•     If you have tried all the ‘treatable’ causes of impotence and still have no result, perhaps the problem is ‘in the mind’. The ideal starting point is to discuss the whole subject with your partner, being careful not to apportion blame.

Stop having intercourse. Once the threat of having to perform is removed, many impotent men can erect perfectly well and, with the help of their partner, can get used once more to having full and spontaneous orgasms, by masturbation. By alternately stimulating and not stimulating the penis the partner of such a man can often train him, over a few weeks, to have long-lasting, good-quality erections.

During all this the couple should go back to courtship behaviour with the emphasis on closeness, loving, kissing, mutual pleasuring, massage and so on. When the genitals are brought into play the emphasis can be more on looking and admiration (like children) than on performance. The woman can be of great help by sharing her fantasies and intimate sexuality with the man. This helps him see her as a real woman with earthy needs and appetites and not as an untouchable virgin who is too ‘nice’ to want sex. This works wonders in many such cases. The woman can also help by making a conscious effort not to behave in a ‘motherly’ way that reminds the man of his mother. Few men can function well in this situation because sex with one’s mother (and by extension anyone who behaves in a ‘motherly’ way) is forbidden. On the other hand, quickly switching to sexy underwear and becoming a sex siren can also be intimidating and could appear to the impotent man to be a demand for performance which can set back his progress.

Along with all this the man should re-establish self-masturbation so that he eventually learns that the ‘uncontrollable’ is in fact not so. Sex aids can be useful at this stage. Progress towards intercourse should be slow and controlled, or good gains made over several weeks can be lost in one love-making episode.

•     Lastly, give yourself a chance to have an erection. Too many men bring their worries and overactive mind with them into the marriage bed. Give yourself a chance to unwind before sex. At work a man is generally non-sexual and few men can change instantly from this mode into the lover role. Get changed into comfortable clothes, relax, have a small drink. Spend time together just talking or reading something erotic. Get the lead-up to sex right, spending time showering or bathing alone or together, then cuddle and kiss before even trying to have intercourse or produce an erection.

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When the sexual dysfunction develops as a symptom of a basic neurotic problem or of a psychotherapeutically treatable psychosis, then a significant period of traditional psychotherapy should be undertaken while at the same time, adequate consideration of the sexual aspect of the patient’s problem is necessary. As an aside, it should be noted that oftentimes patients come to the Masters and Johnson Institute after years of psychotherapy, and yet become sexually functional after only ten to twelve days of therapy.

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The incidence of bisexuality in American men and women is currently unknown. Except among those who constitute a community of bisexual interest, bisexuality is stigmatized by society and the law. Many people cannot, therefore, overtly admit their bisexuality, even if it occurs only in imagination. Others are not so inhibited, but are among those who can actually practice bisexuality, though only when the homosexual component of their bisexuality is situationally evoked—as among teenaged boys reared in a neighborhood in which hustling with older homosexual teenagers or young men is an acknowledged source of spending money, quite independently of affairs with girlfriends— or among men and women who are able to be homosexual while in sex-segregated jails, camps, or schools, but are heterosexual once released.

In some ethnographically reported societies, sequential bisexuality is a universally prescribed way of life. That is to say, young people at puberty and adolescence are sex-segregated and expected to interact homosexually together until, in young adulthood, their families can negotiate a bride price. After the marriage, the predominant and usually exclusive form of sexual expression is heterosexual.

In America today, optional bisexuality among consenting adults is openly discussed as la viable and legal life style. In consequence, an increasing number of people admit their bisexuality. Some may also dare to express it for the first time. There is no evidence, however, that social permissiveness regarding erotic expression actually increases bisexuality. If such were the case, permissiveness would have to encourage a bisexual differentiation of gender identity/role from infancy onward. In actual fact, permissiveness in the spontaneous sexual rehearsal play of infancy and childhood, and permissiveness in sex education, appear to encourage the differentiation of a heterosexual gender identity.

