Susan Kolod, Ph. D

September 7, 2016

Terrorists or Copycats? What’s the Difference?

Detailed coverage of attacks can lead to contagion

By Sue Kolod, Ph.D.

Yasser Arafat, the former Chairman of the Palestine Liberation Organization, famously stated in his 1974 speech before the United Nations that, “One man’s terrorist is another man’s freedom fighter.”

But there is reason to suspect that the killers in the recent Orlando, Nice and Munich attacks were neither freedom fighters nor terrorists at all, but individuals with personal grievances struggling somewhere between rage, suicide and homicide.

The “Copycat” Effect

Self-destruction can be contagious. Research demonstrate the “copycat effect” of highly publicized acts of suicide. The news coverage of Marilyn Monroe’s death in 1962 was extensive and sensational. According to one study, the suicide rate after her death in the United States jumped by 12 percent relative to the same months in the previous year. People at risk of suicide are vulnerable. The extensive and sensational publicity around the suicide of a celebrity can add coins to the scale, tipping at-risk individuals toward identification and imitation.

A similar “copycat effect” has been found after non-ideological mass shootings. A study in Germany of mass shootings, i.e., attacks in which an individual goes on a rampage killing people without any apparent motive, found that such attacks do not occur randomly over time. One attack is frequently followed by others within a matter of weeks. Research suggests that many US mass shootings, such as the one at Virginia Tech, were inspired by Columbine. Shooters who have survived their attacks have claimed they wanted to surpass the attacks in the Colorado suburb. This has been called the “Columbine Effect“.

The “copycat” or contagion phenomenon most recently has been applied to the “terrorist” attacks in Orlando, Nice and Munich. The New York Times, in response to the spate of mass killings, questioned whether these killings by self-professed “terrorists” should be properly labeled as “terrorism” or attributed to the contagion effect. (Terrorist or Disturbed Loner? July 24, 2016) and (Mass Killings May Have Created Contagion, Feeding on Itself, July 26, 2016).

The Label of “Terrorist Attack” may exacerbate the contagion

Are these shootings, in fact “terrorist attacks” or are they more accurately described as the acts of angry, disturbed young men seeking power, fame and a sense of identity? Perhaps, such mass killings are more a problem of public health than of the “War on Terror.”

If so, the solutions are complex: finding ways to identify persons at risk of acting out such suicidal terrorist fantasies; finding ways to encourage such persons into treatment; finding ways to limit easy access to the motivating ideologies; and finding ways to limit easy access to means of mass destruction, such as assault weapons and explosives.

Omar Manteen (Orlando), Mohammed Bouhlele (Nice) and, most recently, Ali Sonboly, the Munich shooter, all had histories of either domestic violence, petty crime, alienation, or a series of life disappointments. Unlike the perpetrators of 9/11 or the Paris and Brussels attacks, none of these men had direct ties to a global terrorist organization. They were merely alienated and troubled young men.

ISIS, of course, is happy to claim responsibility.

Madelyn Gould, professor of epidemiology and psychiatry at Columbia, worries, “Those of us in this field, it’s the first thing we think about when we read accounts of these recent mass murders: The detailed coverage of terrorist attacks may be giving people who are vulnerable or thinking along these line ideas about what to do and how to do it.”

Dr. Salman Akhtar, psychoanalyst, has written extensively about terrorism, its causes and ways to address it. “When you sit and talk with smart people, you get smarter, when you swim with good swimmers, you become a better swimmer. The same is true in the opposite direction; if you interact with/emulate people who engage in anti-social behavior, unacceptable behavior gradually becomes acceptable.”

When an attack is linked to a powerful threat such as ISIS it can inspire an alienated young man to “achieve” even greater bloodshed and carnage. For someone who is unmoored, this can create a sense of belonging and identity. The shooter becomes an overnight celebrity. And by labeling these massacres as “terrorist attacks” we may be exacerbating the copycat effect.

The copycat effect with mass killings, as with suicide, depends on the prominence of the coverage, the ways in which the details of the shooting are reported and the portrayals of people affected by the attacks. Young men who are struggling with thoughts of suicide and homicide, may use these reports as a guide or to feed their own fantasies of glory.

Both Dr. Gould and our own Wylie Tene, Director of Public Affairs of the American Psychoanalytic Association, have been working on guidelines for journalists to reduce the likelihood that media coverage will lead to the “copycat effect”. These guidelines will be similar to those already established for limiting suicide contagion: www.reportingonsuicide.org

It is hoped that following these guidelines when reporting on mass shootings will diminish and limit the “copycat phenomenon”. When writing about these events, remember that words matter. Before you label the next mass shooting a terrorist attack, think about the potential, yet inadvertent, consequences.

Susan Kolod, Ph.D. is the Chair of the Committee on Public Education of the American Psychoanalytic Association. She is a supervising and training analyst and co-editor of the blog, Contemporary Psychoanalysis in Action at the William Alanson White Institute. Dr. Kolod was a speaker at the conference, Violence, Terror and Terrorism Today, May 12, 2016 sponsored by the International Forum of Psychoanalysis.

Will A Pink Pill Make Me Horny?

It depends what kind of sexual problem you are having

By Susan Kolod, Ph.D.

Flibanserin or “Addyi” is the first drug approved by the FDA to treat Hypoactive Sexual Desire Disorder (HSDD) in women. The drug will become available on October 17th. There has been much discussion in the media over whether the drug is pro or anti-feminist. But the really important question is, “does it make you horny?”

