Love and Marriage : Life, Love, and Family Health : The Encyclopedia of Man, Woman, and Child 0600773019, 9780600773016

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Human

Relationships

Love and Marriage

Life, Love and Family Health The Encyclopedia of Man, Woman and Child

Love and Marriage

Hamlyn London - Sydney « New York - Toronto

© Marshall Cavendish Limited (1968, 1 969) This volume has been specially produced for the Hamlyn Publishing Group Limited by Marshall Cavendish Limited, who first published the material in ‘Book of Life’.

1SBN0 60077301

9

This volume may not be sold in the United States of America, Canada or The Philippines. Editorial Advisory Board J.H. Baron, D.M., M.R.C.P. Martin Bax, B.M., B.Ch. Alexander Comfort, M.A., D.C.H., Ph.D., D.Sc. Raanan Gillon, M.B., B.S.

Martin Herbert, M.A., Dip. Psych. H. Beric Wright, M.B., F.R.C.S.

Printed and bound in Yugoslavia

by Mladinska Knjiga, Ljubljana

Contents 9 1 21 2] 35 3g 45 oO 57 63 eS 79 83 37 aI O77 109 aS 2d 127

Introduction

Understanding sexual attraction Falling in love What love is like for men What love is like for women What happens in courtship The many faces of love We need other people

Making a marriage Modern marriage in action Making sense of making love

Sorting facts from fancies Sex or sin ? Coping with conflict Others have their problems too

Planning a family The Pill, the facts

Sterilization Hope for the childless couple Artificial insemination

Index

Picture credits T= Top

B = Bottom

= Lett

Adapted from ‘Living With the Pill’ by the Sunday Times Magazine B.Manchipp 106 Anton Last L30 Associated Press TR/73 Barnaby’s R29,B55

Bavaria Verlag

51,65

B.Manchipp 99,117 British Film Institute R24 British Museum / Photo Peter Clayton TL&CL19 Bulloz 64,67,71 Carlo Bevilacqua 40,41 C.D. Indicator Limited B95 Church of St Bava / PhotoScala C11 Courtesy Art Museum Chantilly, France/ Photo Giraudon L20 Courtesy Schering AG Berlin 101 Courtesy The Gulbenkian Foundation, London/ Photo Michael Holford L81 Courtesy The Peter Stuyvesant Foundation 89 Courtesy Wellcome Trustees 98 Eric Jewell 195,109 Express-Bild TL24 Frank Habicht R11,18,BR19, BR25, TR31 G.D.Searle&CoLtd 102 Giraudon 68 Hayward Cox 122,T &C123 H.U.Osterwalder 10 lanLinn 121 International Planned Parenthood / Transworld Feature Syndicate / CameraPress 110-113 J.AllanCash BC13 Jane Burton, Photo Researches 38 BR13 Japan National Tourist Organization John Banks 94 John Farman 74,75 John Strachen 48 JohnWatney 36,60,91,T92,93,118,119, 125 Ken Thompson 57,58,59 Ken Thompson / PhotoJohn Banks 76,77 Keystone 1C14,BL19,TR20, 22, B26, 45, L73, 96 Look Magazine / Transworld Feature Syndicate 100 Lotto, Prado, Madrid / PhotoScala 52 Mansell L11,T49,R54,BR73 Mary Evans Picture Library R81, TL82 Mary Evans Picture Library /Photo Michael Holford BR37 Michael Holford 39 Mondadori Press TL,CL,TR & BR14, R30, B92

R =

Right

C =

Centre

Museum of Art, Basel / Photo Hinz Basel Museum of Fine Art, Ghent / Photo Scala TR12 BR12 National Gallery, London

56

National Gallery, London/ 1L12,61,62 Photo Michael Holford BL13 National Portrait Gallery, London N. Barratt B123 Novosti TL53 TC,BC &R1 08 Organon Laboratories Ltd Paramount Pictures BR20 87 Photo Frank Habicht / Creative Colour Pictorial Press TC26 BL,CR &BCR14,TR53, L54 Picturepoint Popperfoto BC14 Prado, Madrid / PhotoSalmer B53 Prado, Madrid / PhotoScala 80 BL12, Radio Times Hulton Picture Library TR19, BL24,TR & BL25 Rex Features 21,23,TL25,L26,TL31, 137 Salmer

BR34

Salmer / Photo Carlo Bevilacqua 33,155 Scala 15,66,70/71, BR82 B31,TL34,35, BL37, 42, Snark International 43,46, B49 Syndication International 1L13,27,R28,32 Syntex PharmaceuticalCo 97,104,105, L108 Tate Gallery, London / Photo Michael Holford

Bet2 The Sun 120 Tovenaar / PhotoJohn Banks 85 Transworld Feature Syndicate L28,L29, BL82 Twen / Photo WillMcBride 16/17 Victoria & Albert Museum, Crown Copyright

TR13 Warner Pathe

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88

Introduction Ideally — and, fortunately, very often in practice — love and marriage are one and the same thing. Love is the prelude to marriage but, if the marriage is to be a complete success, it should be accompanied by love. For although the loveless marriage need not be a tragedy, as so many suggest, it is a poor substitute for the marriage that carries with it ‘until death us do part’, the mutual love that first brought the two partners together. What makes so many marriages fall

apart is the fact that the love between

man and woman upon which it is based is in turn based upon sex, one of the two primeval and strongest instincts in Man. The other, of course, is the will to live. So insistent is Nature that the human race should survive that she has provided us with a sex instinct which can play havoc with our lives and those of all around us unless we realize at a very early stage that we possess this potent instinct, and that one of the secrets of successful living is being able to bring it under control. If we thus make it our servant — and not allow it to become our master — we have gone a long way to making a success of life. What this means in practice, as_is admirably brought out in this book, is that we must recognize our sexuality. To attempt to deny it is as wrong as to attempt to abuse it. We are sexual animals, but we are also human beings, and in the recognition of this duality in our nature —- to use a term beloved of the philosophers — lies the secret of a full, enjoyable and ; happy life. The sexual instinct may at times seem so overwhelming as to be uncontrollable but, as mankind has learned - often at great cost -— throughout the ages, it is the controlled instincts that produce the greatest pleasures of life. Like so many lessons, it is one that almost

every generation has to relearn in so far as the tendency of youth is to think that it knows better than its parents. Fortunately, for most of us, this great delusion dies out fairly soon, and we learn, sooner rather than later, that there is much to be learned from the accumulated wisdom of the ages. At the present time, this problem is accentuated by the necessity for restricting the rate at which the world population is growing. The fundamental problem here is that the purpose of sexuality is reproduction. If we separate the sexual act from reproduction, we are introducing a complication which Nature did not foresee. To the man this may not make much difference, but to the woman it

does, no matter how superficially modern she may pretend to be. Fundamentally, a woman has sexual intercourse in order to become pregnant and produce a child. The desire for motherhood may vary tremendously, but it is there all the time, and to deny it is to shut one’s eyes to the hard facts of life. This, of course, is asking for trouble. Suppressed facts always cause trouble. The problem today - and it is a perfectly soluble one, as hundreds of thousands of happy marriages testify — is how to ensure a happy and contented married life, with both partners obtaining the maximum joy and pleasure from sexual intercourse, but with only a very limited number of pregnancies ensuing. What form of birth control is used is one for the married couple to decide for themselves on the basis of the information provided in this book, supplemented, if necessary, by advice from their family doctor. Equally important today is the problem of the infertile marriage. Here modern medicine can do much to convert such a marriage into a

7

happy fertile one, but there is one fact that tends to be overlooked today

when so many people expect so much from medicine. The childless marriage need not be a tragedy. The man and wife who, in spite of full investigation and treatment, have had to accept the fact that they cannot have children of their own, should bear in mind that

there are successful alternatives to natural motherhood and fatherhood. These are but a few of the many aspects of love and marriage that are

dealt with authoritatively and simply in this volume. The secret of success in such fundamental matters cannot be condensed into a few words but, if one sets out on the voyage through

adult life imbued with the right ideas and the correct facts, the course of married life is much more likely to be the exhilarating experience which it has proved to be for so many in the past.

William A. R. Thomson,

M.D.

Understanding

mss motets seo ie presen

.

sexual attraction The human race would have

become extinct long ago without the ability of men and women to attract each other sexually. What is this useful attribute?

ROM

th

il

of a female of their species and fly unerringly towards her. There is no doubt that the female moth has sex appeal. For human beings, the subject is more complicated. Human beings, alone among living creatures, worry about whether they

are sexually attractive or not. Some try to exert more sex appeal than they feel they have naturally (and to do so may borrow the furry skins of wild beasts, the scented substances from flowers and animal glands). And some try to exert less sex appeal, wrapped in the sombre colours of religious communities. Sex appeal, among humans, is not a ‘thing’ that one possesses in the way one either has or does not have a pair of shoes. The girl with shining hair, warm smile and curving figure obviously ‘has’ sex appeal in that men’s heads turn, with something like the enthusiasm of the male moth, when she passes. Breasts, legs, eyes and hair are triggers to sexual response. And most people have spent time before a mirror wondering about themselves and their ability to attract a partner. But really to find out about our own

powers

to

attract

or be attractive

sexually is more than a matter of adding up vital statistics and buying aids to beauty. We have to know something about the deepest instincts and emotions of humanity in general, ourselves in particular. First, it is fortunate for the survival of the human species that men and women are attracted by, and attractive to, each other. For sexual attraction is the first step towards love, marriage, home-making and child-bearing. It is a natural and basic instinct shared in its essentials with the animal world, but immensely complex in its expression in human society. This basic interest in the opposite sex has its roots in infancy. It can be seen developing in young children of pre-

school age. A little girl, for example, usually shows by the time she is three

a marked response to her father. She will behave coquettishly in his presence and may act in a similar fashion with any male friends of the family who call at the house. Men obviously intrigue her in a way which women do not. At one time or another most little girls have said, ‘When I grow up I’m going to marry my Daddy.’ A little boy for his part usually remains emotionally tied to his mother throughout infancy. Though fond and admiring of his father, it is mother who holds a special place in his affection. He may be very possessive of her and show this by jealousy of the father’s

privileged position in relationship to her. Sigmund Freud, the founder of psychoanalysis, studying young children, coined the term ‘Oedipus complex’, to explain his view that, in normal development, the young child passes through a period of being strongly attracted to the parent of the opposite sex. Pre-school children, then, accept the idea of an intimate bond between a man and a woman, and their games will usually include playing at ‘weddings’ and ‘mothers and fathers’. They show great interest in the physical differences between the sexes and they want to know about sexual development and the mechanics of conception. This inquisitiveness is natural, but underlying it is a preoccupation with the attraction which one sex exercises over the other. In adolescence the longing to be loved and to find someone to love is extended by maturing sexuality with its profound physical and emotional changes, and a new awareness of the part played by each sex in intimate relationships. But the love-experiences of childhood are not completely left behind. Psychologists find that most adolescents have, over the years of childhood, built up some kind of ‘image’ of the person they would like to love and be loved by. This image is probably a compound picture of the men or women who have been important to the child earlier on. A boy for example, may have a clear idea of the kind of girl who would appeal to him — blonde, slim, with trim ankles. It is probable that this mental image includes elements of the idealized mother or sister or, perhaps, a teacher. In a parallel fashion a girl may have a mental image of the kind of man she would like to be loved by — though research shows that girls tend to emphasize qualities in the character of a desired male, rather than merely his appearance. He may, for example, be thought of as gentle, good with children, honest and courageous. As well as having an image of the type of girl who attracts him, the adolescent boy is very conscious at this time that he must put to the test his own powers of attraction. For the adolescent stands on the threshold of manhood and is aware that this implies new experiences, new powers, new responsibilities. If he can attract a girl he is reassured because his adult male status is recognized and sponsored by a member of the opposite sex. To make quite sure that girls notice him and feel admiration for his emergent masculinity, the boy’s behaviour is likely to be exhibitionistic and ostentatious. And the girl will experiment with clothes, make-up, hair styles and _ flirtatious

y

mannerisms, testing out different ways to attract male attention. This concern over the ability to attract a member of the opposite sex continues to a certain extent throughout the individual’s life. And it leads to much speculation about what exactly constitutes sex appeal. It obviously does not rest on physical beauty alone for many men and women who cannot be called beautiful or handsome succeed in attracting members of the opposite sex. So many other elements and qualities contribute to a woman’s appeal — tenderness, kindness, gaiety, charm — that fashionable features and a_ perfect figure cannot even be considered the main An eminent zoologist has described Man as ‘the sexiest primate alive’. Various parts of the female body act as triggers to sexual response — cultural and personal factors dictate which are the most alluring to any particular male. 1 Soft, white, delicate hands suggest the woman’s sexual tenderness. 2 Nails were originally designed as claws for digging and scraping: now they are merely added decoration. 3 In animals, hair is a warm body covering: in women, a luxuriant mane functions primarily as an erotic magnet. 4 During intercourse, the eyes glisten, the pupils dilate: cosmetics emphasize the eyes’ sexual overtones. 5 The custom of rubbing noses in some societies suggests they may be erotically sensitive as well as functional. 6 It has been suggested that reddened protruding lips mimic the labia and act as an important sexual signal. 7 Expression is important in human courtship, so naturally the face is a vital focus of attention. 8 Breasts may appeal because their shape mimics the buttocks, which are obviously zones of erotic interest.

9 The narrow waist points the contrast to the curves above and below. 10 A wide pelvis is one of the distinctive female sexual characteristics. 11 Legs lead to potential delights.

10

woman is attracted to a man because he is not masculine, but gives the appearance of needing a woman to look after him. In this he unconsciously appeals primarily to her maternal feeling and only secondarily to her sexual needs as a woman. Sex appeal is normally a natural endowment in the sense that the child who has been ‘brought up in a reasonably normal and loving home will be attracted by and will wish to be attractive to, women. He will, therefore, behave in a relaxed and friendly way with the other sex. He will seek feminine company and respond in a warm and _ affectionate manner to any sign of interest in a woman who appeals to him. But there are, however, some people who, for one reason or another, are unable to respond in this fashion: they will appear excruciatingly shy, diffident, defensive and ‘distant’ and as a result, even though physically attractive, their behaviour hinders the development of relationships, friendly or erotic, with the opposite sex. But physical beauty is obviously an asset to anybody, and as a convenient starting-off point most young adults seek to make themselves as personally attractive as possible. Throughout history men and women have used cosmetics and other aids to increase their impact on the opposite sex. The ancient Assyrians wore their hair in a profusion of curls: Ovid reminds his male

reader that to attract the ladies he must pay attention to bodily cleanliness and avoid scruffy hair and garments: in the eighteenth century both men and women in England decked themselves in high, powdered wigs and squeezed themselves

into corsets. All this effort was directed towards improving what nature had provided in the way of sex-appeal. But, of course, ideas and standards of

ingredients. It was Cleopatra’s vitality as much. as her beauty that captivated Antony. Similarly, many men who appear at first sight to lack physical appeal succeed in establishing warm relationships with women. The reason is that women admire qualities, like courage, forcefulness, ambition, protectiveness, aggression and self-confidence in a man just as much as physical prowess or bearing. Rasputin was unkempt and (reputedly) smelly; Napoleon was small in stature; Byron had a club foot — but all of them exerted a fascination over women. It is also the case, occasionally, that a

beauty and desirability are subject to fashion. Fashions in anatomical architecture, for instance, vary enormously. During the 1960s, the kind of feminine ideal in the West was the slim, narrowhipped girl. Towards the close of the last century, the preferred sexually attractive figure was the bosomy girl with a wasp waist and wide pelvis who wore a bustle to add further emphasis to the hour-glass shape. Compare this with the medieval ideal of the slender, tiny-breasted Venus with a softly rounded stomach. And again — if the paintings of Rubens can be taken as

a

representation

of a contemporary

ideal — girls who today would be regarded as somewhat plump were thought to be enticing and seductive. Clothes, too, have followed shapes and the cultural climate of the times. And in many periods, men have not hesitated to dress as showily as their womenfolk.

The strong, heavy-hipped body of this classical Venus suggests that her appeal is that of the motherfigure. But her proudly-carried head emphasizes that there is no shame attached to her sexuality.

To the medieval churchman, woman was the snare of the devil. So this Van Eyck Eve woefully exaggerates her only redeeming feature — her fecund belly. Procreation not sexual pleasure dictates her shape.

RS Ree

ec ee

s

Liberated by Freud and the Pill, modern. Western woman is more than a‘ breeding-machine. But she may still try to increase her sexappeal by slimming to conform to the fashion for a firm, slender figure.

In the Middle Ages, young men of the upper classes, reflecting the age of the and the concept of gay troubadours chivalry, wore extravagant costume and bright colours. The Elizabethan dandy,

adventurous and confident, was as gaily decorated, jewelled and scented as his lady. With the advent of puritanism, however, came a complete change in fashion. Clothes became sober in style and sombre in colour — while the woman who used cosmetics was considered ‘loose’. To the religious extremist, sex and sin were scarcely differentiated. Sexual intercourse was permissible only within marriage and with conception intended. It was considered sinful for a woman to dress 1 In the Middle Ages, the church 1 considered breeding women’s only respectable function. So their garments drew attention mainly to the swelling stomach, as this painting by Van Eyck of Giovanni Arnolfini with his wife makes clear. 2 This Breughel peasant may not be richly attired, but his cod-piece and tight breeches allow no room for doubts about his masculinity. 3 In contrast, this ‘Gibson Girl’ has squeezed and exaggerated her figure to conform to the prevailing fashion. 4 Menas well as women have often been aware of the value of highlighting their physical charms by costume: in this painting by J. M. Wright, even a tassel is significantly placed. 5 Women have always known how

to emphasize their allure: see how subtly the narrow necklace of this Ingres beauty disappears into her ample bosom. The elaborate formality of her dress vividly sets off her glowing flesh.

in gay colours in order to attract a man’s attentions: rather, she must conceal her body in enveloping garments to avoid stirring male desire at all. The strictest of all the Puritan sects even required their womenfolk to hide their hair under closefitting hats. In the Victorian age, a certain amount

of decoration in women’s clothes was acceptable (though the dress of the men was very restrained), but a form of puritanism pervaded upper and middle class society. It was expected that the sole aim of a ‘virtuous’ woman was to marry an ‘upright’ man and bear his children: no ‘respectable’ woman was supposed to take pleasure in sexual inter-

course: if she did enjoy love-making it was a source of secret shame. Thus the attitude to sex-appeal, as such, was coloured by a fair amount of hypocrisy. However, beginning with the work of Freud, there has been a far-reaching reaction. Freud was able to show that, no matter how earnestly he may deny it, every individual possesses a sexual drive, and that emotional health depends to a large extent upon the degree to which sexuality and love are interwoven in experience. Not unnaturally, the concept of sexual attraction varies not only between differ-

ent historical periods but between one culture and another. Few Western men would be attracted by the deeply-scarred 6 Clothes are often used by the 6 young as a symbol of revolt against current sexual and social mores. This young man is as gay as a courting peacock in his Hippy gear — and will appeal directly to a girl on the same wavelength. 7 The Elizabethan dandy, debonair and gay, padded his shoulders and encased his legs in tight hose to draw overt attention to his physical allure. The languid pose of this young man painted by Hilliard does not mean he has any qualms about the value of virility. 8 Prince Albert, however, rigidly posed and sombrely costumed, belongs to a puritanical age. Only ‘rakes’ and ‘loose women’ took pleasure in love-making, so clothing was formal for men, concealing for women. Prince Albert was the epitome of _ respectability, so decorum breathes from his every pore. 9 The sari may conceal almost the entire body, but it gives considerable grace of movement to the wearer: and it flatters every type of feminine figure. sugkimono 10 The enveloping frailty: delicate a modesty, gests their make like this garments at by hinting seductive appeal the body’s hidden charms.

face of the women in certain African tribes, nor would they consider as sexually stimulating the minute feet crippled by binding of the Chinese women of fifty years ago. Equally well, no Western woman would

find the face of a Papuan native,

with a bone thrust through his nose, a sexually exciting image. What one culture finds sexually desirable is closely related to the local ideas of manhood or womanhood. Ideas of what is alluring in costume vary widely, too: the concealment of the Japanese kimono and the Indian sari contrast markedly with the figurerevealing mini-skirt and tight jumper of the Western girl, but within the respective

cultures the different outfits perform the same functions of emphasizing prevailing concepts of femininity. Which part of the female body must be concealed is also a matter of local, usually religious custom. Sex appeal cannot be viewed as a static thing. It is always there in the sense that men will always be aware of women as desirable, exciting and poten-

A blue-print for a beautiful face 4 does not exist. For it all depends on one’s cultural standpoint. In the East, the ideal for centuries has ‘melonthe flat-featured, been seed’ face —a preference essentially based on ethnic characteristics. In the polyglot West, the mass media — and especially the ubiquitous Hollywood film — has promoted the big-eyed blonde to widespread popularity. But probably most men would warm to the youth, health, shining eyes and glowing skin of these women.1 Polynesian beauty. girl. 3 Siamese _ girl. 2 Tahitian 4 Japanese beauty. 5 Bhill tribeswoman from Central India. 6 Darkskinned African beauty. 7 Southern European girl. 8 Scandinavian girl. 9 Young girl from the Congo.

And women creatures. tially lovable of men as e existenc the ignore cannot strong, protective and stimulating comhowever, variations, Great panions. take place in the ways in which both men and women choose to emphasize their essential masculinity or femininity, in the hope that sexual attractiveness will lead on to mature love and mutual belonging.

Falling in love Here is an experience that delights and hurts, enhances and endangers. How in the world has humanity dealt with the hazards and joys of falling in love?

Rietaissmn love has been likened to a delirium, a sickness, an arrow that strikes deep into the heart. It can be pathetic and ludicrous, or rewarding and enriching. Love is no respecter of persons: some of the greatest love poetry has been written by men about men. Romantic love can be a powerfully creative force — the inspiration of poetry, music and painting and the drive behind a man’s urge to achieve success, fame and fortune. But it can be also an enormously destructive power. Unhappy lovers have been driven to suicide. Kings have given up their crowns for it. Politicians have threatened their careers. Countless ordinary marriages have been wrecked on it: women have suddenly packed their bags and left husband and children; men have disappeared overnight to be with their beloved. It is not, then, surprising to find that in some societies — in traditional Japan or India, for example — romantic love is seen as anti-social: either the interests of the family or the state are considered more

says the dictionary, Dalliance, means amorous play. The word has been in the language since the early far activity, the Ages: Middle is a _ natural, Love-play longer. universal game — for animals as well as courting men and women.

important

than

mere

personal

preference in the matter. For when girls and boys fall romantically in love they may put private fulfilment and pleasure before honour and patriotism. And if they marry completely unsuitable people, unhappiness is likely to result not only for themselves but for their entire social group. Shakespeare crystallized this problem in his study of the tragic strife of the Montagues and Capulets in Romeo and Juliet. In yet other societies, romantic love has a brief, butterfly type of existence. It is thought of as something that adolescents engage in during a passing emotional phase, which is — fortunately in society’s view — soon outgrown. Mature adults no longer expect it. This is the attitude taken by traditional peasant cultures where, after the short period of emotional freedom, the young adult — and particularly the woman — must put away all thought of romance and get down to the hard task of bearing and rearing children. But in British and Western society, romantic love is idealized and all growing children eagerly anticipate the experience. Some people, indeed, spend their entire lives looking for it passing in and out of one relationship after another in their frantic search. The epitome of this is the Don Juan, the man who flits continuously

from bed to bed: however lucky he may “appear to be in the eyes of other envious males, he never achieves complete emotional satisfaction and is always seeking the ideal woman. Some women, too, spend their lives searching for ‘the perfect man’. Certain societies make some allowances and emotional sexual for adolescent

adventure and they have evolved institutions to cater for it. This is kept quite separate from the idea of the love that is suitable for marriage. In America various formalities have developed to express the relations between young people on the college campuses: these involve the boy giving his sweatshirt to the girl, the mutual exchange of nightwear (with club or school symbols decorating them), and the gift of the boy’s fraternity pin to the girl. On some campuses the rituals are even more elaborate. The customs include serenades of the girls by the boys, kissing ceremonies, candle parades or the passing through rings of flowers of those girls who have definitely committed themselves to a boy. Other societies have even more formal systems for regulating early contacts between young people. In some parts of East Africa, cohorts of youths of roughly the same age live in bachelor houses where they may entertain their girlfriends and engage in erotic adventures. In Samoa boys have their first love affair with older, sexually-experienced girls who teach them the techniques of love: in their turn, the boys are later expected to sexually and emotionally initiate girls who have just reached puberty. So, no matter how spontaneous and impulsive falling in love may be, there does seem to be a tendency in most

societies

to try to regulate

it. But all

over the world, the old think that the young are not behaving as they ought — in matters of love as in anything else. For to young people love is frequently not only an impulse but also a symbol. The mid-twentieth century young of many countries hold up an ideal of personal love in place of what they see as the major evils of society — war, police brutality, greed for consumer goods and money, the all-enveloping power of big institutions. Their cries are ‘Make love, not war’: ‘Let’s love one another’: ‘Love is lovely. War is ugly.’ And not only do they carry banners; they may act on their beliefs, opting out of the normal concerns of society and devoting themselves to a life where personal relationships come first and work and social responsibilities poor seconds. Romantic love, however, is a relatively new phenomenon in the history of the human race. Its first flowering came in medieval Europe — it was an essential part of the concept of chivalry. The perfect knight adored a high-born lady for whom he was expected to risk his life and perform any deed her whim dictated. It was a kind of love never linked with thoughts of marriage: in real life, women were chattels, entirely subject in law to their husbands — and their marriages were arranged for them by their families. But the trouba-

15

Shall I compare thee to a summer’s day?

Thou art more lovely and more temperate: Rough winds do shake the darling buds of May, OM aOR CL OR TO CCL ELL LA) ALC And often is his gold complexion dimm’d ; And every fair from fair sometime declines, By chance or nature’s changing course untrimmd; But thy eternal summer shall not fade,

Nor lose possession of that fair thou owest ; Nor shall Death brag thou wander’st in his shade When in eternal lines to time thou growest So long as men can breathe or eyes can see,

So long lives this and this gues life to thee.

Goethe said ‘Love concedes in a moment what we can hardly attain by effort after years of toil.’ In psychoanalytic terms, falling in love occurs when inner fantasies can be related to an actual person in the outside world. The individual finds the best that is in himself outside himself, and thus the inner and outer worlds become one. It has been suggested that ‘in love, man is only loving himself. Not his empirical self, not (his) weaknesses and vulgarities . . . but all that he wants to be, all that he ought to be, his truest, deepest, intelligible nature . . .’ Love of

The Greek philosopher Plato likened lovers to the split halves of a quince — only when they met would

lovers

they

talk

be

about

whole:

modern

‘togetherness’,

being ‘meant for one another’.

this kind

ee

a

la

PAY:

33

a

dours sang of romantic love, none the less: an ideal love interwoven with the worship of the Virgin Mary, the queenly incarnation of perfection. For the ‘highest’ type of this courtly love, no reward — not even the simplest expression of affection from the lady to the self-sacrificing lover — was expected. Romantic love has continued to be linked with the search for the ideal, an ideal all the more precious because it is always out of reach — “The desire of the moth for the star, Of the night for the morrow, The devotion to something afar From the sphere of our sorrow’, as the poet Shelley put it. Because of this it involves pain. ‘ N a way, such love is akin to the religious impulse. It partakes of the same idealism, of the longing for something beyond oneself, the reaching out for something intensely ‘lovely’ in the object of one’s devotion. Mystics have used the language of lovers to describe their search for God, and some of the most passionate mystical writings communicate an experience similar to a lover’s. St. John of the Cross, the Spanish mystic, wrote: ‘The more I rose into the Height More dazzled, blind and lost I spun. The greatest conquest ever won I won in blindness, like the night. Because love urged me on my way I gave that mad, blind, reckless leap That soared me up so high and steep That in the end I seized my prey.’ Like mystical experience love confers a special grace on the lover. For it is not something that can be -ewilled, planned for or, in the last resort, earned: it is something that descends on the lover almost in spite of himself and in spite of his own unworthiness. The German poet

18

is, in fact, love of the lover’s

own ideal self. The growth of love and the ability to express it can, however, be frustrated and circumscribed. In Britain the ‘stiff upper lip’, toughness and aggression have | been considered the male ideal; they form part of the influential public school ethos. Though this concept of masculinity is losing ground today, one writer has pointed out that for many men it has meant a ‘taboo on tenderness’, an inability to express gentle feelings. So the Englishman is traditionally thought to be ham-fisted in love. Yet tenderness like that of a mother with her new-born child is an essential part of adult love, both in men and women. A further problem is the fact that, in Britain, first love — which is often coincident with the first tentative sexual experiments — may take place in an atmosphere of taboo, at once hurried, concealed and shameful. And not only may the young people be ill-prepared emotionally, but they may be without adequate knowledge of contraceptive techniques and their love-affair have dire and life-long consequences for the girl if she conceives an unwanted baby. When they fall in love, many men and women seek, in their beloved, their own mother or father. For in the love relationships of adulthood the satisfactions of early childhood are recreated — and often the frustrations too. This is why

people

may

run into

trouble

in their

love relationships if they have not worked through the problems arising out of stresses in their childhood. Jealousy of a younger brother or sister can, for example, lead in adult life to intolerable jealousy of anyone who seems to be taking away the love of the beloved person; it may even result in crime passionel. In any case, because of the intensity of the feelings involved, love can be very close to hate. Some people are unable to fall in love because they too carefully guard themselves from feeling any overpowering emotion. They may put up a smoke screen or a hard, shell-like exterior between

themselves and the outside world. Without the ability to love, such men and women are often frighteningly alone. Sometimes, if they have not become completely narcissistic or _ self-sufficient, they fall in love later in life, when they

have had time to feel more secure and have learnt to trust their own emotions more surely. Then they may know the raptures of middle-aged love. Antony and Cleopatra were no twenty-year olds but a man and woman of mature age — and their love was no less passionate for that. In love, every sense is heightened: the lover sees, feels everything more keenly so that the skies are more vividly 1 Romantic love is not the prerogative of youth — though many young people seem to think it is. The love affair of Antony and Cleopatra is one of the most famous in history, but many people forget that the pair were no teenage lovebirds but a couple approaching middle age. 2 The German poet Goethe's tale of the unhappy love of Werther for his Charlotte reputedly started an outbreak of suicides for love among impressionable youths. 3 Love caused a king to give up his crown: in 1936, Edward the Eighth renounced the throne of England to marry the divorced Mrs Simpson. He lost his country too — he has of lived in exile, as the Duke Windsor, ever since. But the love proved long-lasting. Romantic love is, however, not always so enduring: much great art mourns its brevity. 4 People in their seventies and eighties can still fall in love. The longing to love and be loved starts remains, unless and in infancy, blocked, for a lifetime.

1

blue, the whole world richer with pleasant sensations. It is this keenness of the senses that is sought by many of those who habitually take drugs like LSD. But it is sad that they can enter on this experience only in their aloneness and not, as in love, in the joy of a meaningful relationship with another person. When the drug experience has worn off the individual is left just as solitary and the world is mud-coloured again. But in love the experience is capable of developing and becoming richer with time. When lovers meet and begin to grow towards one another, to complement each other’s personalities and to answer each other’s needs, it seems to them as if

they and they only could ever have loved one another: they were ‘meant’ for each other. The Greek philosopher Plato likens lovers to the two split halves of a quince: when they meet they are whole again. UT because romantic love is closely BR akin to worship, it is only too easy for the lover to idealize the beloved and then feel cheated when he or she proves to have feet of clay. When the lover is able to see and to accept the beloved’s imperfections and yet go on loving, then he or she has probably passed out of the state of being in love and into the more lasting one of love. Anyone who hopes to retain the state of rapture associated with falling in

1 The love of Tristram and Iseult — doomed, since Iseult was married to Tristram’s uncle — was the theme of much medieval legend and later the subject of an opera by the German composer Richard Wagner. 2 The American politician Nelson Rockefeller risked offending public opinion when he wed ‘Happy’, who left the young children of her former marriage for him. 3 Some societies frown on romantic love because it can cause social chaos as well as personal misery — like the love of Romeo and Juliet, shown in the Zeffirelli film.

20

love has to create a set of circumstances which is highly contrived and artificial and which could prove an intolerable emostrain: frequent physical and tional absences from the beloved must be engineered: the couple must not be bound down by the needs of children or other or dependants by the complicated mechanics of home-making and incomeearning. Only through all this effort, they feel, will their love keep its pristine rapture. They are unwilling to let their love develop because they fear the consequences — total commitment or, perhaps, loss. Some couples in love often fear that their love will gradually turn into mere affection. They seize on love feverishly, trying to catch and retain the moment in all its glamour, colour and_ passion. Here lies part of the tragedy of springtime love — that it cannot be grasped and held for ever. Some of the most moving works of art have played on this theme. William Blake crystallized the sorrow: ‘He who binds to himself a joy Does the winged life destroy; But he who kisses the joy as it flies Lives in eternity’s sunrise.’ Yet, although anyone who has just fallen in love can hardly believe it, romantic love is only one kind of love. Even the most ardent lovers often come to realize that the feelings they first had, the. rapturous state of being ‘in love’, were but the seeds of everything they will become in the future. For falling in love is only the beginning. The love can change and deepen, find expression in a life created together, and in the birth and care of children. And through these children and the developing relationship, the couple’s love will stretch further into time: the fragile romantic love becomes the mature love of a lifetime.

What love is like for men Love, the most popular and the most complex of human activities, has a meaning different for men than for women. Who, what, and why is the Manin Love?

NE of the constant themes in the literature of every country, from earliest times onwards, is the expression of feelings of adoration and tenderness which women evoke in men. Letters and poems surviving from the time of the ancient Greeks reveal a gentle and protective attitude towards the loved and

admired woman. The Bible includes a number of delicately told tales, like that of Ruth, of the love of a man for a maid and the woman’s response to his devotion. Women have always possessed the ability to fascinate, intrigue and attract men. More poems have been written, and songs sung, about love than about any other subject — and the great majority of these have been written by men.

What does love mean to a man? And how does it differ from a woman’s experience of love? Is love anything more than a prolongation of sexual attraction? In the psychological sense of the word, the state of being ‘in love’ is a regressive process, in that it awakens in the mind a deep sense of belonging and dependence which has its roots in the experience of childhood. The first person the man falls in love with is his mother. The very small boy is dependent upon, and totally devoted to, his mother. The warm, tender, loving world in which he lives is created by her, and, at the beginning, only she is important to him. The mother and child enjoy an exclusive and physically intimate relationship which no one else can wholly share. Protectively, Eddie Fisher cradles Elizabeth Taylor. But when their marriage failed, he sought alimony from her. Woman's new, equal role in the Western world turns topsy turvy the traditional pattern of the relationships between the sexes. by Men no longer hold women economic chains. But the need to offer and receive the protection of security and _ stability emotional remains between them.

sg

Research has shown that the quality of this relationship with the mother in infancy determines to a considerable degree the man’s ability or inability in adult life to establish mature relationships. The boy who is not loved by his mother, or who

is abandoned by her, often experiences difficulties in establishing loving relationships with women later in life. On the other hand, the boy who is well loved by his mother, and who grows up in a secure family setting, usually finds little difficulty in relating to others when adult. During the period of absolute dependence on the mother the mouth plays a dominant role. The little boy obtains sensual pleasure at the breast or the bottle, which is felt to be a part of the mother’s body. Sucking the nipple, playing with the nipple between the lips, caressing the breast — all are elements in the baby’s initial loving contact with the mother. Mother and child exchange adoring looks and smiles, and the infant feels secure and relaxed only in his mother’s presence. In the adolescent and adult experiences of love the man returns to a rather similar use of the eyes and the mouth. He exchanges loving glances with his beloved, smiles tenderly at her and uses his mouth to kiss and caress her in ways which largely reduplicate the experience of infancy. In love, as in infancy, the mouth is the chief organ of expression. The child’s babbling is replaced by the lover’s ‘sweet nothings’ and his baby-like terms of endearment. He may call his girl ‘Baby’ or

‘Honey’ or ‘Pet’ and lovers often invent a variety of tender names for each other,

much as a mother will lovingly give pet names to her infant. The baby not only uses his mouth for sucking, but also to express affection. He may lick the mother’s face or playfully bite her nipples or her fingers. In much the same way the man in love will not only kiss but also use his mouth to explore and caress his beloved’s body. He may give her a ‘love-bite’, a caress produced by a com-

bination of sucking and biting the skin. The arms too play a major part in expressing affection, both in infancy and in adult love. The good mother will cuddle, hug, cradle

1 The ‘May-December’ wedding of Charlie Chaplin and Oona O'Neill shocked the world. At the age of 73

he fathered their eighth child. 2 A man is as old as he feels — especially when he’s in love. Pablo Picasso’s 79 years were no barrier when he married Jacqueline Roque, 42 years his junior.

and rock her baby, and it is

very probable that the infant’s early experiences of being held, rocked and played with by his mother lay the foundation for the continuing need in adulthood for intimate expressions of physical affection. The loving man will hold his sweetheart in prolonged embraces which, at first, may have very little genital content. Once a deep sense of need and mutual dependence has been established, the intimate caress awakens in each partner a desire for sexual union and possession. In men the desire for intercourse is easily aroused. For them, the closeness of the

female body leads on to the wish to conquer, possess and penetrate the body of the lover. Given a seductive situation the man may view sexual intercourse as an end in itself, without love. He learns to realize, however, that the woman less easily views

sexual intercourse as an isolated event. Men do not always understand that, for a woman, if only at the unconscious level, sexuality cannot be wholly divorced from the idea of conception and child-bearing. Even in an age when contraceptive techniques can guarantee that conception will not take place, few women are able completely to eliminate the link between sex and motherhood. When a woman is deeply in love with a man there is usually some wish (even though it may be impractical at the time) to have a child by him. At a somewhat

earlier age than men,

women look for permanence and security in a sexual relationship. The maternal instinct compels a woman to seeka relationship which will allow her to become dependent upon a man while she brings up her children. Many women, therefore, find that they cannot abandon themselves completely to a loving relationship which they feel will not be of long duration. Some women find it impossible to enjoy sexual intercourse or to have an orgasm in a relationship which lacks this quality of permanence. It is probably for this reason that women so often give the impression of being more ‘sensible’, more level-headed, even calculating, than men when they are in love. They feel impelled to view their partner not simply as a man who is loved, but also as the possible father of their children. Once in love a woman seeks security as well as romance. man can usually achieve an orgasm

aN with little difficulty, not only be-

cause the male orgasm is a comparatively uncomplicated biological event, but also because he is usually more able than the woman to abandon himself to the urgent sexual need. Biologically, the female orgasm is more difficult to achieve because the erogenous zones of the female body are more widespread. Also, since the primary sexual

22

Men in love play many different roles. The film director Carlo Ponti acted as ‘fairy godfather’ to his wife Sophia Loren, presenting her with a palace to fulfil her childhood dream. organs are less aware

inside her body, she is often than is the man of the part

played by the sex organs in orgastic experiences.