Etiology

The etiology or developmental differentiation of bisexuality follows the same general principles as apply to homosexuality. The evidence from embryonic anatomy and neuroanatomy is that nature’s primary plan is to differentiate a female. Whereas the female pattern differentiates because the male pattern is not activated by something added (the Adam principle), the male pattern is differentiated by the active suppression of the female pattern. For bisexual behavior, one may speculate on the basis of animal experiments, that the female more than the male retains some of the original bisexual potential. The male, by contrast, may become either totally masculinized or only partially so. If this speculation is correct, then it is easier for women than men selected at random to enter into a casual bisexual encounter—for example at a swinging, group-sex party. Some men will be impotent and erotically unable to respond to any stimulus from a person of the same sex. Others will be erotically versatile with both sexes. There is no known single determining factor, prenatal or postnatal, that leads to the differentiation of a potentially bisexual erotic component in the gender identity/role. The first bisexual experience may be preceded by bi-erotic fantasy and desire, a decision for sexual experiments, a change of sexual politics as in the women’s movement, an awareness and admittance of previously covert bisexual orientation, or an alleviation of some traditional taboos among members of the “swinging” and “group sex” subculture.

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Even if a girl does choose a nonconventional career objective, she is apt to run up against powerful obstructions. Vocational guidance perpetuates the notion of occupational distinction between the sexes. Research evidence suggests that both male and female counselors respond most positively to those women who hold traditional career goals (Thomas and Steward). There also is evidence suggesting that professional personnel consultants generally agree that a four-year college is less advisable for women than for men (Cash, Gillen, Burns). In a recent study it was discovered that the counseling given men and women who were not accepted into medical school differed. Men rejectees were urged to persevere in their career objectives or to substitute others that were of nearly equivalent status; women rejectees, however, were encouraged to reconsider and/ or abandon their career goals in favor of those that were more traditionally appropriate to a woman (Weisman, Morlock, Sack, and Levine). Therefore women often are pressured to set traditional career goals and receive little support for deviating from the pattern deemed appropriate to their sex. Consequently, because of their power and authority, those in a position to counsel can create insurmountable obstacles for women hoping to fulfill nonconventional career aspirations. Such behavior is one of the most pernicious forms of sex discrimination. Unfortunately, its effects most often are not recognized until it is too late to undo them.

A Department of Health, Education, and Welfare regulation prohibits discrimination within educational institutions in counseling materials, aptitude tests, and also in the counseling process itself. Some curriculum packages have been developed for counselors to use to help girls examine various careers and lifestyles (e.g., Hansen). At the elementary school level, OCCUPACS enables boys and girls to experiment with a variety of occupations. At the junior high school level, counseling tools have been developed to stimulate girls’ awareness of the potential and challenge of work. Further information about new developments and counseling techniques can be found in Wirtenberg and Nakamura.

It should be remembered that the vocational counselor is in a unique position to intervene in the socialization process by challenging the assumption underlying sex-typed occupational choices. Training of counselors must emphasize this if these individuals are to become instrumental in facilitating rather than in blocking achievement-oriented women.

The absence of role models. There are many-discussions in the literature pointing out the importance of female role models to women with nontraditional occupational goals (e.g., Brenner; Buchanan). It has been proposed that the absence of females who successfully function in traditionally male occupations discourages other women from considering them (Shein). However, the number of women role models still is quite limited.

The term “female role model” usually is used to refer to a woman who has combined marriage and career, and has effectively achieved in the work world without sacrificing her womanhood. In many studies the influence of nontraditional mothers (who combine family with career), on their daughters (who also tend to be nontraditional), is considered the influence of a role model (Almquist and Angrist; Tangri). However, the term role model also can be used in a more general sense. It can simply connote the presence of other members of one’s subgroup in positions of power and prestige. It is in this sense that the absence of female role models can be a source of sex discrimination.

