Yates. Chapter 5
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Intimacy is a term often used but seldom defined. As nebulous as spirit or benevolence, it is not dissimilar to another poorly defined concept, love. Intimacy is derived from the Latin intimare meaning "to put into." The mother and infant who are so completely invested in each other that they appear fused are in a state of total body intimacy. Making love connotes various degrees of mind and body intimacy. Adult intimacy is the ability to blend with another's mind or body and "let go" of many adult constraints. This presupposes comfort and trust — that the other person will not misuse or reject us. If we are unable to trust, we create emotional distance and avoid intimacy.

Sex and intimacy are associated from earliest childhood, when the infant is both close to and stimulated by his mother. A relaxed mother who enjoys holding and talking to her baby promotes both. Her infant learns to like being close as he learns to savor erotic sensations. Through the years, intimacy continues to act as a powerful aphrodisiac. Many a man's flagging erection has been resurrected when his partner rubs his back and they plan together for the future. However, sex is distinct from intimacy and each can exist separately. Sex with little intimacy occurs in the casual liaisons of the singles bar, when a housewife placates an angry husband in bed, or when an aging lothario nourishes his self-esteem in the moans of a protégée.

The vibrator will never replace a flesh-and-blood lover, even when the lover has arthritis and poor timing. This is because the quality of life depends on intimacy — and who can be intimate with a vibrator? Sex serves to enrich and expand intimacy. It cushions the rough spots of living together and provides a vehicle for attachment in a society marked by alienation and loneliness. Many couples communicate directly, by touch, smell, and taste, only in bed.

By rights, intimacy should evolve slowly over the years, to reach its full richness in old age. Unfortunately, this is rarely the case. Intimacy is a will-o'-the-wisp that gradually slips away after the honeymoon, to return, it is hoped, after retirement or when the children are gone. In its place are buttons to push, calls to make, and deadlines to meet. Work rather than love becomes the primary goal. On October 28, 1973, The New York Times quoted Henry Kissinger as saying, "What counts is to what extent women are a part of life, a central preoccupation. Well, they aren't that at all. To me women are no more than a pastime, a hobby. Nobody devotes too much time to a hobby." Blazing efficiency in an empty world.

This pattern, in which intimacy diminishes during the productive years, is also rooted in childhood. A great many parents provide the infant with the basic experience in intimacy through body contact, warmth, and snuggling, but demand a high level of performance once the child can think and act by himself. They reward the child for tying his shoes, but not for playing in the sandbox. Copious attention is paid to the alphabet and naming colors, with precious little for blowing bubbles in the milk or rolling in the grass. The most acceptable child is the one who is busy learning or making something useful. Eventually, the child may feel vaguely uncomfortable when he stretches out to read a comic book or when he watches a non-educational show on TV. He has lost the reasonable balance between work and play, doing and feeling, active and passive pleasuring. Freud recognized the danger of overemphasis in either direction when he responded to a question about what a healthy man needs to do. He replied, "Lieben und Arbeiten" — "to love and to work."

"Love is work" would characterize many families today. The pathetically familiar suburban wife who frantically volunteers for "anything" is an example. She may feel so depleted after the day's station wagon shuttle, malfunctioning appliances, and parent-teacher conferences that she has little taste for a romp in the hay with a husband who does the "really important" things. One such lady interrupted her mate in the middle of lovemaking to inform him that the toaster was broken. (Schwab, 1974) The career mother may be more harassed than her suburban counterpart, who at least can find time alone to masturbate. The overemphasis on work also takes its toll in the man's erotic response. An eminent sociologist, John Cuber, quotes one wife: "He's their top designer, and everybody knows it. Next year he's sure to be vice-president. But when he gets home at night, he is tired. I make sure the girls are asleep or at least in their rooms. Dinner is late, and just for the two of us — after a lot of drinks. We don't have much sex — but I don't expect it under the circumstances."

The work ethic teaches that business must come before pleasure, and utility before beauty. Sex as a duty to one's mate remains high on the priority list, while sex for pleasure slips toward the bottom. Even play becomes work as the golf course is used to make connections and lunches to cement deals. (Kahl, 1957)

Fun with the family may mean a trip with the kids spent racing from line to line at the amusement park, awaiting a few seconds of kaleidoscopic flight punctuated by nausea. Relaxation is the retreat to the anonymous cocoon of the boob tube, or the peach fuzz in the head after the third martini.

The average middle-class male is also the average male client at the sex therapy clinic. His impotence may be precipitated by the failure to gain a promotion, or his premature ejaculation a symptom of resentment at his mate's increasing distance and lack of interest. Subtly, sex is now a product also. The sex clinic client would like a list of infallible techniques and is fully prepared to work as diligently as possible. He wishes to get an erection in thirty seconds upon sighting a nude female posterior, and expects to memorize the proper combinations of sensate buttons to press in order to elicit a medium, large, or super-economy orgasm. His problems must stem from a slight malalignment of the sprockets, easily mended by a certain screwdriver which never bends. If cursed with a lone screwdriver which not only bends, but kinks and wobbles, how about an implant? The labor of love is more labor than love.