All

normal

boys,

for

example,

during adolescence, while masturbate many girls do not. It is often argued that men are naturally polygamous while women are naturally inclined to be loyal to one partner. It has also been claimed that love in the deepest sense is an exclusively feminine experience. The American poet, Ella Wheeler Wilcox, for example, wrote in one of her poems: ‘.. love is a mood, no more, to man, And love to a woman is life or death.’ Generalizations of this kind are not scientifically based, but reflect only the bias of the writer. Most of the great romantic writers. and poets have been men, and men are just as capable as women of being devoted, loyal and tender. Since, however, women cannot usually dissociate love from home-making, they do tend to be more sexually faithful than men since they are more acutely aware that extra-marital relationships might put the family ata risk. A man’s purely physical attraction to a woman can frequently serve as the basis for the establishment of a deeper and more

‘spiritual’ relationship — one which’ joins him to the woman in an intimate union of mutual dependence and need, often to the extent that neither could imagine happiness, or even life itself, in the absence of the other. In such a relationship, there is

a tendency for each partner to idolize the other, for both to believe that their new experience of being in love is totally unique and represents the most profound gift which life can offer. It has sometimes been stated that the sexual urge is stronger in men than in women. It is unlikely that this is so, the misconception probably arising from the fact that men are more easily aroused sexually and because social attitude encourages the man to take the first steps in any romantic encounter. Researches carried out in America by Kinsey, and by Masters and Johnson show that the sexual needs of women are no less urgent and important to them than they are for men. However,

one

interesting

difference

did

come to light: the sexual urge in men is at its height between seventeen and twentyfive years of age, while in women the peak years are from the late twenties to thirtyfive. A famous French courtesan was once asked at what age a woman’s sexual desires

23

waned. She replied, ‘You must ask some“one else. Iam only sixty-five’. Men, of course, may also remain potent in advanced age. A man in his seventies may still be sexually active. AILURE to experience a satisfactory sexual life can have adverse effects on men and women. The man who has never known what it is to love and be loved is often inclined to be envious, depressed and cynical. He may consider that he has just been unlucky, in that ‘the right person’ hasn’t come along. Most probably, however, such an individual is not fully heterosexual. In many cases, the man may not be an overt homosexual but the homosexual element is sufficiently strong to cut across the normal heterosexual experience. Many psychologists think that the Don Juan male — the man who continuously flits from one affair to another — is a

latent homosexual. On the surface he is a womaniser who easily attracts the attention and admiration of any woman to whom he pays court. Over a brief period of excessively romantic courtship he may appear virile and sexually mature. In fact, he is not able to support a permanent relationship with any woman. He is neither able to fall ‘in love’, nor to love in the adult sense of establishing a permanent relationship and accepting the multiple responsibilities of making a home and bringing up children. Occasionally the Don Juan lover, for all his romantic pos-

ing, is impotent. Rudolph Valentino, perhaps the greatest screen lover of all time, was adored by millions of women and behaved in a courtly and seductive fashion when in the company of women: but he was impotent with his first wife, and probably also with his second.

tE 2

1 Timidity, fear of rejection, can dissuade a man from making the first moves towards a new relationship. Arranged introductions between couples preselected by computer matching are one way round the _ problem. For this thoughtful German student the computer picked Dolores Schmidinger, a lively, extrovert Viennese actress. He was anxious to discuss student violence, Dolores, alas, was not. 2 Facially, no one’s notion of a male sex symbol, Alexandre Dumas posed smugly with his doting mistress. 3 Rudolph Valentino, passionately adored by early film goers, suffered in real life from an inability to please his wives. Appearances, in love, tell little. Likely and unlikely people can find their way in love to joy and grief.

24

|

a i

The Don Juan type of lover, like the constantly promiscuous

man,

may

not be

impotent,

uncertain

of his

but

simply

manhood and virility. He needs to engage in a round ot superficial romances in order to prove his masculinity to himself. The Don Juan lover is not a ‘good’ lover. From the point of view of sexual technique he may be relatively skilled, though even this is not often the case. Love is more than sexual skill. It involves, of course, the ability to enjoy the lover’s body, to assist the partner gain pleasure from her body in a great variety of ways and also the ability to make his own body attractive and exciting to her. But the truly mature lover does not view love-

4 The man who helps can risk doing 4! more harm than good. The wife whose husband is over-attentive may feel her role threatened, yet lack any reason to complain. 5 Love shows” another face. Anxiety and hope are here too, but touched with the poignancy of a wartime farewell. 6 Wealthy and indulgent patrons, ‘stage door Johnnies’, wait impatiently for the appearance of the ‘star’ — in the hope of winning, perhaps buying, her favour. 7 Hunters adorn their walis with mounted trophies. Bachelors, hopefully, do the same. In ten years time, will he too be helping in the supermarket?

making simply as a skill divorced from feeling, but as part of his emotional commitment to his partner. He enjoys her body as the infant abandonedly enjoys the body of the mother. He explores his lover’s body tenderly and passionately as an expression of his love for her and to receive her love in return.

At the outset, especially during adolescence, men suffer from many anxieties concerning their virility. Just as a girl may doubt, until experience proves otherwise, that she will ever be able to attract a man or be a satisfactory sexual partner, so men fear that they will be rejected by women, or fail to be virile and potent. Some men imagine that the size of their

relates directly to the genital organ woman’s ability to experience an orgasm, despite the fact that research shows that size is not a factor.

The young man who has been brodght

up by a dominating or aggressive mother may actually be afraid of women, and expect to be humiliated or to fail completely in bed. Anxieties of this kind are often so strong that they do, in fact, lead to failure at the beginning, and in such a

case the woman needs to give gentle understanding and support if her partner is to gain confidence in himself. From the male point of view, sexual intercourse is an aggressive act. He is the pursuer, the aggressor. In him sexual excitement leads on to penetration and possession of the loved woman, and all this has sadistic undertones. At the conscious level, but more importantly at the unconscious level, sexuality, therefore, in-

1 Marking the body to attract the 1] opposite sex is not the prerogative of the female. Tattooing — with hopefully similar effects — has long been a male practice. 2 ‘Watching the girls go by’ has always been a favourite male pastime. The dictates of fashion and the interests of girl-watchers are often in total harmony. As more and more of the female figure became visible to the casual and observant eye, with skirts rising to mini and micro lengths, the female leg became a source of added viewing pleasure. 3 The celibate life has its adherents too. In Roman Catholic religious orders, the vow of chastity demands the rejection of physical love relationships.

LASTALS

volves the fear of injuring the woman and the possibility of guilt and retribution. The consequent anxieties can only be dealt with by experience, the man discovering that, far from being hurt by his aggressive advances, the woman enjoys them and obtains orgastic release. Because, however, the inexperienced man is still the victim of his fears of injuring his lover he may prove impotent if the girl is a virgin and experiences actual pain during intercourse. In previous generations virginity was regarded as a mark of virtue ina girl, and

among certain religious sects this is still true today. It is curious that, despite the ereat changes that have taken place in sexual attitudes, many men still state that they would prefer to marry a girl who is a virgin. And this despite the widespread acceptance of pre-marital experience in men. But this inconsistency is gradually dying out and it is probable that the majority of men no longer demand that the woman they marry should be a virgin. Possibly men value virginity not so much as a sign of virtue but as evidence that a girl has not, as yet, felt able to love a man wholeheartedly. Many different strands make up the fabric of a loving relationship. A man may seek in love and in marriage a woman who can be sexually exciting, yet at other times relaxed and tender. He may wish her to be intellectually stimulating yet home-loving and contented. In one mood he may wish her to be as seductive as a courtesan; in another as gentle and understanding as a mother. He hopes she will prove a sensitive and loving mother to his children, and at the same time he wants her -to be able to help him cope with major decisions and business responsibilities. To paraphrase Saint Paul, a woman must be all things to one man.

What love is like for women Today a woman Is a person in her own right, no longer merely man’s tool and slave. But, emancipated though she may be, she still falls in love.

AN’S love is of man’s life a thing apart; ‘tis woman’s whole existence’. The poet Byron’s assertion was probably never true about all women, and today it seems even less so. Stendhal, the nineteenth century French novelist, stated that ninety-five per cent of a woman’s day-dreams were about love. ‘A woman at her embroidery — an insipid pastime that occupies only her hands — thinks of nothing but her lover; while he, galloping across the plains with his squadron, would be placed under arrest if he muffed a manoeuvre.’ But the woman of today is expected to do a great deal more than embroidery. ‘Men must work and women must weep’ recalls a time in history when the division of labour between men outside the home (fighting, hunting, digging), and women in it (baking, scrubbing, nursing their babies and rearing their young) was so complete that the functions of the sexes hardly overlapped at all. Men and women were expected to be two distinct types of being — complementary, but worlds away from each other. It

was an historically necessary stage of development in male-female relations. Today, in most Western cultures, we have reached the end of that era of human development. The division of labour within the family unit, and with it the role of woman, is rapidly changing. Many women are now highly educated and hold down careers; if they are tied down to domestic chores they may find this emotionally frustrating. Yet men’s expectations often do not keep

Not

all societies

have

recognized

female sensuality as freely as does this Indian sculpture: middle ciass Victorian morality frowned on it. But today, in the West, modern contraception and_ psychology allow a woman sexual fulfilment.

pace with women’s changed roles, and they, in their turn, are frustrated. The husband remembers how his mother behaved and how her life revolved around his father — the master of the house: he is bewildered when he discovers his wife weeping over the kitchen sink and screaming at the children. Men, no less than women, need _ to see how technological and

social change is shaping woman’s expressions of love, her creativity, and her goals in life, into new patterns. In some ways it is true that women tend

to seek more permanence in human relationships than do many men — especially in those involving love. It is through woman that the human race is perpetuated, and, because of her child-bearing role she has a special feeling of responsibility towards other human beings, towards human relations, and towards the home. For it is not only in her own interests but in those of her children to perpetuate the love relationship which produced offspring — to ensure sustenance and continuity of the family life, at least for the time in which her children are small and need concentrated care. The establishment of permanence ina love relationship is generally the pursuit of women

in the Western world, and without

this continuity we find a situation such as exists in West Indian society where many find it difficult or impossible to get financial support from a man for the children they bear him. But in other cultures, certain modification of a woman’s biological and emotional role may make it less necessary. In such situations, sex becomes a sort of currency; the woman provides satis-

faction in the hope that the man will accept the economic responsibility for the children he may father and for those she has borne to other men. In the Israeli kibbutz even newborn babies are sometimes taken into a nursery. The mother visits at certain times to breast feed her child. She may be summoned by a signal from the nurse in charge — perhaps byaflag raised over the nursery which the mother can see from her work in the nearby fields. Children normally return to their parents at night however, after the day’s work is over. But unless Western society is to change radically, child-bearing and rearing will still involve a continuing relationship of dependence and need which will colour the woman’s love for the man whose children she bears or hopes to bear. Unlike fish, who spawn eggs and then pass on, or the mare whose foal can rise to its feet and stagger along within minutes of birth, human mothering initially demands a continuation of the succouring which the baby had in the womb. For the newborn baby is a very incomplete and dependent being— far less able vo fend for itself than any other living creature.

2,

Generally we see feminine love within this context of human reproduction and child rearing. Once it is removed from that context, it is probably not very different from masculine love, and those

women who do not choose to bear children may well feel content with less permanent kinds of relationship. Now that modern contraceptive methods have made it possible for a woman to come to a voluntary decision about having children, it is perhaps time to recognize temporary liaisons

as socially acceptable. But it will take time for society to change its attitude towards the emancipated woman who is as free in her love affairs as a man. The double standard of morality which has long

The path to maturity in love — being able to give oneself wholly and unreservedly to another human being — is a long and sometimes arduous one. Let us first observe the newborn baby girl. She finds her first satisfactions in sucking; all her sensations seem concentrated in her mouth,

and particularly in an area just behind the upper gums where there are nerve endings which will later atrophy. In the beginning she sucks her mother’s breast or a bottle teat. Then she discovers her thumb or fingers (which she may even have been sucking in the womb) and sucks with complete concentration and abandon. Psychologists call this the oral stage of development, and many people retain oral

1 The first object of a young girl's 1 love — the first recipient of her developing maternal and protective instincts — may well be her favourite doll or soft toy. 2 The first man in a woman's life is her father. From a very early age she learns the warmth and happiness that masculine affection offers and she responds to it. 3 Round about the age of six, girls are attracted to the opposite sex — but not romantically: they may simply find masculine pursuits more fun than girls’ games. 4 In adolescence, a girl becomes a woman. As her body changes so, too, do her relationships with men. For the first time, boys become more than friends.

accepted that men may roam while insisting that the woman stays faithful at home dies hard. And even if she decides on sexual freedom, it may be emotionally difficult for a woman to escape from her biological function. And although she decides not to conceive, in spite of herself, she may feel in some way cheated. This may give rise to psychosomatic symptoms involving, for example, emotional illness, disturbances of the menstrual function, or even simulated pregnancy (pseudocyesis). OMEN will probably not be comVoices free to make their own choice until science has so progressed that babies are no longer carried within the mother’s body. And even at such a time there may be some women who prefer to do so!

28

satisfactions throughout their lives. The little girl may continue to suck a strip of cloth or blanket for some years, or her thumb for an even longer time. As she does so, she experiences a quiet satisfaction which is a part of loving and which persists in adult relationships. Later as the child explores her body she finds that touching her genitals produces pleasurable sensations. In both sucking and masturbating the pleasure is concentrated in her own

body,

and

the loving is turned in-

wards. She may use either as a method of finding the peaceful relaxation which will help her get to sleep. This is an important stage of love, but it is sad if it remains the whole story. Gradually the child forms loving relationships outside herself: often very in-

tense and passionate relationships with parents; more tranquil relationships with loving grandparents, other relatives, and friends; tender and motherly relationships through play with dolls and cuddly toys and in caring for pets, or younger brothers and sisters. She learns the grief and pain of love when grandparents (or when loved pets) die, and she begins to cope with all the emotions which are integral parts of love. She is starting to grow up, and this has only an indirect relation to physical maturation. The pubertal girl’s first ‘love affair’ may well be an infatuation with another girl, or an unrequited adoration of a school prefect or teacher. Through such a relationship,

experience the full flood of sexual desire. This is often closely linked with the rhythm of her menstrual cycle. A woman is often most easily aroused sexually around the time of ovulation (when the ripe ovum is released from the ovary), often again a few days before menstruation starts, and also sometimes during menstruation. (The Pill may alter this, as it changes the hormone balance of the body.) In our own society, man is traditionally regarded as the aggressor in lovemaking— he is the attacker, the wooer. Woman’s role has been thought to be more or less passive. He has acted love; she has suffered it. This idea reached its culmination in the sexual morality of the Victorian

the girl learns how to further cope with the emotional stresses and crises of loving. She sees that loving and happy endings are not so simple as fairy tales would have them — she comes to realize that love involves complex emotions. This first love may be associated with fast awakening sexuality or have little or no sexual content, depending on the stage of her psychosexual development and physical maturation. Love of this kind is an important stage in a girl’s development and may also serve as a safety valve; here at least she is guarded from the possibility of conception. For most girls, this is a transitional phase of loving. Soon after this she falls in love with a boy for the first time. From the time of puberty a girl may

middle class: a woman was supposed to know nothing of passion, and with docility and wifely obedience received the attentions of the male. ODAY the wheel has turned almost full circle. In discussion, if not in practice much emphasis has been placed on the equality of rights in marriage and on woman’s sexual fulfilment. Malefemale roles are becoming less clearly delineated. More and more married couples are seeking a real partnership of interests and responsibilities. Sometimes, in their effort to achieve the same sorts of satisfactions as men, women lose sight of the fact that their psycho-sexual functions often make the exnerience of loving different. With so much emphasis placed upon physiological

29

release, a woman often finds that lovemaking is unsatisfactory when she has not

achieved an intensity of orgasm which she feels is her right. Many modern books on sex perhaps unwisely stress the need to experience orgasm at each act of coitus, and not any sort of orgasm at that, but a full vaginal rather thana clitoral orgasm. The distinction is actually ridiculous, as both the clitoris and the depths of the vagina are normally (though not invariably) involved in lovemaking, and recent investigations suggest that there is actually no difference between the two types of orgasm. Obsessional attitudes about the achievement of satisfactory orgasm can result only in frustration

the help and understanding of their husbands — and sometimes help from people qualified and objective — if they are to come to appreciate that their bodies are good and wholesome, and so can begin to enjoy living through them. Sometimes a woman may claim what she feels are her rights in a way that may seriously damage her relationship. She may try to direct her marriage to such an extent that her husband feels small and insignificant. This is a humiliation which many men regard as a very real threat. A man and woman should be able to complement each other’s needs. For a woman to enter into a love relationship waving abill of rights is to endanger it from the begin-

5 A little girl grows up. She has 5 learned what love is all about — that it is tende;sness, warmth and passion. Now as a wife she takes on mature responsibility. 6 The modern woman _§ loves modern science. Safe and sure oral contraceptives have given her real sexual freedom. Now, babies come by choice, not chance.

and exhaustion. The emphasis upon achievement of simultaneous orgasm of both partners in coitus is also unwise, as many couples are happier with different patterns of release, or prefer to vary their methods. Many things make up love — tenderness and compassion, laughter and longing — other than physiological release, and there seems to be no reason why, ina woman, a particular physiological mechanism should always be triggered off in the same way as it is in a man. Some women do, however, experience very real difficulties in expressing their love through their bodies in lovemaking. Perhaps because they have learned to consider physical love ‘dirty’ or are afraid or unsure of themselves, they cannot respond fully to the man they may love deeply. They need

30

ning. Many men would only respond to such treatment with hostility or withdrawal, and co-operation, not coercion is surely the aim. Success may well depend upon the woman’s ability and willingness to exercise the skills which are traditionally associated with feminine nature — intuitive understanding, the giving of comfort and loving care, and concern for religious and ethical problems. Through efficient methods of contraception the link of inevitability between sex and reproduction has been broken. Women have been given the opportunity for a new liberty and capacity for experience. Obviously this can permit them to become more casual in their sexual liaisons. But it can also enable them to find pleasure in serious relationships without the fear of

bearing unwanted children, to lead lives in which creativity is not confined to child-bearing and the home, and to seek the means of expression and the sorts of contribution to society which have been considered the natural right of men. Now, and for the first time in history, those who are able and willing to use modern contraception can make rational decisions about parenthood. In terms of emotional satisfaction safe contraception may have far-reaching results. That sort of joyless sex in which a woman lies rigid, hoping (incorrectly) that if she does not participate actively in coitus, or that if she rushes up and douches afterwards, conception will not result, need no longer exist in the 7 A child

is the

culmination

of a 7]

woman's love. The instinct to bear children is so strong that its frustration can lead to psychosomatic illness in some women. 8 Because she knows that her child needs its father to develop fully, a woman is likely to seek permanence in a love-relationship that has produced offspring. 9 A woman’s loving care extends outwards from her family to friends and neighbours. It is her role to chat, confide and, in times of trouble, to comfort and support.

future. The freedom to enjoy the full expression of her love without fear can not only increase a woman’s pleasure in sex as such but it can also lead to a closer bond between the husband and wife. For if love making is a dreaded duty on the wife’s part, marital happiness can soon be put in jeopardy: the husband feeling that his love is spurned, the wife that her marriage bed is a place of ordeal. Released from the context of procreation, sex takes on a new dimension of choice and freedom.

A woman’s love cannot be divided into compartments — into love for a baby, fora husband or lover, or for parents. Whatever is learned and experienced through one relationship must affect all others.

To a woman, providing food for her husband and family is more than just a matter of filling their stomachs: in preparing tempting meals she also expresses her love for them. So she may feel bitterly disappointed if her cooking is spurned.

For a woman, loving encompasses such a variety of emotions and so many different moods. It involves so much of striving and contentment, of desire and fulfilment. So many different kinds of touch and sensation are involved that it is impossible to divorce the loving element which is present in every woman from the whole of her personality. Neither is it possible to separate this precious emotion from her capacity for forming happy human relationships and from her enjoyment of being alive. The differences in the emotional make-up of man and woman are pronounced. But the existence of these differences is, no doubt, one of the main contributory factors to the unending fascination of the sexes, one for another.

32

What happens in courtship Courtship’s games are played by animals and humans alike. Through childhood, adolescence and maturity, group and individual demands complicate them further.

E ostrich gains an unexpected grace in his ritual courting dance; in springtime the warm sun activates the male canary’s sex glands, making him sing and display to attract the female as a preliminary to mating. The male black headed gull, to woo his mate, regurgitates food for her to eat, will bob his head over his nest to entice the female into it. Ducks preen their wings in a gesture which reveals attractive glossy colours. All these forms of behaviour are carried out with the purpose of stimulating sexual activity. Human courtship may be a more complicated affair, but elegance, a spring day, gifts, perfumes and clothes all take their place within its structure. Courtshipis a social relationship between a man and a woman, often oriented towards marriage. When men and women ‘pay court’ they communicate an attitude of love to one another and may try to bring about one or many goals. But the aims of each in a courtship may not necessarily coincide. The woman may want to win the man’s affections, to make him fall in love

with her; her goal may be marriage. Lovemaking may be uppermost in the man’s mind. But human courtship, though it includes a great variety of behaviour patterns, usually concerns the relationships which take place before and lead up to marriage. Courtship ritual can also take place after marriage: a marriage guidance counsellor may advise a husband to pay court to his wife to restore her love for him, or to bring about a satisfactory physical relationship. For most animals, living together for long periods of time does not occur; in some species courtship behaviour may not begin until after the choice of mates has taken place. To some extent a society’s ‘fitness’ and survival depend on the success or failure of the methods of courtship and partner selection it adopts. The security of marThe secret love of Lancelot of the Lake and Queen Guinevere was the central theme of Arthurian romance. Dante’s Paolo and Francesca read a description of their first kiss: they were tempted, and so damned.

riages and families — vital threads in the fabric of society— depend on the long-term outcomes of courtships, so often casually begun. In the past most societies insisted that the needs of the individual were subservient to those of the family and larger social groupings which were the crucial foundations of the community. Not all societies have moved towards a more individualistic framework: in places throughout the world, personal decision in courtship and marriage is still minimal. There exists in many Western or Western-oriented countries a philosophy of marriage in which individual needs are considered to be all important in partner selection, and the basis of marriage is

mutual ‘romantic’ love. The U.S.A. registers 400,000 annual divorces. Perhaps with these figures in mind, one author has described basing marriage on ephemeral romance as ‘the crisis of the modern couple’. He believes that the family is being menaced, perhaps destroyed, by the ideology of modern Western courtship. On the other hand, many social scientists maintain that there is much of lasting value for marriage in the courting customs of modern youth.

The word courtship originated in medieval love customs in the courts in Western Europe. At the end of the eleventh century expression was given to a new and revolutionary concept of love towards women. Until then, love had had little part to play in ‘marriages of interest’ which were frequently dissolved when the man’s interests had been served, and the unhappy woman had outlived her usefulness. In “The Allegory of Love’, the British writer C. S. Lewis maintains that the concept of courtly love signalled ‘a change which has left no corner of our ethics, our imagination, our daily life untouched . . .’ The idea of romantic love is so firmly entrenched in the ideology of Western societies that: ‘Our only difficulty is to imagine in all its bareness the mental world that existed before its coming — to wipe out of our minds, for a moment, nearly all that makes the food of modern sentimentality and modern cynicism. We must conceive a world emptied of that ideal of ‘happiness’ — a happiness grounded on successful romantic love — which still supplies the motive of our popular fiction.’ Even today, in certain parts of the world, marital love is regarded not only as unnecessary but even subversive. Among the African Barotse tribe, for example, if a man becomes too devoted to his wife, his family claims that his wife and her family ised illegitimate magic to bewitch him out of his senses. HE contacts between unmarried men and women, particularly at adolescence, are carefully circumscribed in

33

physical attraction and compatibility. A parallel assimilation of permissive courtship has not occurred in Eastern countries, although nations like Japan have been slightly affected. In the Eastern world the stability of the family and the requirements of social order come before individual happiness; love is regarded as an unruly emotion, capable of doing great harm. Although notions of romantic love have spread to some young people, traditional ways have been little eroded. A recent attitude survey of people from

people are free to go “1 Young want, to choose whom they where they want, to do what they want. The conventions of another age mean little to them. to illustration romantic 2 A Alexandre Dumas’ La Dame aux Camélias. Warned of a consumptive death, Marguerite meets her penniless lover Armand. 3 An Indian miniature from the School of Lucknow, 1770-1780, typifies the elegance and poise of many Indian illustrations, famous for sexual frankness,

India, Burma and Singapore who were in contact with Western influences, showed little or no acceptance of the American view of marriage.

If the partner-choosing system is to be

a free one, then courtship is essential, so

that young people of marriageable age can meet members of the opposite sex, to discover where their preferences lie. Even in those communities that pride themselves on the freedom of choice of their courting rituals, there is no such thing as an absolutely free or completely random choice. There are always some social restrictions: partners cannot be too closely related; they should be within a certain age range, of some class or religion. Strange courtship customs existed in pioneering communities where conditions were too primitive and harsh for the niceties of present day courting to flourish. One unusual form was called ‘bundling’ and was introduced from Europe and practised by the lower social classes in colonial New England. The custom con-

most cultures by taboos, customs and traditions. Such communities consider the choice of a partner too serious a matter to be left to the whims and inexperience of youth. People in love are unlikely to wish to bargain with each other over such important family matters as status, wealth, good health, good stock, and working skills. The lovers’ priorities of sentiment and physical attraction are relatively unimportant items on the credit sheet of a familysisted in permitting lovers to court in bed, marriage. In communities negotiated partly dressed, and often in the presence which have absolute control of marriage of other members of the family. The lack arrangements, as is still the case in parts of privacy inherent in one-room cabins, of Asia and Africa, there is no place for the pattern of hospitality of those pioneercourtship between young people. Marriages ing days, and the fact that sitting up at are arranged in Japan, but there is a small night courting was inadvisable because of area in which the partners have some say. the expense and shortage of fuel and The marriage is negotiated by the families candles, all made the custom acceptable. A who use a go-between, the nakohdo; the couple meet for the first time at the maz, "eet", an official meeting and commitment of 2 marriage. But the couple are given discreet opportunities to speak to each other in private, and although very little courting occurs, they can veto any further

moves. The industrial revolution broke the pastoral patterns of courtship within secluded rural communities. The radical shift from these rural civilizations meant that the tightly knit family unit, with its network

of related marital

groups,

often

living in close proximity, gradually gave way to small, separate and independent households. These units, consisting of husband, wife and children had influential

but not dictatorial powers. Adolescents, no longer tied to the household for work or recreation, preferred to choose their own partners on the basis of companionship,

34

poem of the period celebrates this economical motive: ‘Since in bed a man and maid May bundle and be chaste, It does no good to burn out wood It is a needless waste.’ How are prospective partners chosen? What are the qualities in those who are finally selected which are likely to lead toa satisfactory marital relationship? Individuals who are similar to each other are most likely to pair off and to enjoy a successful marriage. People who marry tend to be alike in many ways: they may live near each other, their level of education, intelligence, age, race, social and

economic background and religious affiliations may be the same. Their values and attitudes will also

probably be very similar. But a woman does not consciously fall in love with a man because

he is, for example,

Protestant,

middle-class and well-educated. She is more likely to fall in love with someone in her ‘circle’, a network of eligibles who have similar characteristics to herself. The tendency toward homogamy is not the only ‘filter’ — the hypothetical narrowing down process — which makes choosing a partner anything but a random matter. One theory isthat individuals have certain personality traits and psychological needs: a dominant personality will be attracted to a more submissive temperament. This theory maintains that individuals are more likely to be attracted to one another if their needs complement one another, so that the manifestation of one person’s

35

$5

needs gives satisfaction to the other’s. The -practice of ‘dating’ is an American innovation, and the stages of casual dating, ‘going steady’ and ‘getting engaged’ are all aspects of courting which involve increased commitment to marriage. Dating began in the 1920’s among college students in the urban areas of the United States. Several changes in society helped produce this uniquely free and private form of

He dares a whisper, elaborates the suggestion, clasps her in his arms. He is four years old, she is three. Their friendly kiss in a summer's cornfield begins a love affair no less intense for its youthful innocence.

36

courtship. The first world war had accelerated the emancipation of youth, and of women in particular; higher incomes, increased leisure and commercialized entertainment also had the effect of liberating young people from the old patriarchal autocracy.

Boys and girls begin dating today at the age of 14 despite the girl’s greater physical and social precocity. At first girls are in-

terested in boys their own age: they soon turn to older boys for attention and dates, and older boys interest themselves in younger girls. The qualities that boys and girls look for are surprisingly congruent with their parents’ views on desirable traits in a potential husband or wife. These include mental and _ physical fitness, dependability, pride in manners and personal appearance, clean speech and action, a pleasant disposition, a sense of humour, consideration and maturity. Dating and other periods of courtship for young people are often sources of insecurity. A national sample of students in the U.S.A. reported common feelings of inadequacy, self-consciousness, being ill at ease, and general signs of anxiety and unhappiness. Much of the conflict at all 1 Nose rubbing is the way of choosing a bride at Koglamp near Mt. Hagen, in New Guinea. Young girls of 13 and 14 sit ina circle while suitors make the rounds. 2 AVictorian courting couple bring all the trappings of indoor life — clothes, furniture, inhibitions — to talk about their future on a lonely beach. 3 Nostalgia surrounds the relics of a Victorian courtship; crushed flowers, a locket of hair, a love letter and a printed screen all say forget-me-not.

stages of courtship is due to the increased emotional intimacy involved for the court-

ing couple, and problems of attitude and behaviour in connection with their physical relationships. Group pressures often force young people to date, even though they may not particularly want to. There is a gradual transition from casual dating to more serious courtship, as one youthful ‘love affair’ follows another. With succeeding affairs a larger proportion of couples experience. ‘love’ as an emotional aspect of their relationship, suggesting progress towards partner selection and marriage. A strong romantic element appears,

on

average,

a year after dating

begins — at about 15 years of age. Girls ‘fall in love’ (by their own definition) two or three times to a boy’s once or twice in their teens. They experience a greater number of infatuations. Many sociologists feel that dating is a good preparation for more serious courtship and marriage, and that it serves several purposes: socialization encourages poise and competency, young people learn about the opposite sex, to make adjustments to meet each other’s needs, to judge individuals sensibly and objectively. The phase of ‘going steady’ with one or several partners gives way tothe publicsign of commitment to exclusive courtship — the ‘engagement’. The ideal for most young people today in predominantly middleclass Western society is early marriage. Courtship in the U.S.A. from early dating, covers approximately six to eight years. The average age for women getting married for the first time in 1961 was just over 20 and for men, just under 23. In one survey of 526 marriages only one in ten of the couples was acquainted less than six months before they married; as many as two-thirds had known each other for two

years or more. Even in a society where personal and affectional motives deter-

mine mate-selection, a substantial amount

of time is devoted to the relationship which is to progress towards marriage. A function of the engagement is to allow the couple to have the feeling of public commitment to one another, without it being too late to withdraw from marriage; it can often be a positive factor in the suc-

cess of a marriage. Nearly one-half of the men and women ina survey of 900 engagements and marriages consulted no one as to the wisdom of their choice; the other half The dog-fox courting a vixen looks as if he is in an aggressive fighting mood. His elaborate ritual of mockattack will probably end in sexual encounter.

38

consulted an average of two people. Mothers accounted for over 60% of the consultations, while the father was often the second choice as confidant. The engagement is also a time when any opposition to a marriage is mobilized: matters are now ‘serious’ and friends and family may use various pressures to end the courtship. Hesitation about marrying the fiancé often occurs early in courtship. But most of it is resolved before people actually get engaged. However, in one study, 20% of the men and women had some wishes that they had not got engaged, or were considering breaking the engagement. The greatest sources of disagreement were ways of dealing with the families, how to dress and act in public, and the matter of personal friendships. Although courtship is free in Western societies, parents still exert a considerable influence over their children’s choice of mates. The system of courtship based on love has been attacked for several reasons but some writers point out that persons who criticize romantic love are also attacking fundamental values inherent in the family, which should encourage personal freedom and growth in human relationships. The family structure and attitudes to marriage reflect wider social issues; an evaluation of the worth of a particular pattern of courtship has far broader implications than a mere consideration of interesting rituals.

The many faces of love Why are there such marked differences in the capacity of people to give and receive love and such variety in the types of love relationships they choose to setup ?

Love of a man for a woman is everywhere accepted: but the love of a man for a man, or a woman for a woman, is also a pattern that occurs throughout history.

HE expression ‘I love you’ — the basic statement of a loving relationship — can mean many things, reflecting the varied human needs that give each relationship its unique flavour. One author has suggested a wide range of interpre-

tations for this single phrase. Sometimes it means: ‘I desire you’ or ‘I want you sexually’. It may be hopeful: ‘I hope you love me’ or ‘I hope that I will be able to love you’. Often it means: ‘It may be that a love relationship can develop between us’. It can be a wish for emotional exchange: ‘I want your admiration in exchange for mine’ or ‘I give my love in exchange for some passion’ or ‘I want to feel cosy and at home with you’ or ‘I want your protection’. Sometimes it expresses the need for security and tenderness, for parental treatment. It may mean ‘My self-love goes out to you’. But it may also express submissiveness: ‘Please take me as I am’ or ‘T feel guilty about you, I want through you to correct the mistakes I have made in human relations’. It may be a weak feeling of friendliness, it may be the scarcely even whispered expression of ecstasy. And, of course, it can be a full affirmation of the other, taking the responsibility for mutual exchange of feelings. The type of love that has been most celebrated in poetry, novels, plays and films is romantic love, once described as ‘a fever generally light and _ considered infinitely interesting to contract’. Romantic love as the basis of marriage is a relatively modern concept and is only widely accepted in Western countries. And harmonizing the modern concept of romantic love with the life-long partnership that is marriage has proved to be one of the major challenges to contemporary Western society. Some writers feel that marriage and the family are burdens too heavy (and too serious) for an ‘ephemeral’ relationship such as romantic love to believe that experts Other sustain. individual choice made on the basis of romantic feeling can lead to lasting relationships. This controversy raises the question of defining a mature and lasting love relationship. A psychiatrist who is an expert on marriage states that the survival of every marriage depends on the capacity of the partners to meet the psychological needs of the other, which in turn requires a fair degree of maturity. He suggests that a mature relationship is based on mutual understanding and equality between the partners. Authority, power and decisionmaking are shared. This emphasis on equality reflects the dramatic change in the position of women which has taken place in this century: previously the husband was expected to lay down the law and the wife was supposed to unquestioningly obey in every respect.

