reasons for choosing abortion. Their lications and services, to authoritative, them; hurt feelings and misunderstand- powerful stories, filled with poignancy up-to-date information about all ings result when there is no communica- and pain, are as eloquent testimony as aspects of the human sexuality field, tion; communication can save relation- there could be in support of abortion as please send us your name and address, ships; others cannot know what is on a personal decision. Also appearing in along with the appropriate fee as our minds unless we articulate it; the film to discuss the abortion issue in a shown in the masthead box on page2 blocked communication is a major fac- very sensitive manner is Dr. Kenneth of this issue. Be sure to indicate the tor in adolescent suicide; and weshould Edelin, director of OB-GYN at Boston category of membership desired. communicate about sexuality using City Hospital, who does not however tell

SIECUS Report, luly 1986 19 I 1 /BOOK REVIEWS

Safestud: The Safesex Chronicles of Max his job, or his apartment, or his social Hot Living, a collection of short stories Enander by Max Enander (127 pp., $6.95) life, which is practically nil. Max’s social concerning safe sex, offers a number of and Hot living: Erotic Stories About life, indeed his entire life, is focused on different perspectives on sex in the age Safer Sex edited by John Preston (191 having sex, judging from Safestud, of AIDS, without coming up with a fresh pp., $7.95). Boston: Alyson Publications, which, to be fair, is his “sexual” diary. point of view. Here, as in Safestud, the 1985. Throughout the book, he has countless action focuses on hot, anonymous sexual encounters with all kinds of encounters among exclusively Anglo- Reviewed by Michael C. Quad/and, nameless men, most of whom have mas- American men with large genitals. PhD, psychologist in private pratice and sively erect penises and washboard Among the seventeen stories included sex education consultant, New York stomachs. Indeed, two idealized, over- in the volume, many deal with the ways State AIDS institute on AIDS preven- worked bodies adorn the cover of Safe- in which gay men have had to change tion; and john Weir, writer, and leader, stud; hipless, bare-chested, broad shoul- their lives as well as their sexual habits in Gay Men’s Health Crisis Writer’s Group. dered fantasies, with creamy white skin order to deal with AIDS, but none seem Safe sex practices have begun to make and perfectly formed buttocks. Safestud up to the challenge of reimagining gay some headway into gay male pornog- delivers what its cover promises: hot fan- sexuality. raphy. What is new, or different, about tasies and horny males, all of it exagger- The tone of Hot Living is mournful. safe sex porno? Most importantly, of atedly “good,” but also safe in terms of The volume opens with a story concern- course, the sexual acts must be limited to AIDS prevention. ing a man who has lost the use of his what is generally considered safe: non- This could easily be pre-AIDS mate- lower body in an automobile accident. exchange of bodily fluids, especially rial, with the condom as the only unfa- An old friend comes by and helps him to (with some disagreement among miliar presence, except that Max doei have an orgasm, which he cannot health care professionals about saliva); not seem happy, not exactly. When he is exactly feel; it is a “phantom feeling” anal and oral sex can be practiced safely not completely absorbed in pursuing only, a remembered sensation. This only with condoms. The problem of how and recording his sexual adventures, he story is called “The Broken Vessel,” to continue to have satisfying sex that is pauses to deliver long asides on the which expresses clearly enough the feel- reasonably safe is central to two new emotional perils of his sexual lifestyle. ing among gay men that AIDS has liter- books from Alyson Publications, Max His life lacks passion, he concludes, and ally disabled them sexually. Certainly Enander’s Safestud: The Safesex Chroni- it lacks a relationship. Max has been in this is an important issue within the gay cles of Max Enander, and Hot Living; love only once, as a teenager; his lover community, but it hardly seems right as Erotic Stories About Safer Sex, edited by dumped him, and he will not be hurt the opening stroke for a book that John Preston. again. Sex is his substitute for love, he means to eroticize safe sex. Post-AIDS sex, with some imagina- says; he even figures out that his sexual About half the stories in the collection tion, can still be exciting, Max Enander encounters, taken collectively, consti- strike this note, however: “I was in the concludes, in Safestud. Max describes tute an extended, IO year-long relation- prime of life, had worked hard to get himself exclusively in terms of his sexual ship. Towards the end of his chronicles there, and was shadowed by a perilous appetite and large genitals. He con- he does develop a couple of long-term age that