How Does Flibanserin Work?

Flibanersin treats desire, unlike Viagra, which improves performance. Flibanserin is not “female Viagra”–Viagra is taken before sex and it pretty much assures an erection. Flibanserin must be taken every day and is being marketed as a drug to increase desire. So how does Flibanserin actually increase sexual desire?

To find out, I spoke to the expert on rat sexuality, James Pfaus, Ph.D., and learned how Flibanserin affects female rats with the hope this might shed some light on how it affects women.

Pfaus, Professor, Concordia University and President Elect, International Academy of Sex Research, gave me a crash course on the sexual behavior of female rats. Female rats love sex and make their desires known very clearly. They pursue sex actively with partners they find attractive and avoid sex with rats they don’t find attractive. They love to have their clitorises stimulated with a paint brush. No slut-shaming among rats.

In Pfaus’ lab, rats whose ovaries had been removed were administered a low dose of estradiol and then Flibanserin. The low dose of estradiol created a sex hormone scenario similar to women going through menopause. Usually, a female rat whose ovaries have been removed and is given a low dose of estradiol will not initiate or “solicit” sex. After a

two day trial, Flibanserin restored these rats to their normal rate of solicitations. Impressive results!

However, human sexuality cannot be observed so easily, nor is it so straightforward. In the drug trials, some women were given Flibanserin and others a placebo. All were asked to keep a diary of their sexual experiences. They also met with a psychologist once a week. Self-report, especially about sex, is notoriously subjective and often inaccurate.

Diary responses were analyzed for SSE’s or Satisfying Sexual Events. An SSE can be anything from masturbation to multiple orgasms with a partner to intimate touching. It is a broad and somewhat vague concept–it just measures how many times you “did it,” the “it” being something defined as sexual. So an SSE doesn’t really capture the experience of desire.

Flibanserin appears to be a lot more effective with female rats than with women. The increase in SSE’s was only .7 per month for women as compared with an increase in sexual solicitations of 3.94 per month in the rats!!

However, human SSEs and rat solicitations may be two different things.

Appetitive and Consummatory Motivation

Pfaus makes a distinction between “appetitive” and “consummatory” motivation in sexuality. Appetitive motivation is the first phase of a sexual encounter and involves the initiation and anticipation of sex. Appetitive behavior moves the animal (human and non-human) towards an attractive potential sexual partner and is more indicative of spontaneous desire. For example, female rats will press a bar to get access to a male sex partner. This is appetitive behavior.

In humans, appetitive motivation includes such behavior as flirting, planning for a date, fantasizing about a date.

Consummatory motivation, on the other hand, leads to actual physical interaction and completion of the sex act. In female rats, lordosis–arching the back and sticking out the buttocks so the male can mount her–is a consummatory behavior. In humans, foreplay, touching and actual sexual contact, and orgasm are consummatory.

It is possible that different drugs help with problems in one phase, but not another. Pfaus suspects that Flibanserin increases appetitive motivation. In other words, it might help a woman to feel sexual desire towards a partner, to anticipate sex with that partner, and to be motivated to initiate sex.

Three other drugs, still being tested by the FDA, Lybrido, Lybridos and Bremelanotide, may effect the consummatory sytem by maintaining excitement throughout the sexual encounter and facilitating orgasm.

Who Will Flibanserin Help?

Flibanserin, Pfaus suspects, will be most effective with women who are highly organized and always planning ahead. They may find it difficult to be “in the moment.”

For example, Stacey and Linda have been together for 18 years and married for the last 5. They have 2 small children. Stacey is highly organized both in terms of the household and at her job. She often feels overwhelmed by all of her responsibilities. Although she is very attracted to Linda, she is unmotivated to initiate love-making because she is always planning the next thing. This is exacerbated by feelings of resentment towards Linda who is not helping enough with the kids and the housekeeping.

While the interpersonal issues need to be addressed, Flibanserin might help Stacey to feel spontaneous desire and to be “in the moment.” The drug could be a good adjunct to couples’ therapy.

Flibanserin might be less helpful for a woman who can experience spontaneous desire but can’t sustain her excitement. Some of the other drugs to treat HSDD such as Lybrido, Lybridos or Bremelanotide, still being tested by the FDA, could be more helpful with difficulties maintaining excitement and reaching orgasm. These three drugs do not need to be taken every day—only before having sex, like Viagra.

The best outcome would be that a number of different drugs will become available as adjuncts to psychotherapy, couples therapy and sex therapy. And that women will be comprehensively informed about the risks and benefits. Women are entitled to make the best choices for themselves about what makes them horny and helps them to enjoy sex!

Susan Kolod, Ph.D., is a Supervising and Training Analyst, member of the Faculty, co-Editor of the blog, Contemporary Psychoanalysis in Action and on the Steering Committee of the Eating Disorder, Compulsions and Substance Abuse Program (EDCAS) (link is external) at the William Alanson White Institute (link is external). She has lectured and written about the impact of hormones on the psyche with a particular focus on sexuality, menopause and the menstrual cycle. She is in private practice in Brooklyn and Manhattan.

February 27, 2015

Why “Eat Less, Move More” Often Fails

By Susan Kolod, Ph.D.

