UCLA UCLA Previously Published Works Title ISSUES IN TREATMENT OF SEXUALLY DYSFUNCTIONING COUPLES OF AFRO-AMERICAN DESCENT Permalink https://escholarship.org/uc/item/4sb9f5sm Journal PSYCHOTHERAPY-THEORY RESEARCH AND PRACTICE, 13(1) ISSN 0033-3204 Authors WYATT, GE STRAYER, RG LOBITZ, WC Publication Date 1976 DOI 10.1037/h0086483 Peer reviewed eScholarship.org Powered by the California Digital Library University of California PSYCHOTHERAPY: THEORY, RESEARCH AND PRACTICE VOLUME 13, #1, SPRING, 1976 ISSUES IN THE TREATMENT OF SEXUALLY DYSFUNCTIONING COUPLES OF AFRO-AMERICAN DESCENT GAIL E. WYATT RICHARD G. STRAYER W. CHARLES LOBITZ1 U.C.L.A. Wheeler Affiliates University of Neuropsychiatric Plainville, Conn. 06062 Colorado Medical Institute School LA, Calif. 90024 Denver, Colorado 80220 Following the model of Masters and Johnson Myths of Black Sexuality (1970), directive treatment programs have been developed for a variety of sexual dysfunctions, Myths about the sexual practices of black ranging from primary and secondary orgasmic Americans originated with the country's history. dysfunction in women to premature ejaculation As early as 1550, African religion, skin color and erectile failure in men (Kaplan, 1974; Lobitz and behavior were perceived as inferior to that of &LoPiccolo, 1972; LoPiccolo& Lobitz, 1973). the Anglo-Americans (Vontress, 1968). Mis- Although many of the treatment procedures are sionaries who first traveled to Africa to convert amplifications of the general anxiety-reduction "heathens" to Christianity were shocked by the approach common to behavior therapy (Wolpe, "polygamy and diversity of sexual relation- 1969), other aspects of the treatment derive from ships" that they observed (Goldstein, 1948). cognitive, personality, and humanistic psychol- African and Christian religions differed in their ogy (viz., Lobitz, LoPiccolo, Lobitz & Brock- view of sexuality. Early American Christians way, 1974). Direct retraining approaches to believed that many sexual behaviors were of- treating sexual dysfunctions have been effective fenses against God, whereas the African nation- with a Caucasian population (Kaplan, 1974; als followed a religious standard which did not Lobitz & LoPiccolo, 1972; Masters and include sexual morality. The violation of laws Johnson, 1970; Obler, 1973), even where one was perceived by the latter as an offense against a partner has a psychotic diagnosis (Tanner, person and not against God (Staples, 1967). 1973). However, the treatment of Afro- The sexual prowess of blacks has been iso- American couples is a relatively new and unre- lated throughout history as a dimension of spe- searched area. Because of widely-held stereo- cial interest. Written accounts of Anglos' obses- types about black sexuality, a number of factors sion with black genitalia and sexual abilities date must be considered in applying the above treat- back to the sixteenth century. (Thomas, 1972; ment programs to an Afro-American population. Vontress, 1971). These myths have always been The present paper reviews the literature describ- sustained in a negative context. Reported hyper- ing the myths of black sexuality and delineates sexuality of blacks was often equated with their the issues involved in the treatment of sexually potential to be savage and bestial with their dysfunctioning black couples by an interracial partners (Thomas, 1972). Credibility was added therapy team. A case history elucidating these to these accounts by physicians who, fearing factors is presented. attacks on Anglo women, warned of black males' dangerous sexual potential (Thomas, 1972). To quote one early American physician, 1 The first two authors served as co-therapists in the Sex- ual Dysfunction Clinic, U.C.L.A. Neuropsychiatric Insti- "A few emasculated Negroes scattered around tute, under the direction of the third author. and through the thickly settled Negro com- 44 TREATMENT OF SEXUALLY DYSFUNCTIONING COUPLES 45 munities would really prove the conservation of The Influence of Race in the Therapy Process energy, as far as the repression of sexual crimes is concerned" (Haller, 1970). Although black males occasionally have been There has been relatively little research on the reported to be undersexed and unconcerned issues involved when the therapist and patient about their partner's sexual gratification (Kar- are of different races. Furthermore, the majority diner & Ovesey, 1951), the myth of black hyper- of studies have described interracial practice in sexuality is still the most widespread today. The the more traditional psychotherapies. The recent abundance of' 'black sexploitation'' films largest proportion of the studies has examined perpetuates this image of the black male's sexual the social and economic disparity