It has been suggested that today’s happily married husbands and wives have the following characteristics: they are emotionally stable, considerate of others, yielding, companionable, self-confident and emotionally dependent. Two psychiatrists illustrate a mature and happy love relationship by referring to the words of a young American woman describing her marriage: ‘We like to do things together . . . It is a sort of give-and-take relationship . . . Laurence doesn’t tend to dominate me ... And I can ask for advice and get it, but he doesn’t insist on his way being the only way. And I just like being together with him . . . There’s a physical satisfaction too — we’re compatible. He isn’t too pressing that way — neither am I — so there is a nice balance. I like someone I can talk over things with, and sort of come back to, like discussing the day’s work. I like someone I feel loves me too: Ifeel that very strongly. I don’t want criticism but someone who understands my moods.’ A reasonable degree of emotional dependence contributes to a happy love relationship. But taken to extremes dependence may undermine a long-term relationship. A marked feature of the emotionally dependent person who marries to find security, is his or her acute need for

the

physical

presence

of the

partner:

the partner acts as a source of reassurance

and alleviates the dread of being alone. If such a dependent person is courted by a lover who appears attractively strong, reliable and reassuring, but who, when the facade is penetrated, turns out to be insecure and dependent, the outcome is bitter disappointment and a potential source of tension in the long term relationship. People are inclined to look for partners who are like themselves, or who complement their needs. This is probably more an unconscious than a conscious process,

but miscalculations happen only too often. People’s needs frequently have a compulsive quality — what the founder of psychoanalysis, Sigmund Freud, called the ‘repetition compulsion’: certain unresolved needs or conflicts of childhood are repeatedly re-enacted in different settings. And this happens in marriage as well as in other situations. Therefore it is not uncommon to find, say, a woman who has unshackled herself from one unhappy marriage, in which the husband was brutally cruel and violent, marrying a second husband with almost identical traits of character. Here, it would seem that there is a compulsive tendency in the woman towards masochism (taking pleasure in pain).

A type of love relationship much discussed

love

today is homosexual love, that is,

which

another

exists

man,

between

or between

a man

and

a woman

and

39

This Roman couple painted in Pompeii, might not have agreed with the modern Western idea of equality in marriage: for in their age women had less status. another woman.

(The love of a woman for

another woman is also called lesbianism.) Homosexuality appears to be a universal phenomenon, tolerated to a greater or les-

ser degree by societies at different periods of history or in different parts of the world. In classical Greece, for instance, only homosexual love between men was thought of as reaching the heights of beauty and refinement. Other societies have used taboos, social conventions and pressures, and legislation to prevent homosexual relationships. A great deal of personal suffering is caused when society reacts punitively towards homosexuality yet sanctions are probably ineffective, for there is little evidence that a person can change what he or she is. Neither is there any evidence that the incidence of homosexuality alters significantly from generation to generation. Certainly society can never legislate human variations in love out of existence. The psychoanalyst, Carl Jung thought that every person is essentially bisexual — that is, that each man or woman has the

40

characteristics of both sexes. The male frequently represses the female aspect of his nature, but it survives deep in his mind as the element Jung called the anima. Ina man, the anima is his receptive, gentle side which normally helps to soften the logical, dominating ‘masculine’ trends. In extreme cases, the influence of the anima is lost. Some men deny their tender feelings, and may affect exaggeratedly ‘tough’ behaviour, or a cold ‘intellectualism’. Or the anima may predominate — as in the case of some homosexuals or excessively weak men. The female counterpart of the anima is the animus, which is the ‘male’ side of a woman’s personality. This, too, may undergo disproportionate — transformations in the unconscious. The viragotermagant woman, who tries to dominate everyone around her, is controlled by the animus. The over-submissive woman, the ‘door mat’ who gives in to everyone, may have a negligible, shrivelled animus — or possibly a lurking monster of an animus in the unconscious, capable of extreme

aggression. Both men and women can be found who

reject all that is regarded as feminine — soft feelings, dependency and passiveness. Such rejection can lead to psychosomatic illnesses: the combination of extreme compulsive behaviour and the repression of softer feelings can, it is thought, affect the body in such a way as to trigger off bodily ailments. The rejection of all tender feelings can also lead to a fear of being loved, which is part of the fear of dependency. A male character in one of Henri de Montherlant’s novels puts this feeling into these words, “To be loved, he thinks, is a state appropriate to women, animals and children . . . A man who is being loved is a prisoner’. HY are there such marked differences in the capacity of people to love and such variety in the types of love relationships they choose? Psychiatrists have advanced many theories. Freud suggested that the conditions of adult love are established very early in a child’s life. He stated that adult love always conforms to one or other of two types: it is either anaclitic (a word derived

from the Greek for ‘leaning up against’),

Love founded on one predominant need — for financial security, for example — may run into trouble. For what happens to the love should that need disappear?

in which case the individual chooses as,a lover someone with the same characteristics as the people who satisfied his or her needs as a child. Such a person may look for maternal or paternal figures, nurses, teachers, soldiers, the strong man and so on. The second type of love is narcissistic — the lover chooses someone like himself. The narcissistic lover may look for someone like himself in temperament, occupation, sex: or like himself as a child, a youth, an innocent: or what he himself would like to be — an ideal, a hero figure, leader: or like someone who is part of himself — his child.

Freud also advanced a theory which he called the Oedipus Complex. This theory suggested that, in normal development, a young child passes through a period of being strongly attached to the parent of the opposite sex. Freud maintained that as a result of his powerful love-experience in childhood, the adult will fall in love with, and marry, someone resembling the parent of the opposite sex. Later research suggests that Freud’s theory as it stands is an over-simplification. Certainly, some people do choose a partner with the image of the parent of the opposite sex in mind.

One writer, Karen Horney, has described a young man, unusually gifted and successful, who harboured a deep longing for a mother, having lost his own at a very young age: he married an older, plump motherly woman who had two children. She mentions another person — a girl of 17 who married a man of 47 who resembled closely her beloved father. But there are also cases where the spouse had the qualities of the parent of the same sex.

1 The very submissive woman may outwardly show little of the tough ‘male’ element of her personality — but she may have a lurking monster of an animus in her unconscious. Womanly submissiveness’ may, however, be culturally-imposed behaviour. 2 Love can be allied to pain. Psychiatrists describe the_ individual who takes pleasure in pain, either physical or mental, as a masochist, and the person who enjoys inflicting it as a sadist. 3 The woman who insists on dominating her husband and family may herself be controlled by what the psychoanalyst Carl Jung called her animus — the aggressive ‘male’ side of awoman’s personality.

And there are people who choose partners who have exactly opposite qualities from those their parents had. Two psychiatrists, for example, quote this young woman ‘describing her lover. ‘One thing I didn’t like about my father was that he was too passive .. . My mother made all the plans, and although they worked out perfectly satisfactorily, I don’t like that. One thingI always wanted was not to be the boss — I mean | always wanted someone who would stand up for his own rights. That was one thing wrong with those other boys... They were so “in love” that everything I said was all right with them. And I wanted someone, I guess, who was a little stronger than that. At one time I thought Joey looked a little like a gangster . . . I think that’s kind of significant now that I think of it. Because a gangster to me — well, a gangster has the connotation of being a real man.’ IES of affection from the past are T obsions important to everybody, so both parents may well be represented in the traits of the loved one — not usually the parents’ physical characteristics, but often their opinions, temperament and personality. Other factors influence love relationships. Those who fall in love tend to be alike in their social characteristics, but complementary in their psychological needs. Someone, for instance, who needs to dominate is likely to be attracted to someone who is submissive. Such a relationship may work out well in the long _term, but marriages are often contracted when people are immature, and there is a

tendency for the individual to outgrow the childish needs and motivations, and for the love which was based on the needs of childhood to be vulnerable. Despite the poets’ claim of the unchanging quality of love, it is not a static thing; it may dissipate, it may grow, but essentially it is

dynamic and always evolving and changing. There is a positive and negative side to the free choice of partners allowed in Western industrialized societies. The tendency of like to marry like at the level of social compatability enhances the probability of stable people coming together: but ‘assortative mating’, as it is called, also tends to bring together people with personality and neurotic problems. Karen Horney has analysed some of the neurotic components of love. She says ‘we all want to love and enjoy being loved. It enriches our lives and gives us a feeling of happiness. To that extent, the need for love — or more accurately the need to be loved — is not a neurotic phenomenon. In the neurotic the need for love is increased. If a waiter or a newspaper vendor is less friendly than usual, it may spoil (the neurotic’s) mood. This may also happen when at a party everybody is not friendly

43

_ .” The

compulsive

neurotic’s demand

and

for love is

indiscriminate.

It

is

insatiable and jealous — “You must only love me!’: it must be unconditional — ‘You must love me, no matter what I do!’: and the partner must make every possible sacrifice to prove his or her love. In addition, the neurotic shows an extreme sensitivity to rejection (real or imagined), and has, Horney believes, a fundamental incapacity to give love. Patterns of parentchild love, such as the unbridled overindulgence of the child by the parents, are thought to be partly to blame for neurosis of this kind in the adult.

The mother, with her important role in

the upbringing of the child, is obviously a very potent figure in the evolution of attitudes towards love. As the first object of love in most people’s lives, her influence is very persistent. In males, various left-over feelings from this primary love can be seen — their recoiling from the forbidding female; their child-like, happy sense of release when in each other’s company at

N4

clubs, sports and at ease, free from women and particularly from wives (the unconscious symbols for prohibiting mothers). Horney points out another unresolved relationship based on dependence on the mother — one with some dangers: this is the idea of the saintliness of women, which has reached its most exalted manifestation in the cult of the Virgin Mary. It may lead a man to believe that a decent, respectable woman is a-sexual and that she

would be humiliated by his sexual desires.

These are, of course, only a few of the many faces of love. In its fullness, love is based on many needs, likes, preferences and so on. Hence, long-term relationships based on a single predominant need — such as sex, intellectual interest or material benefits, may be at risk compared with love based on a wider or deeper compatibility. Love changes, reasons change: people are complex, not propelled by single, simple motivations — thus their relationships, too, require sturdy and varied foundations.

We need other people ‘No man is an island’ wrote the poet Donne. Psychologists have come to the same conclusion. At almost every level of his being, Man needs his fellows.

The need to reduce sexual tension is so strong that people denied the their forming of opportunity men — s onship relati sexual normal deprived of women by imprisonment, for instance — may form brief liaisons in order to homosexual . find release

|: has often been said that anything that can be done will be done, by someone, at some time. The really remarkable thing, however, is not the extraordinary variety of human actions but the apparently inexhaustible energies that keep people going, spurring them on to act and react continually with each other and with the environment in which their lives are lived. This drive and energy is one of the characteristic features of the human animal. Although rats and mice will explore mazes, for instance, out of no apparent need other than curiosity, and the higher mammals such as chimpanzees will poke and pry into things, only Man seems to have the persistence, the intelligence, above all the drive, to continually make and remake his environment, both physical and social, in the shapes of his imagination. In trying, therefore, to make sense of the nature of human relationships, a good starting place is the concept of drive or energy. Even though there is no overall agreement among psychologists about the research which has been carried out into human behaviour, there are a number of theories or models which explain some of the observations. One of the most important

is the model produced by Sigmund Freud, the founder of psychoanalysis. In simple terms, Freud thought that all human behaviour was motivated by drives that were primarily sexual in character. He also considered that the varieties in human relationships could be explained in terms of the experiences people underwent in early childhood and the degree to which their early expressions of sexuality were restricted or otherwise circumscribed. According to Freud, the most important experience in the child’s early life is his or her attachment to the parent of the opposite sex. This occurs, Freud believed, about the age of four or five: at this time, the growing child meets fully and for the first time, the complexities of relationships. The boy at this age is full of sexual love for his mother and wishes to possess her —but he discovers that she already has a relationship with his father from which he is excluded. Freud also thought that the boy feared that he would be castrated by his father if he pursued his love for his mother. This desire for the mother and fear of the consequences, Freud called the Oedipus complex. The young girl’s equivalent love-relationship with her father, Freud termed the Electra complex. OST people, more or less satisfac\/| torily, resolve these conflicts, but

the way in which the adult deals with others, and the sort of relationships he or she forms, will often stem from these experiences. In cases where the conflict is not adequately resolved the child’s ability to form relationships in later life may be seriously impaired: he may ‘go on to form abnormal relationships, perhaps on a homosexual or sado-masochistic pattern. Freud’s model has been found extremely useful but it does not provide a general explanation. For adult behaviour may be either a response to a childhood situation or a direct reaction away from it. The real weakness of the theory, however, is Freud’s overall emphasis on sex, for to say that all behaviour is rooted in the sexual urge does. not help very much in distinguishing between different human activities. A man’s enjoyment of skin-diving and ballroom dancing may both be sexually motivated, but to say that does not explain the different forms the two pastimes take. What Freud has shown, however, is that sexuality is one of the prime sources — if not the only source — of so much human energy. His theories also help to explain why so much human energy goes into the formation of relationships, particularly relationships between two people. There are, nevertheless, many levels on which people have needs which spur them to action. The American psychologist Abraham Maslow pointed out in 1943 that these needs are arranged in a definite hierarchy and that when needs on one level

45

are satisfied, all the extraordinary energy of human beings is liberated to deal with needs at the next level. The most basic needs, says Maslow, are the physiological needs — for food, drink, sleep and the release of sexual tension. These needs are fundamental and will dominate the consciousness of the person who is deprived of them. Among these primary physiological needs is the need to reduce sexual tension by emission or orgasm. Like hunger —life-or-death hunger, that is, not mere appetite — this need rarely exists in isolation, except in unusual circumstances. Usually it is satisfied in the satisfaction of other, high-level, needs for physical sexuality is only part of a larger relationship. The need for sexual release is, however, an extremely powerful drive, and will take over simply as the need for straightforward physical outlet if it is not accommodated in some other relationProstitutes provide a poor substitute for real relationships, no emotional contact being required or obtained.

46

ship on a higher level. IMPLE sex needs are met by activi-

ties

of the

unconscious

mind

in

dreams and nocturnal emissions, by

masturbation, and also in relationships where the relief of sexual tension is the only reason for the meeting of two bodies. Simple sexual release is often the basis of the relationship between the prostitute and her clients — no emotional contact is required or obtained. This is why the need for prostitutes increases whenever men are deprived of more lasting relationships — in war-time conditions, for example. It is also the reason why men are more likely to resort to prostitutes when they are on active service than most of them would be ‘back home’: at home, they have the chance to make more lasting relationships. During the Second World War a number of nations had field brothels and outside these the troops would line up in a queue. A relation-

The American psychologist, Abraham Maslow, postulated a hierarchy of human needs. At the lowest level are the basic physiological needs — for food, the release of sexual tension, sleep. Above these lie the basic safety needs — for security, for ‘law and order’, for freedom from threat and pain. When these needs are satisfied, the individual searches for love and for acceptance by his

fellows. Closely allied to the need for love is the need for self esteem and social esteem. Right at the top comes the need for selfactualization—.the individual’s need to develop and express his or her own personality and potential. Francis Chichester was satisfying this need iCoM=s-ye-] olIp Maltom(e(-taren avalon alt lone, testing journey round the world. But the needs in the hierarchy do not existin isolation from one another— dat Alan eclag) tie PRU dam dal: more basic needs often taken care of in the satisfaction of needs on _ ahigher level, and ‘vice-versa.

Satisfaction in feeding — breast or bottle. Contented baby. Tender, sensible and relaxed attitude towards bowel control,

Most psychologists agree that the experiences of a child’s early life have an important bearing on the sort of adult he will become. They generally conclude that the wellloved, secure child has a good chance of growing into a wellbalanced adult, while the emotion-

ally-deprived

child

may

possibly

become neurotic in later life. The chart here shows some of the common experiences of childhood. In the left-hand column the experiences are satisfactory and the benefits to the individual are indicated in italics: in the right-hand column the experiences are unhappy and the possible ill-effects are suggested. But this chart is not a blue-print: no-one has a totally trouble-free childhood, and many people who experience frustration and rejection in early life develop into well-adjusted adults.

mothering and environment. Happiness, confidence, ability to’ ‘give’, relaxed body, no ‘dirt’ obsession. Both parents there, and adequate. Understanding of male/female roles in marriage/parenthood.

Dolls, pets, toys, and things to love. Ability to show love easily.

nild feels

rejected, r

sure, too dependent, absent, dequate to fill parental rote. nderstanding of role played

sent parent.

Other children in a happy family.

Ability to share and see other points of view.

Unforced sexual development, frank and open discussion of emotional and physical matters, friendly contact with opposite sex. Happy acceptance, healthy approach to sex and of loving relationships, poise and realistic

attitudes. | a Non-repressive religion or ethical — code. Failures and mistakes accepted as part of life, self confidence.

Rejectionof sex as dirty ore of loving, fear of later exposure of | ignorance, embarrassment, shame, awkwardness in J/ater rel:

Happily married parents. ‘Happy marriage. Wide and varied interests, inter-

esting and satisfying occupation. Pleasure in home-making, ability to lead a full life.

___ligion.

Inferiority feelings, unworthine

a — or adolescent rebellion. 8 Unhappily married parents. | Unhappy marriage. 9 Limited recreational

possibiliti

and unsatisfying otcupations (Put on a pedestal by partner).

Frustration and boredom in m riage, exhaustion, depression, d.

48

ship formed in such circumstances is essentially transitory and depersonalized. And it is not readily tolerated except under conditions of basic physiological deprivation. The same deprivation leads to the formation of brief homosexual relationships, in prisons and similar places, by people who are not homosexually inclined. Rape can also be another case in which the physiological need for copulation is satisfied without any meeting of personalities. Fortunately this sort of sexual deprivation is rare because, as Maslow himself put it, ‘Human culture is a tool designed to provide for the satisfaction of basic needs.’ In Maslow’s hierarchy, the next step up the scale from that of the physiological needs is the level of the basic safety needs —

the need for security, for freedom from threat and pain. The desire for what might be described as ‘law and order’ is one which most cultures are designed to satisfy. The adult as well as the child needs security — though one can most easily see the stress caused by fear and uncertainty if one studies young children. For adults, as for children, routine and order are the best guarantee of safety, and so there have always been enormous social pressures for stable, enduring personal relationships. Almost all societies frown on unstable, transitory unions between people: societies evolve and maintain institutions such as marriage and the family in some form or other, in order to satisfy the basic safety needs for security and safety. S a general rule it can be said that the

A 1 On a Greek bowl, Oedipus and the sphinx: in mythology, Oedipus killed his father unwittingly, then married his mother. Freud believed that children who did not resolve an early attachment (he called it the Oedipus complex) to the parent of the opposite sex might as adults form abnormal relationships. 2 One strange couple.

harsher the environment, the more

strongly people seem to strive to maintain stability in personal relationships, and the more fiercely they uphold institutions like marriage. The ‘permissive society’ can only exist in an affluent society. The reason is that only the affluent society can guarantee to any extent people’s safety needs. For example. if you are sick, the affluent society will look after you: if you run out of money, the affluent society will provide for you in some way. In poor societies, on the other hand, you have to depend for these things on your immediate family and kin. Thus the release of physical tension, the biological urge to copulate and reproduce, together with the provision of safety and security — a roof over your head and a pay cheque at the end of the week — are sufficient conditions for the setting up of permanent, enduring relationships. Indeed, these conditions form the basis of marriage in many societies. A marriage that allows for these needs can be arranged between people who have never met each other beforehand. And the marriage can last and be happy and fruitful, because it satisfies fundamental needs. People who are deprived of security in their childhood often become neurotic in later life and many such people found relationships based on the satisfaction of their need for safety: the insecure neurotic may become dependent upon another individual in order to provide meaning for his or her existence. This dependence may persist: the dependent person will cling to the more dominant and secure partner, however many insults and humiliations he or she suffers, simply because the relationship provides the necessary safety and security. The next level in the hierarchy of needs is, according to Maslow, the need for love. If the physiological needs and safety needs have been satisfied — as they are for most people who live in a stable environment — all the power and energy that drive a

49

hungry man in search of food or a threatened one in search of safety, is set free to seek for some satisfaction of the need for love. Thus the giving and receiving of love, the sense of being accepted by other people, of belonging, can be of enormous importance. So, when people talk of ‘needing each other’ they are expressing a fundamental human truth: the deprivation of contact with other human beings can be as painful as the thwarting of physiological needs. Most people suffer bitterly in solitary confinement: indeed, used as a form of torture, solitary confinement can result in the disintegration of the victim’s personality. People who are deprived of love may become delinquent, turning upon a society that has not given them what they need. Or they may interpret mere indifference as active, damaging hostility. This deprivation is often the cause of paranoia, a state of mind in which a person believes that other people are conspiring against him. The lonely old lady, for example, who complains that the neighbours are leaking electricity under her door, that the people who glance at the house as they pass by are plotting her downfall, that the milkman is poisoning her milk, is saying in effect, ‘Because nobody loves me or shows me affection, they are indeed actively destroying me as a person.’ The need for love is very closely allied with the need for esteem. Occasionally, indeed, the order of these needs is reversed and for some people the need for esteem is more important than the need for love. Basically, people have an image of themselves and it is of great importance to them that this image should be recognized by other people. If other people do not see you as you see yourself, then you tend to feel unhappy or uncomfortable — this is why it is painful to be made fun of or ridiculed. People therefore seek out others who will give them esteem and make them feel confident and adequate: many relationships are based on the unspoken contract ‘You scratch my back and I'll scratch yours.’ To a certain extent, the mutual admiration society is a necessary human institution. At the top of the hierarchy, Maslow puts the need for self-actualization. When, he says, all other needs are satisfied, the

50

personality is free to seek and establish its own identity, to develop and express its basic potential. In this state people will seek relationships with groups and with individuals, relationships that are based on an adult recognition of the sovereignty of other individuals, rather than on their usefulness as objects to satisfy needs. Many psychologists feel that only this free transaction between adults can give rise to fully mature relationships. The peculiar relationships that fill the casebooks of the psychiatrist are often founded on one overwhelming need. Or they are a product of personalities whose hierarchy of needs has become distorted or fixated by stressful experiences. Such relationships are rarely stable in the long term, for the motivation to maintain them changes as the needs change. There are, for instance, the relationships that rise out of circumstances — the shipboard romance,

when people seem perfectly matched and rapidly develop an intimacy in the peculiar situation of the voyage, turns out, when the ship reaches shore, to be viable only in that situation: it cannot survive in a different environment. It is important to remember, in looking at the needs which drive people to form relationships, that the individual may be operating on many levels of the hierarchy at the same time. An individual may well be meeting and satisfying the lower needs in the higher relationship. Two people, for example, in a mature adult relationship may at the same time be satisfying each other’s needs for release from sexual tension. At times of stress their relationship may take on aspects of an earlier, more primary, level: or the relationship may develop through the satisfaction of earlier needs towards later higher stages. For the dynamics of inter-personal relationships can never be interpreted according to one simple formula, but must be seen as an interaction of many and varied factors. For men and women are endlessly com-

plex in their psychological make-up and the ways in which they satisfy their needs and inter-react with other people are everchanging and shifting. No one can define a rigid formula of human behaviour — psychologists can only suggest themes on which there are countless variations.

Making a marriage A marriage may be made In heaven but it is contracted on earth with a wealth of pomp and ceremony designed to emphasize its importance as a social institution.

Tribal cultures have formalities as elaborate as any in the industrialized West.

LRiweman is love between a man anda woman is an intensely personal matter, often involving only the two indi-

viduals in a world of their own. But marriage is different. A marriage is a contract forged under the eye of society and sanctioned by it: the wedded state brings rules that bind, duties that may be inescapable, and responsibilities, financial and social, that cannot be ignored without risk of penalties. Marriage is endorsed in some form or another by all cultures in all periods of human history for it is an institution that formalizes and symbolizes the importance of the family. And on the stability of the family structure rests the stability of a society. One of the major functions of marriage is to control and limit sexuality — that unruly element that all societies attempt to curb in some way in the interests of social stability. Marriage limits sexuality by providing the legitimate circumstances in which sexual intercourse may take place: and it defines as legitimate the children of the married couple. In some societies there is formal or informal endorsement of sexual intercourse outside marriage and there are cases where marriage rites are not expected to take place until the woman is pregnant — for example, among the Dyaks of Borneo and in many European villages just before the industrial revolution: in yet other societies, among the Longua Indians of Paraguay, for instance, although marriage rites take place before sexual intercourse, the marriage is not considered complete and binding until a child has been born. Yet, even in these societies marriage still provides the frame-work for the longterm relationship of man and woman. The fact that marriage defines what is a legitimate sexual relationship and which children are legitimate in society’s eyes is very important and largely explains why marriage is always a civil contract as well as a convenient social custom. Although there are cases where stable sexual unions occur and families are formed outside marriage — for example ‘common law marriages’ in England or ‘consensual unions’ in the Caribbean — these unions seem to carry less than full social approval. Marriage is also important in that it gives to members of the family certain rights and duties, certain expected and preferred ways of behaving both to each other and. to groups in the wider society. Some people think that the function of defining and distributing role and rights to the marriage partners is the crucial defining characteristic of marriage: in Edmund Leach’s phrase, marriage is merely ‘a bundle of rights’. These rights relate to four areas — sexuality: the birth and rearing of children: domestic and economic services: and property. Each of the partners in the marriage

has certain rights, and usually some attendant duties, in all these matters. Rights relating to sexuality include, in some cases, setting limits as to when sexual intercourse may take place. For instance, in some societies there are regulations governing lovemaking during menstruation and after childbirth: where polygamous marriages are the rule a system of rotation is allocated: in some tribal societies, there is a restriction on love-making just before or just after a man has been to battle. IGHTS over children — whether they shall be allowed to live, how anc where they shall be reared, educated and trained for an occupation and status in society — are usually distributed between the marriage partners, or between them and their wider kinship networks or other social groups. In modern Western societies, for example, the State has considerable rights concerning the health and education of children. In some tribal societies — among the Trobriand islanders, for example — most of the rights which in modern Western societies would be the father’s concern fall to the mother’s brother. Among a certain tribe of the Sudan, a woman could be married to the ‘name’ of a man who had died in battle. When she had children by a lover, who would usually be a stable partner, certain crucial rights over their children fell to the kin of the dead husband. These children would inherit property and status from their legal not their biological father. Rights and duties relating to the domestic and economic division of labour in the family are often spelled out in elaborate detail in marriage customs and contracts.

These include not only informal assumptions about what work traditionally goes with the role of husband and wife, but also precise and binding requirements such as for example the legal obligation on the contemporary British and American husband to maintain his wife and children-whether he lives with them or not. Then there are the services or payments which prospective spouses often have to make to the intended

partner or his or her family — the bride price in some tribal societies, the dowry in medieval Europe, or Jacob’s seven years’ service to Laban for Rachel which is described in the first book of the Bible, Genesis. Rights over property are important in all marriage contracts but they vary enor-

mously from one society to another, and often from one stratumof society to another. Many factors affect the allocation of rights over property in marriage: the status of women in the particular society, the system of inheritance, and the relative importance of the conjugal family and wider kinship groups all affect the degree of control over property which is invested in the husband, wife, children or extended kin. And other aspects of law and custom relating to the

51

J Roots

A

i

i 4 Fs

v =

oN ae ifs iM 4

family can be greatly affected by the arrangements over property. The heavy moral odium that surrounded the adulterous wife at certain periods of English history, especially among the landed aristocracy— and the ease with which she could be legally cast off — can partly be explained by the fact that the eldest child of the tamily inherited the property: the great landed families were eager to get rid of the errant wife in case their inheritance should pass to an undetected bastard. Because marriage involves society as well as two individuals, there are normally legal and social controls to prevent people 1 All societies have some form of 2 marriage and the contract is often sealed by the gift of a ring to the bride a symbol, perhaps, of marital unity. 2 This Russian couple chose the traditional church wedding, but in the USSR civil marriages are more usual. The civil ceremony is, however, accompanied by music and processions for the need for ritual is fully recognized. 3 Eastern as well as Western marriages are traditionally celebrated by impressive ceremonial, elaborate costume and huge _ family gatherings and feasting. This Indonesian bride and groom will be made fully aware of their newsocial 4 roles. 4 In many societies, complicated financial arrangements relating to property settlements and dowries had to be made before the wedding could take piace. Often the families of the prospective couple, or professional marriage brokers, conducted these negotiations on behalf of the pair.

entering lightly into the wedded state. Usually, the man and the woman must be single, or of eligible status and must agree to the marriage, although in some Islamic and Hindu communities the father or grandfather of a young virgin may dispense with the girl’s consent in arranging her marriage. Often, but not universally, there are minimum age requirements. Manycultures however, have practised child marriage even where consummation is deferred until puberty. In nineteenth century India, puberty was customarily the maximum rather than the minimum acceptable age for girls to be married. In many societies

the partners’ kin must approve of the marriage — and indeed it is often normal for the kin group to initiate and arrange the marriage and to fix all the financial settlements on behalf of the contracting parties. This happens, for instance, in Muslim, Shinto, Confucian, and Hindu marriages. Financial and property settlements are common to marriages the world over. Such settlements ensure that the new family is soundly based. Sometimes the settlement is designed to compensate the family of the new wife or husband for the loss of valuable labour services, or to provide for the more vulnerable party, usually the wife, in the event of a divorce — the dowry in Islam, for instance, tends to be

world over. All have at their centre either the tacit, or more often the open, acceptance of the married state by the contracting parties. The statement before an official that the man and the woman accept the statutes and duties of husband and wife under the law of the land is almost the only business of the civil marriage ceremony in Britain, the British Commonwealth, America, the U.S.S.R. and other Eastern European states.

But other customs cling even in some civil ceremonies. The marriage feast is a ritual rejoicing found in all cultures. The scattering of symbols of fertility or prosperity is another common custom — for example, confetti or rice in Christian mt EE

kak eo = > Oe

EGER

1 Often a wife has to bring her husband a dowry - this Indian girl is wearing hers. In some African tribal societies it is the manwho has to pay his wife’s father a /obo/a, or bride-price, in the form of cattle; in the event of a divorce, the cattle have to be returned. 2 Marriage has its economic as well as ceremonial aspects. Wedlock may mean a change in financial status — the Victorian husband in England had a legal right to all his wife’s income.

for the wife’s benefit, should she be repudiated by her husband. Almost always there are legal or customary rules to ensure publicity for the marriage and to provide a record of the contractual arrangements: the publishing of banns, residential qualifications, and the presence of formal witnesses at the marriage ceremony all fulfil this function. Since these controls are primarily of social importance, they form part of civil as well as religious marriages. The eligibility of the contracting parties and of the official conducting the ceremony, residential qualifications,

the consent

of the parties

and of their kin-if they are below the age of consent, witnesses, registration and publicity, form a part of all known civil marriage arrangements. Even in places like Gretna Green in Scotland, where historic custom once (but no longer) made marriage easier

than elsewhere in Britain, the only substantial relaxation of these requirements was a shorter period of residence. Marriage ceremonies have many common elements in differing cultures the

54

cultures,

dates

and

sweetmeats

in some

Muslim and Jewish communities. The presence of bridesmaids and groomsmen at the wedding ceremony is another ancient tradition. Some anthropologists have speculated that the original function of the Best Man was to protect the bridal pair: the newly-weds were often regarded in folk societies as particularly vulnerable to evil spirits and black magic. The honeymoon or at least a short period of privacy for the couple, ritual bathing before the ceremony, the use of veils or a marriage canopy, wearing colours considered specially ‘pure’ (red in Islam, white in the Christian West), a bridal procession beneath crossed swords, the ritual smashing of a wine-glass at the end of kiddushin, the Jewish betrothal ceremony, carrying the bride over the threshold of her new home — all these provide a few examples of protective customs which are by no means confined to simple societies or to religious weddings. Whatever the origin of the wedding customs, they always have the function of imaginatively expressing and impressing

on the couple the importance of the step they are taking. Indeed, there are strong indications that civil marriages are felt to be inadequate ‘rites of passage’ if they are too completely stripped of ritual elements — as, for example, are the perfunctory formalities of ‘conveyor belt’ civil marriages in some American states. In addition to all these customs many marriages are, of course, also specifically

3 The dignity of legitimate union is suggested by this Egyptian sculpture.

4 The importance and solemnity of the occasion is impressed upon the bridal couple in most wedding ceremonies, civil and_ religious. often carries symbolic Costume meaning — the Christian bride’s white dress is a sign of purity.

religious acts. Indeed, despite a slow but steady trend towards civil marriage in modern industrial societies most marriages in the West are still religious services. No religion has ever failed to treat marriage as worthy of religious concern, but some religions — in particular Hinduism and Roman Catholicism — regard marriage as a sacrament and the marriage bond as sacred

and indissoluble. It is no accident that the religions that express a mistrust of sexuality often insist either on celibacy or on

ultimate withdrawal from family life fora spiritual elite. This tends to be part of a theology which regards over-attachment to any of the things of this world as a hindrance to spirituality. There are other religions, however, in which sexuality and family ties are not so deeply mistrusted. In Islam, Shintoism, Confucianism, Judaism and Protestant Christianity, marriage is regarded as a contract rather than a sacrament, and while all these religions hold life-long marriage as an ideal they do not wholly condemn divorce and the first three have even encouraged polygamy. It is in some ways paradoxical that marriage is considered indissoluble in those religious traditions which embody the greatest suspicion of sexuality and family ties, while those religions which mingle family and religious duties most intimately — ancestor worship in Shintoism and Confucianism, familybased rituals in Judaism, for example — regard marriage both as less awesome and as a more fundamental part of religious ‘ duty. Different religious attitudes are reflected in marriage ceremonies as well as in religious rules about divorce and re-marriage. Religions which treat marriage as a contract tend to place the couple’s acceptance of the duties of the contract at the

After the ritual and feasting of the wedding comes a life-time of responsibility, a fact stressed by, among others, the Christian marriage service.

centre of the ceremony, although they also include prayers and blessings and normally use an official of the religion to conduct the ceremony. At a Jewish wedding for instance a major feature is the reading of the Kettubah, the man’s acceptance of the duties of a Jewish husband. A prominent part of a Muslim wedding is the publication and acceptance of the marriage contracts and financial settlements. N the other hand, in religions where marriage is a sacrament, the ceremony will tend to feature a symbolic expression of the sacredness of marriage — in Hinduism, for example, the couple, hand in hand, circle the sacred fire, and in Orthodox Christianity the couple are ceremonially crowned. All religious marriages include some element which expresses the couple’s acceptance of the main customs and beliefs of the religion itself — for example the nuptial mass at a Roman Catholic wedding, or the Shinto and Con-

fucian bride’s first involvement in the ancestor cults of her husband’s family. Because of various social changes there has been an increase in the divorce rates in the West. Yet it is important to emphasize that this increase is by no means a symptom of the decay of marriage and the family. Research suggests that the vast majority of couples who marry intend to stay married for a lifetime — and even those who seek a divorce mostly re-marry. In fact, marriage has never been so popular as it is to-day. The age of marriage in the West is continually declining and the proportion of the population marrying is increasing. The divorce rate may well continue to increase slightly for a variety of reasons, but there is little doubt that this is no serious threat to the stability of society or to the continued existence of the family. Marriage undoubtedly has a long and flourishing future despite its increasing number of critics.

. (bi fea

Geile ee!

Modern marriage inaction A French novelist has:called

marriage ‘the loveliest of miracles’ because it can Survive countless vicissitudes: itis acomplex, living, developing relationship.

Engagement parties are fun, but the pre-wedding preparations can reveal latent sources of conflict between the couple.

\ wedding day is the start of an entirely new existence. Two people have joined to become a new unit in society. They have begun something quite original — the one and only marriage of its kind. On their wedding day a man and woman come together, for better, for worse, for life. They come from two completely different backgrounds, even if they happen to live in the same street or move in the same social circles. The fact that they have basic differences of viewpoint may have already come to light during their preparations for the wedding, as a result of family pressures perhaps over the question of whether they will have a white wedding. The way in which they respond to these pressures may teach each something new about the other. Many engaged couples fail to look beyond their wedding day. They may have planned their ideal home, pictured themselves sitting by the fire, entertaining their guests, wheeling their prams or planting their gardens. They may have budgeted down to the last penny, insured against sickness, made certain that their home will be their own after twenty-five or thirty years. But there is more to marriage than this: the ideal marriage continually develops and grows into a more perfect relationship. This is not an easy or automatic process, for the pattern of any marriage is continually changing and any new shape in the partnership has to be accepted by both partners as it occurs. Special adaptability is obviously necessary when the children arrive or later when they grow up and leave home but this need to adapt to another person is essential from the wedding day onwards. Then, suddenly, the friends, the rela-

tives, the fuss and the presents and the speeches vanish into the background, and whether they are on a bus to Brighton ora plane to Nassau the newly married couple are on their own. The majority of couples have a honeymoon, even if they use the time to settle into their new home. Most of them like to get right away from families and friends and their everyday surroundings, even if only just for a few days. A honeymoon is synonymous in many people’s minds with the first occasion when sexual intercourse takes place between the couple. It is an occasion which many people expect to. be completely satisfactory and utterly pleasurable for both partners, then and ever after. It has probably been talked about and looked forward to with eagerness if not urgency. Fortunately, since it is no longer taboo to talk and write about sex, more and more couples are coming to know that instant pleasure and success in love-making is not necessarily to be expected and that lovemaking is one of the things which will improve with time and practice, often over many months and even years. This is one of the first of many occasions when consideration and patience will play an essential part in the relationship between the couple and when the growth of understanding between them can be fostered. A honeymoon is specially important because it should be a time when the couple are able to relax together, to fuse together in other ways than sexually. As an expert put it ‘We can be pretty certain that we are in love in the first two ways — romantically and sexually. Our question is whether we can integrate these two with the third — with affection. Do we like each other as well as being in love and desiring?’ ‘Liking’ becomes more and more important as time goes on, and happy marriages are often the perfect combination of friendship and loving — a good way in which to start married life on the honeymoon. OMING back to hard reality, to the daily chores and the business of earning a living can seem to be rather an anti-climax, and being married is very different from being on honeymoon. It is perhaps easier to look on the return from the honeymoon as the beginning of marriage — and to regard the honeymoon itself as just a light-hearted interlude, a holiday to be remembered. For a time, the magic of being newly married continues. But in time this magic is replaced by something that can be even more exciting and challenging: a living partnership. Although equal partnership in marriage can in itself cause difficulty, the new relationship is alive and growing, not static and dead, as it certainly was during the era when the husband ruledthe domestic scene with a rod of iron and the wife knew only too well her position of

57

inferiority, especially in decision making. Some people think that the new basis of partnership in marriage can mean sacrifices and loss of ‘rights’; but in fact the gains can far outweigh the losses in that the constant consideration of one another’s feelings, adjustment to the other’s point of view, discussion instead of direction, can make a couple much more mature people — far better able to develop and improve their relationship with one another and thus enrich the marriage. Some of the first decisions which have to be made may seem quite practical — probably to do with how the home should be run, how the chores are to be shared if both are working, how the money should

husband to help her with the cooking or washing up as well this may come as quite a shock to him. People can feel intensely about such matters because their ideas of how a home should be run is bound up with their whole background and past way of life. So, in reality not only two people make up a marriage relationship — but the whole of their background comes into it. If this background is a straitjacket, it must be

be allocated and other apparently routine affairs. These practical matters may not even have been discussed beforehand, for the couple may have taken it for granted that things would work out amicably and run smoothly. But it is quite surprising how much more there may be to it, and how difficult some decisions may be. Atits simplest level, the new husband may be used to his mother doing things in a certain way and he may not realize that his wife may have quite different ideas — based on the way her mother did them. Perhaps the coupie have their first mild quarrel over the fact that the young wife does not prepare and serve the Sunday roast in the same way as the husband’s mother. The husband may be quite willing to undertake certain jobs about the house, like, say, fixing shelves or gardening which he remembers his own father doing: when his wife suggests that it may be more practical or useful for her

thought and action is both one of the most difficult and one of the most worth-while objectives in early married life. It is particularly important when the first baby arrives — and in fact this is one of the times when special understanding and

cast off. At least it must be seen in perspective. This may sound harsh, but in fact is

essential if the new family unit is to create its own life. Achieving a happy relationship with parents and in-laws, yet at the same time maintaining independence of

1 Many couples look no further than the wedding day. They forget that it is only the beginning, not an end in itself. 2 Budgeting the domestic income is not always this cosy. Rows can develop over new car versus redecoration.