If you want to lose weight, the solution is simple: eat less and move more, right? Everyone one knows that. But eating less and moving more is a lot easier for some people than others. It is easiest for people who are in the normal weight range and have perhaps gained a few pounds over the holidays. New research explains why this approach often fails with obese individuals. And why some calories are better than others when seeking to lose weight.

The role of hormones

Feeling full or hungry, energetic or lethargic, can be traced to certain hormones—in particular, leptin and insulin. Normally, when a body’s fat cells are filled with stored fat they release the hormone Leptin, which tells the brain to eat less and move more. However, when a person becomes obese this “signaling” goes awry. Leptin is not longer released and the message to the brain becomes “eat more and move less.” Thus eating more and moving less, thought to cause obesity, may actually be the RESULT of obesity.

Sean Lucan, M.D., M.P.H, Albert Einstein College of Medicine in New York City and James DiNicolatonio, Pharm.D., Mid-America Heart Institute of St. Luke’s Hospital, Kansas City Mo., conduct research on weight loss, obesity and public health issues. They suggest that the culprit in the perpetuation of obesity is refined sugar, rapidly absorbable carbohydrates and the hormone Insulin. Refined sugar and starches cause blood sugar to rise. The rapid elevations in Insulin results in a precipitous drop in blood sugar. This causes food cravings, especially for sweets.

Over time, the overconsumption of refined sugars and starches can result in “Leptin resistance,” which leads to an inability to determine fullness. Thus, the result of a dietheavy on refined sugar and starches is increased appetite and decreased activity—a dangerous cycle, and difficult to reverse. The researchers conclude that it’s not the number of calories consumed that accounts for obesity, but rather the type of food consumed—refined sugars and starches in particular. These foods can make changes to the brain that interfere with the ability to determine fullness and cause lethargy.

The problem with “eat less, move more”

Lucan and DiNicolantonio explain why an approach that advocates eating fewer calories is inadequate and simplistic, “By this thinking, a calorie’s worth of salmon, olive oil, white rice or vodka would each be equivalent and each expected to have the same implications for body weight and body fatness.” In fact, proteins, fats, carbohydrates and alcohol each have different effects on hormones relevant to feeling full. Lucan and DiNicolantonio suggest more nuanced thinking about weight loss. That is, some calories satisfy appetite and promote energy while others promote hunger and energy storage—in other words, not all calories are the same.

In addition, if you simply eat less food and consume fewer calories, you will become more tired and hungry—therefore, less likely to want to move more. The cravings for high-calorie foods increases with deprivation, making it more likely that binge eating will occur.

What foods make you want to eat less and move more?

It is more important to consider the type of food than the number of calories consumed. Some foods make you want to eat less and move more—other foods make you want to eat more and move less.

For example, fat, which is high in calories, can satisfy the appetite and promote activity. Nuts, dairy products, oily fish and olive oil are high in fat and calories. But these foods make you feel full and energetic. This makes is possible to eat less and move more, which leads to sustaining weight loss.

Diets that simply restrict calories and pay no attention to the types of food consumed can backfire especially among obese individuals who have become leptin resistant.

In order to reverse leptin resistance, it is necessary to change the types of food to those that will re-calibrate the signaling to the brain—and will promote a feeling of fullness and energy.

A public health issue

It does very little good to blame over-consuming inactive adolescents for getting fat. The advice to simply consume fewer calories and increase exercise is counter-productive. New research suggests that overconsumption and inactivity are caused by neurohormonal changes related to a diet filled with refined sugar, starches and processed food. Promotion of whole/minimally processed food with plenty of “good” fats such as olive oil, oily fish and nuts address the cause, rather than the effect. And may also address the sense of failure and hopelessness many obese people experience when they are told to simply, “eat less and move more.”

January 6, 2015

The Pleasures and Perils of Fighting Among Ourselves

A polarized group becomes less effective as its members become more certain

By Susan Kolod, Ph.D

Polarization occurs when people on either side of a conflict take increasingly extreme opposing positions. A new Pew Research study demonstrates polarization is at an all-time high in American politics. Striking examples of polarization are evident internationally as well. Many groups define themselves as having a common enemy—there is agreement that those who hold the opposing view are wrong. This draws people together and engenders feelings of righteousness, virtue, clarity and certainty. Ambiguity is banished.However, polarization has very very bad consequences.The Bad NewsAs a consequence of polarization, trust and respect for the “other” group diminishes, while distorted perceptions and stereotypes emerge. Negative qualities are attributed to individuals in the opposing group, while members of one’s own camp are viewed as positive and virtuous. The disagreeing parties assume more and more rigid positions and may refuse to negotiate. Those who try to take more moderate positions are sometimes viewed as “traitors.”People are often quick to recognize and loathe qualities in others that they find repugnant in themselves–such as greed, desire for power or hypocrisy. When groups become polarized questionable behavior, which is typically evident in both groups, is only recognized in members of the opposing group, who are then identified as bad or evil.Polarization depletes creativity and saps a group of its energy. People exclude and marginalize one another. Although this can create a feeling of safety in the short run, over time, the group loses the vitality and “cutting edge” that come with collaboration.An Example of Polarization

A synagogue in a small Midwestern city became polarized when the rabbi refused to perform same-sex marriages. The rabbi is a very intelligent, kind and perceptive person. However, he is quite conservative and unbending on certain issues. The executive council of the synagogue was divided on the issue of same-sex marriage, but the rabbi made it clear that on this issue he would not budge.

