Is it really my fault?

– “Doctor…I can’t believe my husband cheated on me—after so many years of happiness.”

Laura X. is a mild-mannered, attractive businesswoman who has been married for more than twenty years and has always bragged about her caring husband and good teenage children. In her latest visit to my office, she looked very distraught and whispered hesitatingly, avoiding my gaze. She confessed to me that she found out that her husband was having an affair with his secretary.

Infidelity in couples is almost as old as the world itself, perhaps only slightly less than the famous bite to the apple that triggered so much passion and eroticism in human sexual relations. Even though in our supposedly modern societies this issue has lost some of its more edginess, we still react with anger and frustration when we learn that our “significant other” was not faithful. The majority of couples still expect to engage in a monogamous relationship and avoid philandering.

Women are particularly vulnerable to the extreme disappointment and hurtfulness of infidelity as they usually are the most committed part of the couple. The ones that strive “to make it work.” They make countless big and little sacrifices to share their lives with another person. One of the more damaging collateral effects of this emotional frustration is the surge of second-guessing and guilt feelings in the aggrieved party to the conflict.

Laura X. asked herself if she was not really at fault for his transgression because she felt that she might be dedicating too much time to her household and had little spare time for her appearance. We always found her attractive and well groomed, without any sloppiness in her body and mind. We had to chat extensively with her to assuage her that it was not her fault at all. It was solely his. We must dispel these toxic feelings of guilt because they can affect the patient’s mental health.

One of the greatest disappointments we had in our childhood was the separation and divorce of our parents at a very early age in our maturing process. Eventually both my brother and I recovered. But we could never overcome a certain disdain for our father—who we loved and respected—due to the fact that he certainly had a clandestine relationship when he was still married to our mother. Oftentimes my dear mother Gladys wondered aloud if it wasn’t her fault that he had an affair; a few times even my grandmother Yolanda scolded her for not being more vigilant with her spouse.

Did I miss any of the signals? How could I be so distracted with my obligations to abandon him? Did I forget to use nice perfumes? Or sexy clothes? Did I abuse of the “headaches excuse”, eh? Perhaps it’s my fault too…Perhaps his fault is not as grave at it seems… The tremendous reservoir of feminine empathy can even sugar-coat the most egregious behavior. As Friedrich Nietzsche, a tough appraiser of the dark complexities of human behavior, once said: “the victim takes the whip out of the torturer’s hands and starts to strike himself.”

Self-flagellation.The ultimate indignity borne by the abused.

When they separated, our parents were barely in their thirties; both my brother and I chose to live with our mother. We stood firmly by her side and consoled her when she wallowed in her grief. We reminded her that it was our father’s fault. Not hers. Raising two children with limited financial means and with no family around entailed personal sacrifices that she squarely faced with stoicism and courage. Muchas gracias Mama!

What do you think? Please tell us.

Don’t leave me alone.

 

Keeping the marital flame alive

– “Doctor…We’ve been married for so many years—we hardly ever make love anymore.”

Sheila X. is a nice, successful lawyer “d’une certaine age” that has had increasing doubts about her marriage during the past few months; every time she comes to my office, I can see the tired look in her face with an evident readiness to say a lot of things but with an unwillingness to do it. She has been complaining of multiple minor ailments of various systems in the past few months that, after a complete medical work-up with referral to specialists, turned out to be “somatization.”

One of the most persistent misconceptions in our society is that the progressive decline in marital passion of married couples is directly related to the loss of libido and/or interest in their partners. Even though there is certainly a dearth of sexual activity in these “bored couples”, we believe that it is usually a symptom of a larger problem that needs novel solutions that go beyond the bedroom. So, recurring to our humble, limited but intense experience with the marital bliss, we recommended her the following:

1 – Watch the communication modes

In the beginning of every relationship, we tend to be obsequious and mellifluous with our partner; unfortunately, the daily routine and the wear-off from labor and family obligations will ultimately sap our readiness to say nice things, progressively drifting into rudeness and worse, indifference. We shake our torpor and try to see our romantic partner in a new light. We must listen to their concerns. We must talk to them as adults, not talk down like children. We must speak softly in their left ears. Why the left? Because the sensory input from the left side of the body goes to the Right Hemisphere, the center of affection, where there is no Right or Wrong (read more in my upcoming book) Never underestimate the soothing effect of the right word of encouragement at the right time.