Many well-educated young men and women make a transition from being young, liberated, and zesty to being old, useful and tired. Marriage is likely to have occurred someplace in the process. Still in their twenties, and fresh from training, the graduates enter the business or professional world. With more money and connections than ever before, they command a variety of erotic experiences. Paychecks are invested in Club Méditerranée rather than house payments. Evenings are spent dining by candlelight, and going to concerts and plays. Stealthily, concepts such as stability, security, and responsibility enter. Painstakingly, youth begins to retrace the parents' footsteps. After several years, the metamorphosis is complete, and the young couple looks and acts startlingly like their parents. Filet mignon by candlelight becomes meat loaf at six p.m. so that the children can finish their homework. Leftover sexual sophistication scarcely intrudes upon the air of tired harassment. This marriage is primarily useful — it provides an acceptable neighborhood and the most advantageous social contacts. (Cuber, 1974) The children are raised properly, attend the best schools, and take piano lessons.

Socrates reportedly described a similar pattern more than two thousand years ago. The process begins around the time when the child first enters school. He develops a conscience and learns to live by the rules of his parents. Responsibility, punctuality, and production are clearly underwritten as essential. Eroticism and sexual experience are curiously omitted from the list of desirable values. He notes that sex is an uncomfortable or worrisome area for his parents. At best, they seem lukewarm or ambivalent. Yet this is the format which inevitably must become his own, and he has little choice about the matter. These same values persist beneath the turmoil of adolescence and the relative sexual freedom of young adulthood. With very few exceptions, these principles resurface after marriage or a firm commitment. Priority is given to production and punctuality while sex interests lag. This again becomes the erotically impoverished portrait presented to the next generation. Thus the inhibited child grows through a period of sexual freedom which he then must renounce in order to become an inhibited adult who will rear an inhibited child. That this is indeed the case is shown by a study by Wake in which thirty percent of mothers acknowledged that they themselves had had premarital sex. Yet only three percent approved of this behavior for their daughters, and only nine percent for their sons.

There is no question that these upright, moral, industrious parents constitute the backbone of society. They're concerned with the child's emotional well-being and success in life. They support civic projects, higher education, and Little League. They read Spock and attend church. Although they may not laugh at a shady joke in front of the children, they certainly don't blackball sex by threat or punishment. If anything, these parents are too good.

Parents can preserve the child's healthy erotic response without making radical changes in their own behavior. A certain awareness, flexibility, a sense of humor, and the application of accepted principles gleaned from the study of adult sexuality are all that is necessary. The techniques used to expand and elaborate the adult sexual response are every bit as useful for the child, providing the appropriate adjustments for developmental level are made. As parents begin actively to further the child's healthy erotic development, sexual values ascend on the list of priorities. Sex becomes not only acceptable but important, assuming its rightful position as one of a number of essential concerns. There is one danger: Eroticism can be absorbed into the work ethic so that sex becomes an achievement rather than a pleasure to be enjoyed. This can be avoided through provision of time, freedom from distraction, and a balanced emphasis on both active and passive pleasuring.

The psychiatrist in private practice serves primarily the striving, anxious middle class. There is no dearth of case material to illustrate how responsible, hardworking families unintentionally impair the child's erotic response.

Mark

Mark was a junior medical student when he approached me after my lecture. He was neatly dressed in shirt and tie, unlike most University of California students. He needed my help because he was in a slump. He tried to study, but the sentences seemed jumbled. He was unable to sleep and began to drink in order to relax. He spent most of his time in unproductively planning how to study. He developed three different index systems for notes but was unable to read the notes after indexing them. He was so anxious about his studies that he seldom left his room at night. He neglected to write to his mother and sister and forgot to return their telephone calls.

When Mark had first entered medical school, he earned excellent grades and received a special commendation in biochemistry. He elected training in basic science research. He was accepted by one of the best fraternities, which was adjacent to the nurses' dormitory. Although Mark was inexperienced, he soon found several attractive nursing students who were fascinated by his sensitive, sympathetic manner. Intrigued, he spent many an evening chatting and, eventually, in making love. Although he studied less, he ranked in the top ten percent of his class.

Midway through his sophomore year, Mark was introduced to a red-haired, curvaceous nursing instructor several years his senior. She invited him to her apartment for scampi the next night. That evening Mark was vaguely uncomfortable, although the shrimp were delicious and the wine well chosen. After dinner it became clear that the dessert would be served in the bedroom. Mark was impotent for the first time. His partner, who had heard tales of his athletic prowess, was offended and peevish.

By the end of his sophomore year, Mark was less involved with the nurses and more concerned with his school achievement. He felt that the noise of the fraternity house interfered with his studies, so he rented a small studio apartment three blocks from the hospital.

