Blog About Health & Medicine

Husband and wife repeat the following sentences: “It’s difficult for me to say that I respect you.” “And it’s difficult for me to say that I respect you.” “If I say I respect you, I’ll …” (Say whatever comes to mind next.)

“And if I say I respect you, I’ll …” (Say whatever comes to mind next.)

“I feel I’m giving something away if I say I respect you.”

“And I feel I’m giving something away if I say I respect you.”

“My mother had contempt for my father.” “My father had scorn for my mother.” “My brothers teased my sisters.” “And my sisters degraded my brothers.” “It’s difficult for me to accept your respect or admiration.” “And it’s very hard for me to accept your respect or admiration.”

“If you say you respect me, I’ll …” (Say whatever comes to mind next.)

“And if you say you respect me, I’ll …” (Say whatever comes to mind next.)

“I don’t feel worthy of your respect because …” (Say whatever comes to mind next.)

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The eighteen cards (sixteen high cards and two jokers) are placed face down on the middle of the table. Then the husband and wife take turns drawing one card from the deck. Each time one draws a card, the other asks, “Play or pass?” If the card holder wants to play, he or she must do whatever is written on the card. If he or she says “Pass,” that player may keep that card and draw again. Each partner is allowed three passes per draw. However, he or she must put $50 in the jackpot for each pass. After three passes, should a partner refuse to play, he or she loses the game and forfeits the jackpot. (The jackpot includes the sum of money that is begun with—perhaps $100, contributed to equally.) If each performs what the cards dictate, the winner is the one with the fewest passes. If the game is still tied at the end, the jackpot is divided—and each partner becomes a winner in more ways than one.

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Once the blindfold is (or the blindfolds are) in place, the couple should lie side by side and slowly explore one another’s naked body. They should start by touching nonerogenous zones—forearms, elbows, calves, knees, the top of the head. Next they should caress the erogenous zones, but without dwelling on them—the inner thighs, the inner arms, the ears, the back of the neck, the nipples, the lips, the penis, the vagina. Finally, they should make love. No words should be spoken during the game, but the couple are encouraged to make mental notes of their thoughts in order to talk about them later.

The blindfold acts as an artificial barrier, filtering out the visual effects and the negative judgments that inhibit sexual desire. It also serves as an aid to regression: Being blindfolded brings about a feeling of powerlessness and submissiveness associated with childhood, and likewise arouses the primitive erotic feelings known in childhood. Youthful passion, as we all know, is stronger than adult passion mainly because it has not undergone the “thousand and one shocks that the flesh is heir to” (as Shakespeare put it). The game is designed to help participants rediscover both play and the intense feelings of lust they have been inhibiting (and perhaps been afraid of).

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The game is straightforward and is played by mutual consent. It begins with the “dominant” partner (in this example, the wife) ordering the “submissive” partner, “Take off your clothes and lie on the bed.”

The submissive partner says, “Yes, Madam.”

“And hurry up about it.”

“Yes, Madam.”

The submissive partner undresses but the dominant one remains dressed. When the submissive partner is naked and lying on the bed, the dominant one ties him, hand and foot, to the bedposts or railing (or in some other convenient way), using a soft rope that will not burn the skin. When the submissive is tied down, the dominant stands over the bed, grinning.

“Now you’re going to get what you’ve had coming.” “I am?”

“You are. You’ve been bad, and you know you’ve been bad.”

“I have?”

“Yes, very bad. I’ll show you how bad you are. Do you like this?” (Puts hand on submissive partner’s crotch.) “Yes.”

“You see how bad you are? You like my hand on your dirty thing.”

“Yes.” … “Yes, Madam!”

“Yes, Madam!”

“Now I’m going to punish you.” “What are you going to do?”

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Players: Husband and wife.

Activists: Both.

Setting: Home or away.

Obsessive-compulsives have fixations at this stage, for they usually had parents who were obsessive-compulsives and chastised the kids severely any time they got very dirty. This also corresponds to the potty-training (anal) stage, when children like to play with their feces and are scolded by parents for that. Second, the game gives the compulsive slob more than he or she bargained for, and challenges the rigidity of the obsessive neatnick. This experience creates stress and also liberates them from their guilt-ridden defensive attitudes. When two people are sitting in a tub with (the perfect example) egg on their faces, all pretenses quickly fall aside.

One thing usually leads to another, and the wrestling turns to erotic play and then to sex. It also leads to a fresh look at one’s general modes of relating and of sexuality.

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From the viewpoint of practicality, it is impossible to summarize in any adequate way the enormous and highly diverse amount of data on which this sex-offender study is based. Consequently this epilogue should not be construed as any summary, but as more of a postscript listing some thoughts we wish to leave with the reader.

It is clear that there is such a wide variety of types and subtypes of offenders that no sweeping generalizations should be made. There is no common denominator distinguishing all sex offenders. One cannot speak of “the sex offender,” and only in well-defined circumstances can one speak of “most sex offenders.”