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tolerance is needed. A first baby is always something of a bombshell and nothing like it will ever happen again. The infant can both delight and horrify his parents: the new mother, in particular, may find that events are not at all what she expected. She and her husband looked forward to this child’s arrival: ina way he was going to complete a picture of family life they had in their minds. But when the first fuss is over, and the young mother suddenly finds herself left alone in the house with this fragile little object (sometimes sleeping peacefully, sometimes screaming and scarlet in the face) she may feel let down,

depressed, lonely and even

frightened. When her husband comes home

he may well find a weary, slightly tearstained wife who just hasn’t managed to clean the house or even get his evening meal ready for him. Such times are obvious points when the warmest understanding between the couple is essential. Once the first trials and tribulations have been experienced and left behind, the couple will realize that, if there has been warmth and understanding between them, this was an episode which has enriched their relationship and deepened their love for one another. A whole host of emotions and changes are set in train by the arrival of a baby. The father may feel rather left out: he has been the centre of his wife’s attention until then

ECOMING a good parent — or at least trying to agree what a good parent is — can be the subject of endless discussion. There are innumerable books on child care, putting forward many different theories about the correct way of bringing up children. This confusion among the experts may disturb the parents, who may

become anxious because their child does not seem to approximate in any way to the children described in the books. They may worry, too, that he does not seem to be at the same stage of development, physically or mentally, as the neighbours’ children. Grandparents may express their doubts: ‘By the time you were his age...’ But every child is different and every

3 Babies are not all bundles of joy. They can mean a tired wife and a jealous husband and less leisure for both parents. 4 When the husband retires and the child leaves home will this couple’s marriage still be a vital, flourishing partnership?

but he seems now to have been replaced by this tiny infant whose sole purpose in life appears to be to disturb his sleep and upset the smooth running of his home. New discussions will begin and even though the baby cannot yet utter a single coherent word, decisions about his future will seem immediate and urgent. What sort of parents are they going to be and what should they do about discipline — starting from the question of whether he should be left to cry himself out at night? The couple may both have strong feelings about this problem, based on the way they themselves were brought up. And what is more, both sets of grandparents may try to exert con-

siderable influence: over the baby’s upbringing and may succeed, unless the new parents are very careful to present a united front and demonstrate that they have quite made up their minds that this is entirely their affair and that they are the only ones to take decisions about their child.

couple have in the end to work out their own way of bringing him up. They can draw on the experience of the experts or the grandparents, but in the end it is their own parental instincts which will prove most helpful. Usually, the parents have to make some sacrifices in leisure time activities when the baby arrives, unless they are lucky to have baby sitters on hand. There may also be a considerable cut in income if the wife has been working until now. Even though the couple may have planned well ahead, they may still be surprised by the difference one less pay-check combined with babyexpenses will make. Budgeting in itself is not quite so simple as it might appear. Before they are married most couples at least have a rough idea of what they can afford and how their income will be allocated: better still if they can have certain specific items firmly agreed. This could simply mean dividing the money

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William Hogarth, the eighteenth century English painter, cynically chronicled the married life of an ill-matched pair in these pictures

which Mode

he called Marriage a ‘Fashionable Marriage’

la

1 The marriage contract is arranged by others while the young couple on the sofa look in opposite directions. The yoked dogs are Hogarth’s comment on what sort of marriage this will be. 2 Husband visits a quack with his mistress.

up under five or six headings ~ such as rent, household, heating, food, leisure, clothing — but it is as well to decide also what the sub-headings should be, otherwise misunderstandings can easily arise. For when it comes to deciding how much money should be allocated for particular items, more than mere financial considerations are involved. The whole discussion as to whether they should have a new car (which he wants) or whether they should have the house redecorated (which she thinks should come first) is based on priorities and very deeply-held feelings. Even if these things are only wanted as status symbols they can mean quite different things for each person: the new car may be needed to bolster up the husband’s confidence at a difficult time in his career, the freshly painted house may cheer the wife up when she is depressed about being tied to it by a small child. If the couple can manage to discuss these matters quite frankly and openly, can realize why each feels so very intensely about certain things, and can admit how deeply hurt they can be, their understanding of each other and their whole relationship will mature and improve. There is probably no such thing as the perfect marriage because, as many philosophers have said, real happiness involves striving towards a goal rather than achiev-

ing it. So the happier marriages will always be those that are developing and maturing with the couple continually learning from each other and striving to improve their relationship.

The anthropologist Geoffrey Gorer has written that a relationship which includes ‘give and take, understanding, love, mutual trust, equanimity, sexual compatibility, comradeship, a decent income, mutual interests, happy home life and no money difficulties’ would seem to be the ideal of most people. Many couples see their goal in marriage as the successful raising of a family and see themselves in middle and old age looking on with satisfaction and with a sense of duty and responsibility discharged, as their children in turn raise their own families. In fact, one of the real tests of any marriage will probably come in middle age when the children grow up and leave home. The parents are on their own for the first time for very many years. If their marriage has been a developing one, if they have maintained interests outside the home and not concentrated all their thought and conversation on their children, they will be able to take their relationship a stage further: if not, they may suddenly face each other across the breakfast table as almost complete strangers. What can they do, what can they talk about? The same applies to retirement, and much discussion and preparation is needed before the husband gives up work and, probably for the first time ever, is at home twenty-four hours of the day.

The later years of married life can, if the relationship has been a growing one, bring back some of the joys of earlier days.

The couple now have more time to devote to each other, free from the responsibilities

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of children. They can take up new interests and hobbies together, share the leisure activities that have had to be shelved while the children were young. They can find a new companionship, based on their years of intimacy which will have given them tolerance and a deep understanding of each other as people. These can indeed be the ‘golden years’. Marriage, then, has many subtle qualities. There is a tenderness which deepens as the years go by, which differs in each marriage partnership. It is almost as if each marriage develops its own folklore, a language of its own, a spiritual unity of its own. It is a pity that great literature has not reflected the reward and magic of maturity

3 The husband has surprised his ry received adeath and ulte wifeinad from the lover’s sword. wound 4 The wife dies from an over-dose of laudanum — the empty bottle lies at her feet. The patch on the child’s cheek probably indicates that it has inherited disease as a result of its parents’ dissipated life.

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in marriage but has rather concentrated on young romantic love, or, in more recent years, on the problems rather than the joys of married life. Francois Mauriac, the French writer sums it up perfectly in his Journal when he describes married love as ‘the loveliest of miracles’, persisting through countless vicissitudes. ‘After many years, still to have so many things to say to each other, from the most trivial to the most serious, without the intention or the desire to astonish or to be admired — what a wonderful thing! No need to tell lies to each other: lying is no use from now on, husband and wife have become so transparent to each other. That is the only love which loves immobility, which feeds on habit and the daily event.’

Making sense of making love Success in the delicate art of love-making, according to one eminent author, is the result of a ‘happy combination of knowledge, inspiration and genuine wish’. Asatisfying physical relationship Is today recognized as an important constituent in a happy marriage, bringing fulfilment and expressing mutual love.

LL living creatures have an urge to reproduce their kind. The physical act that can begin a new life is known variously as the sex-act, coitus, copulation or sexual intercourse. At its simplest, sexual intercourse is performed by the human male and female joining their respective sex-organs and making certain movements which result in the male’s sperm being spurted deep inside the female near the site of her egg. To enable this to be done, the male and female sex-organs are so designed that they complement one another. The male sex-organ, called the penis, is a tube formed of sponge-like tissue covered with skin. The female sex-organ, called the vagina, is a sheath into which the penis fits under certain physical conditions.

When the man is not sexually excited, his penis is soft and hangs limply downwards from the base of his trunk. When he is sexually roused, blood rushes into the spaces of the spongy tissue, causing the penis to become stiff and to stand up almost vertically with the body. The man is then said to have an erection. Only when the penis is erect can it be put into the woman’s vagina. When the woman is sexually excited, the entrance to her vagina, which is situated in the same place in her body as the man’s penis in his, swells and opens. A tiny organ, the clitoris, which is situated a little above the vaginal entrance, also becomes erect:

Sexual intercourse between a man and a woman is most usually performed in the West with the woman lying on her back with her legs apart. The man places himself above her, his legs between her legs, and supporting his weight on his elbows and knees.

When he lowers his buttocks,

the tip of his erect penis is brought directly to his partner’s vaginal entrance. The erect penis is pushed into the vagina, which is so constructed that it will stretch sideways and lengthways to accommodate a penis of any length or girth. The length and thickness of the penis differ from individual to individual with as much variation as the size of the nose, hands, and feet differ from person to person. It is generally accepted that among mature Europeans and North Americans the average erect penis is between five and six inches long, measured along the top side, and between four and four and a half in circumference at the base. When the man puts his penis into the

vagina he moves it backwards and forwards by raising and lowering his buttocks. These movements cause the penis, and particularly the head which has very sensitive nerves, to rub against the corrugated walls of the vagina. After a time, the friction causes certain muscles con-

nected with the man’s sexual system to contract and relax. These contractions force the sperm out of the penis. This ejaculation of the semen is accompanied by exceedingly pleasant physical sensations which flush throughout the whole body but are most intense round the genital area. These sensations begin a few seconds before the first spurt of semen leaves the penis, reach their peak at the first or second spurts — on average there are between five and eight separate spurts to one ejaculation — and gradually die away as the muscle-contractions cease. These sensations, known medically as orgasm, are sometimes called the climax, and in ordinary speech are sometimes referred to as ‘coming off’. A woman also experiences orgasm, with contractions of the muscles surrounding the womb and vagina, at the climax of her sensations. But there is one great difference between the male and female reaction to sexual stimulation. A man experiences orgasm every time he has intercourse which culminates in ejaculation, whereas a woman

may not come off

every time she makes love. This is intercourse at its most basic. For the purposes of reproduction, this is all that is necessary. But men and women have always used intercourse as an expression of the love they have for one another. Love is an emotional relationship. A couple in love demonstrate their love by doing one another kindnesses, large and small, whenever they can, by being tolerant of shortcomings in the partner, by showing sympathy and understanding and affection, by sharing the everyday experience of life as fully as possible. But these signs of love can also be the signs of deep affection between for instance parent and child, or two great friends — people whose fondness for one another has no sexual basis at all. Love between a man and woman is an expression of the particular intensity and closeness of their relationship. When a man puts his penis inside his partner’s vagina they become physically so closely joined that they can almost be regarded as one person. In ancient

civilizations,

a

couple

having

intercourse were described as ‘the beast with two backs’. There is rio other physical contact between a man and woman which can be so intimate. OWEVER, performing intercourse by H simply putting the erect penis in the vagina and moving it about until the man comes off, is not enough if a couple wish to use the sex-act as an expression of love. There must be a preliminary period of caresses, kisses, fondling, demonstration of tenderness and exchange of loving words and phrases — a period which is

usually called ‘love play’. And love play is not only a means

of

63

expressing mutual tenderness. It also helps to increase the woman’s satisfaction in love-making. Physically, a woman requires much longer stimulation than a man before she comes off. From the first moment that his penis becomes fully erect, unless he takes deliberate steps to prevent it, the average man will come off after two to three minutes direct stimulation of the nerves of the penis-tip. But a woman on the other hand usually requires ten to fifteen minutes of direct stimulation of her clitoris to bring her off. If the man puts his penis into the vagina without previously stimulating his partner’s clitoris, he will come off some time before she is ready. FTER he has come off, the man can-

A

not continue the movements that

are likely to bring his partner off. There are a number of reasons for this. First, after orgasm the head of the penis becomes very sensitive, and even the lightest friction may cause discomfort. Secondly, within a couple of minutes or so after orgasm the penis automatically loses its stiffness. Then again, orgasm relieves the sexual tension which made the man want to make love and he may find further love-making psychologically uncomfortable. So it is necessary that the woman should be physically stimulated almost to the point Indian temple sculpture celebrated physical love as part of the divine order. Love was so important that, according to some Hindu teachers, children would not be conceived unless there was joy and passion between husband and wife.

of coming off before the man puts his penis into her for the final phase of lovemaking. This necessity to close the gap in the couple’s progress towards orgasm provides the opportunity for the couple to demonstrate their emotional love for each other through love-play. Even in these days of sexual frankness, there are a surprisingly large number of women who go through life without experiencing orgasm. Indeed, it was not until the end of the 1920s that it was widely accepted among the lay public that a woman was as capable of orgasm as a man, and that her need for orgasm was as great as ‘his. As soon as the fact was’ recognized the whole concept of the woman’s sexual role changed. She was now regarded as a partner in love-making and men who sincerely loved their wives took upon themselves the responsibility of seeing to it that their wives achieved orgasm whenever they made love. The husband who did not bring his wife off was regarded as a failure as a lover. The new attitude led to new anxieties. Many couples devoted all their efforts to the achievement of orgasm in love-making. A great deal of nonsense was talked about the supposed difference between a ‘clitoral’ and a ‘vaginal’ orgasm. In fact, love-making has many fulfilments, involving emotional as well as physiological climaxes, and there is a better chance of reaching real fulfilment on every level if the couple have a relaxed approach. The work of Sigmund Freud, as it filtered through to the lay public, also influenced people’s attitudes to sex. His work, and the influence of modern psychology generally, have made men and women more aware of, and more able to accept, their sexuality. However, it is only fairly recently that people have got round to the idea that the woman’s role in love-making is not only a partnership, but an equal partnership. And indeed this concept has a long way to go before it is generally recognized. Too many women are still content to leave the initiative in love-making to their husbands and to place on them the responsibility of acquiring the art of love-making which will bring them, the women, to orgasm. While this attitude remains, lovemaking as an expression of love will fall short of the ideal. Women myst make as great an effort to learn as much as they can about the techniques of love-making as men. And both husband and wife must accept that if the wife wishes to make love at any time, but her husband gives no sign of wanting to do so, she has the right to initiate love-making, and to take the active role from the very first caress right through to orgasm.

65

If the sex act is to express the love between a man and woman fully, lovemaking must be considered as an art. It is an art which involves an understanding by each partner of the other’s needs. By studying how best to give pleasure in the sex act, the married couple can demonstrate their deep love for one another. technique alone EVERTHELESS, will not lead to perfect sexual harmony. For sex is a matter of matching emotions as well as bodies. Such a sensitive area of married life is open to

many misunderstandings which may occur as a result of simple, practical circumstances. The husband who complains that his passionate bride has become cold towards him, pushing him away every evening with a fretful ‘Leave me alone, men only want one thing’ may not appreciate that domestic chores and perhaps young children have, for the time being, dampened her sexual feelings. It seems trite advice to suggest he make an extra effort to be romantic — bringing flowers and chocolates and a present of money for a

new dress, perhaps — but such attentions can make a woman feel more feminine and desirable, more eager to be seductive. Similarly, a man who is exhausted by a demanding career may not be the ardent lover he was in the early years of married life, and tearful accusations of disinterest or infidelity will not increase his desire. Loving attention and understanding will probably not turn him into a passionate wooer overnight either — but will help him to relax and increase the loving bond between the couple. Sexual quarrels are the most common cause of divorce and nothing can upset the whole sexual side of a married life as much as boredom. Sexual boredom can arise from a couple falling into a routine of love-making — always using the same

1 This terracotta vase dates from the time of the Roman emperor Augustus (who died in 14 AD). Scenes of love-making appear in many artistic media of the classical world. Some, like the pictures on the walls of the villas in the Roman town of Pompeii, are still uninhibited by modern standards. Roman writers, like the poet Catullus, were likewise not afraid of a frank approach to erotic love. 2 This drawing by Rodin also celebrates the beauty of human passion. But in some periods of Western history, physical love was considered unpleasant, bestia!.

Many women suffer from severe premenstrual tension: for a few days before the start of her period, a normally eventempered and loving woman can become extremely irritable, upset by the least thoughtless word. During her period, she may be tired and depressed. Many women say they can be ‘right off sex’ for the pre-menstrual period — only to become exceptionally amorous immediately afterwards. By no means every woman reacts in this way — but it is not at all uncommon. Often couples have an ideal of lovemaking — perhaps based on love scenes in films where all is sweetness and the heroine never has a spotty back and the hero’s stomach never rumbles at acrucial moment. But, in reality, lovers are nothing if not human, with all that that implies of sequence of caresses, always making love the little inelegancies that flesh is capable at the same time of day and in the same of. For bodies must be accepted as tangible position. Variety in all these matters is and earthy, and lovers as individuals with essential. Making love in the sitting room moods and personalities, before lovemaking can be enjoyed in its fullest sense. or the back of the car or outdoors can renew excitement. OST people would agree that the IFFICULTIES may also arise over \/| creation of great art requires a B specific questions and may spring combination of skill and inspirafrom certain myths that have grown tion. The art of love-making is no exception. If a couple aim in love-making to up around sex. One common myth is that it is harmful for the child in the womb if express fully their love for one another, the pregnant wife makes love. In fact, lovethey must extend desire by knowledge. making can safely be continued up to the They need to learn something about techend of the eighth month — and sometimes nique. One of the first and most important later — provided the husband is gentle and things that they need to discover is which the technique used, especially as regards parts of the other’s body — apart from the the position chosen, places no weight on the genitalia — increase sexual excitement mother’s stomach. Certainly orgasm will when stimulated during the period of lovenot bring on premature labour—unless there play which precedes and heightens orgasm. These areas of erotic sensitivity on the is already a general tendency to miscarry. human body are known as the erogenous Then there is the question of practice. zones. The authors of a highly regarded book on In a man, the erogenous zones are the love in all its aspects have emphatically inside of the thighs, the buttocks, the navel, stated that ‘a happy, harmonious sex life the nape of the neck, the throat and behind is not something we are born with.’ Lovers the ears, the small of the back at a certain must appreciate that perfection in lovespot which must be discovered by experimaking comes through long, patient applicamenting, and the scrotum, which is the sac tion. Frank discussion between the couple of skin containing the testicles — the spermwill help, for this way they can come to factories — that lies behind the limp penis understand more about each other’s needs. A sex manual can also be useful. And it is and below the stiff one. Light stroking with the finger tips, palm of the hand, lips or not only young lovers who need to practice tongue on any of these parts will send the art. Like any other facet of marriage, ripples of sexual excitement into the penis the physical relationship should not be and the area surrounding it, where the static but always regarded as growing and sexual sensations are most concentrated. developing into something more perfect However, the most sensitive male erogand rewarding. enous zone is the penis. And the parts of No husband and wife, however sexually the penis which are most responsive of all compatible, can expect perfect sex on are the penis-tip immediately around the every occasion. So much depends on mood. opening, and the small band of skin, called A pressing anxiety, a slight quarrel, a the frenum or frenulum, which attaches the nagging toothache can make a normally ordinary skin of the shaft to the special affectionate lover a dismal failure in bed. membrane covering the head or glans of the Possibly this is particularly the case with penis. This tiny band of skin is literally women, who — generally speaking — are packed full of highly sensitive sexual nerves. more at the mercy of emotional upheavals. If these nerves are stimulated by the Few men — doctors included — seem to be fingers erection may be produced within aware of the havoc that the menstrual seconds, and orgasm within two or three cycle can play with a woman’s emotions.

67

Many people think of Pablo Picasso as primarily a creator of distorted forms, but here in this early work he celebrates the beauty of the lovers’ embrace in a naturalistic style. Physical. love between a man and a woman can express all the tenderness, all the fullness of mutual love, so it is not surprising that it has always been a subject to inspire an artist.

minutes. In love-making, it is the stimulaANY peopie prefer making love tion of these nerves by the friction of the \/| completely naked. They feel that corrugated inside walls of the vagina that pyjama-jackets and even the eventually brings the man to orgasm. flimsiest of nightdresses have a way of Women are even more generously being where they are not wanted at crucial equipped with erogenous zones than men. moments. But this is undoubtedly a matter In fact, almost any area of a woman’s body of taste. Some husbands are stimulated by may be erotically sensitive. Generally the sight of their wives in bra and panties — speaking though, the main zones — in or perhaps in black stockings. And there is addition to those listed for a man which the nothing at all perverted or abnormal about woman also shares — are the back of a this. woman’s knees, the entrance to the vagina, The vast majority of married people the interior of the vagina to some extent, make love at night. Occasionally they may and above all, the nipples. make love in the mornings before getting A woman’s breasts are secondary sexual up — probably on Saturdays and Sundays. organs, and they are connected to her The couple may have been in bed for sexual nervous system. When a woman is some minutes when perhaps a goodnight sexually excited the nipples fill with blood kiss or an affectionate movement may and become hard and erect, like the man’s trigger off in both of them the desire for penis. In fact, the erection of the nipples love-making. A period of love play will actually takes place before the erection of then follow. This is the time when the the clitoris (the tiny organ near the entrance partners concentrate on stimulating each to the vagina). In some women, the nipples other by caressing the most erotically sensiare So sensitive to stimulation that sucking tive areas of each other’s body. them or rubbing them between finger and The husband may feel his wife’s vaginal thumb may be sufficient to bring the entrance, to see whether the clitoris is woman to orgasm.

So well are both the male and female sexual systems organized that everything has been thought of, including lubrication for the penis and vagina. When a man is roused sexually, two small glands secrete a slippery, transparent, tasteless liquid which flows from the opening of the penis over the head and shaft. The woman has also been provided with similar glands at the entry to the vagina. Other glands also lubricate the inside of the vagina. Lubrication of the penis and vagina is necessary since the woman would feel uncomfortable if her partner tried to put his dry penis into her vagina. The operation of the lubricating glands varies from individual to individual, expecially in men. Some men begin to produce lubricating fluid immediately the penis becomes erect, while in others the glands do not begin to function until shortly before orgasm. In some men the flow of lubricating fluid is copious, in others only a few drops. Similarly, some women produce so much fluid that it can be seen trickling from

the vagina while others produce just enough to make the entry of the penis comfortable. Some people do not produce enough fluid and, if they wish, they can buy from a chemist a specially prepared lubricating jelly. However, this can be considered a needless expense for everyone has handy a natural lubricant — saliva: this can easily be used to moisten the penis or vagina entrance. When both the man and woman are

sexually roused,

there is a consider-

able increase in the flow of saliva, so there is never any fear of a failure of this source of supply.

lubricated. If it is not, he should not attempt to stimulate it with his finger but should continue to stroke her erogenous zones. Each should explore the other’s mouth with their tongues. Possibly, the husband will find that the quickest way of arousing his wife fully will be to rub one nipple between finger and thumb while sucking the other. From time to time he will test to see if the vaginal area has become lubricated. S soon as the vaginal area has become jy moist, the husband may begin to stimulate the clitoris with his finger. If he tries to stimulate the clitoris before lubrication has started, he may cause his wife so much discomfort as to kill desire for love-making altogether. If she does not lubricate naturally at all, he should dampen his finger with saliva. Once she has begun to lubricate, her

clitoris will have become erect. Once he has begun to stimulate the clitoris, the husband should keep up a steady rhythm. Some women are most roused by very quick, light movements of the finger tip, while others find slow, rather heavy stroking most satisfactory. One of the very first things that a young married couple should do in love-making is to discover each other’s likes and dislikes in such matters. , While stimulating the clitoris, the husband should continue caressing the other erogenous zones on his wife’s body with his free hand and his mouth. At the same time the wife should be caressing her husband, stroking his erogenous zones, gently drawing a hand over the skin of the scrotum and lightly playing with the penis. She will have to be very careful, however,

that she does not stimu-

69

late him too much. Immediately he either makes asign or tells her to stop, she must stop or else he will reach orgasm too soon. It is here that the great difference between the male and female response to stimulation shows itself. Whereas the stimulation of the wife, once begun — and this is essentially true of the clitoris — must continue

rhythmically

without

a

break,

stimulation of the husband will bring him off long before his partner is ready unless it is applied only intermittently. Through regular love-making and deliberate effort,

The medieval Italian mosaic, from Saint Mark’s Cathedral in Venice by the and the boudoir scene, eighteenth century French painter Fragonard are separated by many outlook. of cultural differences But love-making knows no boundaries for, as art and literature reveal, lovers have always caressed each other’s bodies for joy and mutual satisfaction. Today, doctors, religious teachers and counsellors point out that a satisfying a between relationship physical married couple brings stability to a family, unity to the home. Today, and knowledge increased too, of the nature of understanding a that mean sexuality human couple can approach this part of their married life without fear or shame. And help is now available for those in need of advice and guidance.

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the man can exercise control over his responses, but no matter how great his control, the stimulation will have to stop two or three times during love-making. There comes a moment, in both partners, when the muscles which control orgasm automatically take over. After this moment has been passed absolutely nothing that either can do will stop orgasm. A man can judge, by experience, the precise moment before the point-of-no-return is reached. If, when this momentis reached, all stimulation stops, the sensations die

away. In a minute or two stimulation can be started again. If he is brought to the verge of orgasm several times during the course of love-making, his sensations may be more intense when he eventually comes to his climax. The moment also comes when the woman knows that another few seconds of stimulation would bring her off. It is at this moment that she should tell her husband to put his penis into her. Once this has been done, the couple should proceed quickly towards orgasm, for if the woman’s

stimulation is not continued with the shortest possible break, her desire will wane and they will have to start love-making all over again. This would naturally place great strain on the man’s control. URING the last phase of love-making, the woman should be active. She should make thrusts with her pelvis timed to synchronize with the buttockthrusts of the man. Or perhaps she may perform various other actions which she has discovered will help to bring her off and. also give pleasure to her partner.

Once the husband has placed his penis in the vagina,

he must continue to exer-

cise control. For otherwise he may come off in seconds, whereas his wife may require rather longer since the pause to insert the penis will have set her back alittle. Some authorities make great play of simultaneous

orgasm

— that is, husband

and wife coming off precisely together. But too much emphasis on simultaneous orgasm may lead to more anxiety than pleasure. Recent research carried out by two leading American sexologists, Dr W. H. Masters and Mrs Virginia. Johnson, suggests that maybe the aim of love-making should be rather different. For Masters and Johnson discovered that a large majority of women are capable of having several orgasms in fairly quick succession during the course of a single love-making. So perhaps multiple orgasm should be the goal, since this provides the woman with far greater sensations than a single orgasm, even a simultaneous one. And the husband benefits too, for the longer he holds himself back in

the course of multi-satisfying his partner, the more intense his. sensations will be when he eventually reaches orgasm. Even if a woman has not learned how to achieve multiple orgasm, love-making will probably provide her with more satisfaction if her husband sees to it that she comes off first and then drops his control

sider that jit is stimulation of the clitoris which is responsible for all orgasms in a woman and that the so-called ‘vaginal orgasm’ is a myth. The clitoris has been called ‘the switch that turns on all the sensations all over the body’. And, furthermore, it has been pointed out that the clitoris corresponds to the penis in the man. So possibly, concentration on the clitoris in love-making will give most women greatest satisfaction. AKING love is an activity in which \/| mutual co-operation is essential. It

should be the chief aim of both the partners to help the other to experience the most intense sensations possible at orgasm. A man needs as much help from his partner in achieving this, as she does from him. A wife should take a full part in all sexual activity. It is one of the most fatuous ideas ever thought up that it is ‘not nice’ for a woman to reveal the passionate side of her nature. On the other hand, the wife should not be emotionally blackmailed by her husband over the matter of orgasm. Some husbands tend to accuse their wives of deliberately setting out to hurt them by withholding orgasm. Sexual blackmail, by either husband or wife, can be one of the most disrupting elements in a marriage. NE of the most important aims for @) any couple should be to overcome all inhibitions as quickly as possible and ‘to take really to heart the fact that nothing, absolutely nothing, that husband and wife do with one another during lovemaking in the privacy of their bedrooms, is perverted, obscene or disgusting, so long as it is acceptable to both. Very often a wife may feel that ‘modesty’ does not allow her to take the initiative in love-making or to suggest techniques which would lead to increased pleasure for her. This sort of attitude is disastrous. Many a husband finds his pleasure in love-making notably increased if his wife sometimes makes the first overtures — after all, this is a proof that she finds him a sexually desir-

and brings himself off a few seconds later, rather than if they both struggle for simultaneous orgasm. Psychologically, it is good for the husband to know that his wife has come off, and the knowledge may contribute to the intensity of his sensations. Physically, a woman is notusually adversely affectedby the movements of the penis inside her after she has come off. On the contrary, she may find the movements pleasant. But, as with other aspects of lovemaking, the how and when of orgasms is a matter of individual preference — and practice. Also, love does not follow a rigid pattern. Some days a couple may achieve able male. Likewise, a woman knows best orgasm together or nearly together; on what techniques give her greatest pleasure another day, the wife (or indeed, the and for her to suggest the use of pillows or husband) may not come off at all. But this a different position for love-making when does not mean that anything is necessarily these give her particular satisfaction, is wrong or that the husband is a failure. both practical and a tribute to her interest Orgasm is obviously the aim of love-making in the matter. but intense anxiety over its achievement . Discussing sex frankly with one another does not lead to fulfilment. can be of great help to the couple. For no There are some authorities who mainbook of rules or advice from outsiders can tain that a woman reaches orgasm through provide all the relevant information — after the stimulation of her vagina by the penis. all, individuals have their own preferences While conceding that the clitoris is the in love-making as in everything else. most sensitive erogenous zone, and that in Finally, a point that is not always menthe early years of marriage the woman tioned in worthy manuals of love-techexperiences clitoral orgasm only, they nique — love-making is supposed to be a maintain that after some practice in lovecheerful and relaxed activity. Too much making the chief sensations are transanxiety — even too much strenuous effort— ferred to the vagina. But yet other authorwill lead to frustration rather than the ities — and possibly the majority — conmutual satisfaction that is the goal.

72

Sorting facts from fancies In recent years, eminent scientists have begun to observe and analyse human sexual activity. What discoveries have they made and why are they important ?

AN has never taken his sexual activities for granted. He has always talked about sex and discussed its implications. He has joked and philosophized about it. And he has surrounded it with taboos and prohibitions. In the West especially he has regarded it as a private matter — its problems confined to the bedroom, sometimes the confessional, more recently the surgery or clinic. It is only in the last eighty years or so that the sexual

behaviour of Man has become the subject of specific scientific and medical attention. A number of respectable and highly respected scientists have begun to study human sexual behaviour in the same dispassionate and analytical way that zoologists have studied the sexual life of animals. The researchers have questioned ordinary men and women of all ages and from all walks of life about such things as how often they make love, how many have had homosexual experience,

and so on. Even more

recently, researchers have observed human sexual behaviour taking place under laboratory conditions. They have studied what happens to the human body during sexual activity and they have produced statistical data on their findings. Many people have criticized the work of these researchers. The critics complain that such research is indecent, unnecessary and an insult to human dignity. However,

doctors,

counsellors,

social

workers and many religious leaders support the work of the researchers, who are sometimes called sexologists. For they point out that simply because sex is surrounded by mystique, fear, myths, and private prob-

lems of guilt and frustration — and because it is subject to social laws and taboos — it should be studied dispassionately. For only through knowledge based on the facts of what sexual activity actually takes place — rather than what individuals or society pretends or hopes takes place — will human beings be able to understand the nature of this important area of life. The work of sexologists, and the information that they provide, does not lead to the evasion of the ethical issues. No one is suggesting, for instance, that simply because one form of human sexual activity is prevalent that it is therefore acceptable to society. What the researchers can reveal is that such and such activity occurs, that it is practised by so many people, and that its effect on the individual and others is found to be harmless — or harmful, as the case may be. But it is for society and the individual to decide, on the basis of many considerations, whether this behaviour is morally right or wrong. The information that the sexologists provide can be of practical use in at least two main ways. Many societies have passed laws proscribing certain forms of sexual behaviour on the basis, presumably, that certain acts or desires were ‘abnormal’ or harmful to society. If research can suggest that far from being rare or unusual, the prohibited acts are statistically widespread among otherwise happy, healthy, law-abiding citizens, then there are grounds

for at least a review of the laws. The work of one of the most famous and respected sexologists, Dr. Alfred Kinsey, who studied

the sexual behaviour of the American man and woman, showed that a large proportion of people regularly practised forms of sexual activity that were forbidden by federal or state laws. Yet, in the public eye, these same privately-erring citizens were respectable,

These four peopie are the eminent authors of some of the most respected works on human sexual behaviour. 1 Dr. Alfred Kinsey produced two important studies of male and female sexual behaviour in 1948 and 1953. 2 The American scientists. Dr. William Masters and Mrs. Virginia Johnson published Human Sexual Response in 1966. Their observations under laboratory conditions have provided useful data for doctors, counsellors, social workers. 3 Havelock Ellis published his pioneer Studies in the Psychology of Sex between 1897 and 1928.

civic-minded

individuals.

When such asituation is revealed, there is an argument for amending legislation. Even when certain forms of activity are not actually forbidden by law, custom or long-standing myth may condemn them. This can lead to a great deal of anxiety and guilt among people who practise, or desire to practise, such forms of activity. Doctors and counsellors are constantly aware from people who come to them for help, of the extreme personal misery and physical illhealth that anxiety about sexual desires or activity can produce — to say nothing of the damage to marriage relationships. If the doctor or counsellor can produce evidence that the guilt-ridden behaviour is in fact widespread and harmless, much unhappiness can be relieved. And for a long time,

no such information was available and the doctor or counsellor had to rely on his private experience or opinions, which — with the best will in the world — would necessarily be biased or limited. An example of

73

the sort of behaviour which has consistently been condemned as perverted and physically harmful is masturbation. But modern research shows that masturbation is practised almost universally and without any physiological side-effects. It seems to be a ‘natural’ human activity — whether it is desirable in terms of the individual’s overall sexual life is something that must be decided by the individual concerned. ATA gathered by sexologists can therefore lead to social changes and can be of use in relieving human anxiety. But it can do more. Zoologists have pointed out that among the lower animals sexual activity is primarily geared to reproduction — that is, mating only occurs when there is a possibility of conception. However, among the higher animals and Man, the male and female of the

All societies have sought to regulate sexual activity in some way or another. Certain types of sexual behaviour are proscribed by law, some by custom. Body contact, with its overtones of sexual stimulation, is subject to taboo in most cultures — that is, certain areas of the human body are tacitly agreed to be ‘out of bounds’ to everybody

74

species are capable of full sexual activity when there is no chance of conception — for

intercourse can satisfactorily instance, take place when the female is pregnant. Such studies have led one eminent zoologist to conclude that ‘numerically at least the chief biological function of coition in man is play’. And it is play with a purpose. Frequent sexual activity serves to bind a couple together during the time that they are breeding and rearing a family. And it is also biologically important in that the climax of sexual activity — orgasm — provides a necessary physical and psychological release of tension. If people can recognize this and realize that far from being furtive and shameful, sex is an integral part of human existence, they may be enabled to gain more satisfaction and

relaxation to the benefit of their health and

except those who are on terms of intimacy with the individual. Who may touch whom, and where they may touch, vary from society to society. Professor Sidney Jourard, professor of psychology at the University of Florida, recently carried out a survey among a selection of his male and female students to find out the extent and nature of

happiness. An increased knowledge of the range of human sexual behaviour, which scientific research can provide, can educate people into the sexual potential of their bodies. For there is no stereotype of human sexual activity — the human body is marvellously designed for multiple responses. And while every individual — in the context of his or her relationship—must decide for himself what suits or what pleases him, there is an argument for extending people’s

knowledge of what is possible. For through knowledge, individual men and women can keep their physical relationship a growing and flourishing activity, binding the couple together in greater harmony and unity, to the benefit of their family — and, in the long term, to the benefit of social stability. Among the most important of the early

body taboo in this section of American society. These four drawings illustrate the body touching experienced by the students in four different relationships. The shading on the bodies shows the percentage of students who reported being touched in that area by, 1, their closest friend of the opposite sex, 2, by their father, 3, by their mother,

writers on sexual behaviour were Havelock Ellis, whose Studies in the Psychology of Sex were published between 1897 and 1928 and Richard Krafft-Ebing whose Psychopathia Sexualis appeared in 1902. Other important early researchers in this field include August Forel, Ivan Bloch and Albert Mill. These writers based their work on case histories already available in medical and psychiatric publications and on correspondence with their patients and other people who had contacted them. As a result, the conclusions the writers reached were not generally based on direct observation. It was not until Sigmund Freud, the founder of psychoanalysis, began his work that clinical observation began to have greater significance.

