By Margie Nichols, Ph.D. First, let me say a little more about decoupling sex and love. Because, imho, the source of many of our sexual difficulties is our sloppy sentimentality about sex and love. The reason we personalize our partner’s sexual behavior so much is that we are viewing sexuality through lenses distorted by false assumptions. Read the following assertions: If he/she loves me, he/she will • know how to please me sexually without my saying or showing • always be turned on to me when I’m turned on to them • know instinctively when I DON’T want sex and not ask • be able to keep my level of sexual desire high no matter how long we’ve been together • be able to make sex hot under any conditions • never be attracted to anyone else • never masturbate, view porn, or engage in sexuality, even solo, that does not include me • never fantasize about anything or anyone else, especially during sex with me • always gaze into my eyes during sex • never ask for any sexual activity that makes me anxious • always like any sexual activity I want • be easy for me to turn… Read more »
Author: Margie Nichols, Ph.D.
By Margie Nichols, Ph.D. In the sex therapy field there is a wonderful concept put out by my colleague Barry McCarthy called “good enough sex.” Modeled after the old psychodynamic concept of the “good enough mother,” it proposes that people’s idealized visions of what should be – the perfect mother, the perfect sexual experience, the perfect partner – get in the way of enjoying what they ‘really’ can have. I think we need a concept of the ‘good enough life.’ I’m a boomer who has been around for a while, I came of age in the sixties, my life has been almost a caricature of a sixties lefty chick. Among many, many other adventures I’ve had in my life, good and bad, I weathered losing countless young gay male friends from 1983 through 1996, and in 2004 I lost a child, my daughter Jesse, not quite ten years old at her death. Whatever ills aging brings, it also, if you’re lucky, brings perspective. After my daughter died I felt I never would be happy again. For quite a while I felt I was living primarily for my other children. Only in the last year or two have I reached a… Read more »
By Margie Nichols, Ph.D. The winter holidays are hailed as a time for family, gift giving, and happiness, yet for many they are the most miserable time of the year. Lots of reasons for this: these days evoke memories of horrible childhood holidays that still seem to overwhelm the present; they evoke memories of wonderful childhood holidays that will never be equaled; they always fall short of the cultural expectations of the perfect, loving, connected family. And then there are more mundane reasons: many people are sensitive to the loss of light that reaches its peak right before Christmas; many exercise less in the busy holiday season, and both light and exercise are clearly connected to depressed mood. Add to that the increased carbohydrate and alcohol intake and there can be multiple physical factors adding to the blue outlook. This year the economy makes the season even potentially gloomier. Sales of clothing outweigh those of big ticket items for the holidays, and it is seen as an ‘economic indicator’ that more ‘Dear Santa’ letters ask for clothing and even food instead of toys. How can you beat the ‘Holiday Blues?’ Start with ‘radical acceptance’: our imperfect human lives will never… Read more »
By Margie Nichols, Ph.D. “One of the criticisms leveled against the APA for removing homosexuality as a disorder is that science does not advance by a vote of hands. These critics forget that any list is produced by a group of people who vote for or against it in the first place. “ —Charles Silverstein, Ph.D. I’ve just read an article written by my friend and colleague Charles Silverstein, a psychologist who was instrumental in helping get homosexuality removed from the Diagnostic and Statistical Manual in the early 70’s. In a piece to appear in an upcoming newsletter of a division of the American Psychological Association, Charles recounts the history of how the removal came about from the point of view of a gay professional activist in New York. He begins in 1972, with the disruption by gay activists of a meeting of behavioral psychotherapists who used ‘aversion therapy’ – electric shocks to the body – to ‘cure’ homosexuality, . That led to a presentation to the Nomenclature Committee of the American Psychiatric Association. The “Nomenclature Committee” determines what is in the DSM – the “Bible” of psychiatric illness. Literally, the Nomenclature Committee at the time decided by vote what… Read more »
Book Review by Michael Moran, L.C.S.W With the tragedy of Rutgers student Tyler Clemente’s suicide this past September, the pivotal importance of positively impacting mainstream culture of the issues and experiences our lesbian and gay children face has painfully hit our radar. Too many lesbian and gay adolescents continue to be harassed — GLSEN’s recent National School Climate study indicates that 84.6% of LGBT youth are verbally harassed, 40.1% are physically harassed, and 52.9% experience Cyberbullying*. As troubling as these statistics are, it is equally concerning that too many parents lack the understanding or ability to discuss sexuality openly with their adolescent children, too many teachers and school administrators lack the training to skillfully mitigate harassment when it occurs, and too many school systems and communities lack the resources necessary to effectively address these concerns. It is not a pretty picture. As social workers, we hold the responsibility to look this squarely in the eye, name it for what it is, and do what we can, with what we have, right where we are. Fortunately, we have leaders pointing the way, shining a flashlight toward our next steps for lasting change. Michael Lasala’s insightful exploration of sixty-five families, Coming Out,… Read more »