2 – Respect the differences

When a romance starts we value the differences in our “significant other” as a nice challenge of our sentimental status quo and offer us some needed excitement to “feel alive.” However, that attitude might change over they years as we become less tolerant of previously accepted features. We strongly believe that it is almost impossible to “change someone”, a fallacy that many young women believe when they supposedly marry “the man of their lives” and start tinkering a little. When you love someone, you are ready to change your ways. A little. Sometimes may be more. But don’t you start vacuuming the living room when the football game got finally interesting.Or pester me that you want a salami sandwich when “gorgeous” is about to pop “the question” to her. Ca va de soi!

3 – Encourage the individual initiatives

Perhaps one of the most difficult and yet easier recipes is the fact that, in order to keep a healthy couple relationship, both women and men must have separate activities, either in the labor or social spheres, including reserved times for personal hobbies, old friendships, new business ventures. Of course, there were always couples that “do everything together” but that smacks of other times when women were more compliant and followed the lead of their men and relegated their wishes. Moreover, after some time spent apart, the yearning to be with the loved one gets even stronger.

4 – Surprise your partner regularly

One of the funniest ways to break the routine that might asphyxiate any kind of long-term relationship is to do something completely unexpected to surprise your partner. Perhaps one day you decide to stop by a florist shop on you way back from work and buy her a bouquet of red roses; maybe you even dare, not to use one of those lame pre-printed cards, but to write a few simple lines telling her how much you love her and appreciate all she does for you. Say it. Loud and clear…Or perhaps you decide to wait your hubby with a new dish that you learned from a TV program even if you got all the ingredients from Blue Apron. What’s the matter? Is cooking beneath you? Just do it.

5 – Watch your personal hygiene

This is one of the trickiest issues. Of course. we know that we must take a shower every morning and get ready for our interaction with our work or study mates. But how about at bedtime, eh? We should avoid late feasts with too much red meat difficult to digest, carbohydrates that swell your belly, beans and broccoli that encourage the colon bacteria to produce malodorous flatulence. For years I have had the habitude of “moving my bowels” (Yes, I can talk at ease about this subject because I am a physician, remember?) at least once in the morning before going to work and at night before I take a quick shower to get to bed squeaky-clean. Try it. You’ll smell the difference. And, exuding lavender from Provence, your partner might be enticed to “take a bite out of you.”

6 – Maintain family and friendly relationships

The interaction with other people brings a much-needed breeze of fresh air to the couple, besides cementing their attachment to their family members and their friends. Humans are supposed to live in association with other individuals, not only the lifetime companion they have chosen. We know that it is sometimes tough to bear the relatives or fellow workers of our “significant other” but we have to remember that he/she/sie might feel the same. By agreeing to accompany them along in stride, we are helping them to ease the burden. They will be grateful for our gesture. And we might get cookie points.

What do you think? Please tell us.

Don’t leave me alone.

L’abus au petit feu

– “Doctor…It’s not how much he pisses me off—but rather how often he does it.”

Sheila X. is a jovial, good mannered and efficient nursing aide that has been suffering from chronic migraines for years; almost all the therapies we tried have failed and now she is participating in a clinical trial for a new medication. But her main trigger is located home.

She has a nice husband who nonetheless does not cooperate with any of the housekeeping and child rearing, preferring to slump in the sofa with a beer and the TV remote control after work. Their two teenage children scold him for his archaic behavior, but he ignores them altogether. Occasionally she bursts out in anger fits, which does not change his bad attitude but only exacerbate her headaches. Lately she has given up and tolerates his bad behavior in silence. However. we have watched how the summation of all those episodes is sapping her joie de vivre.

A French chef recently explained in a TV program the advantages of a slow burning fire to tenderize supposedly hard to cook meats like game and fowl; when I watched his explanation, I couldn’t help thinking about how Sheila’s husband is undermining her strength at home and also at work.  Often, I had to write a certificate, so she could skip work and lay down in her bed with lights out. I always asked her if he ever became physically abusive and she vehemently denied any incident.

A flutter of the hand that never lands on a woman’s face but still frightens her into submission. Or perhaps of a not-so-subtle-threat in the middle of a perfectly routine conversation of the couple. Or even worse still, a stony silence after the wife asks for some rational explanation to his deed. Women have been subjected to vast amounts of verbal and physical abuse all along their lives. Oftentimes it does not reach the threshold of intensity that will provoke a radical response. But these low-intensity encounters can slowly erode the self- esteem of the woman and even constitute a terrible example for the daughter. If Daddy frequently does that to Mom, is it then acceptable?