Freud’s

research led him to conclude

4, by their closest friend of the same sex. The colour and percentage key is-given below. Detailed study of the pictures reveals some interesting information — for instance, how little a father touches his children, at least in this section of American society.

76—100%

75

Amanandawoman

Two men

Many people worry about how often they can or should make love. Research has shown that there is absolutely no prescribed frequency— it is a matter couples must simply decide for themselves. Kinsey gave the following estimated figure of the total sex outlet per week for American women: 1 per cent, once a week; 2 per cent, twice a week; 7 per cent, three times; 12 per cent, four times; 13 per cent, five times; 7 per cent, six times; 23 per cent, seven times; 5 per

Before Kinsey produced his reports, it was thought that only one man per 1,000 of the male population was homosexual. But Kinsey's estimate was that four in 100 males were exclusively homosexual throughout their lives. Kinsey produced a rating-scale that showed, among other things, that for a three-year period between the ages of 16 and 55, eight per cent of males are exclusively homosexual and for

cent, eight times; 3 per cent, nine times, 9 per cent, ten times; 3 per cent, twelve times; 5 per cent, fourteen times; 2 per cent, fifteen times;

8 per cent, sixteen times and over. There is no evidence that a couple may damage their health by too frequent love-making. On the other hand there is no reason why those couples who are satisfied with fairly infrequent love-making should feel that they are in any way abnormal. Research has also shown that, though the. urge to make love does decrease with the years, a couple in good health and in practice, can make love far into old age. An investigation carried out by Drs. Newman and Nichols in America revealed that out of 149 people aged between 60 and 93 and still with their partners, 54 per cent were still sexually active. The Masters and Johnson report discovered that the more frequently men and women make love up to the age of 35, the longer will they keep the ability into old age. The old wives’ tale that, in old age, intercourse shortens a man’s life is also disproven for ‘it is well recognized today that the emission of semen is no more of a loss that the expectoration of saliva’.

the rest ot their lives either exclusively heterosexual or partly homosexual. Research also

suggests that 3 per cent of married men are bisexual — that is, they take part in homosexual activities during the same period that they are

co-habiting with their wives. Michael Schofield, a British researcher who recently studied a representative sample of young people in the 15 to 19 age group, reported that 21 per cent of the

boys questioned said they knew of homosexual activities among school friends, while 5 per cent admitted to homosexual activity themselves: just short of 2 per cent of the boys reported homosexual experience with an adult. There was a marked difference in the incidence of homosexual activity between boys at co-ed and segregated schools, and

day and boarding schools. Schofield gives the following figures: at boarding schools, 44 per cent of boys said they knew of homosexual activities (28 per cent admitted taking part) ; among boys at day schools, 18 per cent reported homosexual activities took place (3 per cent admitted taking part). Of boys at segregated schools, 23 per cent said they knew of homosexual activity (4 per cent reported taking part themselves); of boys at co-ed schools, 17 per cent said they knew of

homosexual activities (5 per cent admitted taking part).

- Two women

Aman alone

A woman

Homosexual relations between women — sometimes called lesbianism — seem less common than the comparable male activity. Kinsey reported less _ homosexuality among his sample of women. However, he gave the following figures: between 2

Western industrialized societies are concerned over the sexual morals of their young people. Schofield provides some interesting

Schofield’s figures for sexually experienced girls show that only 2

data on early sexual experience: among the fifteen year old boys, 6 per cent reported sexual intercourse; at sixteen, 15 percent; at seventeen, 25 per cent; at eighteen, 35 per cent. Schofield found that 46 per cent of boys had their first intercourse with a girl of

of intercourse; at sixteen, the figure was 5 per cent; at seventeen, 10 per cent; at eighteen, about 18 per cent. It was found that 66 per cent of girls had had their first experience of intercourse with an older partner; 33 per cent with a boy about the same age; 1 per cent with a younger boy. Only 3 per cent of the girls described their first boy as a pick-up; 45 per cent described him as a steady, while 34 per cent called him an acquaintance. Like the boys, the first experience was very often unplanned — 82 per cent of the girls said it was unpremeditated. Only 30 per cent enjoyed their first experience; 25 per cent were ashamed, while 15 per cent were afraid

and 6 per cent of unmarried women and (per cent of married women are exclusively homosexual between 20 and 35 years of age, while 2:3 per cent are exclusively homosexual for a three-year period between the same ages. Among Schofield’s sample of young people between 15 to 19, he reported 12 per cent of girls who said they knew of homosexual

activities at school, and 2 per cent who said they took part. Schofield’s breakdown in terms of different types of school is as follows: homosexual activities were reported in 13 per cent of segregated schools and in 10 per cent of co-ed schools; homosexual activity was found in 11 per cent of day schools, and in 39 per cent of boarding schools. Rather less than 1 per cent of girls said they had had homosexual experience with an adult. (Schofield points out, however, that both boys and girls were shy to admit to homosexual experience, and also that the percentages were

based on small totals. So the figures he provides offer a guide to, rather than conclusive evidence of, homosexual activity among teenagers.) One eminent author has pointed out that there is a strange inconsistency in society's attitude to male and female homosexuality — until recently, homosexual activity among

men in Britain was a punishable offence while homosexuality in a woman and is free from legal sanction.

was

about the same age; 31 per cent with an older girl; 12 per cent witha younger girl. Very few boys hadtheir first experience with an adult woman or a prostitute.

Only 16 per cent of the boys saidtheir first partner was a pick-up; 34 per cent described her as an acquaintance, while 45 per cent said she was a steady.

Love-making seems to have crept up on the boys — 84 per cent of the boys said their first experience was unpremeditated.

alone

per cent of fifteen year olds reported experience

that every sphere of Man’s activity is, in some way, influenced by his sexuality — a conclusion that eventually had _farreaching effects on social attitudes. Until the mid-1940s, however, interest in the results of research was more or less confined to psychiatrists, psychotherapists, anthropologists, sociologists and members of related scientific disciplines. In 1948,

however,

an

event

occurred

that

catapulted the subject from the closed circles of science into the glare of general public interest — it was in this year that Dr. Alfred C. Kinsey published his Sexual Behaviour in the Human Male. He followed this with Sexual Behaviour in the Human Female,in 1958. Journalists and social commentators seized upon Kinsey’s huge volumes, interpreted the information they contained — much of it in the form of statistical tables — in terms a layman could understand, and revealed that the human male and female behave sexually in ways that ordinary people had not dreamed they did — or could. Kinsey’s work made a considerable impact not only in America but throughout the world. This was due not only to the often startling revelations that the reports contained, but also to the fact that men and women generally had become interested in what makes them tick sexually, as

individuals. Kinsey and _his assistants relied on the interview method of gathering information. The interviewers, who were carefully trained, questioned 6,300 males and 5,300 females, a far greater number of people than in any comparable piece of research. People in all age-groups from 18 upwards,

from

different

educational

and

working backgrounds, married and unmarried, people of different religions, attitudes towards sex, grades of sexual experience, and so on, were included. As a result, when the work was completed Kinsey was able to compare the incidence between certain groups of certain types of behaviour. For example, on premarital intercourse, Kinsey was able to report that incidence increased as age increased: and that while workingclass couples rarely practised mouthgenital contact, among the professional classes it was practised frequently by a strikingly high proportion of couples. Kinsey, however, was not without his professional critics. They condemned, among other things, his reliance on the interview method to arrive at conclusions which he presented as irrefutable facts. In fact, they

said the only completely reliable way to assess sexual behaviour was to observe people actually involved in sexual activity. The critics were soon to be answered. In 1966, two American scientists, Dr. William H. Masters and Mrs. Virginia Johnson, published Human Sexual Res-

78

ponse. This report was based on eleven years work. In their laboratories, Masters and Johnson had studied couples making love, taken readings with sophisticated instruments, and dispassionately analysed what happens physically to both men and women when they reach orgasm. The Masters and Johnson report has immeasurably increased our knowledge of human sexual behaviour. Some of the Masters’ and Johnson’s findings are even more startling than Kinsey’s. For instance, their study of female orgasm confirmed what some 'researchers had been maintaining for years — that the vagina alone does not produce the woman’s orgasm, and that only in a very few cases does the penis touch, and stimulate, the clitoris when in the vagina. Perhaps Masters’ and Johnson’s most important discovery is that all women are capable of having several orgasms to the man’s one, though a very large number of men up to the age of 35 can also have two or three orgasms in rapid succession. Even after the age of 35, seven per cent of all men can have multiple orgasms. ASTERS and Johnson have also cor| rected false ideas about penis-size. Because the penis of an average

mature man is between 3% and 44 inches when relaxed and between 55 and 6 inches

when erect, it had been thought that penises of all sizes increased in these proportions. Masters and Johnson discovered, however, that the larger the relaxed penis is, the less it increases in erection-size: similarly, the smaller the relaxed penis, the more it increases. They report one 34 inch relaxed penis measuring 74 inches when erect, an increase of 120 per cent, and another of

4+ inches increasing to only 7 inches, that is, an increase of only about 55 per cent. The value of this information is that it should do much to remove one of the most common of male sexual worries — worry over the fancied smallness of the relaxed penis, because general gossip equated the man with a large organ with the good lover. Worry over the size of his penis can often affect a man’s sexual performance. This is just one example of a mistaken belief about sex which scientific study has corrected. Even more serious were the myths concerning masturbation. Less than fifty years ago boys were told that masturbation was sinful and dirty, and that people who masturbated would eventually go mad. Through research we now know that more than 90 per cent of all men and 70 per cent of all women masturbate frequently from puberty to fairly late in life and not one has gone insane as a result. Another myth exploded is the AngloSaxon’s supposed sexual ineptitude — research suggests that the Anglo-Saxon, though not so flamboyant as his Latin counterpart, makes love as frequently and as successfully.

Sex or sin? Western society tends to regard sexuality as an unfortunate, though necessary, intrusion into the business of life. Is this valid, or is there an alternative ?

HE sexual act, between two people who love each other, ought to be the happiest, the most free and satisfying of human experiences. But all too often, as

we very well know, this just does not happen. Western society, in particular, suffers from excessive guilt. The child wants to please his parents, and if his own growing feelings of sexuality conflict with the views of his parents — and through them, the views of society — then he is bound to feel that he is ‘wicked’ and so insecure and guilty. We live in an age of anxiety. There is tremendous emphasis on the need to succeed, to succeed at work, to have a better home than the Jones’s, to be a citizen of the greatest nation in the world. All this is reflected in the need to succeed in sex, a very shaky foundation for a trouble-free relationship. The situation is further exploited by the advertising men who sell their product by insisting that without it, sexual success is impossible. It is small wonder that many escape these excessive demands by furtive visits to the prostitute, secret purchases of pornographic magazines, or express their frustration in motiveless violence. In marriage, where the sexual relationship ought to be the most satisfying of all, inhibitions can threaten the existence of the marriage itself. A young wife, happily married for three years, wrote to a psychiatrist, saying: ‘My husband has decided that our lovemaking is getting into a rut, and he wants to try new caresses and new positions. In the past we have used mutual stimulation and the usual positions. But now he wants to experiment.

This young West African boy is erotic figures up some holding with an expression of innocent delight. He is growing up in a society with a very open attitude to sex.

‘I object to cunnilingus and _ fellatio, because I cannot believe that they are natural activities for human beings. I have always been brought up to the view that God wouldn’t have made us sexually as we are if He hadn’t intended us to obtain our sexual satisfaction in a decent and becoming manner. After all, it is one of the things about us that sets us apart from animals, isn’t it? And that is my main objection to rear-entry. I find it degrading to have to take the position animals use. Whereas in the normal positions I can cooperate in love-making, in rear-entry I can’t, and though I may have an orgasm and feel satisfied afterwards, I do have a definite feeling of being used. I think this is not only because of the posture, but because to make me come, my husband has to stimulate my clitoris with his hand while he is in me, which he doesn’t have to doin other positions. This seems to me unnatural.’ Cast your eye once more over what the woman has written, only this time look at the phrases — ‘I cannot believe they are natural activities for human beings,’ ‘a decent and becoming manner’, ‘I find it degrading to have to take the position animals use . . . thisseemstomeunnatural’. Used in this context, this is the voca-

bulary of shame. She believes that her husband is asking her to indulge in animal behaviour and that as a human being to do so would be shameful. She loves her husband. Challenged on this score, she would protest that she would do anything for him. Yet she cannot bring herself to permit these methods of making love because if she did, these simple sexual contacts would

day. I was told this was wrong — you know, sinful — but I couldn’t help it. Is this the reason for my coming too soon now? Am I being punished for what I did as a boy?’ This is yet another classic example of sexshame and sex-guilt. Counsellors and psychiatrists know that, in our sophisticated society, it is inhibitions such as these which deprive large numbers of men and women of the achievement of a full and completely satisfactory sexual relationship. Anthropologists have found that more primitive peoples are free of such inhibitions. OME of the most carefree of these S people are the Polynesians of the Pacific islands of Samoa, Hawaii, Tahiti, Tuamoto and the Easter Islands. Their attitude towards sexuality is emphatic and appreciative; they accept sex strictly at its face value, as a means of indulging in erotic experiences which they enjoy to the full, without mental or physical reservations. From a very early age the children enjoy, and indeed are encouraged by their parents to enjoy, the fullest possible sexual freedom. Nothing is hidden from them; they sleep in the same huts as their parents and frequently witness their parents’ sexual intercourse. Masturbation is considered quite a natural thing, and parents often urge their children to masturbate when they want peace and quiet. As soon as the children reach puberty they are initiated into the full enjoyment of sexual intercourse by older boys and girls and often by an uncle or aunt or another relative of their parent’s genera-

Albrecht Durer’s paintings of Adam and Eve cover their obvious sexuality with tastefully-placed apple leaves.

make her feel ashamed of her womanhood. This she readily admits, but feels she can do nothing to change her attitude. For a woman of her intelligence, it is extraordinary that she does not know that probably, ever since men and women have been making love, large numbers of perfectly normal people have used, and, even in our own cultures are still using, the mutual exchange of oral caresses in their love-making; while in some cultures — especially the ancient Roman — rear-entry

was the ‘traditional’ position rather than the recumbent, face-to-face positions. What a majority does cannot be abnormal or unnatural, and in fact, there is nothing that a man and woman can do together sexually — apart from one or two serious deviations,

aberrations and perversions —

that can be unnatural or abnormal. The reasons for her disgust arise, of course, from

the teaching of her parents and the whole cultural climate in which she was raised. A young man writes: ‘Whenever my girlfriend and I make love, I always come too soon. As a boy I used to masturbate every

80

tion. Curiously, very few babies result from this sexual freedom, for until they are 15, by which time they will have married, the majority of the girls are barren. Once married they continue to behave

towards each other and towards their children as their parents behaved towards them. They are expert in sexual techniques, and have no guilt or shame in their sexual relations with one another. No oath of fidelity is made or required by either the man or the woman. Such an interesting society has naturally attracted the attention of anthropologists and sociologists who have made exhaustive studies of these peoples. They report that the Polynesians are free of most of the psychological complexes which so bedevil our own society, and that this is especially true in the area of sexual experiences. This is the outcome of the Polynesians’ positive attitude towards sexuality. When people openly accept sex as pleasurable as well as an inescapable experience there can be little chance of anything in their sexual behaviour giving rise to guilt or shame. When children, from an early age, are given practical instruction in the conduct of sexual intercourse there can be little chance

of ignorance or lack of expertize leading to physical and psychological frustrations such as many couples in our own society experience in the early years of marriage or develop as the years go by. In contrast with the positive attitude of the Polynesians towards sexuality, the attitude of Western society is largely a negative one. The main reason for this is the traditional Western attitude towards morality, based largely on the Christian religion, whose founder made few, if any, pronouncements on sexuality and sexual behaviour. Christianity i is alone among the world’s great religions in this. It was left to the early Church Fathers to formulate the regulations to which they

1 This painting by Peter Philip entitled For Men Only — MM and BB Starring is aimost self-explanatory. To be sexually-exciting, sex be forbidden, must or at least restricted. 2 Victorians, however, felt that the female leg was too erotically exciting to be exposed. Contrary to general belief, they did not cover up table-legs through modesty, but this advertisement shows how far they were prepared to go.

required their adherents to conform, and the lead was given by that dynamic Christian and missionary, St Paul. His character and background have the greatest significance on the later developments in the Christian attitude towards sexuality. He was an ascetic man andastrict Jew who, from an early age, had been searching for the true God. He was a man who, when he discovered what he had been looking for, spent his time wholly and solely in the propagation of that faith. He felt no need for the love of a woman to help him. Writing to the Church at Corinth, St Paul said: ‘It is good for a man not to touch

w—D's

a woman. Nevertheless, to avoid fornication, let évery man have his own wife, and let every woman have her own husband. For I would that all men were even as myself (that is, unmarried). But every man

hath his proper gift from God. I say therefore to the unmarried and widows, it is good for them if they abide even as I. But if they cannot contain, let them marry: for it is better to marry than to burn... .’ In fact, Paul was not sucha hard-hearted man as he might seem. He certainly did not say, as did Buddha, that it was impossible to lead a Christian life if a man or woman was married, but simply that it would be easier to become a true missionary of Christ if he could give his full and undivided attention to his job. But there is no doubt that he considered sex an intrusion into the business of life. Mainly, however, it was the later Fathers of the Church who laid the foundations for the medieval obsession with sex — even within marriage — as a sin, a distasteful necessity for the procreation of children, to be indulged in as little as possible. St Anselm, for example, saw woman as ‘the torch of Satan’. So obsessed with sex did the medieval Church become, that at one time regulations for the frequency of sexual intercourse by the married were laid down; it was pro-

NEW PATENT MODESTY. MACHINE. FOR FITTING the LADIES!

hibited on Wednesday, Friday and Sunday, on three days before receiving Communion, for forty days before Christmas and Easter, and throughout the whole period of a penance. Fornication and adultery were designated prime sins. Horror of masturbation is a more recent innovation. The medieval Church considered it a sin, as it was a pleasuré unconcerned with procreation. But the panic about the alleged results of ‘self-abuse’ started with the publication of Onania in about 1710 by a priest turned quackdoctor. To help him sell his patent medicine, he quoted Genesis 38 which tells how Onan ungenerously ‘spilled his seed on the ground’ rather than give his widowed sister-in-law a child, as he was required to do by the Law of the Levites (priests), and

God struck him down for his sin. Not only was this incorrect — he was killed for his lack of family sense, not for ‘spilling his seed’ — but it represented that his action was masturbation when, in fact, it was coitus interruptus. However, Onanism is still a synonym for masturbation. The theme of Onania was taken up by the Pope’s physician, and snowballed from there. Victorian physicians were convinced

1 The caption to this Victorian cartoon runs: ‘That girl seems to know you, George!’ The middle classes had a strange attitude to sexuality. While denouncing immorality, the men often had mistresses.

Their

wives

sometimes

knew of the liaisons, but ignored them, because they were not sup- 3 posed to enjoy sex, and they knew their husbands had certain desires which had to be satisfied. 2 Hugh Heffner’s Playboy clubs are a booming business in America and Britain. They work on the principle of: ‘Look at the Bunny Girls, but don’t touch.’ This sexual emasculation seems to suit the monogamous Western male. 3 Hindus believe that spiritual release can be obtained through sexual ecstasy. Consequently they decorate their temples with a wealth of erotic detail which serves a religious purpose.

82

beautiful women plus his earthly wives. INDUISM teaches that men have H four main goals in life, one of which is kama, the satisfaction of desire. Through sexual ecstasy Man achieves spiritual release. To help him reach this goal, later teachers produced handbooks on sexual techniques, the best known of which is the Kamasutra of Vatsyayana. Christianity,

on

the other hand, until

very recent times has regarded sex as sinful, even when it recognized that the sexual drive was something which a man could not resist. The Church’s harsh early teaching was given a tremendous revival by the Protestant teaching of Luther, Calvin and Knox, and this in turn was further strengthened by the hypocritical puritanism of the Victorians. Whether or not we are religiously minded, there is little wonder, therefore, that the idea of sex as a sin should leave its traces on the attitudes of large numbers of people, who in every other sphere may justifiably regard themselves as_intellectually emancipated and sophisticated. No matter that all the evidence shows us that masturbation is natural behaviour in those deprived of normal sexual outlets; that we can now accept sexual

of the dangers of blindness, lunacy and even death, advocating castration as one

no matter

cure for children and lunatics. As late as 1928, The Mothercraft Manual wrote: ‘Untiring zeal on the part of the mother or nurse is the only cure: it may be necessary to put the leg in splints before putting the child to bed.’ Whether through the influence of psychology, or simply because the paranoic witch-hunt had run its course, today a working-class mother can say: ‘He just has a feel, you know, when I’m changing his nappy. They like to know what they’ve got, don’t they?’ Common sense has at last prevailed. Although Islam came from the same desert regions that produced Judaism and Christianity, its teachings on sexuality are by no means so harsh. The meanest of the faithful of Islam has his sexual needs provided for in Paradise by 72 houris, very

our experience of living, bestowed on us as a talent to be put to the best use; it is

experience

as an essential

ingredient of

neyertheless understandable that some of the teachings deeply implanted in us over the course of twenty centuries should remain to bedevil us. It is possible to overcome these inhibitions. Many couples today in our vastly complex society can, and have, successfully replaced the negative attitude towards sex, with a positive attitude, without any deterioration in ethical standards. All that is required is the acceptance of sex as a normal, happy, ecstatic experience and the shedding of the feeling that sex is somehow ‘not nice’ — which still exists even today — to obtain release from the sexual frustrations which inevitably arise from our heritage of sex-shame and sex-guilt.

Coping

ceONFLICT is as natural as breathing.

with conflict Conflict, says the dictionary can mean a prolonged struggle. Everybody faces external obstacles, fights inner battles. But why does conflict arise ?

,

It is produced when external circumstances oppose inner desires — the tired office worker, woken by the insistent alarm clock, strives against. his body’s demand to go back to sleep: weighs up his desire for sleep against the consequences of being late for work. Or the conflict may be internal — the individual is faced with a choice of two alternatives, both with their advantages and disadvantages. Perhaps a man wants to change his job. The new job offers more opportunities. But in his old post he is secure. And then there are, of course, the day to day conflicts between people whose aims, desires, needs are in opposition. The man who survives competition, who masters, rather than sidesteps life’s challenges can emerge a more complete person. But the conflicts that do not resolve themselves, that drag on and drag down a personal relationship, will lead to frustration and misery. The structure of society is complex — especially in the increasingly urbanized West — and conflicts may have no easy solutions. But recognizing the forces that shape them is a powerful aid to coping. In many cases, conflict is healthy and constructive. The child meets conflict situations early. As soon as he begins to crawl and explore he finds he is often prevented from satisfying his curiosity — eager to tear up his parents’ books or poke his fingers into the fire, he finds he is physically prevented from doing so by his mother. He finds he must learn to modify his behaviour or risk unpleasant consequences. Later he learns that he cannot have his own way all the time when playing with his friends: he learns to sacrifice the short term satisfaction of always being ‘king of the castle’ for the longer term satisfaction of being a popular member of a group of playmates. He finds that his sexual curiosity about his own body and later the bodies of others is controlled or limited in some way by his parents and society in general. In the conflicts of childhood can lie the seeds of many adult problems. The way in which parents bring up their children, and the inborn tendencies of the child itself, determine whether conflicts are resolved in a healthy manner. If the parents too fiercely repress the child’s curiosity, its desire for expioration and independence — or if those drives are inherently weak — then the child may grow up emotionally dependent. If this emotional dependency persists, the indi-

vidual conflicts

may

later be unable

which

require

to resolve

assertion

on his

part. If the child is over-indulged, or for some other reason never learns necessary self-control, he may grow up unable to delay the gratification of any impulse or desire and, consequently, meet difficulties

in adult relationships. Similarly, if the infantile sexual feelings of the child arouse anxiety in the parents, so that they withdraw or too sternly condémn the child’s behaviour, sexual conflicts in later life may result. For example, the child may come to believe that sex is ‘dirty’ or unpleasant and be unable to reconcile this with his sexual desires in later life. Nevertheless conflicts are inevitable and they are to a great extent healthy and natural. In resolving — or at least recognizing — their existence, the child grows and develops emotionally. S childhood passes into adolescence

AN the conflict which tends to dominate all others is that between dependence and independence. This particular conflict often causes great unhappiness and emotional turmoil, and may never be satisfactorily

resolved. In adolescence,

social

demands begin to increase and become more complex: sexual maturity, the first earned income, the expectations of other people, all press the adolescent to demand more and more freedom and independence. Against these claims are set the natural tendencies of parents: not only do they tend to underestimate the capacity of their children to manage and organize their lives without them, but the parents often cannot come to terms with the emptiness in their own lives which threatens as the children prepare to leave home. This conflict is obvious, but the real problems are often inside the adolescent, who is himself not free to remain a child. The strength of the complaints directed at the parents is often a measure of an adolescent’s fear of being alone, and of taking responsibility — thatis, he may protest very loudly about the restraints his parents place on him, simply because underneath he is, in fact, frightened of the freedom he would have should they give way. Internal conflict, in which the individual is torn two ways, is called ambivalence: and it can be taken as a general principle that in conflicts between two people in a relationship in which much violent feeling is generated, there will very often be an internal conflict in one or both of them, in addition to the overt conflict they share. The individual can also be subjected to an inner stress by carrying over from child-

hood emotions which belong more naturally to the early years. It is natural and healthy for children to admire and love their parents, and the ability to do this helps later in forming relationships with others. But those children who have never had satisfactory parents or parent figures — for example, those brought up inaseries of unsatisfactory children’s homes or who have had mentally disturbed parents — have greater difficulties in later life in establishing relationships with others. This can show up in a marriage relationship,

83

in but certain elements can be defined The nature of conflict is often complex nd rsta unde this page are an attempt to conflict situations. The diagrams on the forces at work. In each diagram, the certain types of conflicts by analysing sign h the individual is pulled. The plus arrow indicates the direction in whic tis, —tha minus sign a negative goal represents a positive (desirable) goal, the drawing, left, the individual is inthe In . an outcome that repels the individual circumstances: he is prevented from volved in a simple conflict with external to

For example, a man may wish reaching his goal by a barrier (vertical line). lack of academic qualifications enrol for a particular course of training, but his

debar him and provide the external obstacle.

with himself because he is Here the individual is involved in a conflict t decide which one is best. attracted by two equally desirable goals. He canno d to go drinking with his Maybe, in a social context, a man has been invite ing up the pleasure ofa friends. But he is very tired. So he is faced with weigh of falling into bed and action satisf companionable outing against the equal accommodating both by ed sleeping. Often this sort of conflict can be resolv his drinking friends later. desires: perhaps the man has a nap first and joins attractive after some thought Often, too, one of the two goals proves the more the need for sleep. And at — drinking and companionship may well outweigh e outcome either way. least the individual has the satisfaction of a pleasurabl

individual is faced with This is the ‘devil and the deep blue sea’ situation — the risk failing his exams: two unpleasant alternatives. The student must study or eck by leaving the the executive must work at a hated job, or lose his paych by vacillating — react ically firm. People caught in this dilemma characterist which is the least they move a little one way, then the other, trying to find out

to one or other. Or unpleasant situation, or at least delaying final commitment arrow above the they opt out by daydreaming of a pleasant resolution (the

a stimulating, head in the diagram) — the executive imagines he is offered in this way may well-paid alternative post. Delaying through daydreaming well make it more difficult to resolve the original conflict.

is The conflict situation has become more complicated still. The individual here to attracted is both attracted and repelled by the same situation or goal. Aman he a girl who is physically desirable to him in every way, but whose personality can He her. wants he her from away fight: dislikes. When he is with her, they d to not decide what to do. He refuses to see her for weeks, then is compelle he But up. her contact her. He may despise himself for not being able to give is obviously remains strongly drawn to her physically. This sort of conflict other social ble innumera by ted difficult to resolve and may well be complica causes and personal factors. The personal upheaval that this sort of conflict

may lead to fruitful self-appraisal, but at the cost of great anguish.

Everybody can think of conflict situations which are so complicated, so tangled and that it is almost impossible to sort out the relative strength of the positive adolesThe kind. this of often are nce negative goals. The conflicts of adolesce cent wants to be independent — he is a wage-earner and considers himself adult: he fights with his mother and father to gain freedom, but at the same time he finds the outside world tough and partly wishes to retain a child's deference to the secure authority of his parents. The adolescent's parents are similarly in conflict: they know their child has to grow up and leave home, but dread the emotional gap that will be left in their lives after he has gone. This sort of conflict often lasts years and, insome families, is never fully resolved.

when a young man or woman looks for, unconsciously, a substitute mother or father. Conflict is likely when someone whose demands on his girl friend or wife are essentially those of a child, finds that this new partner cannot give him all he asks for in the way of support and love: the partner is unable to satisfy the demands because they are unreasonable in the context of the adult relationship. Conflicts can arise in a complex way from a mixture of inner and outer difficulties. A middle-aged couple with two children were faced with a situation in which the man changed his job and had to move to another town. He had, in fact, left

his job because he had felt himself increasingly attracted to a woman in the same office, and had decided prudently to withdraw — although he did not tell this to his wife. Instead he talked of the greater opportunities the new position in another place would bring him. His wife, who wanted to stay, phrased her arguments in terms of the need to keep the children at the same schools, how the couple would miss their friends if they moved, and so on:

all were

entirely

rational

and _ practical

arguments, to which no-one could object. What she was unable to say was that she could not bear the idea of moving away from her mother, whom she saw almost every day, and who was much more important to her than was her husband. The real forces which motivated the couple were expressed in the passion with which

they confronted each other: each feeling anger at the other, and guilt over their own unacknowledged feelings. ME couples seem to live in a state of perpetual war, nagging, quarrelling Mr. Punch, hook-nosed, humpbacked and aggressive, deals with all problems by knocking his opponents over the head with his stick. Punch’s conflicts are those that everyone can understand, and his solution is one that most people would like to try, sometimes at least. Thus the secret of Punch’s long life as an entertainer. Laughing at a puppet’s aggressive solution is one way of recognizing — and partly relieving — the violent feelings that many forms of conflict produce in the individual. The puppet Punch can trace his ancestry back to ancient Greek and Roman puppet shows — his name may even be derived from the Greek word po/ynices which means ‘man of many quarrels’.

and humiliating each other in public, so that one wonders why they stay together. The factors which hold them together will certainly include those which such couples usually mention if questioned about it — that it would not be fair to the children to part and, on the wife’s side, that by the time the children were old enough to leave home she herself would be too old and untrained to fend for herself. Yet in such relationships

break-up

is often

avoided,

and when one dies the other may be heartbroken. With one couple, the wife became very depressed after her husband’s death. She had had a father who tyrannized his family, and especially the mother, a passive and sad woman. The girl had hated her father, but deep down had admired and been drawn to him. She had married a man much older than herself, very quiet and withdrawn, feeling that with him she would be safe: but she had immediately provoked him into behaving like her father — with considerable success. Only in anger and quarrels could she have asatisfying relationship, reliving in a way her child-

hood

experiences.

One

eminent

author

writes, in fact, that ‘many chronically fighting couples stay together and defy attempts

to tame

or part them, because

of... dovetailing needs’. In another case, a young man had hada long series of brief love affairs with older women: each time he let the woman down in a very abrupt and cruel manner after about six months, for reasons he felt hard to explain. He finally married and had a child, but continued to show the six-month pattern by having violent quarrels with his wife and briefly leaving home at about the same intervals. His wife left him: he remarried, and a similar pattern emerged. By this time he knew the cause lay within himself, and asked for help. It turned out that he had been illegitimate. He had been adopted by his grandmother, who had always been very kind: but his real mother had kept on returning to the home at, in his memory, six-monthly intervals. Each time there had been frightening quarrels between the mother and the grandparents: the mother had attempted to win the boy’s affection by presents and promises, and once or twice had abducted him from the school gates, only to send him back abruptly to the old couple after a few weeks. The man’s inner conflicts were rooted in his ambivalent feelings towards his mother — he loved and hated her: in his treatment of other women he revenged himself. These rather dramatic examples illustrate the way in which adult conflicts may reproduce those of childhood, but of course there are many other sources of inner conflict and tension. For instance, there are those derived from homosexual drives — although these in turn are related to early experience. In many people, homosexual drives are unrecognized: the drives may be happily and usefully re-channelled into some activity, or safely ignored. At times, however, the homosexual drives may be so strong — even though they are still not consciously recognized — that they interfere with the individual’s heterosexual

activity. The individual may find that an emotional relationship with someone of the opposite sex cannot be completely satisfactory. Partners in a marriage may remain obscurely at war with one another for this reason. Another major source of conflict is that arising in women who have to reconcile the roles of wife-and-mother and career woman competing with men in the business or professional world. As with other conflicts, there are deeper levels of internal conflict, in that a woman may be driven to compete with men because she feels unsure of her own identity and role. Her conflict about her role may stem from childhood experiences but often it seems as though the uncertainty of the social structure itself is the most important factor. For society is

85

in transition between regarding women as basically the companions of hearth and home, and accepting that they can fulfil wider roles in society in positions formerly reserved only for men. A woman with a career may meet this conflict on two levels at least. She may find herself expected to be calm, responsible and efficient during office hours, yet sweetly dependent and helpless in her relationship with her lover or husband. On a more obviously social level, the mother who works may have to reconcile a definite need to earn money to help support her family with the tacit or expressed condemnation of that section of her social world who imply that she is simply neglecting her real duties in taking a job outside the home. N ambiguous situation like this pro-

a

vides an example of the difficulty of

defining what is meant by ‘maturity’ and an ‘adult relationship’. In the West, people tend to think of a ‘mature relationship’ in terms of emotional equality, companionship, shared experience and mutual responsibility: but other societies may regard very different relationships as normal and valuable. And indeed, ‘equality’, companionship and so on have not always been accepted in the West. There is a paradox, too, in that changes in society, accepted later as normal and desirable — changes such as the improved position of women — are often produced by people who were themselves maladjusted to the society into which they were born, and who would probably not have been regarded as ‘mature and adult’ in that sense by the majority of their contemporaries.

OME couples appear to live without conflict and in perfect harmony. But in some

of these cases at least, the

harmony is at the expense of the individuality of the weaker party who ‘gives in’ to keep the peace. There are other marriages in which the husband and wife are proud of doing everything together, of never even going out separately for an evening, and of never disagreeing, and they can gain great support and emotional satisfaction from their union. They do tend however to be very vulnerable, in that the death of one partner leaves the other desperately alone, unable and unwilling to survive as an individual. And sometimes with such

harmonious couples, there may be an exaggerated ‘unity’, in that neither party can face up to even the slightest, most natural conflict. This may lead to a damaging ‘blow-up’ at some time if one or other of the

86

partners can no longer contain strong emotions. If a marriage is to be a ‘going concern’, the partners must be prepared to com-

promise, because otherwise conflict will be continuous or one partner will become subordinate to the other. Marriage is the most difficult test of the process of ‘socialization’ which began in childhood and in which the individual slowly and often painfully learns that his own needs must be controlled in the interests of others. The selfish and primitive drives of the infant remain within everyone, often in conflict with the outer world and with the inner standards. But, in adulthood, the personality, ideally, gains satisfaction from being able to play a different role, and form relationships in which gratification is not only sought, but also given. If this two-way relationship develops in a marriage, the personalities of the couple often continue te develop also: with the increasing insight into the character of another can come a general broadening of sympathies and understanding. Such desirable changes do not automatically follow marriage — although people are often led to believe they do. What can be done by marriage counsellors, clergymen, psychiatrists, and others, to help in the resolution of marital conflicts? The answers to this obviously include offering practical advice, ranging from help with housing to advice about cooking, but from the psychiatrist’s point

of view, the first essential is to get an idea

of the personality of the husband and wife, and then to concentrate on what it is that they are really demanding from each other in their relationship. The inner demands are likely to be hidden, but when they are brought to light they are often revealed as essentially unreasonable: they could never be fulfilled, and conflict is inevitable unless they are moderated. Perhaps the commonest single unreasonable demand is that one partner wants the other to change in personality: so that a man wants his young wife to be loving, practical, helpful, calm, and accepting of his own vagaries — wants her, in fact, to be like an ideal mother as well as a wife — rather than the gay, impractical, easily-flustered young girl she really is, and who first attracted him sexually. An outsider may be able to help in such situations by bringing to light the unreasonable nature of the demands. Fresh insight may lead to a change of heart and some sort of workable solution.