Certain variables of behavior or vital statistics are important in particular types of offenders as, for example, the high frequency of self-masturbation characteristic of homosexual offenders, but inconsequential in other types of offenders, and the sexual restraint typical of the incest offenders vs. adults.

Some of the variables common in the sex offenders are seen also in the prison group and should not be considered as peculiar to sex offenders, but rather as associated with poverty, emotional and material deprivation, familial and employment instability, and lesser education. Persons who have grown up under and never escaped from such adverse conditions are likely to be convicted for some sort of offense, sexual or otherwise.

We interpret our data to show that there are two broad classes of sex offenses:

1.    Offenses consisting of behavior which is statistically normal and otivated by desires which most laymen and clinicians would consider within our cultural norms. One might summarize these offenses as “normal” but for various reasons inappropriate and punishable. Such offenses would include sexual activity with willing postpubescent unrelated females and occasional opportunistic peeping. These offenses do not seriously threaten social organization, and psychological damage to the individuals is generally absent or minimal. Consequently our

social sanctions should be tempered accordingly and society should expend a minimum of time and money with such cases.

2.    Offenses consisting of behavior which is statistically uncommon and motivated by desires which most laymen and clinicians would consider definitely outside our cultural norms and/or pathological. Such offenses would include those involving force or serious duress, those involving prepubescent children, most incest offenses, exhibition, and compulsive peeping. These offenses tend to disrupt social organization, if only by the furor they cause; the possibility of individual psychological damage is greater; and the offense may constitute a public nuisance. It is on these offenders that society should focus attention and be prepared to spend money for detention, treatment, and research.

Some behavior, such as homosexuality between consenting adults, falls in neither broad class. When an activity does no direct harm to the individual or others and yet is frowned upon by the layman, clergyman, and clinician, we have a problem of great philosophical complexity. Concepts of individual freedom, the relation of the individual to society, religion, mental health, and social function are all interwoven. No single answer can be sufficient for this problem, and the solution probably lies in a series of alternatives of action and attitude gradated to suit circumstances and permitting freedom but preventing public affront.

It is obvious that within the foreseeable future there will be no great reduction in the number of sex offenders unless our laws are changed to an unlikely degree. Man’s sexual drive inescapably clashes with the numerous, complex, and often contradictory demands society makes upon its members. Consequently, sexual behavior which is legally punishable is commonplace, and the question of who is caught and punished depends upon variables such as intelligence, impulse control, socioeconomic status, alcohol intake, and simple chance. However, we need not be pessimistic. With increasing knowledge we can ascertain more accurately what situations predispose toward the more serious sex offenses and, armed with such knowledge, prevent some of them. Given the data in this present volume and life histories of individuals comparable to the histories we took, one could predict with an accuracy better than chance what sort of sex offense an individual would commit were he to commit one. Deficient and crude though it may be at this stage of our knowledge, such predictability is most useful to the psychiatrist, psychologist, parole officer, and social worker. Furthermore, with increasing knowledge we can improve not only our diagnostic and therapeutic measures but also arrive at more rational viewpoints ourselves.

Ultimately our society may solve many of its sexual problems by

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It is obvious on logical grounds that we were destined to find significant differences between sexual psychopaths and other offenders. It would be strange indeed if several screening operations which included sexual criteria resulted in two groups with essentially identical sexual characteristics. Assuming that the clinicians did not change their criteria when examining persons in different offense types, we were also bound to find some uniformities existing among the sexual psychopaths, giving an impression of some homogeneity.

The sexual psychopaths may be described as a relatively intelligent, better educated, younger group of males who had difficulty in adjusting emotionally and socially with their parents and peers. Not unexpectedly they had even greater difficulty in working out sexual adjustments with adult females. This trouble was associated with greater inhibitions, especially moral inhibitions, concerning heterosexual activity. Despite these inhibitions the sexual psychopaths were more inclined toward socially unacceptable sexual behavior: homosexuality, cunnilingus, and contact with animals. Lastly, they did not avail themselves of the common escape mechanisms of gambling, alcohol, and drugs.

Refining this description still further, the sexual psychopaths must appear to the clinicians as a reasonably bright, well-educated group of younger men tied up with inhibitions and emotional and sexual problems giving rise to socially unacceptable sexual behavior, some of which resulted in their imprisonment. Note that this abbreviated description contains three vital elements:

The sexual psychopaths are amenable to treatment because of their intelligence, youth, and education.

The sexual psychopaths are more like the private patients with whom the clinician has worked than are the other offenders.

The sexual psychopaths are in many respects like the upper socioeconomic level male (including the clinician) in their greater education, inhibition, morality, and conservative heterosexual life.