Without claiming the mantle of “political correctness’ in our relationship with women in general and our family members, we believe that we are doing better than our parents and grandparents did in other times when society tolerated little abuses in stride. And our children should be even better than us. There is no excuse for the mistreatment of women and children. None is acceptable. My father Mario always taught us: “the man that raises a hand against a woman is a coward.”

Occasionally we witnessed how such a silently suffering woman suddenly erupts in a fit of rage that breaks the status quo in a supposedly “happy marriage” to the dismay of all. But hardly ever they take the extra step. Nora’s move. Leave slamming the door behind.

In some traditional societies like Japan, more and more young women are refusing to get married or have children. They even suffer from the “Narita syndrome.” Named after the Tokyo airport for international flights, it refers to their reaction towards their inexpressive men once they come back from a trip and realized there is another way. They dump them right at the arrival gate. Hopefully they will put them on probation.

What do you think? Please tell us.

Don’t leave me alone.

The cyber chantage

– “Doctor…My ex-boyfriend is blackmailing me to get laid—those damn pictures.”

Thelma X. is a nice, good looking medical assistant that after a few failed romantic relationships has finally met what she considers “the man of her life.” They are living together now but they are carefully planning their wedding, so their respective traditional families give them their blessing. She is a proud Millennial who has smartly used the social media to enhance her personal life. Sadly, she had the bad idea of allowing her former boyfriend to take some suggestive poses of her during and after sexual intercourse, which at the time seemed like innocent confidential jokes.

The smartphones have democratized and cheapened the access to some forms of expression that had been the preserve of the moneyed classes for centuries: the sharing of racy, explicit portraits. We must remember that “L’origine du monde” –a tableau of the external aspect of an exuberant vulva made by the French painter Gustave Courbet in 1866—was commissioned by Khalil Bey, an Egyptian diplomat of the Ottoman Empire for his collection of erotic depictions of anatomy. Even some of the hung masterpieces in European museums have shown some hidden images of nude women and what not, a comic diversion of the artists, when they were examined with x-rays.

Unfortunately, many men have shown their pitiful willingness to take and send pictures of their penis to all kind of female recipients, some of them underage girls who were not expecting them; in the USA a few celebrities have faced social disgrace and criminal charges for this behavior. But this sorry habitude has spread worldwide. Last year I was appalled to learn that a friend of mine, a physician practicing Radiology in Buenos Aires who is divorced, had the occurrence of sending such a picture to his young girl-friend; he erred with the keyboard and sent it to his own daughter.

As another sign of the feminine empowerment in all aspects of life, the vulva became fair game. Laren Stover said in a recent article in “The New York Times” that: “the V-selfie, though very much here, is perhaps less insistent (than the male counterpart). Shared on dating apps or in texts, it has been sent to create longing and a sense of intimacy; a missive of lust and promise to lovers, or would-be lovers, who are separated.” The women that practice it see it as a bold and unequivocal statement that they are fully in charge of their sexuality and how they share it. Those images are also used in the virtual practice of “cyber-infidelity”, which may or may not end in an actual affair. Some exalted feminists are calling for the final baring of all the mysteries surrounding a woman.

When we were medical students in the University of La Plata, we had the opportunity to study anatomy with the excellent Testut-Latarjet textbook and the Necker illustrations, which did not elicit any kind of erotic arousal. Without the context of a smiling, enticing woman those illustrations were just what they were supposed to be: a learning tool.

Mary Cassatt was a gifted and brave American painter that joined the Impressionist movement right at the start as she chose to reside and work in Paris in the late nineteenth century; her often maligned work is now finally the subject of a great exposition in the Musee Jacquemart-Andre. Being a close friend of Eduard Degas, she was the inspiration for “The Box”, whose image honors this article. In the 1870s, women were not allowed to sit in the orchestra section of the Paris Opera and could only be accompanied by a man in the rear stalls in the matinee function, not the soiree.

In an article in “The London Review of Books” Julian Barnes said that: “at evening performances, women were allowed to attend in pairs or in groups, when they might sit together in the upper loges, or boxes. And needless to say, no respectable woman was allowed backstage, where only the entitled male—a self-declared ‘connoisseur’ of women, whether as lecher, or in rare cases, as painter—might tread.” The camouflaged yet explicit rules of the socially accepted manners of that time explain this painting.