By Margie Nichols, Ph.D. I believe in pharmaceuticals. I take them. We all do. Medicine- medications, drugs – are a necessary part of life. But, just as I like my car manufacturer to monitor problems with my car after it is off the lot and swiftly recall dangerous cars, I like my pharmaceutical companies to be honest about the drugs I’m taking – or the ones given to my children. On March 31, 2004 my nine year old daughter Jesse was admitted to a hospital with a large, slow-growing tumor. On April 2 the tumor was removed ; her prognosis was excellent. But because the tumor was large, Jesse needed extensive residential rehabilitation in a center, and because she had one post-operative seizure she was put on phenytoin (Dilantin.) While in rehab she caught a hospital bug called C.difilis and given the potent antibiotic Flagyl. Within twenty-four hours she developed a raging case of Stevens Johnson Syndrome/Toxic Epidermal Necrolysis, a syndrome induced solely by pharmaceuticals. She was taken off the Dilantin and Flagyl and transferred to a burn center —SJS/TEN is essentially like having a chemical burn, inside and out. The disease ravaged her and she died on June 2, 2004,… Read more »
By Margie Nichols, Ph.D. The Diagnostic and Statistical Manual of the American Psychiatric Association (Fourth Edition) is the “Bible” of mental illness. The DSM is being revised, and in a few years DSM 5 will come out. I think – along with a lot of others in the mental health field – that there is a diagnostic category we could use that might actually be useful but is being ignored because it is seen as indicative of a highly stigmatized disorder. One of the revisions that didn’t make it into DSM 5 was the recommendation to create a disorder called “Emotional Dysregulation Disorder.” Instead, people who suffer from the inability to control their own emotional reactions and moods are lumped in the category of “Borderline Personality Disorder,” now to be called “Borderline Type.” Borderline Personality Disorder – BPD – is stigmatized even by mental health professionals. Until a type of therapy called “Dialectical Behavior Therapy” came into existence twenty years ago or so, it was considered ‘untreatable’ and ‘incurable,’ and many if not most therapists still see it this way. There are ten symptoms, according to the DSM 5 proposal, of “Borderline Type.” A few of them are pretty extreme:… Read more »
By Margie Nichols, Ph.D. There’s an interesting piece by Gina Kolata in the Times today about how funds used to combat smoking in teens is now diverting into obesity prevention in children. The question is: if you have to choose, which is more important to prevent? Obesity or smoking? Clearly we shouldn’t HAVE to choose….but if we did? The answer isn’t obvious. Kolata discusses some of the pros and cons. For example, anti-smoking campaigns aimed at teens appear to have been partially successful- teen smoking has gone down, although since rates of smoking have gone down in all age groups, it’s a little hard to attribute that purely to prevention efforts. And, the truth is that we know of nothing that prevents obesity. As Kolata says, “..no interventions, when tested in large studies, have caused a big difference in children’s or teenager’s weights.” So all the ‘common sense’ about preventing obesity – promoting healthier choices, more activity, soda taxes – might be about as effective as, say, the D.A.R.E. program was in keeping kids away from drugs (i.e., zero percent) My guess is that many of these measures may prevent obesity in a small percentage of what I call ‘accidentally’ obese kids –… Read more »
By Margie Nichols, Ph.D. By coincidence, as the news about a drug that can ‘de-masculinize’ female fetuses hit the blogs, one of my sex therapy listserves began a fascinating discourse about the prevalence of PCOS in female to male transgender people. Polycystic Ovary Syndrome (PCOS) is a genetically transmitted syndrome with some potentially distressing symptoms and consequences. However, in the population of young women presenting themselves for hormone treatment to transition from a female to a male body, PCOS is relatively prevalent. Since PCOS is a syndrome caused by an excess of androgens – male hormones – in biological female, this again raises the issue of hormones in both gender identity and sexual orientation. Certainly hormones could not be the sole factor determining these complex psycho-social phenomenon, but it looks like they may play a role and that the two- gender and orientation – are at least partially intertwined.
by Margie Nichols, Ph.D. What we now call ‘intersex’ conditions – children born with a whole variety of biological variations that can result in ambiguous or mixed gender – have long been interesting because of what they might tell us about how genes and hormones effect not only physical characteristics but also behavior. For example, Congenital Adrenal Hyperplasia is a condition that affects genetic females. Medical specialists believe it results from over-exposure of the female fetus to androgens – male hormones. CAH girls not only sometimes exhibit some male body characteristics – they also tend to be tomboys and, as adults, while most are heterosexual a higher than expected number are lesbian or bisexual. Makes one think about the role of hormones is sex-stereotyped behavior – and sexual orientation. But a physician named Dr. Maria New is promoting the use of a drug called dexamethasone for women carrying CAH girls to use while they are pregnant. This drug is not FDA approved for this use and has never been tested in pregnant women before. But it is increasingly used to prevent ‘abnormal behavior’ in CAH girls. As Sharon Begley reports in Newsweek, New and a colleague suggest that women having little interest in… Read more »