haunted me and others of my stantly reminds the reader, and himself, involvements, one with Paul, a sex- kind,” says a character in Tripp Vander- exactly what is important to him about buddy, and the other with Eddie, a ford’s “The New Cosmic Conscious- sex. He lives in San Francisco, works in a potential life mate. Still, Max continues ness.” The title is misleading, for the bank, and likes a lot of casual, uncom- to have as much sex as he wants with as story does not offer a new consciousness mitted sex. He has two gay roommates many different men as he can find. He at all, not about sex. It focuses on regret, who are sometime lovers; he has one does not always seem to enjoy it, not and a sense of loss, as well as on the friend named Chad, who spends most of because it is safe sex, but because it is protagonist’s passion for a classically the time disappering into the clutches of uncommitted sex; he wants to feel a modeled young stud at the gym. Predic- his Safe Sex Master, Lord Dennis. Max is sense of connectedness with his sexual tably, the stud turns outto have the same comfortably urban-white-middle class: partners. Yet when he is on the verge of large penis and washboard stomach as he does a lot of reading and goes to the making a commitment to Eddie he pulls every other male in the book, whose movies, gets away to Yellowstone Park, back, again. While Max’s sexual exploits body parades past the reader’s impres- spends time at the beach, and spends his may be safe, they are proof that safe sex sionable . Safe sex is just like unsafe holidays alone, except when he is having can be just as lonely, and as frequently sex, focused on perfect bodies and large sex. He does not have much tosay about unsatisfying, as unsafe sex. A genitals, in spirit, if not in action.

Audience Level Indicators: C-Children (elementary grades), ET-Early teens (junior high), LT-Late teens (senior high), A-College, general adult public, P-Parents, PR-Professionals.

20 SIECUS Report, July 1986 Hot Living is a lament for a time gone ly testable and applicable by asking Whether or not this is true, . . . when I by, for fifties Boyd MacDonald sex, for readers to test a concept on themselves structure my behavior as if it is true, the nameless, limitless, unrestricted sexual or apply a given technique to situations results provide . . . testimony to its use- encounters. A lot of gay men miss that in their own lives. I, personally, com- fulness (p. 131).” era, according to the voices in Hot Liv- plied for only a minute or so. Yet in one This seems an unfortunate way to deal ing; perhaps this first phase of safe-sex instance I gained a new perspective lead- with the need to realistically limit and porno is a period of mourning, of look- ing to a deliberate behavioral change. In focus therapy. At base it reflects the ing back to the past before fully imagin- another, a new perspective was fol- medical model the author decries, in ing the future. It would be a shame at lowed hours later by an indirectly but which clients’ perceptions are by defini- this point in gay history to get hung up obviously related and desirable change tion “pathological” and therapists’ are on the sexual loss, however, and over- in physiological response to a certain “healthy.” Indeed, it is the same “blame look the opportunity to discover aspects stimulus. One could hardly ask for a bet- the victim” stance rightfully under of sexuality that do not press gay men ter demonstration of NLP’s potential attack by feminists, gays, and other civil exclusively into casual, sexually exploita- power or the effectiveness of Cameron- rights groups. tive relationships with each other. Both Bandler’s presentation. Perhaps this explains the uncharacter- Hot Living and Safestud fail to imagine Solutions is not, however, flawless. For istic times in sample interviews when her safe sex that is particularly innovative, one thing, it is aimed at both prof- use of NLP techniques seems to contra- creative, or different from unsafe sex. essional and lay markets, but is essen- dict the respect, accurate empathy, res- The books offer nothing new; just the tially a clinician’s handbook and should traint, flexibility, and parsimony she same group of urban-white men going be labeled as such; for another, many advocates. At such times the author to the gym for an ogle and a grapple in nonverbal communications may be cul- seems to ignore or miss important com- the steam room. A turally defined. In her few references to munications, to make unwarranted culture, it is unclear whether the author assumptions, and to treat patients with- is asking for reader attention to cultural out adequate information. Her thera- Solutions. Leslie Cameron-Bandler. San variations or suggesting that her content peutic decisions may have been correct, Rafael, Calif.: Future Pace, Inc., 1985 (259 is universally applicable. but since she has departed from her pp., $11.95). Two small additions seem needed. usual style of sharing her