“Degas had the freedom to place his focus anywhere in the theater…whereas Mary Cassatt, in paint as in person, was restricted to the view from the lodge. This: a woman in black is what her painting in ‘The Loge’ shows: a woman in black sitting in a theater box, holding a fan, leaning on a balcony rail and training her opera glasses on the (out-of-shot) stage. However, in the background, a curve of boxes away, a man is blatantly training her binoculars on her. ” The message is clear: men, and their eyes, rule here.

What do you want me to say? Whatever expression of freedom the feminist movement, which is really a succession of there major social upheavals during the past fifty years, has rightfully gained, it can, and will, be twisted by the malicious maneuvering of a still resilient patriarchal society. Young women should not delude themselves into assuming that they will always get an equitable treatment from society; they should be extremely careful of what they allow “to get out there” because there is a clear, always present danger that a mischievous male can, and will, blackmail them to his advantage. Unfair?

In a famous line of the great cable show “The Sopranos” in HBO, Tony rebukes AJ, his son, when the teenager dares to question an order from his father: “unfair? Life is not fair…Ask the victims from Katrina!” My children watched it diligently with me.

What do you think? Please tell us.

Dom’t leave me alone.

 

 

 

 

 

 

The sex toys

– “Doctor…My hubby gave me a dildo with a cute little tickling ear—such a sweetheart.”

When the time of Valentine’s Day came, most physicians would teasingly ask their lady patients if their “significant other” remembered the date. Usually they would start talking their heads off about beautiful flower bouquets, or bags of tasty chocolates or romantic dinners in smart restaurants. Or the three of them. But they would never dare to tell us what happened that night afterwards. Sometimes a giggle or a wink was all that we needed to know that they had had some fun; we never dared to ask for details.

Alicia X. is a very smart and gorgeous young clinical psychologist who happens to be my patient. She was never shy about her discussing her sexual preferences and frustrations, being a source of inspiration for many of the article in this series. Two years ago, she found her “soul mate”, a very nice businessman who adores her and literally lives for her and their one-year old daughter. Being an outspoken feminist, she proudly tells everybody that wants to listen that he is “super in bed” because he knows how to engage in the necessary foreplay to excite all her senses. Last year she told me that he had given her some saucy lingerie. But this year he went a step further. Way further.

Unfortunately, the malicious double sexual discourse of the perennial patriarchal society—on one hand exposing us to the more vile forms of pornography in the media and on the other hand playing prudish when the time to discuss healthy sexual behavior in the public forum—has blurred the significance of “sensuality” in our media. It originally refers to using all our senses—vision, hearing, smell, taste and touching—to potentiate our sexual experiences in an innovative way. The over-reliance of males in the issue of “penetration” in our phalo-centric cultures is based on the subconscious masculine fear of “not being able to satisfy her” in the bed and fail as a partner. If they would only know that her sexuality is not only limited to her vagina but distributed all over her body.

The concept of “sex” involves much more that a ready penetration of a cavity and empowered women are determined to remind and/or teach their partners about mind-spiritual connections. The sexual act begins when someone looks at another person in a different, original way and then approaches him/her for further contact. The mellifluous chat, the open flirting, the occasional touch, the furtive kisses, the sharing of exciting cultural and gastronomic events are part of the act. The ladies are shedding their traditional timidity and asking for more romance, more eroticism. Better listen, guys.

The sex toys are part of that ensemble of additives to make the sexual act more enjoyable for both. The special oils for relaxing massages, the online stimulation programs, the vibrating ring to prolong the erection, the provocative lingerie in black or red, the masks, the various vibrators, etc. Even though many men still consider them an unwarranted intrusion in their intimacy, which can distract their partners from the “business at hand”, more women are demanding their step by step inclusion. As it has been for centuries, the ladies are the ultimate arbiters in the intimacy of the bedroom.

What do you want me to say? I still can’t figure out what that cute little ear is supposed to tickle…

What do you think? Please tell us.

Don’t leave me alone.

Addicted to sex

– “Doctor…Got to make love every night—my husband has to keep up with me.”

Solange X. is a gorgeous thirty something lady that has a loving husband and a small child, besides working as a busy manger in a local communications company. She consulted me a few months ago due to a painful bursitis in the right shoulder that she attributed to a fancy sexual pose she had tried with her partner a few days before. When I prescribed some anti-inflammatory medication and rest for a few days, she forthrightly told me that she would not stop her nightly risky maneuvering in bed.