Others have their

problems too Much of humanity’s misery springs from the very secrecy we shroud our problems in. Alone with our difficulties, we tend to overrate their uniqueness.

O human relationships are problem free. But the problems of sexual relationships are, for many people, major obstacles to happiness. In some part, this is because few of us discuss, even with close friends, problems of this kind. Many people feel their problems are unique, or at the least abnormal. For many men, in the words of one authority, ‘the fear of being or becoming impotent hangs like an obsession’. In fact, all men are impotent on occasion. The word has nothing to do with inability to produce lively sperm. It means the inability to achieve an erection of the penis or the inability to sustain an erection long enough for successful intercourse. Most men can be ‘off’ sex from time to time for a variety of reasons — over-work, illness, too much alcohol and so on — and can be temporarily impotent,

but

anxiety

about

the matter

can exacerbate the condition out of all proportion. Some men are permanently impotent as a result of a physical abnormality — in the reproductive organs or in the Most people have both a public and a private face. Daily, they may present their formally-dressed, conventional selves to the world: offduty, they express livelier, more Bohemian tastes. Some people’s public and private faces are equally acceptable to themselves and their partners. But sometimes an individual’s public image is used to conceal a private tragedy. The individual shrouds his misery, considering himself unique or ‘abnormal’. Many secret woes spring from sexual relationships — fears of impotence, frigidity, homosexuality. Yet, the pity is, these problems are common and can often be treated or alleviated.

brain or spinal chord — and some men are made impotent by functional disturbance — illness, circulatory or inflammatory disorders, or subnormal activity of the male hormone glands. But most impotency has its origin in the mind. And it isnone the less real for being mentally induced. The pity is that worry about impotence can lead to the condition feared. A man begins to worry, and the worry leads to one ‘failure’. Then guilt at not satisfying his partner, shame at his ‘incompetence’ and embarrassment, leads to more tension — and lack of success at the next attempt. It is when this vicious circle has started, that long-term difficulties can begin. Where failure to achieve an erection is the result of a physical defect or malfunctioning due to illness, medical treatment is obviously the answer. In any case, a man who is concerned about possible impotence should have a medical examination: there may be a simple explanation and discussion with a sympathetic family doctor can relieve his fears.

Myths of potency and exuberant sexuality are endlessly created by the mass media. But film idols, advertising beauties, newspaper pin-ups, are images of society's fantasies, not its facts. one film that managed both to glorify and look behind the popular image of gunman as virile hero was Bonnie and Clyde. Clyde, gangster portrayed by Warren Beattie, needed his gun to boost a confidence shaken by an awareness of impotency. Much concern with guns, psychiatrists note, is linked with self-doubt of sexual powers. How many people, in everyday life, use

status

symbols

boost private quacy?

—

like

feelings

cars of

—

te

inade-

Where failure to achieve an erection is the result of psychological factors, understanding some of the possible causes can be helpful. Fear can be a powerful deterrent to a satisfactory sex life. And fear can take many forms. It may be deep rooted fear of women or unconscious distaste for the partner. Or a sensitive man may be afraid of hurting his partner daring intercourse: he may fear that he cannot satisfy her in the way he thinks she wants, he may fear she will become pregnant. A young lover may think he will fail through inexperience, be made to look a fool. A man may worry that masturbation may have made him impotent — a totally groundless anxiety. Most of all, fear of failing to be a good lover can prevent a man from being any sort of lover at all. Maybe the circumstances in which the couple make love are inhibiting — a small child in the room or next door. The couple may share a house with in-laws and feel that love-making is not sufficiently private. Incompatibility of temperament between the partners, or interminable conflict over financial or other matters, can reduce desire. Long term frustration, worry, feelings of inadequacy, can have the same effect on the sexual relationship. ATURALLY, when possible causes are so varied, there is no one simple solution. Discussing the situation

frankly with a partner can help but a couple may need a guidance counsellor’s help to get them to the situation in which they can begin to discuss the problem openly. Again, an understanding wife will help to ease her husband’s anxiety by being tolerant and affectionate. On a practical level, there are at least temporary solutions to impotence. The work of the American research scientists, Masters and Johnson, has emphasized that, despite much misunderstanding on

the subject, most women reach orgasm through stimulation of the clitoris (the tiny organ near the entrance to the vagina) rather than from the vagina. Therefore a man who is unable to achieve or sustain an erection for some reason may still give his partner satisfaction culminating in orgasm by manually stimulating her clitoris. There is no reason why either partner should feel a sense of guilt or failure if they employ this method. Sometimes, a man’s inability to achieve an eréction can be eased by sexual expertise on his wife’s part. Many men, and pos-

sibly even more women, feel that there is something ‘unnatural’ about regarding love-making as an art, with techniques that can

be learnt.

But

an

ignorant,

clumsy

lover — either male or female — can be a disaster to the loved partner and miss much in his own life by failures to achieve his full personal sexual potential. The wife who truly loves her husband should see to it that she learns wavs of stimulating him

during love-making so that he may achieve the greatest possible satisfaction: likewise the loving husband will learn the best ways of satisfying his wife sexually. This will mean finding out and adapting to each other’s sexual needs — discovering which parts of each other’s bodies are most erotically sensitive, which positions for love-making give greatest satisfaction, and so on. The wife of a man who finds it difficult to achieve an erection will try to stimulate her husband emotionally by being loving and seductive, but there is no reason why she should not also try to massage his penis, testing out ways to stimulate the sensitive head or glans. Various forms of stimulation, manual or oral, may excite the husband, and there is nothing ‘immoral’ or disgusting about applying such techniques. Men whose problem is not reaching, but sustaining an erection — the man who ejaculates at once on placing the penis in the partner’s vagina — needs help of another kind. Often the cause of premature ejaculation, as this condition is called, isa high state of sexual tension. Sometimes, the reason may simply be that the man is over-excited by his partner — particularly if he is a young lover in bed with his beloved for the first time. Control over orgasm comes into the category of sexual technique: it takes time to learn, as all young lovers need to be aware. Hence the stress that many experts in this matter lay on practice and tolerance: achievement in the physical relationship in marriage grows with months and years. ‘First nights’ are rarely as successful as the fairy tales and folklore of the subject persuade us. Much misery grows from disappointment on honeymoon. Another reason for premature ejaculation may be that the man’s penis is exceptionally sensitive at the head. Sometimes the use of a sheath will help reduce sensitivity in the man whose problem is immediate ejaculation on penetrating the vagina. Sometimes a man can learn to control ejaculation by concentrating hard on nonsexually stimulating matters. Such an approach, long familiar to Indian experts on the topic, can be alittle discouraging to the partner! Adopting different postures for love-making may make a difference. Some people find sedatives or ointments helpful: this is a topic on which doctors will advise. BOVE all, no one should condemn themselves — or their partners — to frustration simply because they are ashamed of asking for advice or help. That is not to say all doctors are funds of wisdom on problems of this sort. If you do take the step of seeking advice, and find it difficult

to establish a successful ground for discussion with your adviser, do not retreat into your shell. There are a great number of doctors and psychiatrists who are deeply experienced in problems of this kind, and

taking advice before a crisis situation occurs to threaten the breakdown of a relationship is a sensible and realistic step towards improving matters. Many women, through a false sense of modesty, spend many years condemning themselves as frigid — they see themselves as unable to enjoy sex or to reach orgasm. Often, they cannot discuss the sexual side of the relationship with their husband. They may accept an unsatisfactory situation because they cannot bring themselves to suggest to their partner techniques which they feel would give them pleasure. Other women may (sometimes unconsciously) regard sex itself as something basically repugnant and resist giving themselves to the total abandonment that is orgasm. Such a person may feel herself to be only the sexual tool of her husband. Unless she can come to look on love-making as an equal partnership, a natural and mutual expression of loving between a man

and a woman,

she is likely to remain

‘cold’ for the rest of her life. Because problems of this sort lie deep in the structure of our individual personality, no quick solutions are available. Expert counselling may provide some help. — Some women who may regard themselves as ‘emancipated’ may be so obsessed with the quest for the perfect orgasm that they cannot relax and so they defeat their object. They may feel that unless they achieve orgasm on each and every occasion they are failures to themselves and to their husbands. They may, in fact, worry them-

At the height of her popularity in the late 1950s, Marilyn Monroe was publicly a fairy-tale goddess of glamour and sex-appeal. But the story of her disturbed childhood, her tortured private life, her tragic death, gives deep poignancy to the myth. Painter Richard Hamilton created this picture from photographs marked by Marilyn Monroe herself. “Towards the end of her life,, he says, ‘she insisted that photographers submit their work to her... anything she did not like she crossed out... the marks she made were often so forceful they scratched the emulsion. It was as if she was attacking her own image.’

selves into frigidity in this way. Overseriousness, over-anxiety in sexual matters is a sure way to end up dissatisfied. Biologically speaking, as one eminent scientist has pointed out, the chief function of sexual activity in Man is play. As with the man’s failure to achieve erection, a woman’s inability to reach orgasm may be overcome if both partners learn something about the techniques of love-making. The husband should find out which are the most erotically sensitive areas of his wife’s body — that is, her erogenous

zones

—

and

concentrate

on

stimulating them: and the wife should help him by telling what particular actions — for example, sucking her nipples and so on — produce pleasurable responses. Possibly concentration on the clitoris will be most satisfactory: the old belief that a clitoral orgasm was ‘immature’ is today considered entirely mistaken. The woman who simply does not lubricate enough to make entry of her husband’s penis comfortable should dampen the vaginal area with saliva or special ointment bought from a chemist. Where the woman suspects that her failure to achieve orgasm is a matter of physical malfunctioning — or indeed any woman who finds intercourse painful or difficult — she should consult her family doctor to find out if there is a physical cause. Should the family doctor be a man and the woman be shy to discuss such a matter with him, it is always possible to ask for an appointment with a woman doctor. In conclusion, it is important to remem-

ber that though technique is important, sex is more than a biological response. One leading authority suggests that many women feel it is shameful to think of sexually exciting objects or fantasies during lovemaking. But this attitude is foolish since imagination plays a great part in stimulating the body, and its powers should not be ignored. There is certainly nothing inherently immoral about mental stimulation of this sort, indeed one expert advises a

woman to focus her mind on ‘stories, pictures, past sex participations, thoughts of future pleasures — anything and everything that excites (her) mentally’. Neither the

body’s responses nor the mind’s contribution should be disregarded during the complex and individual activity that is love-making. Whilst the normal pattern of sexual behaviour in our culture is a relationship between two individuals of the opposite sex, it must be recognized that this has not always been the case. Some societies retain the heterosexual relationship for the reproduction of its kind, but reserve the homosexual pattern for the emotional relationship. The so-called characteristic homosexual with his mincing gait, lisping speech and flamboyant clothes is a relative rarity and is usually a homosexual prostitute, whilst the vast majority of homosexuals appear perfectly normal and are indistinguishable from their fellow men. Again, it is probably inappropriate to speak of homosexuality as an all-or-none situation. There is a continuum of sexual behaviour from the completely heterosexual on the one hand, through bisexuality, to completely homosexual on the other hand. OME individuals are described as facultative homosexuals: that is, they are normally heterosexual in behaviour but can achieve a satisfactory homosexual relationship in situations

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where a heterosexual pattern of behaviour is not available — as, for example, inprisons or similar institutions. This range of homosexual activity explains why many such individuals can make a satisfactory heterosexual relationship including marriage and fatherhood, yet may afford their partners considerable distress by their need to experience occasional homosexual relationships. Sometimes this can be satisfied by

casual homosexual contacts — for example, at a public house — but sometimes more prolonged association is needed. Such individuals occasionally run great risks by importuning strangers. The more disturbed form, and one lending support to the view that this condition represents sexual immaturity, is the homosexual who can only achieve relationships with young children. Such a person, an object of pity rather than scorn, tries to entice youngsters into the cinema or park with offers of sweets. While changes in the law in Great Britain now allow homosexual behaviour between consenting adults in private, the seduction of young children rightly remains a serious crime. However, it is doubtful whether anything is achieved by sending these individuals to prison, where they are looked on with contempt by their fellow prisoners. They are simply kept out of circulation for a limited period of time but return even more lonely and isolated to seek satisfaction with the only individuals whom they find sufficiently non-anxiety provoking. There is considerable doubt concerning the efficacy of treatment for homosexuality. Some psychoanalysts believe prolonged treatment can achieve a change in orientation. Others believe that, so long as the homosexual is not a threat to young children —and given that the lawin Great Britain has been modified towards consenting adults— the most satisfactory approach is to reconcile the homosexual to his state.

Planning a family It is now widely accepted that a couple have the right to plan their family. Planned parenthood is today made possible by anumber of techniques.

In simple, agricultural societies numerous children can be a blessing; they help with farm tasks, take over the land when parents age. But in the industrialized West, many children can mean great hardship: suitable accommodation may be difficult to find, clothing and good food expensive. Welfare benefits may take care of necessities, but larger opportunities may be severely limited.

revolution in attitudes towards family planning has occurred in the twentieth century. The most important reason for this is the growing threat to Mankind caused bya rate of population growth unprecedented in human history. Then again, it has been accepted that family planning is an essential factor in the worldwide campaign to improve the health of mothers and children. And, not least, today women all over the world increasingly wish to play an equal part with men in their community, and control of their fertility is essential if they are to achieve this. In an undeveloped society based on subsistence agriculture the need for small families is not immediately apparent. Children: can perform useful work in the fields and are generally regarded by their parents as a safeguard against poverty in their old age. It is only when infant and general death rates fall as a result of improved medical care and arise in living standards, that, in a generation or so, it becomes apparent that there is not enough land to go around, and a desire for reduction of fertility begins to be felt. In an industrialized urban society this process is accelerated dramatically. Children do not contribute to the family’s economy nor provide essential labour: indeed they are, economically, a liability to their parents. In addition, parents are aware of the benefits of smaller families to the health of the mother and children,

and the welfare of all family members. Family planning seems to many to be a very modern idea — but in fact people have been interested in controlling the size of the family from the time of the ancient Egyptians, who in 1850 B.C. recorded ona papyrus, fragments of which still exist, several methods of contraception in use at the time. Almost every other culture and civilization has left some kind of record of contraceptive methods known and used. Soranos, the greatest gynaecologist of ancient Greece, wrote an account of the methods he knew and his book is as sophisticated as many written in the twentieth century. He even considered which method was the most suitable for a given patient. Little progress was made during the Middle Ages as the Church was hostile to such studies, but the knowledge was not lost and up to the seventeenth century methods were often prepared for individual patients by their medical advisors. Simple methods were also prepared in the home from recipes handed down from mother to daughter. In the sixteenth and seventeenth centuries new discoveries were made as scientists began to study anatomy and physiology in greater detail. Advances such as the vulcanization of rubber in 1843 made mass production of rubber contraceptives a practical proposition. During the present century the refinement of techniques already in existence

1 Well-educated, high-income couples often make the most use of contraceptive techniques. They want to give their children the benefits of good education, pleasarit surroundings, educational holidays and interests — all the comforts, in fact, that a high standard of living can bring. So .such couples plan for well-spaced children whose individual needs they can accommodate. 2 Most people in Britain, it has been calculated, have between two and three children. (The figure is in fact given as 2:3 children.) In most Western societies, small families are the norm. Fewer children ease the physical burden on the mother who has to cope and Care, prevent her prematurely ageing through the effects of repeated childbirth, allow her to keep up personal interests, or a career.

has made traditional methods more acceptable, safe and effective. Oral contraceptives and the discovery of the new plastics used to make intra-uterine devices that are simple and acceptable have put reliable family planning within reach of millions of women. And today, more and more people, including religious and political leaders, look on family planning as a basic condition of a reasonable existence. In 1967 the leaders of 30 countries, representing more than two-fifths of the world’s population, signed a declaration that includes these words: ‘We believe that the great majority of parents desire to have the knowledge and the means

to plan their families; that the

opportunity to decide the number and spacing of children is a basic human right. We believe that the objective of family planning is the enrichment of human life, not its restriction; that family planning, by

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assuring greater opportunity to each person, frees man to attain his individual dignity and reach his full potential.’ The United Nations International Con-

ference on Human Rights accepted unanimously the proposition that family planning is a basic human right. OR family planning is not only a global necessity but a matter of common humanity. For generally speaking, a planned child is a wanted child. Unwanted, uncared for children are some of the most tragic of the world’s unfortunates. Likewise, there is the private misery of those women who are slaves to their bodies’ rampant fertility: constant childbearing can result in ill-health, exhaustion for the mother, strain and tension in the family circle. And for centuries women have resorted to abortion, figures for which in the industrialized countries today are still extremely high. There can be few supporters for this method of dealing with un-

wanted fertility. So preventative methods of some sort have to be considered. Many authorities have also stressed that freeing the sexual expression of love between a married couple from the fear of unwanted pregnancy can bring a greater degree of harmony and stability to the marriage, and thus to the family. Also the freedom from fear in the sexual relationship can offer a greater potential for sexual fulfilment. for both partners in this important area of human life. The whole question of family planning is complex and raises numerous social and moral issues — but it is one that cannot be ignored, either by the individual or by governments.

AIN methods of contraception are described and illustrated in the following pages. Methods vary in degree of reliability. Women who wish to practise effective methods of contraception should always get advice from their own doctors or the Family Planning Association. Oral contraceptives (Key: 1) should be taken only under medical supervision. There are a number of preparations with different dosages and ingredients. (Full information about oral contraceptives is given on pages 97 to 108.)

An only child has many advantages. He or she has the parents’ full attention, sole claim on any benefits available. Some couples plan for only one child — for a variety of economic or personal reasons: some couples, of course, are simply unable to have more. The only child, however, may be the lonely child, isolated from the valuable, knockabout companionship of brothers and sisters.

As a rule, one Pill is taken every day for 21 consecutive days, followed by 7 days without Pills, during which time the monthly period will begin. The chart shown in the illustration, is used to keep track of the Pill-taking. If the doctor’s instructions are followed carefully, it is almost impossible to become pregnant when using this method. Oral contraceptives work in several ways — by preventing the release of the egg from the ovary, or by making the mucus at the neck of the womb (the cervix) thick and impenetrable to sperms. It is also thought that by altering the conditions within the womb, these drugs may make it impossible for the fertilized egg to attach to the wall of the uterus. Intra-uterine devices (Key: 2) are devices — coils, loops, rings, bows, and so on — which are inserted inside the womb by a trained doctor. No anaesthetic is needed. The modern IUD is manufactured from plastic or metal, and there are many different sizes and shapes. Once in position, the IUD gives very good protection against pregnancy and needs little further attention. The woman should, however, visit her doctor for regular check-ups. The way in which these devices prevent pregnancy

is not yet established. The IUD does not interfere with sex relations, and no further action is needed by either partner. Neither does the device interfere with the monthly period: the periods may, however, be heavier, and there may be some additional pain, especially in the initial cycles after the device has first been inserted.

A Sheath (Key: 3) is also known as a condom. It is worn by the man and is one of the most widely used methods of family planning. A sheath over the penis acts as a barrier preventing the sperm from entering the womb and fertilizing the egg. Modern sheaths — the method dates back to antiquity — are usually made of rubber, although animal membranes and plastics are sometimes used. The sheath should be put on before there is any contact between the penis and the vagina. It should be carefully rolled on to the erect penis, leaving a small air-free space (about + inch)

projecting at the end to receive the fluid: some

sheaths

(like the one in this photo-

graph) are designed with a teat end to accommodate the sperm. As an added precaution,

a little spermicide

(chemical

that kills the sperm) may be used. In countries where their free sale is permitted, sheaths are sold by chemists, barbers and through slot machines. When used consistently it is an effective method and has no side-effects. Creams, jellies and pastes (Key: 4) are types of spermicide — chemicals that are placed in the vagina and are intended to kill the sperm. There are four main types. Creams, jellies or pastes can be inserted with an applicator (shown opposite) to ensure that the chemical spreads as widely as possible throughout the vagina. Caps (Key: 5) are mechanical barriers used by women. There are three types, the diaphragm (Dutch cap), cervical cap and the vault cap. All types should be first fitted by a doctor or trained nurse, who will give advice about how to use it. The principle behind all the caps is the same — they cover the neck of the womb and prevent sperm entering. Caps are made of rubber or plastic, and come in various sizes. This is why it is important to be properly fitted so that the correct size and type of cap is obtained. The method of use is as follows: the cap is placed in position in the vagina by the woman shortly before intercourse takes place, and must remain in place for six to eight hours afterwards. It is always used with a spermicide. The cap method is reliable if used correctly but some women tire of it or grow careless. Sponges (Key: 6) are veryoccasionally

To practise the rhythm method, it is necessary to calculate the days on which a woman is fertile. This calculator enables her to work out the ‘unsafe’ days.

used as a mechanical barrier by women. A sponge, often attached to a piece of string, and preferably smeared with a spermicide, is pushed as far as possible into the vagina. One of the earliest methods of contracep-

tion, it may be uncomfortable to use.

Suppositories

(Key:

7) are

spermi-

cides which should be placed as high up in the vagina as possible, preferably about 15 minutes before intercourse: they melt, with body-heat, to a liquid. Foaming tablets and aerosol foam are two other variations on the chemical method. Spermicides are sold under many brand names: some manufacturers suggest that their product can be used alone, but most authorities feel they give only moderate protection. They are best used as a supplementary protection with a sheath or other barrier method.

Coitus

interruptus

(not on

Key)

is

still, perhaps, the most common of all methods of family planning and is a very

old one. The man withdraws his penis from the vagina just before orgasm so that the semen is ejaculated outside the vagina. Its disadvantages are, firstly, that sperm may be present on the top of the penis before ejaculation takes place and, secondly, that anxiety and frustration may attend love-making reliant on withdrawal at the crucial moment. Although not very reliable, this method has had an important effect in lowering the birth rate in many countries.

The Rhythm Method (not on Key) is a method of contraception based on the fact that a woman only once a month produces a ripe egg to be fertilized. For contraceptive purposes, the method consists of avoiding sexual relations during the days when a woman is ovulating. Scientists have worked out that the ripe egg is produced about 14 days before the start of menstruation. Therefore, sexual relations must be avoided for several days round the fourteenth day. The method may be used accurately if the woman has a record of the dates of her periods for the previous year. Cycles are counted from the first day of the period when bleeding occurs — through the following days, up to but not including the first day of bleeding of the next cycle. The first fertile days of the shortest cycle and the last fertile day is determined by subtracting 11 days from the longest cycle. If, for example, the longest cycle numbered 29 days and the shortest 26 days, the days on which the woman would be most likely to conceive are from the eighth to the eighteenth. The method can be made more reliable by recording the body temperature: this rises after ovulation. While it is not highly reliable in comparison to some others, the rhythm method is important since it is the only form of contraception sanctioned by the Roman Catholic church. VELOPMENTS in contraceptive OItechnology in the twentieth century have come only just in time. As far as we know, the world’s population reached

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for Population was established in 1968. So many important programmes of assistance are being carried out by the specialized agencies that a committee has now been set-up to co-ordinate their activities. At the beginning of this century the major world religions were largely united in their opposition to family planning. But, as with the State, the Churches are modifying their attitude. The Muslim areas of the world. In fact, there is a fertility but leading faith encourages distinct division between the richer counspokesmen all over the Muslim world tries, with a slow population growth of have, in recent years, spoken up for family around one per cent a year, and the planning as compatible with their beliefs. poorer countries with rapid rates of popu‘Asian religions such as Buddhism and lation growth of an average from two to Hinduism have never expressed an attitude three per cent and rising to as high as four on family planning. per cent a year in some countries. The gap Within the Christian faith, Protestant between rich and poor nations is widening churches now consider family planning an and rapid population growth is one of the important part of parental responsibility main reasons for this. To achieve social and have officially approved the use of conand economic development a country must traceptives. The Roman Catholic Church invest a percentage of its national income now approves the principle of responsible in new factories and industries and modern parenthood but in the recent encyclical fertilizers to produce profitable cash crops. Humanae Vitae the Pope confirmed the This investment becomes impossible when traditional opposition to all but the savings must be diverted to provide the rhythm method. The debate continues, necessities for an increasing number of however, within the Roman Catholic dependants — children who need housing, Church, and many Catholics have recently schools and clothing. In many developing expressed their belief that contraception countries between 40 and 50 per cent of is a matter for individual conscience. the people are under the age of 15 and The Orthodox Church is opposed to this burden on the worker and on the comcontraception in principle but the question munity is preventing development from is* treated as a matter of conscience taking place. between the priest and the individual. Experts generally agree that, in the long Orthodox Judaism is also opposed to conterm, the world can support a larger poputraception, but the reformed synagogues lation than it does at present. The natural accept it in the same way as Protestant resources of much of the planet still remain Christianity. to be developed and there is great potential ITH the growing acceptance of for improvements in agricultural techfamily planning by Church and niques. But these improvements cannot State, attention is now moving be made fast enough to cope with present to the problems of making it work. A rates of population growth. So population embarking on a_ family growth must be tackled with real vigour if government planning programme faces some daunting the standard of living in the developing obstacles. Most developing countries world is to be raised or even maintained suffer from extreme shortages of trained at its present inadequate level. Food means _ health. ‘The number of doctors, nurses and trained administrative personnel. Those that exist are unlikely people in the world living on nutritionally to have been trained in family planning deficient diets today is certainly far over techniques. Most methods that are avail1000 million; the number who suffer from able for large scale programmes require an absolute shortage of food may be as high some medical supervision. as 500 million.’ This estimate was given to Governments face problems of manuthe United Nations General Assembly by facture, supply and distribution of conthe President of the World Bank, Robert traceptives. Perhaps the most difficult of S. McNamara, who went on to say: “The all is the problem of public information and consequence is that many millions are not able to work productively enough for motivation. Only 20 per cent of the popuadequate support of themselves and their lation of India, for example, can be families. Poor nutrition leads to disease reached by mass media, and even where and death.’ people can be informed about family planIn the last few years governments the ning this may not be sufficient to persuade world over have become aware of these them to practise it. problems. There are now 17 governments And all this is only part of the solution to actively developing nation-wide family a long-term problem. Ideally, the answer planning services and a further 20 governlies in the proper education of young people for family life, so that they only ments are committed to developing such embark on a pregnancy when it is desired. programmes. A Special UN Trust Fund

1000 million by 1830. Since then it has accelerated rapidly. The second 1000 million: came in 100 years, the third in 30 years and the fourth 1000 million is expected in 15 years, that is by 1975. Itis probable that the world’s population will reach 6—7,000 million by 2000 A.D. The effect of this population ‘explosion’ is being felt primarily in the developing

The world cannot feed, house, care adequately for its existing peoples — conditions far worse even than this Italian back-street exist. Yet the world’s population may double by 2000 AD.

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The Pill, the facts Pills designed to prevent conception have existed since the first century. The Pills that millions of women take today ’ are asuccess story of medical research. Although the Pill is over 99 per cent effective, many women reject it. Now scientists are at work on aPill which may take all risk out of oral contraception.

The Mexican yam, Dioscorea: the origin of a synthetic hormone that is a vital ingredient of the Pill.

G 2000" AD. te calculate that by 2000 ‘A.D. there will be 6—7,000 million people on Earth. Three hundred years ago the figure was 250 millions. This population explosion has led governments all over the world to show concern about birth control — an obvious answer to problems of population. Since 1850, reliable contraceptives have been available to many men and women, but the development of an oral contraceptive — the Pill — during the 1950s heralded a revolution in thinking about planned parenthood. Throughout the world today, many millions of women take the Pill every day. In the past, women have inflicted an enormous variety of treatments upon themselves to free them from the burden of childbirth. In ancient communities, women believed that, to ward off the spirits responsible for childbirth, they would be safe from pregnancy if they spat into a frog’s mouth three times, ate castor oil seeds or wore an amulet. Other, similar safeguards were drinking the froth of a camel's saliva, wearing a magic charm made from the womb of a lioness or taking pills composed of quicksilver. The ancient medicines were taken in vain. The first reliable product that would prevent a woman from conceiving and at the same time one which could be taken by mouth did not appear until 1955 and it was not licensed until 1960. For the first time a daily dose of a medical preparation could ward off pregnancy. Much of the groundwork that eventually

led up to the development of the Pill was done in the 20 years up to 1955. Around the turn of the century, physiologists already knew that a yellow tissue produced by the ovary every time a mature egg was released brought about a temporary inhibition of the release of eggs from the ovary. This process of release is known as ovulation: the yellow tissue is the corpus luteum. In the mature female, one egg is released every month until the onset of menopause. An important advance came in 1934, when it was discovered that a hormone called progesterone is responsible for the inhibitory effect of the corpus luteum. Physiologists found that when this socalled ‘pregnancy hormone’ was injected into rabbits they did not ovulate. Other hormones were later found to have similar effects. Female hormones named oestrogens which, with progesterone, help the female body prepare to receive a fertilized egg every month, would produce and prevent ovulation, so would a male sex hormone called testosterone. The study of natural abortion was a vital step in the development of the Pill. Physiologists found out that oestrogen went to work to stimulate the lining of the uterus. This stimulation ensures that the womb is ready to receive a fertilized egg.

They also found that progesterone was needed for pregnancy to be maintained for nine months. Doctors thought that progesterone might help women, who had already undergone several natural abortions, to conceive successfully. But although the results were encouraging, the cost of extracting enough progesterone from animals was prohibitive. Professor Russell Marker an American chemist, was among those who were convinced of the value of progesterone in stopping natural abortion. Prevented from tests and research by the cost of progesterone, he looked to the plant world for his answer. Marker found that the roots of members of the lily family yielded a substance called diosgenin from which synthetic progesterone could be produced. Diosgenin got its name from the plant Dioscorea. In 1936, some Japanese scientists had extracted diosgenin from the plant. Marker set out for Mexico where he knew the rare Dioscorea grew. From acollection of more than 400 different plants he found one, a vine with heart-shaped leaves called cabéza de negro whose brownishblack roots yielded diosgenin. Disheartened by the lack of official enthusiasm for his discovery, Marker resigned his professorship and returned to Mexico. There ‘he made two full bottles of artificial progesterone — they were worth about £50,000. These two jars were the start of the Mexican progesterone-producing industry. In 1950, another American, Dr. Gregory

Pincus, was asked by birth control experts to undertake some research into a method of contraception that was safe, simple and more acceptable than those in use at that time. The Pill was his idea, but its production would have been impossible without the work of Marker. Allowed a budget of only 2,100 dollars, it was fortunate perhaps, that his first idea proved to be the right one. He gave rabbits synthetic progesterone orally. Like the natural hormone it inhibited ovulation. Experiments were also going on at Boston. There, a gynaecologist called John Rock was testing the hormone oestrogen. He argued that if the hormone produced changes in the uterus, women who were producing ripe eggs but who remained infertile might be helped by the administration of extra oestrogen. His line of argument turned out to be correct. Within four months 13 of his 80 volunteers were pregnant.

Rock and Pincus decided to work together. They found that when progesterone was given to patients for 20 successive days out of the 28-day menstrual cycle, conception was prevented. But although progesterone was effective.in preventing ovulation, it was not the ideal contraceptive. Its efficiency when pure was only 85% and

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levels for effective protection without breakthrough bleeding were very large. The Pill that was finally developed contained a synthetic substance that mimics the action of progesterone and oestrogen. The new synthetic substances were cheaper and effective in much lower doses. O find out more about the way the Pill works, it is necessary to look more closely at the female reproductive system. The hormones oestrogen and progesterone do not circulate in the bloodstream unordered. The body organ which ‘supervises’ the whole proceedings is the pituitary gland, which is situated at the base of the brain. The pituitary sends out

progesterone by the female body special names. The iirst is known as follicle stimulating hormone or FSH. This is the one that has the main control over oestrogen production. The other, luteinising hormone, LH has an effect on the final stages of ripening of the female ovaries and the release of the egg. A third hormone, luteotrophic hormone, LTH, influences the formation of the corpus luteum and the secretion of progesterone. After childbirth, it is the same hormone, LTH, which maintains milk production. At the start of the monthly menstrual cycle, while bleeding from the wall of the uterus is still going on, some of the eggs in the ovary are passing through the various

1 A drawing of 1633 gives the botanist’s view of the mandrake. Both male and female parts were described. 2 For centuries, the magical mandrake was believed to be able to produce natural abortion. A painting of 1560 illustrates the legend that because the screams made by the plant as it was pulled up could turn a man mad, a dog must be used for the task.

a whole fleet of hormones all controlling different parts of the body, but there are three concerned with the reproductive process. These are covered by the general name of gonadotrophins. The gonadotrophins are one of the clues to female fertility. Two of them are related to the production of oestrogen, the other has an effect on progesterone production. Physiologists give the hormones that influence the production of oestrogen and

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stages of ripening. This ripening is under the control of FSH which acts directly on the follicle or sac which surrounds each egg in the ovary. At this stage, very small amounts of oestrogen are being produced by the ovaries. As the follicle ages, the secretion of oestrogen increases. The hormone is released by the ovary, and in turn prepares the lining of the uterus to receive a fertilized egg. The rise in the oestrogen level of the

X

The clue to the way the Pill works lies in the pituitary gland. 1 The pituitary secretes the hormones vital to female fertility. In the fertile woman, follicle stimulating hormone, FSH, and luteinising hormone, LH, act on the ovaries every month to produce an egg. Under their influence, the ripening follicle, 2, secretes the hormone oestrogen. Oestrogen prepares the uterus for conception. After ovulation, a luteotrophic hormone, LTH, orders the formation of a corpus luteum, 3, in the empty follicle. From it, the hormone progesterone is released, which completes the preparations for pregnancy. The hormones of the Pill, oestrogen and a progesteronelike substance, make the pituitary ‘think’ that the body is making enough of these hormones, so FSH and LH secretion stops. In pregnancy, the corpus luteum, 4, is nourished by a hormone produced in the uterus, 5. The cells round the developing embryo, 6, grow into the placenta and produce both the hormones of the Pill. Ovulation stops until the hormone balance changes.

A 32 year-old Kentucky mother of nine receives a call from her doctor. Under his care she has been taking the Pill: it has successfully prevented further pregnancy. body has a feed-back effect on the pituitary gland. As the amount of oestrogen increases, so the output of FSH diminishes. Here, a second, luteinising hormone, LH, comes into play and ensures that the egg is ejected from the ovary. Scientists think that both LH and FSH are needed-for oestrogen production. After the egg has been released, the yellow tissue of the corpus luteum is formed under the control of the luteotrophic hormone, LTH. It is the production of LTH by the pituitary which influences the secretion of progesterone by the corpus luteum. As it increases in size, the corpus luteum liberates the hormone progesterone which, temporarily, stops the release of an egg from the ovary. Like the oestrogen case, the progesterone ‘feeds back’ to the pituitary, and the flow of LH stops, thus preventing further ripening until the fate of this egg has been decided. If the uterus receives no fertilized egg, its lining is shed as the monthly period. From month to month, as the production of gonadotrophins waxes and wanes, so do oestrogen and progesterone also. When the level of hormones produced by the ovary is high, the pituitary thinks that all is well and shuts down production until the level falls again. When a woman takes the Pill, the two hormones

progesterone

and _ oestrogen

arrive in the body in a proportion that will deceive the pituitary. Finding an abundant supply of hormones in the blood it

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shuts down its own supply. As aresult, the ovary stops work as the go-ahead from the pituitary ceases to arrive. Because both organs stop their normal function, no eggs are released by the ovary. Some scientists are anxious that the ovary and the pituitary may suffer from this lack of activity. However, there would seem to be more evidence to show that over activity is more dangerous than under activity. Doctors give the Pill in a way that mimics a woman’s natural monthly cycle. This policy is designed more to reassure her than for well established scientific reasons. The one month period appears to be arbitrary, and other animals work very well on different time schedules. But it is essential that life should be as normal as possible for the woman on the Pill to prevent her worrying unduly. Some doctors think that harmful side effects of the Pill may be accentuated by worry. The Pill is usually: given in cycles of 21 days. A 20-day cycle is strictly more natural, but now the proportions of hormones in the Pill have been adjusted to put the timing on an easy ‘three weeks on, one week off’ basis. For three weeks, the concentration of hormones in the bloodstream remains steady. Then the amount is allowed to fall to zero so that a period can occur. Because the amounts of hormone in the Pill are fairly small (yet large enough to stop the ovary producing ripe eggs), the build up of the lining of the uterus may be meagre. As a result, the period will be

Mass production in the 1960s turn- 1 ed out an annual total of over 2,000 million Pills, consumed by millions of women. 1 Pills are packed into bottles for use, not as contraceptives, but to treat disorders of the menstrual cycle. 2, 3 Sophisticated packaging helps to make the Pill easy to take. As an aid to memory, these packs will be stamped with days of the week. People who make the Pill are constantly concerned about its acceptability to the women who take it.

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scanty. This in itself is no cause for alarm, and indeed it proves a blessing to many.