thinking with The visual aid of a chart for assessing eye readers, one is left with unanswered Reviewed by jean S. Cochros, PhD, movement is stressed as applying to questions. AASECT Certified Sex Educator and right-handed people. Are directions to Some ethical issues in her approach Therapist in private practice; author, be reversed for the left-handed? An must also be raised. In one transcribed What to Say After You Clear Your added statement and chart might have initial interview, she ignores the client’s Throat: A Parent’s Guide to Sex Educa- been useful. Similarly, the author fre- obvious wish for information about NLP tion, The Sexually Oppressed, and Help- quently mentions touching a client’s and simply begins to use such tech- ing the Sexually Oppressed. right or left side, but does not state niques as anchoring through specific It is a rare but immensely satisfying expe- whether the choice of sides is purpose- touch. In marital counseling, having rience to review a book that does for ful. Elaboration would have been anchored a wife’s sexual response to a clinicians exactly what it purports to do. helpful. certain touch, she instructs the husband- Cameron-Bandler promises to explain More hazardous weaknesses are the without the wife’s knowledge-to use the and apply a relatively new therapeutic implications that all intrapsychic and touch to communicate sexual desire. She model, Neuro-Linguistic Programming interpersonal problems are created by treats a student/client covertly, illustrating (NLP), to help people enjoy satisfying clients’ own perceptual distortions and the use of metaphor in a class seminar couple, including sexual, relationships. subsequent dysfunctional behaviors, with a metaphor aimed directly at him. She promises to translate theory into that they are always within the individu- Her success is verified when he tells her assessment and treatment plans; to pro- al’s power to correct, and that NLP later that he does not need therapy after vide step-by-step demonstration of NLP procedures alone are sufficient to help all, since he has suddenly found his own techniques; to show how to know clients reach their goals. The professions solution. whether a given goal has been reached of social work and sociology have pro- Cameron-Bandler argues that any during the interview; and how to help vided ample evidence that such assump- effective technique used for the client’s clients repeat that success after leaving tions are unrealistic. Institutionalized good is ethical. However, clients do have the interview. Finally, she promises to racism and sexism, for example, create the right to know in advance what a given make her concepts understandable and and maintain many problems, often therapy might entail, to be involved in the useful to professional and lay leaders affect marital and sexual relationships, treatment planning, and to have some say alike. and can even thwart individual attempts in what techniques will be used. They In fulfilling these promises, she brings to change dysfunctional behavior. have the right to expect therapists to work new dimensions to marital and sexual Cameron-Bandler dismisses socio-polit- with them in a joint problem-solving counseling and to such concepts as love, ical, economic realities in such state- effort, rather than therapists deciding empathy, and non-verbal communica- ments as: “It is not the world that lacks what is good for them and doing things to tion. She skillfully leads readers through choices, but the individual’s model of them without their knowledge. her therapeutic process, demonstrating the world (p. 224),” and, “A basic pre- Neither Solutions nor NLP (nor any such new techniques as Erickson’sstory- mise of my work is that people have all other theory, author, or book) should be telling and NLP’s anchoring and refram- the resources they need to make the used solely or unquestioningly. Indeed, ing. She makes her concepts immediate- changes they want and need to make.. one would hope that as one of NLP’s origi-

SIECUS Report, July 1986 21 nators, Cameron-Bandler will reexamine tents,” Weeks convincingly argues that and Nancy Chodorow, which renders an some of her tenets and make better use of current discontents, reflected by the mul- account of how gender and sexual identi- the knowledge provided by other profes- tiplicity of interpretations and values ties are constructed within the linguistic sions. Despite these shortcomings, Solu- around sexuality, frame a crisis in latecap- order of the unconscious. In this reading, tions is a concise, useful, and thought- italist societies of the West. The roots of the unconscious is cut away from a deter- provoking book that can be highly this crisis are located in the failure of the ministic biology and “becomes the way in recommended to all clinicians, no matter sexual revolution commencing in the which we acquire the rules of culture what their specialty. PR 1960s to generate gender equality and through the acquisition of language.