This description partially answers the basic question: does the division of sex offenders into two sexually differing groups—sexual psychopaths and others—serve any useful purpose? If the sexual psychopathy procedure winnows out those men with whom the clinicians can work most effectively and comfortably, and with a higher probability of alleviating their problems or at least ameliorating their behavior, then its existence’ is justified. This procedure would also redefine the sexual psychopath simply as a sex offender more amenable to treatment than others.

But such a definition and procedure bring us to a deep confusion in the sexual psychopathy laws. If the primary function of these laws is to segregate the dangerous, their objective is not being achieved, for some of the most dangerous men are those rejected as sexual psychopaths merely because they are not amenable to treatment, while some of the least dangerous (e.g., homosexual offenders vs. adults) are retained. If, conversely, the primary purpose is to select those more amenable lo treatment, we must then ask, “treatment to what end?” The judge and the public at large would answer that the aim of treatment is to pro

vent the repetition of socially unacceptable sexual behavior. If we accept this definition, then the sexual psychopathy laws should exclude most of the confirmed homosexuals as untreatable. However, on the whole, clinicians define the aim of treatment as simply making at possible for the person to return to society and function without serious trouble. From this point of view, the confirmed homosexual need not be “cured,” as the judge or layman would probably desire, but instead can be taught how to live without offending others and how to avoid undue risks. If we now restate the question and ask whether the sexual psychopathy laws are useful in sifting out persons who can best be treated and returned to society, we can answer that this appears to be true in California and could be true in other jurisdictions.

In summary, the concept of sexual psychopathy is vague and probably invalid from a psychiatric and scientific viewpoint, but has a certain practical utility in sorting out those patients who are more likely to benefit from treatment.

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Among our six comparative sex-offense types from roughly three quarters to one half of the sexual psychopaths and other offenders had some gambling experience. In five of these six groups the sexual psychopaths had fewer individuals with such experience, the differences ranging from three to 23 percentage points. Only among the aggressors vs. adults did the sexual psychopaths exceed their nonpsychopath counterparts in the proportion with gambling experience.

From 7 to 29 per cent of the sexual psychopaths and other offenders had used, at least once, some drugs or marijuana. In five of the six sex-offense types the proportion of sexual psychopaths was smaller, the difference between their figures and those of the other offenders being seven to 12 percentage points. The exception was the incest offenders wherein the proportion of sexual psychopaths with drug experience was substantially increased by an unexpectedly large number of marijuana smokers.

A tabulation of whether or not a person ever drank alcoholic beverages did not differentiate sexual psychopaths from other offenders, but a subdivision based on the degree of alcohol use proved very illuminating. The sexual psychopaths were far more moderate in their alcoholic consumption than were the other offenders. In all but one of our comparisons they had substantially larger proportions of men who used alcohol very little or rarely, and substantially smaller proportions of alcoholics. For example, the sexual psychopaths had from 7 to 18 per cent of their number rated as having been alcoholic, whereas the range for the other offenders was 20 to 33 per cent. In the individual comparisons the differences were from eight to 25 percentage points.

This lesser use of alcohol by the sexual psychopaths is certainly to some unknown degree the result of the clinicians’ using amenability to therapy as a criterion in determining who shall be called a sexual psychopath. Because heavy drinking and particularly chronic alcoholism create such an unfavorable prognosis there appears to have been a tendency to eliminate such men from the initial step in the sexual psychopathy procedure (i.e., asking for an examination). Even if an alcoholic were caught up in the sexual psychopathy procedure, there was again a tendency to regard him as untreatable and hence not diagnose him as a sexual psychopath.

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Whether or not the organisms that cause proctocolitis, proctitis, and enteritis are acquired sexually, the symptoms are usually those of a gastrointestinal illness. How much time elapses between initial infection and the appearance of symptoms depends on which infection is present. Although abdominal pain and rectal discharge are common, the specific symptoms depend on which area of the gastrointestinal tract is involved.

The symptoms of proctitis include pain in the anal area, a mucous discharge from the anal area, constipation, and feeling an urgent need to have a bowel movement without being able to do so, despite straining. Blood may be noticed in the stool or when wiping after a bowel movement. If the proctitis is caused by herpes or syphilis, then lesions may be present. Infections such as chlamydia and gonorrhea usually produce far fewer symptoms in men when they are present in the rectum than when they are present in the urethra.

The symptoms of proctocolitis are generally the same as for proctitis, with the addition of diarrhea and abdominal pain. Less often, proctitis and proctocolitis are symptom free.

The symptoms of enteritis include diarrhea and cramping or pain in the abdominal area, often in the lower left abdomen. Nausea and bloating often accompany these symptoms. The diarrhea may be bloody, depending on which organism has caused the infection, and there may also be a mucous rectal discharge. Other possible symptoms include fever, chills, and malaise (a generalized sense of not feeling well). Significant weight loss can result if food is not absorbed well because of inflammation in the bowel.

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