The congregation is a diverse group of individuals who run the gamut from very conservative to very liberal. Although there is a fair amount of disagreement, people in general respect one another and there is a high level of tolerance towards ambiguity, complexity and uncertainty. However, the issue of same-sex marriage divided the congregation into two camps—“for” and “against.”

The enemy of my enemy is my friend. The regrettable wisdom of this proverb was manifested in the congregation as it became ever more polarized:

People who had not been close previously began to bond with each other and against the other side.
If they had opposing views, people who had been friends broke off relations.
Each side accused the other of ill-intentioned behavior, but did not recognize it in themselves.
Energy, enthusiasm and a sense of belonging to a single cohesive group were eroded.
Both groups felt disrespected and maligned by one another.
The atmosphere of fear and anxiety spread to other issues.

What Causes Polarization?

Kenneth Eisold, Ph.D., author of What You Don’t Know You Know: Our Hidden Motives in Life, Business and Everything Else, is apsychoanalyst and Faculty member at the William Alanson White Institute. One of Eisold’s specialties is consultation with polarized organizations (like businesses and charities)—he helps them reestablish a collaborative atmosphere.

Eisold emphasizes that polarization is a normal process–it often develops when people become overwhelmed with complexity and uncertainty. He notes that individuals within a polarized group think in terms such as, “I know where I stand and what I feel.” This is very satisfying when the group has just gone through a period of intense stress and confusion.

What Can Be Done?

Eisold emphasizes that working with polarized organizations is tricky: “Timing is key. When a group is in the midst of polarization, they need the simple clear version of events…they lose ability to listen to the views of the other. There is no point in trying to intervene while a group is in the midst of intense polarization. But once a group reaches a point where they are asking for help, something can be done.”

When that occurs, Eisold uses various techniques to help the two groups come to a more moderate position, such as asking members of each group if there was a time when members of the “other” group were seen as having positive qualities. Such reflection often catalyzes a shift back to tolerance and unity. Having members of opposing groups work together on specific projects with a common aim is an effective way to bring people back together, enlivening their interactions and recapturing the energy of cooperation.
Susan Kolod, Ph.D., is a Supervising and Training Analyst and co-Editor of the blog, Contemporary Psychoanalysis in Action at the William Alanson White Institute. She has lectured and written about the impact of hormones on the psyche with a particular focus on sexuality, menopause and the menstrual cycle. She is in private practice in Brooklyn and Manhattan.

August 14, 2014

New Publication in the Journal, Contemporary Psychoanalysis

Volume 50:3, 484-491

2014

READING THE FEMININE MYSTIQUE ON THE 50th ANNIVERSARY OF ITS PUBLICATION

By Susan Kolod, Ph.D.

On the 50th anniversary of the first volume of Contemporary Psychoanalysis, what better time to reconsider Betty Friedan’s The Feminine Mystique, first published 50 years ago? This book was an important part of the Zeitgeist into which CP was born. On rereading The Feminine Mystique with the knowledge of what occurred after its publication, it is possible to appreciate how much Friedan accomplished in furthering the cause of women’s equality. In particular, her critique of the Freudian position on female development is still fresh and vibrant. But, with hindsight, it is clear what she got wrong.

My Aunt Margy, who died in 2004 at the age of 86, was a brilliant housewife. Margy’s apartment was spotless and she was an expert on cleaning products and procedures. If I couldn’t remove a spot from a blouse or get the crud off a pan, I’d call her and she knew what to do. A favorite family story about her: She got some greasy dirt on her white pants and exclaimed, “I couldn’t even Shout it out!” referencing the commercial for Shout, the laundry stain remover.

Margy once told me she would never go to a “woman doctor”—women were just not as capable or smart as men. She did not understand why I wanted a job outside the home and frequently commented on my lack of expertise regarding the removal of dirt. I was damaging the children by having a career. Margy exemplified the postwar generation of women who opted out of the work force in favor of becoming moms and housewives. These were the women Betty Friedan wrote about in The Feminine Mystique.

Fifty years after its publication, Betty Friedan’s The Feminine Mystique continues to influence how women think about what “makes them tick.” Friedan got a lot right, but 50 years later, it’s easy to see she got some things wrong as well.

Friedan’s book catapulted the Women’s Movement into the public eye. She identified the “problem that has no name”: the boredom, depression, and empty lives of educated women who had given up careers to care for home and children. Friedan tapped into the experience of a vast number of mid-20th century suburban women: “It was a strange stirring, a sense of dissatisfaction. … As she made the beds, shopped for groceries, matched slipcover material, ate peanut butter sandwiches with her children, chauffeured Cub Scouts and Brownies, lay beside her husband at night—she was afraid to ask even of herself the silent questions, ‘Is that all?’”(p. 15).

Friedan, who died in 2006 at the age of 86, graduated from Smith College in 1942 and gave up a prestigious scholarship for graduate school because of her boyfriend’s objection. The book was based, to a large extent, on her own experiences. Fifteen years later, Friedan interviewed her classmates and discovered that most had given up their career dreams. Instead, their resumes read: Occupation: Housewife.