By not placing women in visible and important positions, organizations and professional groups may be ensuring that they do not attract the interest of women making career decisions. Data supporting this point of view recently has been collected (Heilman, in press). When told that a moderate rather than the traditionally meager proportion of women would populate a given occupation during the next decade, female high school students expressed a greater interest in that occupation. They also indicated a higher estimate of their probability of success. These results attest to the fact that the number of women within an organization or professional group communicates important information to women actively seeking career paths.

Number is not necessarily the only issue; visibility may be very critical. Anecdotal evidence supports this contention. After this author had been a member of the faculty for several years, she was appointed the director of her undergraduate program at Yale College. Immediately following this appointment there was a sudden and dramatic increase in the number of women who “signed up” for that major. Similar trends have been evident in female course enrollments when women rather than men faculty members are instructors. Although causation obviously cannot be attributed in these cases, they nevertheless provide food for thought.

The reasoning implied here appears to be rather circular. If a woman’s career choices are determined by the conspicuous presence of successful women already in that career, then occupations currently without women would never shift in sexual composition. Of course this is not so. Many other factors besides the existence of role models enter into career decisions. But the perceived absence of women within the occupational ranks may deter the entry of women and/or slow down the rate at which they seek access to a given career.

Nontraditional career choices can be inhibited both by the stereotypical beliefs of vocational counselors and also by the tacit messages conveyed by the sexual composition of an occupational group. Despite these potential deterrents, some women do select nontraditional career paths.

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I have laid down the rule that I shall sleep with each one for four days in succession, and then go to the other. I find them [my wives] both equally desirable, but when I have slept with one for three days, by the fourth day she has wearied me, and when I go to the other I find that I have greater passion, she seems more attractive than the first, but it is not really so, for when I return to the latter again there is the same renewed passion.

Lowie similarly treats Morgan’s hypostatized “group marriage” stage of evolution. By rephrasing “group marriage” as “sexual communism,” Lowie first demotes the stage from the social organizational to a sexual level and then shows that when it occurs it is temporary, sometimes existing simultaneously with marriage. Lowie’s demonstration is designed to show that the institution of “sexual communism” has nothing to do with unrestricted sexual license but is a native notion of reciprocal hospitality. Because some sexual partners overshadow others, Lowie concludes that the husband “enjoys an undisputed preemptive right over his wife”. Again, Lowie emphasizes considerations of reciprocity and obligations, while systematically denying the relevance of erotic dimensions in this so-called communism.

Morgan and Lowie reach similar conclusions about erotic sexuality, but for different reasons. Morgan assumed that sexuality had been transformed in all existent societies of his day, since societies are by definition social and not sexual, but Lowie completely disregarded sexual/erotic considerations in his criticism of Morgan’s unilinear evolutionary theory. In both cases, the study of the sexual/erotic is not relevant to larger theory. Followers of Morgan’s Ancient Society or of Lowie’s Primitive Society will equally disregard sexual matters in cultural analysis.

This side-stepping of the cultural study of sexuality, as it were, has at least two ramifications for contemporary studies. The first is a generally conservative approach to sexuality, treating it in the context of marriage, if at all. The second consequence is more subtle, as it stems from the decision to treat sexuality as a universal physiological phenomenon which everywhere is limited in certain ways by social constraints. Suggs and Marshall, for example, view the relationship between physiological sex drive and society as universal. Again, as in Morgan and Lowie, there is an implicit shift from sexuality to sociality. Should we follow Suggs and Marshall, we would attempt to compare societies as social controlling mechanisms, that is, we would ascertain the ways in which the same physiological drive was contained and cathected cross-societally. We would learn, for example, that adult male sexual drive is distributed differently in marriage in polygynous as opposed to serial monogamous societies, and we would seek the mechanisms which regulate men in these two societal types. These mechanisms, often called “institutions,” then become the focus of a comparative study. Although this general approach can be useful, the system of meanings attached to sexual symbolism is equally important; we should look at the symbolic dimensions of social action, not just the variation of constraints on behavior.

