THE IMPAIRMENT OF EROTIC AROUSAL AND EXCITEMENT Topic: Sex & Love Addiction
Because erotic arousal and physical excitement are so intertwined, we will treat them together. In women, lack of sexual desire and impairment of physical excitement in appropriate situations is called sexual unresponsiveness (formerly "frigidity").
Some of the symptoms are subjective: the woman may not have sexual fantasies, she may not enjoy sexual intercourse or stimulation, and she may consider sex an ordeal. Other symptoms are physiological: when she is sexually stimulated, her vagina does not lubricate, her clitoris does not enlarge, her uterus does not swell, and her nipples do not become erect. Frequently, she becomes a spectator rather than losing herself in the erotic act. When she finds herself unstimulated, she begins to worry about her own sexual adequacy and what her partner is thinking about her. She thinks, "He must think I'm frigid." "Is he getting pleasure?" "Will I climax?" She remains outside the act, observing and studying how she and her partner are reacting. Fear of failure, scanning for cues of failure, and presiding as a judge at one's lovemaking can diminish pleasurable sex and worsen the problems of arousal and of orgasm. The woman may be unresponsive in all situations or only in specific ones.
For example, if the problem is situational, she may be enraged or nauseated by the sexual advances of her husband, but she may feel instantly aroused and may lubricate when an attractive, unavailable man touches her hand. Such a woman may have problems with orgasm as well, but it is not uncommon for a "sexually unresponsive" woman-whose arousal and excitement are impaired-to have orgasm easily once intercourse takes place.
Women's reaction to this problem varies. Some patiently endure nonexciting sexual intercourse, using their bodies mechanically and hoping that their partner will ejaculate quickly. But this is often a formula for resentment. Watching her husband derive great pleasure from sex over and over, while she feels little pleasure may be frustrating and alienating for the woman. And eventually some women will attempt to avoid sex, pleading illness or deliberately provoking a quarrel before bedtime (Kaplan, 1974).
The partner's reaction to the woman's sexual unresponsiveness also varies. Some men accept it and indeed may expect it, based on a false belief that women don't or aren't supposed to enjoy sex. Other men attribute their mate's lack of arousal to inadequate performance on their part and feel that they are poor lovers. Still others will pressure their wife to perform anyway and this, ofcourse, only makes her more unresponsive. Many other couples seem to have good marriages in spite of this and spend a lifetime together without the woman ever responding to her husband sexually.
In men, the most common dysfunction of arousal and excitement is called erectile dysfunction (formerly "impotence"). It is defined as a recurrent inability to have or maintain an erection for intercourse. This condition can be humiliating, frustrating, and devastating since male self-esteem across most cultures involves good sexual performance. When erection fails, feelings of worthlessness and depression often ensue. Here, as with the other sexual dysfunctions, the man becomes a spectator during sex. He mentally steps back and thinks, "Will I fail to get an erection this time too?" "She probably thinks I'm not really a man." "Is she really getting pleasureor just pretending?" These fears make it even more difficult for him to maintain an erection.
Like sexual unresponsiveness in females, erectile dysfunction in the male can be either primary or secondary, situation specific or global. Men who have had primary erectile dysfunction have never been able to achieve or maintain an erection sufficient for intercourse; whereas men who have secondary erectile dysfunction have lost this ability. When the dysfunction is situation specific, a man may be able to maintain an erection with one partner, but not with another. Some men can become erect during foreplay, but not during intercourse. When the dysfunction is global, a man cannot achieve an erection with any partner under any circumstances. It is important and reassuring for a man to know that a single failure in no way implies "erectile dysfunction," which is by definition, recurrent. Virtually every man on one occasion or another-particularly when upset or fatiguedcannot get an erection or keep it long enough for intercourse.
Here is a case of primary impotence that begins, typically, with a particularly sordid circumstance surrounding the man's first attempt at intercourse:
STORY: Sheldon was nineteen when his teammates from the freshman football team dragged him along to visita prostitute.The prostitute's bedroom was squalid; she seemed to be in her mid-fifties, had an unattractive face and a fat body, and foul smelling breath. He wasto be the last of a group of five friends scheduled to perform with her. Sheldon had never had intercourse before and had been anxious to begin with. His anxiety increased as his teammates returned one by one to describe in detail their heroic successes. When his turn arrived, the other four decided to watch and cheer him on, and Sheldon could not get an erection. His teammates shouted that he should hurry up and the prostitute was obviously impatient.
He was pressured beyond any ability to perform and ran out of the room. After this incident, he avoided all erotic contact with women for five years, fearing that he would fail again. At age twenty-four, when his fiancee pressured him to have sex, he wasoverwhelmed with fears that he wouldfail, remembering his humiliating failure with the prostitute. In fact, he failed again. This brought Sheldon into therapy for primary erectile dysfunction. (Adapted from Masters and Johnson, 1970.)