Friedan raised challenging questions about psychoanalytic views of female development and psychology, then in vogue, and the ways these views kept women “in their place.” When The Feminine Mystique was published in 1963, the classical Freudian view of female development was still the accepted wisdom: anatomy is destiny, and normal female development includes penis envy, faulty super-ego development, masochism, and passivity. Friedan correctly pointed out how these theories kept women in a submissive role relative to men. She writes,”How can an educated American woman, who is not herself an analyst, presume to question a Freudian truth? She know that Freud’s discovery of the unconscious workings of the mind was one of the great breakthroughs in man’s pursuit of knowledge … that only after years of analytic training is one capable of understanding the meaning of Freudian truths. She may even know how the human mind unconsciously resists that truth. How can she presume to tread the sacred ground where only analysts are allowed? ” (pp. 103–104)

Perhaps Friedan’s most brilliant insight is her analysis of the way Madison Avenue employed ideas from contemporary psychology to convince women that their essential nature is to become experts in home economics. In the mid-1940s, men returning from war needed to resume their place in the workforce. During the War, women had attained a great deal of equality and autonomy, taking the place of men in the workforce during the War. Now that the men were back, this posed a problem. How could women be convinced to return to housewifery? Enter Madison Avenue. According to Friedan, advertisers realized that, “The really important role that women serve as housewives is to “buy more things for the house” and that “women will buy more things if they are kept in the underused, nameless yearning, energy-to-get-rid-of state of being housewives” (p. 207). The trick was to convince women that homemaking is creative and a career unto itself, equal to or better than going out into the workforce.

Thus, Friedan suggests, Madison Avenue teemed up with Freud to brainwash women into believing that “occupation: housewife” was a woman’s essential nature. The goal was to help women get rid of their suppressed penis envy and neurotic desire to be equal—to help women find fulfillment as women by affirming their natural inferiority. She quotes from the report of an ad executive: “The modern bride seeks as a conscious goal that which in many cases her grandmother saw as a blind fate and her mother as slavery: to belong to a man, to have a home and children of her own, to choose among all possible careers the career of wife-mother-homemaker” (p. 220).

Friedan was particularly horrified by the focus of advertisers on “getting them young” while the woman’s mind was impressionable and before she knew any better.

From another chilling report she quotes, “Properly manipulated, American housewives can be given the sense of identity, purpose, creativity, and the self-realization, even the sexual joy they lack—by the buying of things” (p. 208) … the solution, quite simply, was to encourage them to be “modern housewives.”

“This professionalism is a psychological defense of the housewife against being a general ‘cleaner-upper’ and menial servant for her family in a day and age of general work emancipation.” Capitalize, the report continued, on housewives’ “guilt over the hidden dirt” so she will rip her house to shreds in a “deep cleaning” operation, which will give her a “sense of complete-ness for a few weeks” (p. 208).

Friedan describes a generation of women in a kind of trance state. The Feminine Mystique, although melodramatic and overreaching at times, was the wake-up call.

As stated previously, Friedan got a few things wrong. She observes of Freud, “He was a prisoner of his own culture. As he was creating a new framework for our culture he could not escape the framework of his own” (p. 105). The same can be said of Betty Friedan. Without diminishing the importance of her contributions, Friedan made several serious errors that have been difficult to eradicate because of her tremendous influence and impact on the culture.

Friedan correctly pointed out how the classical Freudian view of female development kept women in a submissive role relative to men. However, Friedan went on to completely dismiss the importance of ovarian hormones and the menstrual cycle on a woman’s identity, mood, and thought processes. Friedan’s mission, or one of her missions, was to assert there was no meaningful difference between men and women, that anatomy is immaterial. Friedan’s attack on psychoanalytic views of female development, contributed significantly to the avoidance of the body in contemporary psychoanalytic thought (Kolod, 2009, 2010, 2013).

This thesis became very relevant to me while I was researching the topic of menopause, an endeavor prompted by the onset of my own. I noticed how little was written on the subject, and that women rarely spoke about their physical and psychological suffering.

Friedan thought menopause inconsequential. If a woman has a meaningful life, menopause should be a nonevent. She believed that only women whose identity and self-worth were tied to being a wife and mother, and for whom, therefore, youth and sexual attractiveness are all-important, would find menopause difficult. Other hormonal emotional experiences, such as premenstrual tension and postpartum depression, she likewise refused to recognize as physiologically determined.

Friedan, and many other feminists who are now in their 70s, 80s, and 90s, espoused the view that the miseries of menopause are solely a consequence of the repressive Freudian environment Friedan detailed in The Feminine Mystique. Friedan went so far as to say that menopause didn’t really exist—it was invented by the pharmaceutical companies!

What was wrong with me, I wondered? I had a career and meaningful relationships but found menopause disorienting and painful. The changes in body image, the physical discomfort, mood swings, and insomnia all made me wonder, “Who am I?” and “What am I becoming?” According to Friedan, I should have been immune to this distress considering my own independence outside the home.

In 2005, I invited Friedan to speak at a conference to explain her views. The conference topic was “Is There Menopause?” Friedan initially agreed, but her failing health prevented this. She did, however, allow me to videotape an interview to be screened for attendees. She died soon after the interview.

On January 12, 2005, I went to Friedan’s apartment. I had sent her a list of questions in advance of the interview: Have women’s reactions to menopause changed since you wrote The Feminine Mystique? Do women experience it the same now as they did in 1963? Do you think menopause changes the way a woman sees herself? Does it change her identity?

Friedan became increasingly annoyed, and even hostile, as I asked my questions. The very word “menopause” irritated her. Menopause does not exist—and shouldn’t be talked about. I persisted with my questions until she finally yelled, “What the fuck are you asking me?” Questions about “aging” were okay with her, so long as I didn’t use the word “menopause.” Men and women both age, but only women are alleged to go through menopause. To acknowledge the body at all was to accept male domination.