“The freedom of sexual choice. Four changes second chapter in Part III weaves together which have shaped the current situation ideas from the Lacanian School, the Freu- Sexuality and Its Discontents: Meanings, of crisis are discussed: the commercializa- dian left (Wilhelm Reich and Herbert Myths and Modern Sexualities. Jeffrey tion of sex, shifting and increasingly prob- Marcuse), and post-structuralists (Gilles Weeks. London: Routledge& Kegan Paul, lematic relations between the sexes, the Deleuze, Felix Guattari, and Foucault) to 1985 (324 pp.; $25.00 hardcover, $13.95 (uneven) liberalization of laws regulating provide an outline for an analysis which paperback). sex, and the appearance of intensified would connect a theory of unconscious social antagonisms around sexual issues. desire with a theory of societal develop- Reviewed by Carol A. Polk, Ph.D., Asso- Particular attention is paid to the resur- ment grounded in history. This discussion ciate Professor of Sociology, Social gence, during the 197Os, of an absolutist constitutes a very useful overview and Change and Development Program, Uni- politics based on the moralism of theNew critical evaluation of some difficult and versity of Wisconsin-Green Bay, Green Right. challenging ideas, derived largely from Bay, Wisconsin. Part II, “The Sexual Tradition,” exam- continental theorists, which may be rela- The British social historian Jeffrey Weeks ines the role which scientific sexology has tively unknown to most American sex has written extensively on the theory, his- played in constructing the myths, mean- researchers and practitioners. tory, and politics of sexuality. This new ings, and crisis of modern sexualities. The final section, Part IV, deals with book, coupled with is earlier ComingOut Weeks draws heavily on the work of challenges to “The Boundaries of Sexu- (1977) and Sex, Politics z&Society (1981), French philosopher-historian Michel ality” shaped by the sexual tradition. completes an unplanned triology on the Foucault in presenting a position which Here Weeks examines the central role social organization of sexuality in the focuses on the positive power of sexolo- men and women participating in radical modern era and makes a significant con- gists to create sexuality. Like Foucault, he sexual politics of the 1970s and 1980s tribution to defining one variant of the is interested in how sexologists, operating have had in changing such boundaries. social construtionist approach to sexual- within the privileged status of science, He analyzes both the contribution of the ity. A fundamental assumption of this have defined the truth of sex so as “to gay and feminist movements in estab- approach is that there is no natural or naturalize sexual patterns and identities lishing a sexual identity based on choice essential sexuality which transcends his- and thus obscure their historical geneal- rather than destiny in addition to the tory, but only historically grounded con- ogy.” The ideas referenced in support of complex moral and political problems cepts and systems of knowledge which this position are those of: early sexologists posed by the debate on pornography define a sexual nature or essence. Sexual- who assumed a sexual essence, anthro- and the development of subcultures on ity and the present importance assigned pologists who saw cultural regulation as the sexual fringe-those advocating to it are not determined by biology- critical but whose ahistorical cultural sadomasochistic, public and/or inter- though there is the physical body and its relativism did not challenge the concept generational sex. The efforts of the sexu- possibilities for pleasure-but by the indi- of a sexual nature, and recent sociobiolo- ally oppressed to legitimize and natural- vidual and collectively generated defini- gists concerned with “the biological ize their own sexual needs has created a tions which constitute it. mechanisms that provide the basis of new type of sexual-political subject Sexuality and Its Discontents, which social phenomena.” Unfortunately, little whose activities have, he maintains, expands themes developed in an earlier is said about how the vast quantity of post- gradually “evacuated meaning” from essay by the author, analyzes the complex Kinsey empirical research fits into this the- many of the sexologists’ categories. ways sexual theory and sexual politics sis. Such silence weakens an otherwise These new political subjects must now have interacted to produce and change much-needed appraisal of the power establish a political commitment which the”historical invention”of sexuaJity.The exercised through sexological discourse. will bring sexual radicalism into play heart of the bookdiscussestheorganizing Part III, “The Challengeof the Uncon- with feminism and socialism to effect a and limiting functions of scientific sexo- scious,” takes up the psychoanalytic tra- general social transformation. Under logical discourse over the past century dition within sexological