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A typical example of the way adultery viewed and managed is described in Davenport’s account of the East Bay people. Before marriage, control of the right of sexual access to a young woman belongs to her father. When the bride price is paid to him at her marriage the controlling right passes to her husband and any kin who contributed to the bride price. Adultery, then, with a married woman is an offense against the husband and the other contributors. Although a wife has some of the same rights in her husband, she, as a woman, has no recourse to law. Therefore, any offense by her, as the accused or the accuser, immediately affects those close male kin who are her legal representatives. If the offense goes into litigation, it affects the men of several families and may become very complex, as all the offended ones must finally be compensated in money. Although most of the concern seems to be for the violation of the rights of the men with an investment in the woman, the moral culpability rests more heavily on the man in the adulterous relationship. In this society, in which women are trained to serve and to be obedient to the men with legitimate authority over them, it is expected that they are unable to refuse the request of a male for sexual services, especially if he offers presents. . Another widespread pattern includes the expectation that husbands will stray, but wives will be faithful. In Tepoztlan sexual promiscuity is for males only, and married men are expected to prove their masculinity by having affairs, usually with widows, unmarried women, or prostitutes. Husbands are anxious about their wives’ fidelity in the early months of marriage and feel most secure when they are pregnant or caring for an infant (Lewis).

In horticultural societies there is often an option according to which adults can have sex with someone other than a spouse (Friedl). Even so, adultery is thought to be risky for both partners and may be punishable by penalties or divorce. Men have firmer entitlements to their wives’ sexual services than do wives to their husbands’. An adulterous man may be required to pay a penalty to the husband of his lover or to her father if she is unmarried. A wife, however, cannot usually extract a penalty from the woman with whom her husband is involved.

Finally, Schneider described an institutionalized form of adultery among the Turu of Tanzania. The lover relationship, called mbuya, is compared to romantic love in the West, with the same components of courtship, mooning, and jealous, possessive behavior. Love songs are composed and gifts exchanged. The furtiveness of the relationship adds to its delights, so that its clandestine nature may be preserved even when the affair is well known to everyone and tacitly approved by the husband. A husband may forbid such a relationship but may have difficulty doing so, since others will not cooperate with him. His wife may point out to him that he, himself, has a<— mistress, юг she may go to her father and request an annulment of her marriage on the grounds that her husband is treating her shabbily.

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It was in the early twentieth century that connections between the immune system and the altered reactions of allergy were made. An immune system operating in this way was termed ‘hypersensitive’. Experiments in the 1920s showed that hypersensitive reactions to pollen or food could be transferred from one person to another, by injecting a small amount of blood serum from the allergic person into another. The previously unaffected person would show reactions to the allergen, demonstrating the involvement of the immune system.

A further major advance took place in the 1960s when IgE, the antibody particularly associated with allergic reactions, was identified. One of the main lines of attack used by the body’s immune system against any substance entering the body is to produce antibodies that bind to the invading substance and activate the rest of the body’s defences by chemical reactions. IgE is one such antibody. Its proper function is to defend the body against parasites, such as worms, which could infest the body. The first time such an invader – called an ‘antigen’ – enters the body, the immune system produces specific IgE antibodies, which then attach themselves to cells in tissues and the bloodstream ready to react should the invader return. There is no reaction as such on the first encounter.

IgE antibodies are primed to bind specifically to the antigen they have already recognised. They are lodged in cells known as ‘mast cells’ in solid tissues, and in ‘basophils’ in the bloodstream. Mast cells are especially common in the breathing passages, lungs, gut and digestive tract, and in the skin. There, the antibodies lie in wait for the returning invader. If it returns in the bloodstream, they recognise it and lock on to the molecule of the antigen, thus triggering chemical reactions and the release of chemicals in the body. ‘Histamine’ is released immediately, while other chemicals – ‘leukotrienes’ and ‘prostaglandins’ – are released more slowly. These chemicals are very powerful and stimulate defence mechanisms to expel invading parasites.

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