At the conference, along with the Friedan interview videotape, I presented my own paper on the impact of menopause on a woman’s identity. Much to my surprise, several feminist psychoanalysts, 10 to 15 years older than I, approached me afterwards warning me that this was a dangerous topic, a slippery slope, and that I should perhaps discontinue talking about it.

The dangerous topic is not menopause—it is the acknowledgement that female hormones make woman feel and behave differently from men. Historically, a focus on the female body, ovarian hormones and the menstrual cycle has been used to stigmatize women as moody, flighty, and unfocussed. As such, they should not hold positions of power. If a woman was president, she might start a nuclear attack while suffering from PMS!

Friedan should be forgiven for this error. She wanted to send the message that “A woman can do anything a man can do.” For the postwar women who had been “brainwashed” to believe they could only do housework, this message was urgent. So the “hormone” question was dismissed out of hand. Yet, today, the issue of a woman’s role and her power in the workplace is still far from resolved. In Sheryl Sandberg’s bestseller, Lean In: Women, Work and the Will to Lead (2013) argues that women have not, in fact, come very far. There are many more women in the workforce but for the most part, men still are in charge. As she told a group of students at the Harvard Business School in 2011, “If the current trend continues, fifteen years from today, about one-third of the women in the audience will be working full-time and almost all of you will be working for the guy you are sitting next to” (pp. 65–66).

Friedan’s critique of the Freudian view that “anatomy is destiny” contributed to an almost complete avoidance of the body in contemporary psychoanalysis and theories of gender construction. Laan and Everaerd (1995) note, “Feminists have long criticized the notion that behavior and abilities of women are uniquely determined by their biology. This criticism led to an almost total rejection of the role of biology in the construction of gender. It also contributed, unfortunately, to an image of female sexuality devoid of the body” (pp. 22–23). Balsam (2008) comments on the avoidance of the body in contemporary psychoanalytic theory. She notes that although the term “embodiment” shows up regularly in contemporary psychoanalytic theory as a metaphor for psychological containment, there has been a turning away from concrete bodily experience. She writes, “In many of the influential new psychoanalytic theories of gender, biology has been sidelined as irrelevant” (p. 102).

Betty Friedan had wanted to become a psychologist herself and was familiar with the work of the prominent psychologists of her time. She borrowed concepts freely, sometimes with attribution, at other times incorporating their ideas into her own as if she had thought of them herself. She used the “ph” spelling of the word “phantasy” rather than the more common spelling, “fantasy.” There is no way to know at this point why she chose this unusual spelling; I presume she wanted to show her familiarity with the work of Melanie Klein. However, the “phantasy” spelling in Klein’s writing indicates unconscious fantasy. Friedan used the word, incorrectly, to refer to conscious fantasy.

In some cases, Friedan incorporated psychological concepts brilliantly, as with her use of Fromm’s “marketing personality” (Fromm, 1947), which clearly informed her ideas about women and Madison Avenue. At other times, her use of the concepts comes across as exaggerated. For example, she used Bettelheim’s theme of the dehumanization of concentration camp victims to bolster her argument about the dehumanization of the housewife. “The women who ‘adjust’ as housewives, who grow up wanting to be ‘just a housewife,’ are in as much danger as the millions who walked to their own death in the concentration camps—and the millions more who refused to believe that the concentration camps existed” (p. 305).

Some of Friedan’s “psychologizing” was outright wrong and had a lasting and damaging effect on views of women. She blamed stay-at-home mothers for a wide variety of psychological and social problems in their children such as delinquency, kleptomania, and promiscuity. According to Friedan, these problems developed out of mother’s failure to self-actualize and her obsessive focus on the child. She goes on to hold stay-at-home mothers responsible for autism, schizophrenia, bestiality, and homosexuality and uses concepts from Bettelheim (1950), Frieda Fromm-Reichmann (1948), and Thompson (1947) to substantiate these claims. Although none of these writers addressed the issue of “stay-at-home-mothers,” Friedan used their concepts of the “refrigerator mother” and the “schizophrenigenic mother” to bolster her argument. In this way, The Feminine Mystique reinforced the “blame the mother” culture of the 1950s and 1960s.

The women of the Baby Boomer generation, their children and grandchildren are the benefactors of the changes brought about by the Women’s Movement. We should be immensely grateful for Friedan’s potent critique of that which oppressed women, but also cognizant of the ways in which some of her errors have negatively affected psychological understanding of women since that time.