between white prowess. Accounts of black female sexuality are therapist and black clients (Oberndorf, 1954; more contradictory. A limited study of black Kardiner & Ovesey, 1951; Bernard, 1972; women suggested that they suffer "quite fre- Sager, 1972), and the resulting problems that quently" from "frigidity" (Kardiner& Ovesey appear to influence treatment (Hollingshead & 1951). In the popular press, black females have Redlich, 1958). Much of this research has in- been described as being sexually aggressive and volved documenting the value and life-style dif- having less sexual hang-ups about sexual role ferences between the middle class therapist and playing than white women (Young, 1974), while the lower class client. However, life-style dif- another comparison saw them as more sexually ferences and similarities between white restrained and traditional in their sexual expres- therapists and middle to upper class Afro- sion than white women today (Staples, 1974). Americans has yet to be examined. The variety of myths that circulate in the lay A second major focus has been the emerging press only confuse blacks about their sexual black consciousness and the attendent an- abilities and the overall importance of sexual tagonism toward whites (Bernard, 1972). This expression in the total relationship. Many black has been explored both in terms of the client's men and women internalize the expectation that distrust and anger toward his white therapist they have extraordinary genitalia and sexual (Kennedy, 1952; Schachter & Butts, 1968) and prowess. This situation can create both identity the therapist's reactive fear and lessened sense of and sexual dysfunction problems when an indi- competence as he receives, or expects to receive, vidual does not live up to these stereotyped im- hostility and rebuffs from his black clients (Ber- ages . These problems can be compounded by the nard, 1972; Reiss & Bernard, 1971; Schachter & highly competitive and exploitative attitudes Butts, 1968). which blacks have been found to have towards The third issue, raised by only a few studies, is sexual relations (Rainwater, 1969). that of the therapist's own racial attitudes and There is little behavioral data to support any of stereotypes (Bernard, 1953, 1972; Goldber, the black hyper- or hypo-sexuality myths. For 1973). Schachter and Butts (1968) suggest that example, information gathered by the Kinsey this is not only a problem when encountered in Institute on penis length of black and white the form of prejudicial discrimination, but is males revealed no significant differences in the equally destructive when the therapist is too ra- length of the erect penis (Bell,1968). Similarly, cially conscious. This leads to the therapist black teenage women are reported to have a over-emphasizing the existence of racial con- higher incidence of premarital sex than white flict, thereby depriving the patient of working teenagers (Zelnik & Kanfner, 1972), but these through the nonracial aspects of his difficulties. differences disappear at older ages (Hunt, 1974). Although there has been little research on in- In another study of adolescents, blacks and terracial practice in the more traditional males were found to be more sexually permis- psychotherapies, even fewer such studies have sive than whites and females (Reiss, 1967). The developed from a behavioral perspective. This is paucity of research on actual behavior only per- particularly true regarding behavioral ap- petuates confusion about the sexual behavior of proaches to sexual dysfunctions. It would appear black men and women. In addition, the absence that cross-racial treatment considerations in a of normative data handicaps professionals who behavioral modality emphasize the individual's attempt to help dysfunctioning black couples conscious control of his own behavior and through re-education. minimize the role of the unconscious. As a re- 46 GAIL WYATT, RICHARD STRAYER & CHARLES LOBITZ suit, transference and countertransference reac- rather than allowing the clients to choose on the tions are not the primary focus of therapy. The basis of their own needs and desires. most salient dynamics in this form of treatment exist within the client couples, rather than be- tween the therapists and clients. Thus, the Case History therapist's role is based more on the expert- Sarah and Nick (pseudonyms) are middle class Afro- technician/educator model than on the analytic Americans in their early thirties who sought treatment at modes. (LoPiccolo & Lobitz, 1973). Sexual the Sexual Dysfunction Clinic, NPI, UCLA. Nick was dysfunction therapy, by its very nature, focuses experiencing premature ejaculations, which restricted his explicity on sexual behavior, thoughts, and feel- ability to bring Sarah to