discourse, a such a transformation, the flux of sexual and recent feminist and gay movements tradition barely mentioned in Part II. desire would be allowed to flourish in of affirmation which have produced a Unlike many contemporary theorists who the context of new social codes and new “grass-roots sexology” to challenge such have rejected Freud, Weeks emphasizes types of relationships. Weeks eschews discourse. The primary goal of this discus- the radical impulse within Freudian the- invoking a particular theory on how sion is to present a case for a radical ory and the role a dynamic unconscious such a transformation can be achieved, pluralist position concerning sexual polit- plays in linking the individual to social though like Marx, he holds that humans ics, a position which advocates a concep- forms which shape sexual expression. He make their history and they can change tion of history as politics directed to favors a reading of Freud, developed by it. “All we need,” he says, “is political building an economic, cultural, and sex- French psychoanalyst Jacques Lacan and commitment, imagination and vision.” ual democracy. fruitfully appropriated and adapted by A major strength of Weeks’ analysis In Part I, “Sexuality and Its Discon- feminist thinkers such as Juliet Mitchell flows from his ability to draw on and

22 SIECUS Report, July 1986 integrate seminal ideas from radical In addition, the whole range of sexual area of people’s sexual lives, if you sociology; structuralist anthropology; behaviors described is further divided recommend that they limit their choices semiotics; and psychoanalytic, feminist, into three major categories: safe, possi- recommendations must be made to and Marxist theory. Such ideas, except- bly safe, and unsafe. This further replace what has been lost; otherwise ing those of Freud, have typically not strengthens the easy accessibility of the the message is ignored. This book scores been included in discussions on theories vital information in this book. a major success in my opinion on this of sexuality within mainstream Ameri- The book is one of the first to empha- point. can sexual science. This yields an analysis size the risk of AIDS infection to both Other positive points of the book which, while it does not always succeed men and women, gay and straight. It include: and certainly raises as many questions as contains discussion of the risk for trans- it answers, points the way to one strategy mission of HTLV-III through vaginal 1. The careful distinction between for developing a theory of gender and intercourse and cunnilingus. Sincethere HTLV-III infection and AIDS: “People sexuality grounded in history. A major are now well over 1,000 women in this don’t catch AIDS”; a distinction many weakness of the book is a failure to inte- country with AIDS and an alarming other books do not make, which then grate effectively the biological level into number of pediatric AIDS cases, such compounds the public’s misunder- this analysis; a critique of sociobiologi- information is vitally needed. Damn the standing about a complex medical cal ideas does not obviate the need to government for not having taken up this condition; provide an extended interpretation of challenge-and, through neglect, per- 2. Examples of conversations for neg- the biological factors which will support petuating myth and prejudice and put- otiating safe sex with a new partner; a social constructionist approach. ting people at risk-and bless these 3. A short test to determine if you are Nevertheless, this is a fine book which authors for responding to this need! a high-risk ; should and will be of considerable inter- The book is also highly recommended 4. A listing of products to help enrich est to those concerned with sexuality in for its chapter directed to adolescents. the individual’s while protecting history, theories of sexuality, sexual and The authentic, personable tone of this them from the AIDS virus; , or sexual politics and chapter clearly indicates a sensitivity to 5. Handy little cut-out safe sex cards social change. A, PR the challenges faced by teens, as well as for both men and women. long-term experience in counseling and working with them. Hopefully the Insti- Overall, this book is commended for tute might consider publishing this its tone of encouragement and em- chapter as a stand alone pamphlet for powerment of the individual to make distribution to youth. I also hope that responsible sexual choices to limit the inclusion of this chapter on teens will spread of HTLV-III infection. Without Safe Sex in the Age of AIDS. Prepared by rouse public health officials and others the medical control for AIDS, that is the The Institute for the Advanced Study of to recognize the serious danger that only option open to us at this time. Human Sexuality. Secaucus, NewJersey: HTLV-III infection poses for young peo- Of course nothing is perfect, and Citadel Press, 1986 (88 pp., $3.95). ple in this country. A review of the