Mark's father was a distinguished professor of economics in a small but well-acclaimed college. He was home more than other fathers, but was largely occupied with lecture notes and the preparation of a textbook. The mother described him as her "absentminded professor." He never remembered birthdays or anniversaries and often forgot to kiss his wife good-bye. Yet he was concerned and thoughtful whenever problems arose. Mark's mother readily shouldered all major family responsibilities, such as paying bills and arranging for home repairs. When Mark reached school age he helped by raking the yard and washing the car.

Intelligent and likable, Mark was elected president of his tenth-grade high school class. He was a part-time printer's assistant for the town newspaper and played an excellent game of tennis. He was shy with girls, although he dated occasionally.

After several months of therapy, Mark associated his poor concentration and depression to his confrontation with the nursing instructor. Following that, he had systematically chopped away every source of pleasure. He no longer played tennis, listened to classical music, or attended a movie. He drank alone, to quiet his nerves rather than for enjoyment. When his mother asked him about medical school, he replied in vague generalities, although he had always enjoyed her attentions. He felt strangely inadequate, as if he didn't deserve her interest.

One day, Mark recounted a terrifying dream. He was driving along a lovely seacoast on a winding, cliffside road. He jabbered excitedly to his mother, who sat behind him. The road abruptly ended, and the car swerved out of control and plunged over the cliff toward the water. His hands shook as he recalled his terror. Next Mark described a family reunion where he was taken when he was five years old. Because of limited sleeping space he was placed crosswise in a double bed with three girls. In the middle of the night he awoke to find his pajamas warm and moist. He had drenched himself, the bed, and its three other occupants. Mother was mortified. She announced to all that Mark had never in his life done such a thing. Crestfallen, Mark walked by himself at the edge of the creek. Then he remembered a different scene. When he was ten, his family lived next door to a house with many children. Mark persuaded the twelve-year-old neighbor to entice his five-year-old sister, Janie, to give them a "show." The boy agreed although he lacked personal interest, as he saw his little sister nude almost every night. Janie gladly lowered her panties and spread her legs for a candy bar. Mark peered closely but was afraid to touch. Suddenly ashamed, he left the shed, even though Janie wanted to do it again for another candy bar. Thereafter, he avoided Janie and her entire family. He told his mother they were all lazy people. Yet he thought of Janie when he began to masturbate at age twelve. He tabulated each orgasm, timed it, and carefully caught the semen in a tissue.

Elvina

Elvina was a self-possessed, brilliant college girl who swept into the student health service demanding information. She certainly did not wish to be examined and refused to reveal her concerns to the receptionist. Once in my office, she produced a notebook and fired a list of questions at me. The interrogation was about sex. In high school she had decided to begin coitus in her first year at college and so she did. Unlike many of her classmates, she obtained contraceptive pills through a free clinic. She chose an acceptable young man with similar background. They had sex on the third date. She had not expected to enjoy it the first time and was glad to "have it over with." She continued her sexual activities with other partners but still experienced only mild excitement. She ran the gamut of books, scented oils, marijuana, Kegel exercises, and "poppers" to no avail. She asked me if birth control pills decreased desire, if she could have her glands checked, and if there was an operation which would "rearrange" the clitoris. She definitely did not want therapy.

Elvina described her mother as an ambitious, domineering lady who organized not only her family but sections of the community as well. When Elvina was young her mother's efficiency nearly overwhelmed her. She was terrified of being swept up in the vacuum cleaner by mistake, or popped into the washing machine with a load of soiled clothes. Elvina felt too helpless to complain. She was certain that there was a good reason for everything her mother did. Her mother made sure that Elvina was always suitably occupied. She was to lie down in order to sleep, sit in order to eat or read, and otherwise be up and about some worthwhile task. She remembered no early sex play and doubted if her mother would have allowed such an inefficient use of time. Elvina was a docile but clumsy child who felt especially awkward with friends her own age. In all of her childhood, she recalled only one instance of noncompliance. When she was five years old, her mother served her an inadequately cooked egg. She felt repulsed by the gleaming gelatinous crown with its bloody speck. In spite of her tears, her mother insisted she eat the egg. After the second bite she vomited her entire meal. Thereafter, she meticulously removed any trace of egg white and absolutely refused scrambled eggs. By the time she entered college, she hastily ate the egg white first in order to "save the best part for last."

Both Elvina and Mark were bright, productive students from good, middle-class families. Both perceived the climax as an achievement and dysfunction as a failure. Both were reared in the work ethic without any affirmation of the value of sex. Industry was emphasized to the detriment of passive erotic pleasuring. Elvina worried so much whether she would have an orgasm that sex became a chore. Mark was so devastated by one episode of impotence that he eliminated all gratification. Although Mark was treated through analysis and Elvina entered a sex therapy clinic, both eventually found relief when they learned to relax and receive erotic pleasure without concern for performance. They could have been spared much misery if their parents had prepared them as well for bed as they did for work.

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