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External Articles | Posted: September 5, 2010

Experts' Holistic Views on Sexuality

Excerpt from "Scobel -Mehr Wissen über: Sexualität und Sexualtherapie" [more knowledge on: sexuality and sex therapy]

In spite of the openness of today, the number of people seeking help from sex therapists increases. This shows that the goal of sexuality without problems is still a long way. This topic concerns many people, but is seldom discussed. Gert Scobel and his three guests, Dr. Sophinette Becker, Dr. Ulrike Brandenburg, and Prof. Dr. Jakob Pastötter, talked about how to define sexual problems and how to treat them.


Scobel: Is this controversy whether to use medications [Viagra] or not, or has the dispute long been resolved?

Prof. Pastötter: The dispute has certainly not been resolved (laughs). There is a simple reason for that: we have to realize that sexuality is a bio-psycho-social phenomenon. That means I cannot separate body and soul. If I try to do that, the result will be this erroneous belief, which has also led to the Viagra hype, that a man who has an erection automatically feels like having sex. A lot of men still believe that. Fact is, however, that sex is not fun just because I have an erection; the erection is a very useful means, certainly, but the erection as such doesn't take us any farther. It is not the decisive factor for sex that is felt as fulfilling or satisfying.

It is a pity that for decades we have perceived sexuality primarily as something that exists as a separate experience phenomenon. That may have to do with... - well, sexuality is quite a new category of study. Only in the 19th Century, in the early 19th Century, it was formalized as a physical, as a physiological, category.

Scobel: Although I always find it difficult to imagine, how was it before? I mean, well, we could discuss that now extensively, but I can hardly imagine that we used to have what we now call sex, but obviously weren't able to talk about it or had a totally different perception of it.

Dr. Brandenburg: Yes, its meaning has changed. Sex or sexuality has an immense significance. We have always lived it, but now its importance is totally different.

But I would like to add... May I say a word about medication? Although I also view that in a critical light and basically completely agree with you. But of course we have those cases in the clinic or in our practices, that sometimes the men come and are simply glad to take one of those pills.

For example, we also have a number of elderly men with organic, i.e. physical problems, and there I have to support medication a bit and, as a sex therapist and a doctor, I am quite glad...

Prof. Pastötter: The most famous example is Hugh Hefner who said that thanks to Viagra he was given a new life.

Dr. Brandenburg: Certainly, and there is still the psychological part in it. I wouldn't abandon it totally. I am also quite glad that we have got this sort of stuff.

Dr. Becker: As a "propulsion unit" it is very useful sometimes... (laughter)

Prof. Pastötter: That is also a mistake we usually make in the West, according to the motto "The soul is something that is linked with the body, but somehow it is still subordinated to it." It must be said clearly: both are intertwined.

Dr. Becker: And again we are confining ourselves to male sexuality. And female sexuality gives the researchers so much trouble, because the women always... -when you can measure something they don't feel anything; and when they feel something, the researchers can't measure anything. So they can't be pushed into this simple scheme; and there is no such drug like Viagra that can simply be given to the women. Women have always understood their sexuality, their body and soul as a unity, but I must say: the men are following suit. Before, I had much more the impression that men come who say: "Here's my penis, you are the 'Motor Vehicles Inspection Station', please get that straight, I don't want to have anything to do with that." Now, there are many more men who are already coming with the knowledge that their penis which is making problems has to do with them as a whole personality, with them as a man, and with their past.

Dr. Brandenburg: I would even say, even this... - you've just pointed that out -this increasing number of apathetic men. That's surprising, well, I didn't have... -I don't know what is your experience -five or ten years ago, the couples sitting there, and she says, "Here, he does not want it any more!" And he is also sitting there, almost silent, and says, "It's true. There is a psychological strain -I don't know where it comes from. I also don't know why."

Dr. Becker: All that's missing is the migraine. (Laughter)

Dr. Brandenburg: Yes, but sometimes...

Scobel: But now I have to ask you: do you have any idea what the reasons are?

Dr. Brandenburg: I just wanted to say: of course we are trying to figure out what's behind it. And sometimes I do have the impression -even the men say that, and they put the finger on it, too, "We as men are also tired of the fact that it's all about our having to function." So I think there are several reasons. On the one hand, it is this "I don't want to fulfill this pressure as a man anymore, this 'ancient duty'." I think it also has to do with the women's new aggressive position in sexuality. The women who are -this can be observed particularly among the young women -who are much more active, who are also significantly more able to express their needs - this, of course, creates a shift of influence within the relationship dynamic.

Scobel: Is that actually new?

Dr. Brandenburg: I would say this is clearly new.

Dr. Becker: A big difference that has taken place over the last twenty years is that women masturbate much earlier, have experience with that. Formerly it used to be like this: 99.999 percent of all boys masturbated - be it with feelings of guilt or without.

Scobel: Usually with...

Dr. Becker: Usually with, but they did. And many women didn't have this experience and had their first sexual experience with a man. This meant a lot of pressure for the man, but also the great possibility to "kiss the flower awake" and much more. Now the women start their sexual relationships with a much greater knowledge about their bodies. This relieves the man of a huge responsibility, but it also brings many more claims, and it also gives the gender interaction a different direction.

Dr. Brandenburg: But also, when the women speak about orgasm there are many surveys on orgasm -now almost all women say very honestly: it is easiest when I do it alone. This pressure -when I notice he is doing his best, and then all that performance anxiety, then I'm under stress. And they have the competence to amuse themselves all alone.

Scobel: Let me now -excuse me - say it quite grossly. What you are telling me sounds like as if the real problem with sex is the psyche, the real problem is the soul, that is, in the broad sense, the communication between the partners.

Prof. Pastötter: No, in fact it's not that simple. At the moment, we from the DGSS find it incredibly exciting that we cooperate with the Chinese Federation for Sexology and discover more and more that very much of what is still quite new for us at the moment -for example, something like this vaginal pain -a few years ago, there was the very first examination that confirmed: women -even young women - can actually have quite unpleasant feelings in their genitals, which are only partially related to sexuality, but they do exist. Women had naturally always known that there is such a thing, but it was just pushed aside, and they could not talk about that with the doctor, because anyway the -often male - doctor could not understand at all that having feelings in one's genitals can be unpleasant.

Dr. Brandenburg: Even the woman doctors...

Prof. Pastötter: (Laughs) Thank you. And for the Chinese this is a very old phenomenon that, by the way, has nothing to do with sexuality as a western concept. They have great problems to understand our concept of sexuality, because they say: but there is no isolated sexuality at all! For sexuality is always connected with our feelings, it is always connected with our psyche, and it is also related to the most diverse organic connections. And in this case, a Chinese doctor would now say, "This is interesting, I'll just check and see what symptoms we are facing," then he will realize, "Oh, this has only very little to do with what the stupid westerners understand by 'sexuality'. We will first treat something else and then we'll see whether the feelings change accordingly, and whether afterward sexuality may also change. So this is a holistic approach to sexuality from the very beginning.

Dr. Becker: No, anyway it's a limitation to assume a soulless body and a bodiless soul. There is not only the body as a machine, which is then repaired with some drug -there is physical experience, and a good psychotherapist must also consider this very closely, and in a language that is close to the body, especially in sexual issues. The soul is not separate from the body; the body is included, but this does not mean that you are working with drugs or with methods that are immediately acting on the body. ...

Original source (in German):
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About Prof. Dr. Pastötter