gen- there are some points which need Reviewed by George Marshall Wor- eral morbidity trends among youth improvement. The price of $3.95 seems thington, M/PA, President, Worthington should be enough to convince anyone high for its size and is prohibitive for and Associates International. that a significant number of adolescents many people, such as teenagers or low- are engaging in high risk behaviors income people who also need this infor- Every once in a longwhile, a book comes (drug experimentation, unprotected mation. The cost of the book might along that is near perfect in content, intercourse, etc.) which are also known discourage the widespread distribution tone, format, and timeliness. Such a risk factors for transmission of HTLV-III of this book. book is Safe Sex in the Age of AlDS by a and subsequent development of AIDS. Second, though I admire the book for group of professionals associated with Despite this, few organizations are plan- its candid approach, I did not think The Institute for the Advanced Study of ning to address the issue. Hopefully the enough street language was used in the Human Sexuality in San Francisco. I importance given to the su bject of youth pages on sexual behaviors. More slang wished it had been written sooner, but and AIDS in Safe Sex will encourage terms should be included to reach a now that it is available, I hope Safe Sex people to address this issue. wider audience, although the plain- will be widely distributed and read. Finally, the book is to be recom- English descriptions together with the The book has a number of convenient mended for its emphasis on the positive most common slang terms is sufficient features regarding its format and con- aspects of safe sex instead of the nega- for most readers. tent. For starters, its size is small enough tive aspects of unsafe sex, including its I was also concerned by the statement to fit discretely in a pocket or purse. It is guidelines on what one can do to erotic- that the primary method of spreading 80 pages in length written in a no- ize and enrich safe sex practices. This is the AIDS virus is through sexual contact. nonsense and concise style. The content sound pedagogy, but prior to this book, The federal Centers for Disease Control of the book-what is considered safe many successful educators writing about (CDC) has long been challenged for its and unsafe in sexual conduct-consists prevention and AIDS have failed to heed concept of “hierarchical ranking” where- of single page descriptions of each sex- the lessons of their experience. Too by gay intravenous (IV) drug users were ual practice together with a short para- many “don’ts” and not enough “dos.” only counted as gay in the national sta- graph detailing what is known about its Not that the “don’ts” have no place in tistics, thus underestimating the serious associated degree of risk. This format AIDS prevention education; that goes threat of transmission through IV drug made referencing topics especially easy. without saying. But, particularly in the use and shared needles. In New York

SIECUS Report, July 1986 23 City, the statistics are changing rapidly sexual relations. Perhaps it is an attempt economic and emotional burden, which and drug use now accounts for the to give the book the broadest appeal is already exacting a heavy price in the majority of cases. Other metropolitan and based upon the knowledge that form of pain, fear, and rekindled preju- areas can be expected to follow this there is some excellent safe-sex litera- dice that could destroy decades of pro- trend. Therefore, I am concerned that ture available for gay people, and almost gress in civil liberties. these statements focusing on sexual none for heterosexuals. I found it a little The book’s non-prejudicial, no- transmission will date the book before off-putting, and believe it would have nonsense concise and positive approach too long, and it is too important a work been helpful to use more inclusive directed at all sexually active people is a to have that happen. In addition, I think language. triumph of collaborative writing. If this this down plays the importance of In my opinion, Safe Sex in the Age of book gets into the hands of enough recreational drug use as a co-factor in Aids is recommended reading for people-and I hope that this review will development of full blown AIDS once anyone who wants to know more about encourage people to go out and pick it infection with HTLV-III has occurred. AIDS or anyone associated with the up-it could be a real life saver. in the Finally, many of the behaviors are dis- health field. Onlywith education can we age of AIDS, it’s the perfect gift for those cussed in terms of male-female hetero- begin to free society from this growing you love. ET, LT, A, P, PR

SIECUS is affiliated with the Department of Health Education of the School of Education, Health, Nursing, and Arts Professions of New York University.

July 1986

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