1 The earliest of all contraceptive recipes were formulated by SunSsmo in China during the first century AD. One of his prescriptions was ‘Take some oil and quicksilver and fry a whole day without stopping. Take one pill as large as a jujube seed on an empty stomach and it will forever prevent one from becoming pregnant... It will not injure the person’. 2 Soranos, a Greek (98-138 AD), invented this contraceptive technique: ‘Pine bark, rhus, coriaria, both to equal parts: pulverize it with wine and use shortly before coitus with the help of wool.’ 3 Ibn Sina, one of Islam’s most famous scientists compiled a medical encyclopedia which included methods of contraception. According to one of them, a woman should insert in her vagina, before and after coitus, the flowers and seeds of cabbage. These were meant to be effective when dipped in special juice. 4 ‘One tola (about half an ounce) of powdered palm leaf and red chalk taken with cold water on the fourth day (of menstruation) makes a woman sterile with certainty’. An early Indian remedy. 5 In the Middle Ages, an alchemist known as Alfred the Great published a treatise, which included many recipes for the prevention of conception. By one of them, ‘if a woman would spit thrice in the mouth of a frog, or eat bees, she will not become pregnant’. A piece of cloth soaked in barberry oil and placed on her temples was also, in theory, effective.

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HROUGHOUT the normal reproductive cycle, oestrogen appears first in the cycle, and once an egg has been released progesterone finishes the job off. In the conventional Pill, the two are always given together. Another clue to the way the two-hormone Pill works lies in the way the female body functions during pregnancy. When a fertilized egg is implanted in the uterus, some mechanism prevents further conception until after the baby is born. In the last six months of pregnancy, both oestrogen and progesterone are produced in large quantities by the placenta. This change in the balance alters the functioning of the pituitary — it stops producing the gonadotrophins FSH and LH, although LTH secretion continues to initiate and maintain milk production. In this way no more ripe eggs are released during pregnancy. The body is, in fact, deceived by the hormones in the Pill into thinking it is pregnant and acting accordingly. Doctors have found that the Pill has other effects on the female reproductive system. Under the influence of progester-

one and oestrogen, the lining of the uterus is changed slightly. Under such changed conditions a fertilized egg would be most unlikely to become established. Also progesterone makes the mucus substance in the neck of the womb thicker and stickier. Male spermatozoa find it hard, if not impossible, to penetrate this barrier. Some scientists think that the change in the mucus may be, in itself, adequate protection against conception. A woman taking the Pill for the first time will be told by her doctor to take the first Pill on the fifth day of the menstrual cycle. On his calculations,

the first day is

that on which bleeding starts. Usually, a woman will be safeguarded against conception from that day, but doctors usually recommend them to take other contraceptive precautions for the first month. If an egg has already started on the final stages of ripening when the first Pill is taken, it will not always be prevented from bursting from the ovary in the usual way. Most women find that the easiest way to remember to take a Pill every day is to take it on waking up in the morning or just before going to sleep at night. To help her, most of the packages in which the Pill is

distributed are either numbered or labelled with days of the week. Should she forget to take one, but remember within 24 hours,

then she will probably still be protected. But the minimal doses of hormone in the Pill do not ensure protection if the gap is longer than this. If the hormone level drops for, say, 48 hours, the pituitary will go into action to produce an egg. And there is little point in taking all the missed Pills in the hope that the extra dose will make up for those lost. Probably the best thing to do in this case is to leave well alone and let the period come. Some manufacturers suggest that adequate protection is not resumed

Failure rates Withdrawal 17% Rhythm 38% Diaphragm and chemical 10% Sheath and chemical 11% Chemical barriers alone 20—45% Intra-uterine O20 Douche 45-60% Pill 5%

until the seventh day of the next cycle, but medical opinion favours the argument that the two-hormone Pill starts to work at once. Research into the best possible composition of Pill and into the way it works did not stop once an acceptable solution to the problems of oral contraception had been found. Since the first Pills came onto the market, the concentrations of hormones in them have been much reduced. The present generation of Pills are about 10 times less concentrated than the first ones in general use, and 20 times less concentrated than the ones on which the first experiments were done. Other new methods include the development of a sequential Pill, in which oestrogen is given during the first half of the month and progesterone during the second half. This Pill mimics the body’s natural

cycle more closely than the two-hormone one. But should a woman forget to take one of these Pills, then she is much more likely to conceive. Absence of the second hormone makes the pituitary respond at once. Recent literature and findings have done much to increase reservations among women contemplating taking the pill. HE Pill is a dose of female hormone “compounded into tablet form. As a contraceptive it has a 99.7% record of success. Yet it remains a subject of controversy among women, doctors and theologians. It is the responsibility of individual women to take guidance if they so wish on the deeply held religious views that have been expressed about the Pill. Research into the Pill, however, is concerned with

the

physical

and

medical

phenonema

associated with it. By the late 1960s a doctor prescribing the Pill had more than 20 different brands to choose from. They differed mainly in the concentration of the hormones oestrogen and progesterone in them, except for the ‘sequential’ Pills in which oestrogen was given at the beginning of the month and both hormones at the end. Much of the variation is accounted for by the potency of the seven sorts of artificial progesterone then used by the pharmaceutical industry. Some Pills are weighted more heavily towards

oestrogen,

others have

a greater

proportion of progesterone. Doctors choose brands to suit the particular woman who is about to take the Pill. The choice depends in part on the total

dose of hormones and in part on the relative dose of oestrogen and progesterone. If a woman is underweight, the doctor would probably decide on a Pill biased towards progesterone. This sort of Pill would also be his choice if the patient has heavy periods, for doctors think that progesterone influences the rate of body metabolism and that it plays a part in reducing the build-up of the uterus wall in the body’s monthly preparation for pregnancy. Some women find that a low dose Pill does not control her periods properly, and that she experiences spotting or breakthrough bleeding in the middle of the month. For the sake of convenience and peace of mind she may need one of the higher dose Pills, but this is not necessary

for complete contraceptive effectiveness. In such cases the hormone level is not quite high enough to override the body’s own mechanisms. Where possible, however, all doctors will try to keep the dose as low as possible.

There is a reduced risk of side effects with a low-hormone Pill. However, it is the side effects and the fear of sideeffects that causes many women to reject the Pill as a method of contraception. Of all the Pill’s side effects, the most common is nausea and perhaps vomiting among women taking the Pill for the first time. These symptoms usually only last one or two days, and may not recur during the second month of Pill taking. If they do, they are unlikely to persist past the third month. Other widespread side effects are soreness of the breasts, irritability, cramp, vaginal discharge and weight gain. A doctor will be reluctant to prescribe the Pill to a woman who is already overweight, as some of the Pills on the market do tend to cause weight gain. But doctors are continuously trying to find the right Pill for the right person. Most women take the Pill under the supervision of a doctor, and persistent side effects, if reported to him, will allow him to change the type of Pill. Vaginal discharge, for example, may be due to the oestrogenic component of the Pill. A Pill with more progesterone in it will probably be successful in reducing the level of secretion. The Pill works in a way that mimics the state of pregnancy, and the side effects of the Pill are often the same as the symptoms experienced by the pregnant woman. This explains, at least in part, the feelings of nausea, especially in the morning. Some women find that the Pill causes brown marks to appear on the face. A similar colouration occurs during completely normal pregnancy, not only on the face,

103

but also round the nipples and on the abdomen. Doctors have found that the women who develop this skin pigmentation during pregnancy are the ones most likely to develop it while on the Pill. In

such a case, a doctor will recommend another form of contraception. UCH of the medical controversy about the Pill stems from the view that it may cause some diseases of the blood system and the liver. Most doctors agree that a relationship has been established between the Pill and the formation of blood clots in the veins (venous thrombosis). These clots may move round the body and block one of the body’s

Non-stop synthesis of the two hormones in the Pill. It takes four weeks of continuous processing to make artificial oestrogen: progesterone takes ten weeks.

104

arteries as clots called thrombo-emboli. When this happens the emboli may, in particular circumstances, cause death. But statisticians who have investigated the relationships between the Pill and venous thrombosis have published their results in different ways. One survey states that the risk of thrombosis: is increased three times by taking the Pill. Another said that women who use the Pill are nine times more likely to be admitted to hospital suffering from thrombo-embolism. A recent study carried out in Britain estimated that, of every 100,000 Pill users,

the Pill is likely to cause the deaths from thrombo-embolism of the lungs and thrombosis in the brain of 1.3 healthy women aged between 20 and 34 and 3.4 of the 35 to 44 age group. In the final analysis, a woman must decide whether she is prepared to take the risk. But to put the risk in perspective, the incidence of thrombosis in pregnancy, which is undoubtedly higher than that of the Pill, may outweigh the dangers of oral contraception. Even the risk of dying in pregnancy is larger than that of thrombosis caused as a direct result of the Pill, so it may; in fact, be safer to take the Pill than to become pregnant.

Many experts feel that the figures of the British survey give an over-optimistic view of the risk of thrombosis. Others feel that it is an accurate measure of the chance any woman takes when she decides on the Pill. Yet doctors are reluctant to recommend the Pill to women who have a family history of coronary thrombosis. As thrombosis takes many years to develop, still other doctors feel that there is insufficient evidence to lay all the blame at the door of the Pill, and would not be deterred from prescribing it by present estimates of the risk of thrombosis.

There is some evidence that the hormones of the Pill may interfere with the working of the liver. The Swedish drug authorities have received 150 reports of jaundice, a liver malfunction, from women taking the Pill, although none of the effects were permanent. Doctors are always careful to reduce the risks of the Pill toa minimum. They will strongly recommend a woman who has had jaundice to reject the Pill for many months, if not altogether, until it is absolutely certain that her liver is functioning normally. It should then be quite safe for her to continue taking the Pill unless the trouble recurs. Some of the Pill’s short and long-term

side effects may, in fact, be beneficial ones. For many women, the reduction in the length of the menstrual period and the reduced bleeding produced by the Pill is a worthwhile advantage. The blood loss. of a heavy period can be a factor contributing to iron-deficiency anaemia, so the decrease in menstrual bleeding can act as a definite aid to health. The hormones of the Pill reduce the build-up of the lining of the uterus each month, so there is less blood to shed. Should the Pill produce an increase in bleeding, the doctor will suggest a different brand whose hormone concentrations are more suited to the individual requirements of the woman concerned.

ee _

re Nit

thon

a

:

iss

1 Manufacturers must ensure that every Pill they make has the right actions on the human body. Samples are taken for long and shortterm studies on rabbits. 2 Absolute purity is the concern of

quality control departments. The hormones are dissolved in a special solvent and sprayed onto an absorbent sheet. There, the substances that constitute each hormone separate out. Further tests

will reveal any contamination. 3, 4 The physical properties of the newly synthesized hormones are examined. Here, density is investigated—an unchecked rise could lead to an overdosage in the Pill.

105

Normal cycle

pituitary gland

corpus luteum

lining of womb

cervical plug

pituitary gland

lining of womb cervical plug

a 106

day5

@ 00000008

The Pill, the pituitary gland, and pregnancy prevention. Month by month, throughout her fertile life, a woman produces mature eggs. At birth, all the eggs are formed in the ovaries, but they are not fully fertile. Under the influence of the pituitary gland, one ripe egg is released every 28 days. Carefully controlled by the pituitary, the female body secretes the hormones which prepare her for pregnancy. On the first day of the menstrual cycle, eggs are maturing slowly, and the ovaries are only producing small amounts of the hormone oestrogen. Triggered by the low oestrogen level, the pituitary produces a hormone FSH, or follicle stimulating hormone. As a direct result, oestrogen is released which acts on the lining of the womb and prepares it to receive a fertilized egg. Now another hormone, luteinizing hormone, LH, is released by the pituitary. This ensures that the ripe egg is pushed out around day 14. Once the follicle is ruptured, it turns into a hormone secreting structure called the corpus luteum, and releases progesterone. As oestrogen and progesterone levels rise, the pituitary ‘turns off’ the secretion of FSH and LH. Oestrogen has an effect on the plug of mucus through which sperms must pass on their way to the egg: it becomes nonhostile. Progesterone completes the preparation of the lining of the womb. If the egg remains unfertilized, the uterus lining is shed as the menstrual period on day 28. The 21-day Pill contains synthetic versions of female hormones oestrogen and progesterone. Similar to those secreted by the ovary in the _ usual monthly cycle, they inhibit the production of FSH and LH by the pituitary. Because FSH and LH are absent, no eggs mature, so conception is prevented. The first Pill is taken on the fifth day of the menstrual cycle. The oestrogen of the Pill causes some build up of the lining of the womb. Progesterone, on the other hand, alters the lining in some way so that even if conception did occur, implantation of the fertilized egg would be unlikely. Another effect of the hormone progesterone is to keep the plug of mucus thick, and, unlike that of the normal cycle, hostile to sperms. After the taken, been have Pills 21 the uterus lining builds up until it is shed as the period on day 28. Before the pituitary can start on the maturation of another egg, the first Pill of the next cycle is taken. in the late 1960s, scientists began work on a ‘Minipill’ containing only progesterone. The new, synthetic progesterone does not block norripen eggs so action, pituitary But the combined action is of mally.

the

hormone

and

cervical

nancy.

on

the

mucus’

uterus

lining

prevents”

preg-

Pains associated with monthly periods are diminished by the Pill. Physiologists think that the progesterone of the Pill damps down the contractions of the uterus at menstruation which cause backache. Sometimes the Pill will stop a period altogether. Again, the cause may be aslight imbalance of hormones. It is important that the doctor is told about this sort of occurrence, so that he can initiate a change takai There is medical evidence, too, that the Pill may help women during the menopause. The hot flushes characteristic of the middle age are caused by the pituitary overworking in an attempt to push the ovary into action. But any remaining follicles do not respond. If the Pill, or equivalent doses of hormone are given to the woman who suffers from hot flushes they will disappear as the hormones go to work to slow the pituitary down. Today, trials are being made to see if there is any real and longlasting improvement to be gained from taking the Pill after the menopause is over. The sequential Pill is used in these experiments because its action is closer to the natural action of the body. Many workers have found evidence that oestrogen and progesterone reduce the incidence of mental illness and help to keep the skin supple. Other, more unexpected benefits have also been discovered during the continued research on the Pill. For instance, the Pill seems to have a protective effect against cancer. Tests which involve giving animals progesterone suggest that it is this substance at work. In developing countries, too, cancer

of the cervix is distinctly less

common in women who take the Pill. The acceptance of the Pill by a wide cross-section of the world’s societies has heralded a completely new era in the field of relationships between man and woman. In the past, societies have been ruled by laws intended to regularize the procreation of the species through marriage. Now, for the first time men and women are free to choose not only the size and timing of their families, but whether they will have any children at all. Some people reject the Pill because they feel its near-total effectiveness is unacceptable. To them the possibility of becoming pregnant, however remote, is preferable to absolute security. Some sociologists are concerned that a Pill freely available to all women will lead to an increase in promiscuity among the unmarried and among the married to more sexual relationships away from marriage. In addition, there is evidence that venereal disease is increasing among students. This may be a direct result of the Pill. Against it must be measured the efficiency of the Pill in guarding against unwanted offspring. Up to 20 years ago, many countries were officially opposed to all methods of

birth control. Today, attitudes have changed so radically that some nations, among them India and Turkey, actively encourage men and women to practise birth control. A new economic awareness has made both governments and people realize the power of contraception to control the size of populations. The population of

Turkey,

for example, doubled in the 30

years up to 1967. The Pill fits into this picture of changed

attitudes, and it is offered to women in India and Africa as a method of contraception. There are, however, economic drawbacks to the Pill. It is the most expensive of all contraceptive methods: the average cost in America is between one and two dollars per month, in Britain it is from six to ten shillings. Added to this the Pill can lose its effectiveness if forgotten for even a single day, or at most two days. ESPITE the undoubted success of the Pill, research is still going on in an attempt to eliminate the failure rate of the Pill through forgetfulness. In one set of experiments, the hormones that make up the present Pill are injected into a woman once a month. The injection is made into the muscles of the hip and the hormones are released into the bloodstream. The amount released each day is exactly equivalent to the amount taken ina daily Pill. Scientists have found that the chief problem with this method is perfecting the system of hormone release. If too much hormone is given at the start of the month, by the nineteenth day it will all be used. This means that a woman cannot be sure of absolute safety against conception. Efforts to reduce the total amount of hormones given each month to a woman on the Pill have led to research on a ‘Minipiil’. The Minipill is taken every dayof the year and so eliminates many of the forgetful errors of the 21-day Pill. This Pill has been put on trial with great success in New York. Of a group of 600 women, many of them

illiterate, only eight failed to follow

the instructions to take one Pill every day. Of 1,328 women taking part in trials in America, Britain and Mexico, only 10 pregnancies occurred in a total of 7,002

Pill-taking months. The Minipill only contains one hormone: a new synthetic progesterone-like substance. Because there is no oestrogen, eggs are released from the ovary in the normal way each month, but the constant presence of progesterone prevents fertilization and implantation. In this way,

the pituitary function is not altered as with the 21-day Pill, for probably the oestrogen component of the 21-day hormone treatment causes the chief interference with the working of the pituitary gland. Scientists are particularly interested in the apparent reduction in the risk of thrombosis with the Minipill. In all the tests

107

1 Temperature tests complete the Pills Here, quality. on control which melt at 201 to 206 degrees centigrade are being studied. Contamination may change the melting point. 2 Now the hormones can be compounded into tablets by _ this machine at a rate of 2,000 Pills per minute. Next they will be coated with sugar. 3 Pill packing is carefully supervised. Each Pill is enclosed in a small vacuum within an aluminium pack. 4 The tablets are regimented in rows and fed into packages.

carried out so far, over a period of three years,

at the end

of 1968

no

cases

of

thrombosis had occurred. Even more encouraging are the results of tests on blood samples. The new progesterone developed for the Minipill seems to reduce the speed of clotting significantly. Furthermore, the tissues lining the uterus appear to undergo no significant medical changes. ESULTS with the Minipill suggest that it may be an acceptable answer to many women who have rejected the Pill because they feel it was interfering too much with the normal body mechanisms. Still other research, with variable results, is being done on a Pill which is taken only one day a year and on a Pill

which will act as an efficient contraceptive ‘the morning after’. Tests have not been going on long enough for confident predictions to be made about them, but scientists working on the ‘once a year’ Pill find that rats given this Pill have been protected against conception for nine consecutive months. Because the Pill for women has been so successful, scientists have been exploring the development of a Pill for men. They have tried to produce a chemical which will prevent the growth of sperms to full maturity. Such a Pill should be possible in theory, but so far, no simple and effective answer has been found. The hormones used in the female Pill prevent the development of sperms, but at the same time, they have an adverse effect on other aspects of masculine physiology. In America, experiments on a Pill for men have been carried out in volunteers from a prison. Although the drug preparations proved effective in stopping sperm maturation, when doses were repeated on subjects who were free to drink alcohol, the drugs produced vomiting and distortion of vision so severe that the use of such Pills was immediately ruled out. It seems that alcohol and the drug were totally incompatible. The Pill is undoubtedly one of the success stories of modern science. Apart from irreversible sterilization it is the most effective method of contraception available today. Scientists fully realize the drawbacks and disadvantages of the Pill. There is undoubtedly a risk, albeit a small one, of thrombosis, and because of its comparative novelty, there is no evidence about the Pill’s effects when taken for 20 years or more. And to some women, persistent and unpleasant side effects may act as a permanent deterrent. Modern medical research is striving to find a completely safe oral contraceptive which is, at the same time, completely effective in preventing pregnancy. There is every chance that they will be successful, and that women of the twenty-first century will have a large range

of safe Pills to choose from.

108

Sterilization As‘a means of preventing pregnancy, sterilization has a 99.99% record of success. Despite its airoffinality, voluntary sterilization is growing In popularity.

1 For a woman, sterilization can mean a week in hospital. The sur2 geon makes an incision in her abdomen and locates the fallopian tubes, the ducts down which a ripe egg passes every month. An inch is taken out of the tube, A, and the cut ends tied tightly together. Or each end can be tied off separately and ‘buried’ in the surrounding tissue. in a third variation ,B, the corner of the uterus is removed, plus part of the fallopian tube. Again, the cut ends are tied and buried. 2 In the man, two passages, each one called a vas deferens, transmit mature sperms from the testes. In the operation for male sterilization these tubes are cut and both ends overlapped. Then they are securely tied. The doctor makes a cut less than an inch long on each side of the sacs enclosing the testes. The vital sperm-carrying tubes are thus exposed. Because of their accessibility, the whole operation takes only a few minutes. The small scars soon disappear.

F all the methods designed to prevent pregnancy, voluntary sterilization is the most effective. It is also the most drastic. But for the couple who have decided that they want no more children, or feel they should not have a family for medical reasons, sterilization may be an acceptable answer to their contraceptive problems. In ancient times, women in countries as far apart as Australia and Egypt had their ovaries forcibly removed as absolute protection from child-bearing.

Today, the operations performed on men and women are done with the full consent of both husband and wife. Modern methods are speedy and safe. They involve blocking, or, more usually, cutting, the transport tubes that carry sperms in the man and eggs in the woman to the site of conception deep inside the female body. In the course of nature, women are made sterile by the menopause. Men do not become naturally sterile until they reach 80 or over, if at all. Both sexes can become

i

1 vas

! deferens rl

109

sterile incidentally as a result of certain operations undertaken for other reasons: women, for example, by removal of the womb or hysterectomy; men, by removal of the prostate gland or prostatectomy. The prostate is the gland which secretes a thin fluid, part of the semen, which stimulates the swimming powers of sperm. Obviously a man can be made sterile by removing his testes, the organs which produce the sperm cells. Similarly a woman will

become

sterile

if her

ovaries,

the

organs which produce the egg cells, are removed. Needless to say, operations designed to achieve primary sterilization, that is, sterilization as an end in itself, do not invoke such drastic and mutilating

110

procedures. In skilled hands the sterilization of either a man or woman is safe, simple, and in neither case is it a long or painful ordeal. The operation for sterilization of a man is quick and reasonably easy. The testes hang in a pouch of skin known as the scrotum. Each testis is connected to the inside of the body by a structure known as the spermatic cord. One of the constituents of each cord is a thin, hard tube called the vas deferens through which the sperms travel at ejaculation. These tubes, the vasa, can be felt under the skin on either side of the scrotum. The surgeon, therefore, can expose them merely

by cutting through the skin of the scrotum without having to open up the abdomen. Having located the vasa and separated them from the other structures within the

spermatic cords, the surgeon divides and removes a portion of each, then he ties the cut ends. The surgeon may leave it at that but most doctors now think it wise to overlap the cut ends and tie them together, making it virtually impossible for them to rejoin. The operation, known as vasectomy, takes about 15 minutes from start to finish. Some surgeons perform it under a general anaesthetic, in which case the patient must stay in hospital for some hours, or possibly overnight. Other surgeons operate under a local anaesthetic,

1 Location Bombay: crowds massed for a religious festival symbolize India’s population problem. In 1968 Indian statistics read: ‘total numbers 528 million, birth rate one child every two seconds’. 2 Facts and figures about population are used as part of the Indian campaign to promote birth control. Sterilization is by far the most popular method. It outnumbers the insertion of intra-uterine devices by three to one. 3 Queuing for the surgeon’s attention, each man clutches a signed consent form. 4 Because many of the volunteers are illiterate, the thumbprint serves as a substitute for the signature. 5 Once registration is complete, the operation can proceed. At the Bombay central sterilization clinic, the doctor takes about fifteen minutes to complete each vasectomy. 6, 7, 8 One man’s story is told in these three pictures. Munshi Ram

was

married

in 1951.

5

By 1967 he 6

had seven children, three girls and four boys. He looked and felt far more than his 40 years. Encouraged by doctors, he decided on sterilization. Afterwards, he counts out his 30 rupees, the payment made to all men who undergo the operation.

in which case the patient is allowed to go home an hour or two after the operation. Thus a man sterilized on one day, may well be fit to resume his normal occupation on the next. Many men worry about the effect of sterilization on their potency, but the outward appearance of the male fluid ejaculated is quite unchanged by the operation of vasectomy. The reason for this is that by far the greater part of the seminal fluid is secreted by special glands inside the body, the seminal vesicles and the prostate, and the sperm cells only make up a very small proportion of it. After sterilization, the sperm cells are held back by the blockage of the tube. They are discharged as usual

at the time of orgasm but, as they cannot get out, they die and, like any other dead cells, are absorbed into the bloodstream and destroyed, causing no ill effects. To the naked eye there is no difference in the appearance of the fluid before and after vasectomy. But if, at an appropriate interval after the operation, the fluid is examined under the microscope, it will show up as completely sperm-free. OMPLETE absence of sperms does not come about immediately, because some sperms may be lingering in the part of genital tract above the block. These have to be emptied out by repeated ejaculations and may take several months, during which time other contraceptive precautions are necessary for absolute safety. For pregnancy can occur if there are only a few sperms present. Two consecutive, completely negative, sperm counts must be obtained before the semen can be guaranteed sperm-free. The first count is taken about 12 weeks after the

operation,

the

second

two

to three

weeks later. If both are negative, contraceptives may be abandoned, but, if not, further counts must be done until two con-

9 Wall charts help a well-informed / secretary to explain the various methods of contraception. Sterilization is promoted as a worryfree, totally effective method. The operation is explained in detail, and young men like this one are reassured about the safety of vasectomy. In a special birth control drive held during 1968, more than two thousand sterilizations were performed every day fora fortnight.

~

secutive negatives are obtained. Some men take longer than others to achieve this state of aspermia, the word doctors use for the complete absence of sperms. But the reason for the variation is not known. The precaution of ensuring that aspermia has been achieved may seem troublesome but it is well worth while if failures, that is, unwanted pregnancies, are to be avoided. The corresponding operation for fernaale sterilization

is longer, more

gectomy, makes sterility certain.

ECAUSE a woman normally produces BRonly one egg during each monthly cycle, she becomes sterile immediately after this operation. The only two provisos are that an ovum has not escaped from the ovary and travelled down the tube before it is blocked, or that the woman

is not already pregnant at the time of the

Pee 2 See

La] ae

112

complex and

involves making an opening into the abdomen. The gynaecologist first locates the fallopian tubes on either side of the womb. It is these tubes which lead from the ovary to the uterus and down which mature eggs pass. Next he divides them. He usually cuts away a portion of each tube, ties the cut ends securely and buries each one below the membrane that surrounds them called the peritoneum. Some gynaecologists crush the cut ends as well as tying them, an operation known as tubal-ligation. Other gynaecologists go even further and remove the tubes completely, leaving the ovaries intact. This operation, known as salpin-

Ce

|

Indian hospitals are always crowded, and three or more doctors have to work together in sterilization units. The Indian Government makes special grants to hospitals performing more than 175 operations each month. The money is used to build theatres devoted to sterilization. Indian workers are awarded annual prizes for outstanding contributionstothe family planning programme. Private firms allow their factory walls to be used for murals, and exhibitions explaining sterilization, as well as other methods of birth control, are held throughout the country. The aim is to halve the birth rate by 1975.

operation. Since for a woman a general anaesthetic 1s necessary and the operation involves opening the abdomen, she will have to stay in hospital for about as long as she would have to stay for the removal of her appendix. New methods are being developed, however, in which no incision into the abdomen is necessary, and which require only 48 hours in hospital. Are the operations of sterilization reversible? This is a question commonly asked. The answer is that, in the male, the chances of reversibility are at present not much more than 50 per cent. In fact not many seek restoration to fertility. Nor do many women since they are sterilized mainly for therapeutic reasons, that is, for the surgical treatment of a disease, or else to prevent further pregnancies which might jeopardize their health or even their lives. The physical after-effects of sterilization are minimal. Provided, too, that the couple has considered all aspects of the matter before either party submits to operation, psychological after-effects occur only rarely. Indeed, with the fear of pregnancy completely removed, there is often psychological improvement and an enhancement of marital harmony. There is certainly no physical change as a result of sterilization by vasectomy. Nor is there any loss of virility, for no organ has been removed. Similarly, there is no diminution of sexual response in women sterilized by cutting the fallopian tubes. Certainly there is no artificial menopause, because the ovaries are left undamaged and intact. Many couples who seek sterilization belong to the 30 to 40 age group, and have two or more children. They have decided that their families are complete and are dissatisfied, for one reason or another, with conventional methods of contraception. There are other couples, such as those in which the wife has experienced difficulties during pregnancy and labour, couples in which there is Rhesus incompatibility, or those in which either partner has a family history of disease. These couples may be quite young, perhaps in their

twenties, with only one or two children. There are also certain childless couples: who are anxious not to breed because one or the other of them is suffering from an incurable disease, such as disseminated sclerosis. Other childless pairs may have reason to think that they could transmit a hereditary disease. Yet another group is made up of those who have married comparatively late in life, perhaps for the second time, may have children by a previous marriage and are anxious not to start another family. A small group of quite young couples with small families seek sterilization purely for economic reasons, feeling that they cannot give a fair chance in life to any more children than those they already have. Single men and women seldom seek sterilization and would be allowed to be sterilized only in exceptional circumstances. In the United Kingdom about 20,000 women are sterilized yearly, but the reasons are largely therapeutic rather than for effective birth control. It is now a growing practice among gynaecologists to offer sterilization to what are called grandes multiparae, that is, women who are highly fertile and at the same time exhausted by repeated pregnancies. In such cases, but of course only with their consent, sterilization is often carried out while these women are in hospital recovering from the birth of their last child. More and more perfectly healthy men, with the full consent of their wives, are turning to vasectomy as a method of limiting their families. There are reasons for this. Firstly, once a man knows how to proceed, vasectomy is much more easily attained for him than tubal-ligation would be for his wife. A second reason is that,

when the comparative simplicity of the male operation has been explained to the couple, most husbands opt for vasectomy. They are ready to undergo this comparatively minor operation rather than let their wives submit to a major one. In Britain the vasectomy operation cannot be performed under the National. Health Service, unless it is done for therapeutic reasons, though many public spirited surgeons perform the operations for a fee of anything from five to 70 guineas. Naturally, if the operation is done under a general anaesthetic, the cost is greater. In America the: cost varies, but the minimum is about 200 dollars. TERILIZATION is a legal operation S in many countries of the world. Yet there are still people, some of them medical men, others laymen, who believe quite mistakenly that sterilization is illegal. Before Britain’s sterilization project was launched, the Medical Defence Union obtained counsel’s opinion. The outcome was a statement to the effect that an operation for sterilization was not unlawful

113

whether performed on therapeutic or eugenic grounds or for other reasons, provided that there was full and valid consent by the patient concerned. The Medical Defence Union, which is, rightly, a cautious body, then went further and issued a form of consent to primary sterilization. This it would never have done had there been any doubts about the legality of the procedure. Most surgeons and gynaecologists in Britain and America require such a consent form signed by both partners to the marriage before they will operate on either. The acceptance of sterilization as a safe and reliable method of birth control is gradually becoming more widespread. In Britain, it was first recognized as safe and reliable by the Royal Commission on Population of 1949 which included it among ‘all deliberate practices which have the effect of permitting sexual intercourse to take place while suppressing or reducing the risk of conception.’ During the past few years, mainly owing to the activities of the Simon Population Trust in Britain and similar organizations in other countries, the old taboos against male sterilization are rapidly disappearing. There is no stigma attached to it, and many men who have undergone vasectomy will discuss it freely with their friends and workmates. So will their wives. and other means, the operation popularized. HE first recorded voluntary |tinin the United States formed in the year 1897. now, there were no particular

By this, is being

sterilizawas perThen, as

hazards about it but it did not achieve immediate popularity, probably because of social and religious prejudice. Sterilization is carried out extensively in Pakistan, and in Japan it is presented as an alternative to abortion, a practice very common in that country. But it is in India that sterilization has been introduced on a vast scale. By the end of 1968,

more than 45 million male sterilizations had been carried out. Over two million of them were performed in the period from January to August of that year. In Britain, vasectomy is a fairly recent innovation, thanks largely to the initiative taken by the Simon Population Trust. Its Voluntary Sterilization Project was launched in May 1966. From day to day the project receives hundreds of enquiries from all sectors of society. Couples interested in sterilization are, first of all, sent leaflets and general information. If they subsequently decide that they wish to go further, they are advised to discuss the matter with their family doctor, since it is for him to refer them for sterilization, as for any other operation. An applicant cannot, of course, refer himself direct. If the doctor is sympathetic towards vasectomy and is in touch with suitable surgeons, he will refer the patient in the usual way, but it often happens that a doctor, though sympathetic, does not know of a surgeon to whom he can refer his patient. The director of the project can supply him with the name of an appropriate surgeon. In cases where the doctor, for religious or other reasons, does not feel himself able to refer patients for sterilization he will generally permit the director, himself a family doctor, to refer the patient on his behalf, so that there is no infringement of medical ethics. Definite figures show that at least 3,000 men have been sterilized through the mediation of the British project though the actual figure is much higher. Unless and until even better methods of ‘conventional’ contraception are discovered it is safe to say that sterilization will hold an important place among methods of birth control. Couples who seek it must decide whether or not to take a calculated risk. The very notion of compulsory sterilization remains unacceptable to any free country.

Hope for the childless couple The population explosion may seem to be the world’s most pressing problem, but to the childless couple, a baby is more than another mouth to feed. Today, medical skills can investigate and aid a wide range of causes of infertility.

HEN a husband and wife are both healthy and trying to have a baby, 85 per cent are successful in producing pregnancy within a year, and 65 per cent are successful inside six months. In an age when contraception is so widely practised, it is difficult to know how many married couples are infertile, but statisticians estimate that in about 10 per cent of marriages no children are born although the couple is anxious to have them. Childlessness can cause a great deal of unhappiness. And one special cause of unhappiness arises if a couple stop regarding their problem as one they share, and begin wondering who is to ‘blame’ for

VV

the situation. Of course, neither is ‘to blame’. But in many societies men tend not to imagine that the problem could be

solved if they took advice. Once a couple have decided that they want a family, the time they are prepared to wait before there is any sign of pregnancy varies greatly. Some may become anxious very quickly while others may stay childless for years before they seek medical advice. The variation probably depends upon the strength of their wish to have a family. There are some couples who never seek advice and who have mixed feelings when the wife finally discovers that she is pregnant. Other couples begin to get worried and frustrated if there is no sign of pregnancy after only a few months. Worry may lead to feelings of inadequacy in both partners and sometimes to mutual recriminations. Later the anxiety could cause sexual difficulties in both husband and wife which may, in turn, be very difficult to overcome. For conception to occur it is necessary that the husband should produce sperms and that the wife should produce an egg, most months, if not every month. There must be no blockage in the tubes which lead from the testes to the penis in the man, or those leading from the ovaries to the uterus in the woman. The wife’s uterus should be healthy and normally developed, so that the fertilized ovum can implant there and grow successfully to maturity. For the best chance of conception, intercourse should take place two or three times a week, especially round about the most

fertile time of the wife’s menstrual cycle, so that living sperms are in her genital tract, ready to meet the egg. As soon as a couple begin to get anxious about their inability to begin a family they should seek medical advice. The family doctor is the obvious person for them to consult, as he knows more about their general health, home background and personalities than anyone else. All these factors have to be taken into consideration in assessing the causes of infertility and deciding on suitable treatment.

The doctor may either interview the couple ‘together or separately. He will need to know if there are any past illnesses in either partner which might be a cause of infertility. Next will come questions about the marital relationship. Are there any difficulties with intercourse? Is intercourse occurring often enough to give the best chance of pregnancy? He will want to know whether the wife’s periods are regular and will advise on the most likely time of the month for conception to occur. He may advise her to take her temperature each morning as soon as she wakes. A chart of this will indicate whether she is producing an egg each month and show her most fertile days, for the temperature rises after an egg is released. In some cases the doctor will advise a couple to go on trying for another few months, in others he will refer them straight to a specialist who can perform more detailed tests. Some hospitals have special fertility clinics where both husband and wife can be seen. The couple, or the wife,

are instructed to attend close to the time of the wife’s ovulation. This is about 12 days from the beginning of the menstrual period in a cycle of 28 days. The specialist asks them to have intercourse during the night preceding their visit. The doctor takes a case history which includes age, date of marriage, and length of time they have been trying to have a baby. Usually the wife is first to be examined. The doctor takes particulars of her previous illnesses as some of these may possibly have affected her fertility. Illnesses that may arouse his suspicions include tuberculosis, which occasionally settles in the pelvic organs, appendicitis or other abdominal operations. Peritonitis, in particular, may damage the Fallopian tubes. A previous miscarriage, and especially an illegal abortion, may also affect the tubes in a way that makes conception difficult or impossible. Among the ,venereal diseases gonorrhoea can also cause infertility. Details of menstruation are important. If a woman was late in starting her periods and these are irregular or infrequent, she may have some glandular disturbance and be ovulating irregularly. UESTIONS are followed up with a ()eeais examination. If the wife is overweight this may indicate a glandular upset. On the other hand she may seem immature and poorly developed. A routine medical examination will ensure that she does not suffer from any illness which would make pregnancy inadvisable. The pelvis is examined to make sure that every organ is healthy and normally developed. Next in the routine, a little mucus is taken from the mouth of the uterus and is examined under the microscope. If the mucus is healthy, intercourse normal and

115

Injected with special oil, the uterus and Fallopian tubes are seen on an X-ray. Fluid has built up in the lefthand tube which is blocked at the uterine entrance. the husband fertile, active sperms should be present many hours afterwards. If the test is positive, it is not usually necessary

for the husband to be examined. Doctors have a test to investigate the integrity of the Fallopian tubes. A narrow instrument is passed into the uterus and carbon dioxide gas blown through it ata measured, controlled pressure. If the tubes are normal, gas will pass through them in waves. These waves are due to the contraction and relaxation of the tube walls. If the tubes are open but damaged, gas may pass through at a higher pressure and without normal waves. Gas cannot penetrate closed tubes. Its pressure will rise and none will pass through them. These tests called tubal insufflations are done without an anaesthetic and rarely cause more pain than may be experienced during a normal period. If tubal insufflation is unsatisfactory, or the patient has a history of some previous illness which may have affected her tubes, the doctor will usually advise an X-ray. This is carried out in the same way as the insufflation except that a small amount of X-ray opaque fluid is injected. X-ray films produce a picture of the uterus and tubes. Any abnormality in either, which might make conception difficult or impossible, will show up clearly. ROVIDED the patient has been keepPp ing a morning temperature chart, the specialist will have a good idea whether she is producing an egg each month. Further proof of this in doubtful cases can be obtained in two ways. The doctor samples a very small piece of the

lining of the uterus just before the period is due. At this time it should have reached its maximum development. Microscopic examination will tell him whether it is healthy. He will also know whether it has reacted to the production of an egg during that month by changing in the way essential for the successful implantation of a fertilized ovum. Before ovulation and following it, the vaginal lining reacts to the hormones produced by the ovary. If weekly smears are taken from the vagina these changes can be checked under the microscope. Although these examinations and tests are designed to diagnose the reason for failure of conception, the tubal tests may themselves sometimes help to clear the tubes. An unsatisfactory outcome of the mucus examination plus fertility in husband and normal intercourse may mean that the sperms are unable to survive in the wife’s cervical mucus. The mucus may be scanty and tacky, or it may be infected. In the first case, small doses of female hormone taken during the first half of the menstrual cycle may produce a good flow of mucus and sperms will be present in the next test. Infection can be successfully treated with antibiotics, or by cauterization of the cervix, a process in which the surface layers are burnt off, which may make it more healthy and receptive to the sperms. If the tubes are blocked an operation is sometimes advised to attempt to openthem. At present, the success rate ofthis operation is not high. Usually, it is only reeommended as a last resort for those who are anxious for everything possible to be done.