REFERENCES

1. Balsam, R. (2008). Women showing off: Notes on female exhibitionism. Journal of the American Psychoanalytic Association, 56, 99–121. [CrossRef], [PubMed], [Web of Science ®]
2. Bettelheim, B. (1950). Love is not enough: The treatment of emotionally disturbed children. Glencoe, IL: Free Press.
3. Friedan, B. (1963). The feminine mystique. New York, NY: Norton.
4. Fromm, E. (1947). Man for himself. New York, NY: Rinehart & Company.
5. Fromm-Reichmann, F. (1948). Notes on the development of treatment of schizophrenics by psychoanalysis and psychotherapy. Psychiatry, 11(3), 263–273. [PubMed]
6. Kolod, S. (2009). Menopause and sexuality. Contemporary Psychoanalysis, 45, 26–43. [Taylor & Francis Online], [Web of Science ®]
7. Kolod, S. (2010). The menstrual cycle as a subject of psychoanalytic inquiry. Journal of the American Academy of Psychoanalysis, 38, 77–90. [CrossRef]
8. Kolod, S. (2013). Why Betty Friedan threw the body out with the bath-water. Retrieved fromhttp://www.psychologytoday.com/blog/contemporary-psychoanalysis-in-action/201306/why-betty-friedan-threw-the-body-out-the-bathwater
9. Laan, E., & Everaerd, W. (1995). Determinants of female sexual arousal: Psychophysiological theory and data. Annual Review of Sex Research, 6, 32–77. [Taylor & Francis Online]
10. Sandberg, S. (2013). Lean in: Women, work, and the will to lead. New York, NY: Knopf.
11. Thompson, C. (1947). Changing concepts of homosexuality in psychoanalysis. Psychiatry, 10, 183–189. [PubMed], [Web of Science ®]

April 20, 2014

Is Hookup Regret More Common in Women? The better the sex, the less regret

Young women are becoming equal partners in the hookup culture, often just as willing as young men to venture into sexual relationships without emotional ties. But research suggests hookup regret is twice as common among women as men.

Is that because women are “hard-wired” to be monogamous? Researchers say no—it has more to do with sexual satisfaction. Or lack thereof.

The “Hookup Culture” has generated a wealth of research on how both men and women respond to casual sex. These studies conclude women are much less likely to orgasm in a hookup as in a committed relationship, and that hookup regret is often linked to an unsatisfying sexual experience.

Justin R. Garcia, an evolutionary biologist at the Kinsey Institute at Indiana University, studied 600 college students and found women were twice as likely to reach orgasm in serious relationships as in hookups. Both men and women sometimes experience hookup regret, but Garcia found women are twice as likely to have a negative reaction later on.

Likewise, Paula England, a sociologist at New York University, in a study of 24,000 college students over the course of 5 years, found only approximately 40 percent of women had an orgasm during their last hookup involving intercourse, while 80 percent of men did. By contrast, roughly three quarters of women in the survey said they had an orgasm the last time they had sex in a committed relationship.

England suggests that for women, practice makes perfect—in other words practicing sex with a partner is far more important for a woman to achieve sexual satisfaction than for men. Communication, which is a key element in a woman’s sexual satisfaction, is less likely in hookups. “Women are not feeling very free in these casual contexts to say what they want and need.” Another problem, according to England, is that women may still be stigmatized for having casual sex.

Most of subjects in these studies were heterosexual. But Terri Conley, a research psychologist at the University of Michigan, did a study involving bisexual women. She found that if a bisexual woman was approached by both a man and a woman for casual sex, she would be more likely to accept the offer from the woman. Why? Less likelihood of disease, violence or stigmatization and greater likliho0d of sexual satisfaction with a female stranger than a male stranger.

Conley challenges the argument that gender differences relating to casual sex are “hardwired” i.e. biological or evolutionary in nature. She examined the following assumptions:

Men think about sex more than women
Women orgasm less frequently than men
Men like casual sex more than women
Women are choosier than men

She suggests that these gender differences have more to do with societal factors: prohibition against women expressing sexual desire, and the greater risk of being subjected to sexual assault and disease. According to Conley, when these conditions are factored out of the equation, women and men appear to enjoy casual sex similarly.

Furthermore, if a woman finds her sex partner attractive, sexually skilled and non-judgmental she is just as likely to engage in and enjoy a hookup as a man. And she will most likely not regret the experience.

But before a woman can communicate what she wants, she has to know what she wants. Sex education does not teach women how to have good sex, let alone ask for what they need.

In a recent New York Times article on this subject, In Hookups, Inequality Still Reigns (November 11, 2013) a young woman reports sex education in her school was aimed at stopping teenagers from having sex entirely; there wasn’t any discussion of how to achieve satisfaction. She noted thatporn can be a great source of sex education but in porn people don’t tell each other things like, ‘Oh, my foot’s falling asleep, we need to move.”

Men’s sexual anatomy makes it is easier to achieve orgasm, whether the sex occurs within a committed relationship or not. Women’s sexual responsiveness is more complicated and requires the woman know what she wants and be willing to ask for it. Her partner must be mindful of the time and attention required to ensure the woman achieves orgasm.

It is quite common for women to disconnect from sexual experiences in hookups, particularly if they are drunk or high. It is just too difficult to stop things once they get started. As one female patient reports, “I just decided to pretend it wasn’t happening.” She describes being in a trance-like state during a casual sexual encounter and regretting it afterwards.

An unsatisfying sexual experience like this can have lasting negative consequences, resulting in feelings of shame, depression and low self worth.

In taking sexual histories of women who were having problems with arousal as they went through menopause, I found regret over unsatisfying or risky sexual encounters could linger. During the “Sexual Revolution” of the 60’s and 70’s, as now, there was considerable peer pressure to be sexually adventurous. Some of the sexual experiences women reported occurred under the influence of drugs and alcohol, and with multiple partners. While these experiences may have felt adventurous at the time, they are now recalled as painful, humiliating and even traumatic. This may be due to the fact that the woman was not really enjoying herself—just pretending and going through the motions in a very disconnected way.