The issue of “sex addiction” is being contested in professional circles at present, which led to a fight whether to include that entity in the DSM III; the lack of clear cut evidence finally tipped the balance against including it as a new diagnosis in it. An addiction implies the existence of two main factors, which are the following:

  1. The search for a compensation or pleasure
  2. The existence of a conflict surrounding this behavior

An addiction is different than an obsessive-compulsive behavior because in the latter there is not the acquisition of pleasure as the final goal. Some psychologists argue that in addictions, the abnormal behavior can produce physical/psychological harm. The obsession for food and gambling were recognized as abnormal clinical entities.

Dr. Walter Guedin, a psychiatrist specializing in Sexology in Buenos Aires said: “in the addiction to sex the desire is mixed with the impulse, pleasure with anxiety, the temptation with moral values, danger or the risk sensation with the self-preservation. The addiction to sex is an irrepressible, repetitive behavior that carries the stigma of guilt and sensation of void that appear once the sexual tension has come down.”

After patiently listening to Solange’s explanation, I looked into her eyes and said:

– “Do you lift you baby in your arms to play with him or look into his eyes?’

– “Of course, all the time… When I come back from work, it’s the first thing I do.”

– “Well, there you are…If you don’t wear a sling for a few days and avoid stressful situations for your right shoulder, you might not be able to do it in the future…”

She demurred for two seconds and then replied: “all right…I’ll follow your advice.”

What do you think? Please tell us.

Don’t leave me alone.

Toxic feelings of guilt

– “Doctor…Whatever I do or say to my boyfriend is always wrong—I’m exhausted.”

Isabel X. is a gorgeous young graduate student that has had a longstanding conundrum. She fell in love with a dashing fellow student two years ago and they started living together six months ago. Initially she felt that her dream had come true: a handsome, intelligent and romantic guy. However, she found out that the pretty packaging was concealing a particular personality trait: narcissism.

It is easy for a woman to fall in love with a narcissistic man: they are so much fun as a company. They are very sociable, eager to meet new people, have wonderful conversations, show courtesy. However, there is a telltale sign that trouble lies ahead: they talk too much about themselves. Living with him under the same roof, Isabel found out that her partner was not listening to her. Worse, every time she opened her mouth to share something big or small, he interrupted her. Her emotional frustration was gnawing slowly but readily her self-esteem, which negatively affected her studies.

Her strong romantic bondage and high level of expectations for her partner, prodded Isabel to take his sickening attitude in stride, which was obviously worsened by her big fear of abandonment. Her girlfriends and her mother, who occasionally dropped by in her campus dorm apartment, got it right from the start; they all encouraged her to drop that relationship and clean her slate quickly. She continued to give, give, give…In return she was getting nothing except toxic feelings of guilt.

“Is it my fault?” “Should I talk differently?” “Am I asking for too much?” “Do I deserve him?”

Jeffrey E, Young said that the only way to break off negative life patterns is to re-evaluate your relationships and start to appreciate those persons, who, in spite of appearing boring, listen to us. Oftentimes a companion that sits down or snuggles in the sofa next to you is very precious. The always fun-always attractive-always romantic hero of so-called “chicks’ movies” is a total fake. Wait a minute. With my daughter, we did enjoy watching the film “Leap Year” where the central character found out that the rough Irish guy she met on vacation was better than her NY boyfriend. Amy Adams fortunately found out that Matthew Goode was a better match for her. He listened.

Isabel did ask me what to do. My answer: “move out immediately and cut all contact with him.” When she left my office, I didn’t think that she was going to follow my tough advice. She did. She later told me that the same evening she said to him; “we need to talk.” Like Nora had done before in “House of dolls”. Her boyfriend became very aggressive and refused to even listen to her. But she stood firm. In the morning she gathered her belongings and moved out with a girlfriend living in the same dorm. She re-connected with her network of friends and went back home for a long week-end. Despite his frantic attempts to contact her, she was shielded by her circle of friends and family.

After a month, she finally accepted that she had engaged in an extremely damaging relationship. She vowed never to repeat the same mistake. She found a boyfriend who was willing to listen. Exhilarated with her blessed happiness, she learned how to cook. Compared to the sorry version of herself I had witnessed, she was simply radiant.

And she brought me delicious cookies. What do you want me to say? If most men only got a glimpse of the strategic advantage bestowed unto others by just listening more.

What do you think? Please tell us.

Don’t leave me alone.