Je)sy93101 (I0Y CO edad GARDS What chance fertility? Doctors agree that the odds depend on the cause of infertility. Sometimes it is easily cured with drugs or simple treatment. But a woman may have to decide between consistently low odds and complex surgery.

Cervical mucus that is scanty, tacky or infected can block sperms. Treatment with hormones or _ antibiotics is often successful.

Blocked Fallopian tubes stop the release of eggs. Often obstructed by miscarriage, tubes may be cleared with suitable injections.

A uterus misplaced by illness forms a physical barrier to fertility. Surgery is the only hope, but its success is uncertain.

Morning temperature charts help a woman find her most fertile days. Combined with drugs, these may combat monthly irregularities.

Hormone treatment aids the woman whose ovaries pro-

duce no eggs. But the amount has to be finely adjusted for success.

sat? Good chance of success after treatment, but surgery less successful Least chance of success and perhaps permanent infertility after treatment Moderate chance of success after advice Failure to conceive can be the result of tension. Professional psychological treatment may remove fears and lead to fertility.

In a uterus that has been the site of TB, implantation may be impossible. Hormones can help, but often the uterus is unreceptive.

and treatment

Possible success after

psychiatric treatment

qa.

A failure to produce eggs can he a cause of infertility. It may be associated with irregular periods, infrequent periods or none at all. If accompanied by obesity, reduction in weight may improve matters and in every case is desirable on the grounds of general health. Some simple hormone treatment can be an effective cure if the patient lacks hormones secreted by the thyroid gland and the ovaries. For severe cases, doctors often prescribe a drug which will stimulate ovulation. If the patient is already having her period she will take one tablet a day from the fifth to the ninth days of the menstrual cycle. If she is not menstruating the doctor will choose a suitable time to start the course. The treatment is successful in stimulating ovulation in about a third of patients,

provided

that woman

and drug

are both carefully chosen. newer development has been the proa duction of a hormone which will stimulate the ovaries even more effectively. The hormone, extracted from the human pituitary gland has been in very short supply, and in 1969 was only available in a very few places. The treatment can only be given under specialized medical supervision in a hospital which has facilities for complicated and frequent biochemical tests. Such tests may have to be done every day so that the exact dosage of the drug can be estimated. The difference between an ineffective dose and one that will over-stimulate the ovaries so that they produce many eggs at once is extremely small. Even with this exact supervision, excess doses have been given. The Distressed by their failure to have a family, this couple have sensibly sought advice while they are still young.

118

result is that women have conceived several babies at once. Many of the pregnancies have resulted in miscarriage, but the birth of sextuplets in 1968, all of whom were

premature and very small, and three of whom did not survive for very long, is an example of what may happen. That three of the babies were healthy and that the

mother experienced no damage to her health is a great credit to everyone concerned. But these hormones can only be used when infertility is due to failure of ovulation, and when the woman is perfectly healthy. If no sperms are found in one or more post-coital tests taken from the wife and her cervical mucus appears to be healthy the doctor will either suspect that intercourse is not occurring properly, that the husband is not producing enough sperms, or that the amount of semen is too small for the sperms to be deposited in the cervical mucus. In any of these cases the husband should be examined by a specialist who will probably recommend a semen test. For this the husband produces a specimen of semen into a sterile jar. The specialist then examines the specimen within three hours.

He

measures

its volume,

which

should be approximately three to five cubic centimetres, and the number of sperms per cubic centimetre are counted. Normally there should, if the husband is highly fertile, be at least 100 million sperms in each cubic centimetre, although conception can occur with a count of considerably less than this. The mobility and shape of the sperms are examined in detail. The doctor will then enquire about any pre-

vious illness that might have affected the man’s fertility. Mumps after puberty may damage the testicles and venereal disease can affect the reproduction system. An operation for a hernia can damage the tubes which run from the testicle to the penis, or surgery for undescended testicles may suggest infertility. Diabetes, tuberculosis

and

fibrocystic disease,

too, can

result in infertility. Obesity may indicate a low level of fertility due to a glandular upset. Finally, the doctor makes a thorough

general medical examination. There was in 1969, very little that could be done to help the husband a doctor suspected of not producing sperms. Attention to general health, including reduction in weight and treatment with hormones, can sometimes help to raise a low sperm count. If a man’s testes appear normal, yet there

are no sperms in the semen, he will suspect a blockage in the duct leading from the testes to the penis. Surgery may seem the obvious answer. During the operation, the surgeon will confirm that sperms are being produced and try to overcome the blockage which prevents them from being released. Like the one attempting to restore a woman’s tubes, this is a very delicate operation, and is only successful in a small proportion of cases. For some three per cent of patients seeking advice on infertility, the cause will have its roots in the marital relationship. Difficulties with intercourse are fairly frequent, especially during the early months of marriage, and are nearly always psychological in origin. Men and women who are not highly sexed tend to be attracted to each other and may live quite

Taking X-rays is part of the routine for examining the wife. Doctor and nurse study the results as they appear on the screen. Any physical barrier to fertilization in uterus or Fallopian tubes will be clearly shown.

119

happily together with little more than a brother and sister relationship until they want a family. Then a problem will arise. In many cases a frank talk with the family doctor or another sympathetic person may help a great deal, but when the problem is more deeply seated some form of psychotherapy will be necessary. When the trouble seems to stem from the wife, when she is afraid of intercourse or of being hurt, a consultation, very often with a woman doctor, will allow her to bring her fears to the surface and help her to get rid of them. If the problem seems to lie with the husband, similar treatment, usually from a doctor of his own sex, may be of

great help. Despite treatment, the husband may still remain impotent. In this case, artificial insemination by him may occasionally be considered, but it is only advisable if the psychotherapist agrees that, in spite of its difficulties, the marriage is a happy and stable one and that the couple will make good parents. Before artificial insemination can be done it is essential that the husband can produce a specimen of semen that is normally fertile. The wife must be healthy and apparently fertile. The specialist will tell her to keep a temperature chart for a few months to find out when she is most likely to conceive. Artificial

Louise was conceived with the help of a female hormone. The hormone

stimulated inactive ovaries into producing a viable egg each month.

120

insemination,

that

is the

injection of semen into the wife’s vagina by means of a syringe, may be carried out by the couple themselves, or by a doctor. In either case the husband produces the semen into a jar just before or at about the time of the wife’s ovulation. If both partners are normally fertile the chances of pregnancy resulting from artificial insemination by the husband are good. A high proportion of men whose wives become pregnant by this method find that their difficulties with intercourse diminish and that they are able to have further children without any medical help. When the husband’s sperms are defective, the couple may seek artificial insemination by a donor.

|HE

study

of infertility

in human

beings is a relatively new one, and most fertility clinics are less than 30 years old. Infertility is often preventable. Twenty years ago a small proportion of men and women were left infertile after a tuberculous infection. This has now been very much reduced by routine vaccination. Some cases of infertility in both men and women are due to gonorrhoea. Its early recognition and treatment should help to prevent them. Appendicitis and peritonitis in young girls and women may cause infertility by damaging the pelvic organs. Again early treatment will guard against infertility. Abortion, particularly if induced illegally, is often associated with infection which may block the tubes and make a woman sterile. Now that, in some countries, abortion can be done legally and in hospital, many doctors hope that the number of illegal abortions will be reduced. Boys born with undescended testicles should have specialist treatment before puberty if they are to have a reasonable chance of fertility. Hormone treatment for the failure of ovulation is still in its infancy. Synthetic hormones are only effective for a few women, but it is possible that the more effective hormones which can only be extracted from the human pituitary gland will eventually be produced in the laboratory. There is, as yet, no treatment which can be relied upon to increase the production of sperms in infertile men. Nevertheless, it is possible that hormones will be found which will act effectively on the sperm-producing tissues in the testicles. The surgical treatment of infertility in both men and women is still relatively new. As doctors gain more experience and surgeons perfect their techniques of operation, the chances of success should improve. In spite of all these possibilities there will still remain some incurable cases. Even so, many childless couples will be grateful to a considerate and sympathetic doctor who has been frank enough to tell them that nothing further can be done.

Artificial insemination Parenthood Is one of nature’s strongest instincts. For the couple who are childless, artificial insemination may be available to fulfil and complete their lives.

| [coures hard they try, some couples who wish to have children fail to do so. Though a man’s pride in his sexual prowess makes it difficult for him to accept any suggestion that the cause of the failure may lie in him, there are a number of factors which give rise to male sterility. For example, a man may not produce sperm at all. This may be due to a malfunction of the testicles which prevents the production of sperm, or it, may be a malformation — a blockage or a naturally caused crimping of the vasa deferentia, the tubes by which the sperms make their way from the testicles to the sperm reservoirs or seminal vesicles. Or he may make insufficient seminal fluid, which is produced by the seminal vesicles and a gland called the prostate. Without this fluid sperms do not become mobile. His seminal fluid may have a highly acid content which quickly kills or maims the sperms when they come into contact with it. Poor quality sperms will lack the energy they need to propel themselves on their long journey from the vagina, through

the womb to encounter the woman’s egg in the Fallopian tube. Too few sperms will greatly reduce the chances of successful fertilization, and some men may produce no sperms at all. The normal healthy male ejaculates at one orgasm between three and five cubic centimetres of semen in which there are between 300,000,000 and 500,000,000 sperms, only one of which will fertilize the female egg. Men may also suffer from retrograde ejaculation, in which the semen is forced backwards into the bladder. Sometimes the acid content of awoman’s vaginal secretions is so high that sperms are killed before they have time to move from the vagina into the womb, and nothing can be done satisfactorily to counteract the acidity. There may also be other reasons for sterility which spring from the interaction of male and female causes. The most common of such reasons is Rhesus incompatibility. When a couple’s blood groups are incompatible, babies may die at birth or be destroyed while they are stillin the womb. But these are the exception, and this sort of trouble occurs in less than two per cent of

1 Building up a sperm bank, in a1 university’s zoology department, where semen can be kept frozen for years, the laboratory technician examines a ‘cane’ that holds six small ampoules of sperm. By her side is the grey can containing liquid nitrogen that forms the bank, and a simple thermos flask for the first stages of freezing. 2 Via a pipette, prepared semen, diluted, is transferred to an ampoule. The diluting mixture is designed to ensure maximum survival of sperms. Glycerine protects them during freezing; egg yolk ensures that the sample _ stays alkaline; sodium citrate and fructose mimic the natural secretions of the male. 3 To start the freezing process, the can with its full ampoules, each one meticulously date-stamped, is hung inside the thermos flask. In the bottom of the flask is a two-inch layer of liquid nitrogen. This gradual, preliminary temperature drop is vital to success, for sperms shocked by sudden cold will be killed instantly. 4 To find out how sperms stand up to freezing, samples are thawed out after periods that vary from a month to several years. Each ampoule is dropped into warm water and left for five minutes. Tests will show how many sperms have survived. Experiments like these are designed to help childless couples through artificial insemination.

121

A man’s testes produce so many millions of sperms that normally 30 per cent are deformed. But a proportion of 50 per cent defectives can mean infertility. 1 The twin-tailed sperm has its swimming powers reduced. The tails lash against each other and the sperm is immobile or swims only very slowly.

2 The bullet-headed sperm is also sluggish, and has no sense of direction. In both 1 and 2, sperms froma donor may fertilize the egg. ;

3 Three normal sperms are trapped in a cell from a woman's cervical mucus. Conception may succeed if the husband’s sperms can be injected past the mucus plug.

iz22

4 If sperms are few, then the chances of conception are low. A normal number shows up like this under the high power lens of the microscope.

5 Onthesame magnification, alow sperm count reveals only one.

6 Toreach an accurate assessment, sperms can be counted ona grid. Here they have been diluted, and are seen enlarged 350 times. Each sma!l square contains one four thousandth of a cubic millimetre of fluid. There is an average of two sperms per square, and the sample is diluted 200 times, so in the 160 there were semen original centicubic per sperms million metre —a normal number.

marriages where there is Rhesus incompatibility. More serious, perhaps, is a family history of congenital disease on the male

side, which would deter a couple from having a family of their own. For many of these causes of sterility and the barrenness that goes with them, there are a number of remedies. Physical defects in both male and female can often be put right by surgery, and normal conception can then take place. For those that cannot be treated, and provided the woman is organically sound, the difficulty may be overcome by artificial insemination, known as Al for short. Artificial insemination is a way of bringing about conception by mechanical means instead of normal sexual intercourse. Semen is injected into the woman, usually by a doctor, using a syringe or some other instrument. Though it has only come into comparative prominence in recent years, artificial insemination has quite a long history. There is a reference to it, ina hypothetical case which a student put to a rabbi, recorded in the Babylonian Talmud (sixth century A.D.). The student posed the question: supposing a woman went swimming in water in which semen had been ejaculated, and some of the semen found its way into her vagina and she conceived, would the woman be guilty of fornication? The rabbi replied that the insemination would be accidental and that, therefore, the woman’s innocence would be unimpaired. HE recorded history of animal AI goes back several centuries. An Arabic story of 1322 recounts how warring tribes injected their enemies’ thoroughbred mares with semen from inferior stallions. In 1780, Professor Lazzaro Spallanzani, of Pavia University, published a paper on his experiments with dogs, and Ivanov, the-Russian physiologist, made out a strong case for artificial insemination in animals in his book of 1907. In the late 1780s John Hunter, an English surgeon, reported a_ successful experiment on humans, in which he had injected semen from a man suffering from a congenital defect of the penis into the wife, who then conceived. In 1866, an American, Marion J. Sims, carried out an experimental series of 55 inseminations, in which he injected the husband’s semen into the womb. He had only one positive success, and he blamed his failures on the imperfection of his methods. From 1890, however, another American, Robert L. Dickenson, began to practise artificial insemination regularly. There are two categories of Al — artificial insemination using the husband’s semen, known as AIH; and artificial insemination by a donor, known as AID. Artificial insemination by the husband is

124

used where the woman acts as a chemical barrier to sperm and the husband’s semen is normal and healthy, or if he is physically incapable of ejaculating his semen into the vagina in normal intercourse, AID is used where there is a defect in the man’s sperm — if it is of poor quality or not sufficiently mobile, or he produces

no sperm at all — or if there is a history of serious blood group incompatibility. Artificial insemination is a very simple procedure. Since ordinary cleanliness rather than strict antiseptic procedures is all that is required, it is usually carried out in the doctor’s surgery. The woman is placed on a special gynaecological table and the vagina is extended by means of a special instrument called a speculum. A glass syringe containing the semen is inserted and the semen is deposited at the entrance to the neck of the womb. Sometimes a little is placed in the canal of the neck itself. Another technique deposits the semen actually inside the womb by means of a curved cannula fitted to the syringe. After the injection has been completed, the woman is kept lying on her back with her pelvis area raised, for 20 or 30 minutes. This is to help the semen to fall into the womb instead of trickling out of the vagina. _ Since insemination is so simple a procedure, it might be thought that it must succeed every time it is properly carried out. When, one considers the number of virgins who conceive at their first, often casual, intercourse and from that intercourse alone, it becomes all the more puzzling why careful artificial insemination procedures should fail. But they do. Several factors account for this. Doctors do not know exactly how long the human sperm lives in the vagina; it is thought they have a life of between 14 and 36 hours. Similarly, it is not known how long the female egg survives; it is presumed to be between two and 24 hours. In order for both natural conception and artificial insemination to succeed, the semen must therefore be deposited in the vagina as soon as possible after the egg has matured. This means that one ought to know the exact moment at which an egg is released from the ovary. But it is this ovulation which is most difficult to judge, for there is no reliable means of discovering when it takes place. There are a number of signs, but unfortunately not all women exhibit them. The most satisfactory of these guides is the change of temperature. Shortly before ovulation, the woman’s temperature drops and afterwards it rises slightly. Several tests have been devised to pinpoint these temperature changes, so far none of them have proved completely reliable. Usually, only the keeping of a temperature chart

The gynaecologist’s tray shows all the equipment for artificial insemination. He uses the glass tube at the back to widen the vagina, and the metal speculum on the right to open the cervix. The earliest inseminator has a black rubber end; both this one and the longer pink tube are easy to use at home. The newest instrument, right front, has caps attached which help to guide sperms for maximum chance of conception. Round the tray are all the preparations essential to hygiene.

Mere

for a period of several months is a reasonably reliable means of detecting ovulation. Despite this difficulty, however, the success rate of AID is quite high. Several injections are given at monthly periods and produce the following percentages: 30 per cent conceive in the first month, 18 per cent in the second and 18 per cent in the third, giving 66 per cent in three months, which can rise to 70 per cent or 80 per cent after six months. AIH is much less successful. Only 5-3 per cent of all attempts end in conception. LTHOUGH AIH presents few or no

a

problems from the practical, moral

and legal aspects, AID presents many. Practically, the donor must have certain definite and clear-cut qualifications. He must enjoy first class general health. He must be of the same race as the woman’s husband and should look as closely as possible like the husband. He must be absolutely free of venereal disease, must have a high degree of fertility and must be free from any psychological disorders. He must match the mother’s Rh _ factor. Another important requirement is a heredity free of all communicative defects and diseases. He should be of the highest moral integrity, and is very often a university student or graduate. In fact, the majority of donors are chosen from among

medical students. The responsibility for seeing that all these factors are present is the doctor’s. Usually he submits to the couple the fullest possible details, along the lines indicated above, of 10 to 15 donors. But the final choice is made by the couple. It is essential that the donor should remain anonymous. The practical considerations are the least exacting of the difficulties. The moral side of AID presents so many questions

vA

that the problem of making the decision can be almost insuperable for some couples. Insemination by donor means that the wife makes contact with the sex cells of a man who is not her husband, and this raises, in some minds, the question of whether there is any ethical difference between her receiving another man’s semen via his penis in intercourse, or via a syringe ina doctor’s surgery, or, a third possibility, via a syringe in her own home. HE courts have so far done nothing which might help solve the moral issues. No pronouncement has yet been made by any judicial authority about whether the offspring of AID could, in law, be accepted as the legitimate heir of the husband. Equally, the law has remained silent on whether a woman who receives the semen of a donor has in the eyes of the law committed adultery. Many gynaecologists see very little difference in law between the two sets of circumstances — insemination by donor condoned by the husband, and physical adultery condoned by the husband. The latter is rejected by the law as a ground for divorce, so there is logically no reason why AID condoned by the husband should be treated differently. However, though this may solve the problem as far as divorce is involved,

it does not solve the problem of legitimacy. But to remove all doubts about heirship and succession, there seems no reason

why the husband should not take steps to adopt the child born as the result of AID, making it his legally adopted child, who under most systems of jurisdiction would be recognized as a legal heir. There are also considerable psychological difficulties. Though the husband may enthusiastically give his consent to AID, he will know that the child is not his, and

125

this can, and often does, set off a chain

reaction of psychological change that damages the relationship of all three. To help overcome this psychological problem, gynaecologists suggest that the couple make love immediately before the injection of the donor’s semen is carried out so there would be a chance, however remote, that a child born as a result was his’ own. The husband could be psychologically prepared professionally beforehand to make acceptance more easy. Religious difficulties can also be paramount. Some Churches have laid down straightforward guidance for their members. The Roman Catholic Church objects to both AID and ATH. Collection of semen,

either by masturbation, coitus interruptus or in a condom, is immoral in the Catholic view. The only method which is approved by Rome is the insertion of a cervical spoon to help the semen into the cervix after normal intercourse has taken place. But this, of course, leaves out of all consideration the abnormalities of the male, either organically or in the nature of his spermatozoa.

The Church of England has given its approval to AIH, but despite the rejection of AID at the Lambeth Conference of Bishops in 1958, attitudes have become more flexible in the decade since then. The Swedish Church has taken the same line. There has been no Rabbinical pronouncement whatsoever.

126

Most of the remaining

Protestant Churches — especially in America — have thrust the responsibility firmly on their members by leaving it to individual consciences. Theoretically, the potentials of artificial insemination are immense, and its implications frightening. Though the freezing of human semen is still in the experimental stage — a successful insemination has been carried out with frozen semen after two years in the deep-freeze — the use of frozen bulls’ semen has been perfected by agriculturists and there is no reason to suppose that the difficulties which now confront those researching into the problem of human semen will not be overcome. When this happens, it will, at least in

theory, be possible to perpetuate whatever strains in the nation that the society of the time regards as the ‘best’ to produce a Master Race. The semen of geniuses in all fields could be kept frozen for an indefinite time, and periodically, in each generation, be used in the hope of producing the geniuses of the next. Artificial insemination on this scale could open the way to government control of conception. But in the late 1960s artificial insemination brought personal happiness to a great number of childless couples. People have benefited who would otherwise have felt unfulfilled as human beings because of their inability to take to its normal conclusions one of the strongest instinctive urges implanted in human nature.

Index Note: ‘p’ after a page reference indicates that there is relevant material in either the illustration or its caption on that page

Abortion: cause of infertility, 115, 119; family planning through, 92-3 Adolescence: awakening sexuality, 9-10, 28-9 and p; conflict situations, 83; ‘crushes’, 29 Anaclitic love, 41 Anima, in Jungian psychology, 40-1, 43p Appendicitis, cause of infertility, 115, 119 Arms, function in loving relationships, 22 Artificial insemination: by donor, indications for, 119 124; by husband, indications for, 119, 124; history,

124; in problems, success, 124-5 and

animals, 124; legal and moral 125-6; religious attitudes to, 126; failure rates, 124-5; techniques, p

Babies, effect on marital relationships, 58-9 andp Beauty, standards in 10-4 andp Bloch, Ivan, 75 Bonnie and Clyde, 88p

different

societies,

Clitoris, structure, functions, 63, 65, 69, 70-2, 78, 88, 89 Clothes, erotic functions,10, 12 and p, 13-4 and p, 26p Coitus interruptus, contraception by, 82, 95, 103p Computer-matching of men and women, 24p Conception, optimum time of sexual intercourse, 115

Condom, contraception by, 95 and p Conflict situations: characteristics, 84p; in adolescence, 83; in childhood, effect on adult relationships 83-5, 86; in homosexuality, 85; in marital relationships, 85-6 Contraception, contraceptives: different success/failure rates, 103 and p; effect of modern, on attitudes to sex, 18, 22, 27p, 28, 30-1, 107; modern methods, 91-2,

93-5;

primitive

methods,

102p,

also individual methods Corpus luteum, 97-100, 106p Courtship: emotional insecurities of, 37; rituals different societies, 33-5 and p ‘Crushes’, in adolescence, 29

Diaphragm, contraception by, 95, 103p Diosgenin, basis of the Pill, 97 and p

Breasts, erogenous zone, 10p, 69

Divorce:

p, 59-61 and p

Bunny girls, 82p Buttocks, erogenous zone, 10p, 67 Cancer, relation of incidence to Pill, 107 Caps, contraception by, 95 and p Castration complex, 45 Celibacy, for religious motives, 26 Cervical cap, contraception by, 95 Cervical mucus, relation to infertility, 115p,

116, 117p, 122p Cervix, cauterization of, 116 Chemical contraceptives, 95, 103p Child marriage, 53 Childhood, children:

effect of experiences, on adult relationships, 83-5, 86, on personality development, 48p, 49-50, see also Oedipus complex; problems of only child, 93p; rights over, in different societies, 51 a. Christianity: attitude of different denominations to family planning, 96, 126; teaching on e sexuality, 81-2 Church of England, attitude to artificial insemination, 126

50

Dioscorea,

source

of diosgenin,

contributory causes, increased rate, 56

67;

97

reasons

and

41-3, 45

Forel, August, 75 Freud, Sigmund: influence on attitudes to sex, 65, 75-8; on formation of love-relationships, 41-3; pe of infant sexuality, 9, 21-2, 28, -3, 45

Girls: first sexual intercourse, 77; masturbation by, 23, 28, 78, see also Masturbation; origins and growth of sexuality, 9-10, 28-9 and p, 37; relationship with father, 9, 28-9 andp

.

Gonadotrophins, 98-100 Gonorrhoea, cause of infertility, 115, 119 Guilt feelings, association with sex, 73-4, 79, 81-2, 83 Guns, association with fears of impotence, 88p

in

‘Dating’ customs, 36-7 and p Delinquency, relation to deprivation of love,

Boys: first sexual intercourse, 77; masturbation by, 23, 78, see also Masturbation; origins and growth of sexuality, 9-10, 37; relationship with mother, 9, 21 Budgeting, importance in marriage, 57-8 and

see

Family planning, attitudes to, world need for, 91-3 and p, 95-6 and p, 97, 107, 108, 114 Father and child relationships, 9, 28-9 and p,

p for

Don Juan type, psychology of, 24-5 Douche, contraception by, 103p Dowries, in marriage customs, 54p Diirer, Albrecht, Adam, Eve, 80p Dutch cap, contraception by, 95

Ejaculation: physiology of, 63; premature, 88; retrograde, 120 Electra complex, 45, see also Oedipus complex Ellis, Havelock, 73p, 75

Emotional dependence: effect on personal relationships, 39, 49-50, 83-5, 86; origins, 83 Engagement: causes of stress during, 38, 57 and p; functions of, 37-8 Erection, physiology of, 63, see also Penis Erogenous zones, 9, 10p, 22, 67-9

Falling in love see Love Fallopian tubes: blockage, cause of infertility, 116 and p, 111-3 109p, in sterilization 117;

Hair, erotic functions, 10p Hate, relation to love, 18 Heterosexuality, and homosexuality, 76, 90 Hinduism, teaching on sex, 82 and p Homosexuality: and heterosexuality, 76, 90; attitudes to, 39-40; basis of, 24-5; leading to conflict situations, 85; leading to crimes against children, 90; predisposing factors, 45, 49; prevalence in schools, 76-7 Honeymoon, function of, 54, 57 Hormones: basis of the Pill, 100-3, 105, 106p; functions in reproductive system, 97-100, 106p Hot flushes, effect of Pill on, 107

Illegitimate

children,

consequences

for

mother, 18 Impotence: causes, treatments, 24, 87-9 and p; fears of,

25-6, 87, 88p Infertility: anxiety, causes, effects of, 115, 117p; causes, treatments, summarized, 117p; medical investigation techniques, 115-6 and p, 119p;

through blocked Fallopian tubes, 116 and p,

117;

through

character

of

cervical

mucus, 115p, 116, 117p, 122p; through difficulties in sexual relationship, 119-20; through faulty production of sperm, 118-9, 121, 122-4p; through illness, 115, 119 Inheritance, laws of, 51-3 and p Inhibitions, effect on sexual relationships,

79-80, 82

Intra-uterine device, contraception by, 93-4, 103p

127

Jealousy, effect on sexual relationships, 18 Judaism, attitude to family planning, 96 Jung, Carl, 40-1, 48p

Narcissistic love, 41 Nausea, side-effect of Pill, 103 Navel,.erogenous zone, 67 Neck, erogenous zone, 67 Neuroses, in love-relationships, 43-4, 49-50 Nipples, erogenous area, 10p, 69 Nocturnal emissions, 46 Noses, erotic functions, 10p, 37p

Kinsey, Dr. Alfred, 73p, 76, 78 Kraft-Ebing, Richard, 75

Obesity, cause of infertility, 115, 118 Oedipus complex, 9, 21, 41-3, 45, 49p

Islam: attitude to family planning, 96; teaching on sex, 82

IUD see Intra-uterine device

Legs, erotic functions, 10p Lesbianism: attitudes to, 39-40; prevalence of, 77; see also Homosexuality Lips, erotic functions, 10p Liver, side-effects of Pill on, 105 Love: concepts of romantic, 15-8, 20 and p, 33-5 and p, 39; effects ofdeprivation, A48p, 49-50; falling in, attitudes to, in different societies, 15, 18, 19p, 20p, psychological basis, 18-20, 23, 35-6; growth to maturity, 20; in later years,

19 and

p, 22p;

neurotic

elements,

43-4, 49-50; relation to mystical experience, 18; relation to hate, 18 Love-making: modern attitudes to, 57; techniques, 25, 63,

67-72, 79-80, 88 Love-relationships: different levels, 46-50 and p; essence of mature, 39; psychological factors affecting, 18-9, 39-43 and p, 45 Mandrake, properties of, 98 Marker, Russell, 97 Marriage: arrangement of, 34, 49, 53; average ages of, 37-8, 56; ceremonials in different societies, 53p, 54- 6 and p; conflict situations in, 83-6;

effect of babies on, 58-9 and p; effect of inhibitions on relationships, 79-80; factors affecting choice of partner, 24p, 35, 38, 39, 41-3; legal controls over, 53-4 and p; practical, economic problems, 57-8 and p, 59-61 and p; relations with in-laws, 58; relationships in later years, 61-2; religious concepts, 55-6 and p; rights conferred by, in different societies, 51-3 and p, 54p; sociological basis of, 49, 51; see also Divorde Maslow, Abraham, 46-50 and p Masochism, elements of, in sexual relationships, 39, 43p, 45 Masters and Johnson, 72, 73p, 76, 78, 88 Masturbation, 23, 28, 46, 74, 78, 80, 82, 88

Medical Defence Union, 113-4 Men: achievement of orgasm, 22, 63, 65, 70-1, 78; attitude to relationship with women, 22, 23, 27; attitudes to sexual intercourse, 12-3, 22, 26, 29-30, 72; erogenous zones, 67-9; factors

determining ability to love, 21; love in later years, 19 and p, 22p; strength, duration, of sexual urge, 19 and p, 22p, 23-4 Menopause, effect of Pill on, 107 Menstruation, menstrual cycle: and problems of infertility, 115; causes of disturbance, 28; effect of Pill on, 100-3, 105, 106p;

normal

progress

of, 97-100,

106p:

pains during, 107; relation to sexual urge, 29, 67

Mill, Albert, 75 Minipill, potential development, 107-8 Miscarriage, cause of infertility, 115 Monroe, Marilyn, 89p Mother and child relationships, 9, 21-2, 28-9 and p, 41-3, 44, 45

Mouth, source of sensual experience, 21-2, 28 Multiple births, effects of fertility drugs, 118 Mysticism, and concepts of love, 18

128

Schofield, Michael, 76 Scrotum, erogenous zone, 67 Sexology, 72, 73 Sexual attraction: basis of, 10; function of clothes, cosmetics, 10-4 and p, 26p; origins in childhood, 9-10 Sexual behaviour: association with guilt feelings, 73-4, 79, 81-2, 83; scientific study of, 72, 73-8; taboos, myths surrounding, 773-4 and p Sexual intercourse: attitudes to, in different societies, 12-3, 81p,

Oestrogens, 97-100, 102-3, 106p, 107

Onanism, 82 Oral contraceptives, see Pill, The Oral stages of development, 21-2, 28

Orgasm: achievement by men, 22, 63, 65, 70-2, 78; achievement by women, 22-3, 26, 29-30, 63, 65, 70-2, 78, 88, 89; simultaneous, 30, 72 Ovulation: failure of, cause of infertility, 117p, 118; in reproduction system, 97-100, 106p; stimulation by drugs, 117p, 118, 119 and p Paranoia, relation to deprivation of love, 50 Parenthood, effect on marriage relationship, 58-9 and p Partner-selection, see Marriage Penis: erogenous zone, 67-9; size of, 25-6, 63, 78; structure, functions, 63, 65, 69, 78 Period pains, effect of Pill on, 107 Peritonitis, cause of infertility, 115, 119 Permissive society, predisposing factors, 49

Pill, the administration, 100-3; effect on sexual relationships, 29, 107; failure rate, 103 and p; for men, 108; future developments, 107-8; manufacture, marketing, 101p, 104-5p, 108p; physiological basis, 93, 97-100; side effects, 102, 103-7, 107-8

Pincus, Dr. Gregory, 97-8 Pituitary gland, functions, 98-100, 106p Polynesians, attitude to sexuality, 80-1 Population explosion: and availability of sterilization, 114; and need for family planning, 91-2 and p, 95-6 and p, 97 Pregnancy: love-making

during,

67;

unwanted

con-

sequences, 18, see also Abortion, Family planning Progesterone, 97-100, 102-3, 106p, 107 Property, rights over, in different societies, 51-3 and p, 54 Prostate gland, 110

Prostitution, 46 and p

Protestant churches: attitude to artificial insemination, 126; attitude to family planning, 96 Pseudocyesis (simulated pregnancy), 28 Punch and Judy, psychological basis, 85-6p Rape, psychological basis, 49 Repression, effect on love-relationships, 41 ou incompatibility, cause of infertility,

120Rhythm method, contraception by, 95, 103p Rock, John, 97-8 Roman Catholic Church: attitude to artificial insemination, 126; attitude to family planning, 96 Romantic love, concepts of, 15-8, 20 and p, 33-5 and p, 39

Sadism, elements of, in sexual relationships, 26, 43p, 45

Safe period, see Rhythm method St. Paul, teachirtg on sexuality, 81 Saliva, increase during sexual excitement, 69

82 and p; attitudes to, of men, women, 12-3, 22, 26, 29-31, 72; biological processes, 63,69, see also Love-making; ; continuation in later years, 76; during pregnancy, 67; frequency On /63 optimum time to ensure conception,

15s physical changes during, 10p; rituals regulating, in different societies, 51; statistics on first experience of, 77; attitudes to, of men, women, 22-3, 27, 30-2; causes, effects, ofunsatisfactory, 24-6 and p, 119-20; effect of conflict situations on, 83-6; problems of, 65-7, 85-7, 88-9 ‘Sexuality, sexual urge: attitudes

to, in different

societies,

79-82;

basic biological needs, 45-9 and p; Freud’s theory of infant, 9, 21-2, 28, 41-3, 45; relation to menstrual cycle, 29; rights relating to, in different societies, 51; strength, duration, 23-4, 76 Shakespeare, ‘Shall I compare thee to a summer’s day?’, 17 Sheath, contraception by, 95 and p, 103p Simon Population Trust, 114 Skin pigmentation, side-effect of Pill, 103-4 Solitary confinement, effects of, 50 Spermatozoa: faulty production of, cause of infertility, 118-9, 121, 122-4p; storage of, 120p, 126

Spermicides, 95, 103p Sponges, contraception by, 95 Sterilization: after-effects, 113; and policies of familyplanning, 110-4p; indications for, 113; legal, ethical problems, 113-4; of men, 109 and p, | 110-1 and p; of women, 109 and p, 111-3; reversibility, 113 Suppositories, contraception by, 95

Tattooing, 26 Testicles, undescended, 119 Testosterone, 97 Thighs, erogenous zone, 67 Throat, erogenous zone, 67 tne relation of incidence to Pill, 104, 107-

Tuberculosis, 119

cause of infertility, 115, 117p,

Vagina: discharge from, 103; structure, functions, 63, 69, 78 Vas deferens, in sterilization operation, 109p, 110-1 Vasectomy, see Sterilization, of men Vault cap, contraception by, 95 Victorian age, attitude to sex, 12-3, 81p, 82 and p Virginity, attitudes to, 26 Women:

achievement of orgasm, 22-3, 26, 29-30, 63, 65, 70-2, 78, 88, 89; attitude to relationships with men, 22, 23, 27, 30-2, 89; attitudes to sexual intercourse, 12-3, 22, 26, 29-31, 72; biological need for childbearing, 28, 30-1 and p; career—home conflicts, 85-6; erogenous zones, 9, 10p, 22, 67, 69; role in different societies, 21p, 27-8 and p, 29-30, 3lp, 40p,

51-3 and p, 107; strength of sexual urge, 23-4

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