What is the takeaway for young women today? Know what you like and want sexually and make sure to communicate this to your partner. It is never a good idea to disconnect and pretend you are enjoying sex if you are not. These reactions lead to feeling “used.” Hookups aren’t for everyone, but they don’t have to be a source of dissatisfaction, shame or trauma. If you have a great time with a casual sex partner, you are less likely to regret the experience afterwards!

Susan Kolod, Ph.D. is a Supervising and Training Analyst and co-Editor of the blog, Contemporary Psychoanalysis in Action at the William Alanson White Institute. She has lectured and written about the impact ofhormones on the psyche with a particular focus on sexuality, menopause and the menstrual cycle. She is in private practice in Brooklyn and Manhattan.

Dr. Kolod will be speaking at the Division 39 Meeting in New York City at the Sheraton Hotel on April 24^th, 2014. The topic is The Female Body in Psychoanalytic Treatment.

October 6, 2013

Five Reasons We Love Scandals

What makes scandals so interesting? A good scandal can be titillating, outrageous, entertaining, satisfying and edifying—it allows us to feel superior, to pity or despise the transgressor and to get vicarious pleasure, all at the same time. It becomes a “feeding frenzy.” People can’t get enough of it—every morsel is chewed and devoured like delicious rich cake.

Scandal allows us to fantasize about the lives we don’t lead. In Adam Phillip’s new book, Missing Out: In Praise of the Unlived Life he makes the point that everyone lives several parallel lives—the life we actually live and the lives we feel we SHOULD or COULD have been living. Depression, anxiety and other types of dissatisfaction result from the frustration one feels that he or she should be living a different, more exciting, more daring, sexier life. Scandals allow us, through fantasy, to vicariously experience an “other” life, while leaving us reassured that we are better off in our ordinary, non-scandalous existence.

What exactly is scandal? Scandal derives from a Greek word for “snare,” implying that one is “snared” into moral failure. Scandal was originally a term used to denote a discredit brought upon religion by “unseemly conduct in a religious person,” especially if it encourages a lapse of faith in another (Merriam Webster).

Today, scandal has a spectrum of meanings, including discreditable or immoral conduct, damage to reputation caused by such misconduct, and malicious or defamatory gossip, whether or not well founded. “Scandal” and “Slander” share the same root.

Scandal is relative. What causes a scandal at one time or in one place might not in another. There can be no scandal without a scandalized public. Former Prime Minister of Italy Silvio Berlusconi’s solicitation of underage prostitutes resulted in his arrest, but apparently, no significant scandal. According to Italian filmmaker Paolo Sorrentino, that is because, in Italy everyone loves a party. (New York Times, Sept 8, 2013).

On the other hand, the scandal of former Congressman Anthony Weiner who ran and lost the primary election for Mayor of New York City is remarkable for what he did NOT do. “He did not commit adultery. He did not break up a marriage. He did not employ the services of a prostitute. He did not stalk. He did not misuse public funds…He did not have inappropriate physical contact—or any physical contact—with any person.” His scandal resulted solely from “pixels on a screen.” Herzberg (New Yorker Magazine, August 28, 2013). Or, perhaps, from his persistent lying and acting foolishly in public.

Scandal takes on a life of its own, and, sometimes, the actual facts of the matter are of little importance. As the dictionary definition above implies, the gossip may be more enthralling than the details of what really occurred.

Every person struggles with impulses to break the rules, to violate boundaries. These unacceptable attributes are rejected in oneself but are embodied in the scandalous person, who becomes larger than life. Similar to watching porn or a horror film, one can experience terror, outrage, extreme anxiety, sexual excitement and relief, without having to engage in risky behavior.

Here are 5 reasons we love scandal:

Vicarious pleasure in the rule-breaking of another. Transgression is titillating. Every person is tempted to break rules and boundaries but for the most part, resists. The scandalous person has given into temptation.
Pleasure at the punishment of the transgressor. There is a sense of moral satisfaction when the scandalous person is humiliated or punished. It restores faith in the orderliness of the moral universe. Scandals exaggerate the sense that there are good and bad people.
Pleasure at watching someone “get away with it.” In Missing Out, Phillips writes that “getting away with it” occurs when you obtain the forbidden object of desire without paying penalty. The unpunished transgressor allows us to imagine this (potentially thrilling) experience.
Pleasure at being asked to forgive. This elicits a feeling of power and triumph in the person to whom the request is made. The transgressor has to grovel, and forgiveness can either be granted or denied. This provides the non-transgressor a feeling of superiority, however fleeting.
And perhaps most importantly, distraction from the tedium of one’s own difficult everyday problems. Reading about the scandals that have beset others is a great distraction. Not only does it take our minds off our problems, it also assures us that our problems are small and manageable in comparison.

We all have parts of ourselves we don’t want to acknowledge that wish to do harm. These disowned parts are easily projected onto the alleged perpetrator who is experienced as repellent and alien. Abby Stein, Professor of Interdisciplinary Studies at John Jay College of Criminal Justice notes, “In the presence of perpetration we may be repelled but we are also excited. In an odd way, people who have done awful lurid sexual things to others are not just interesting—they are downright sexy.”

When someone breaks the rules, violates boundaries, it can be upsetting to observe. But reactions to scandal are more complicated than simple moral outrage. If it were just outrage, people would not become so fascinated and involved. It is the combined reactions of outrage and disgust on the one hand, and fascination and titillation on the other, that makes scandal exciting. That’s where fantasy and vicarious pleasure take center stage.

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REFERENCES

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