Category: My Writings from College & Graduate School

Language

Purdue University

English Composition II – Eng 105

Fall 1988, Dr. Bolduc

Grade:  (A)     

Language

I disagree with Orwell. I do not think our language is in a bad way just because there are some who abuse it. There will always be people who make a mockery of the creative beauty our language possesses. Twisting words can have many causes; to say these causes are only political or economic are absurd.

I think that people who use big words and worn-out phrases are merely exhibiting their lack of language skills or being pretentious. My personal favorite authors are Isaac Asimov, Andrew Greeley, and Mike Royko; they all use common words and are quite successful at getting their messages across. In fact, I see their simplicity as their very genius.

Orwell says the political language is designed to make lies sound truthful, murder respected, and give an appearance of solidity to pure wind. His message is clear, but it goes too far. I agree that politicians attempt to remain vague, avoid direct answers, and twist words to argue their points. But because Orwell goes too far with his criticism I do not take his argument seriously. He sounds like an old fuddy-dud professor who would not be pleased by anything that did not meet his rigid standards.

Language can pose a barrier between people if it is not shared. I think that global community relations could be enhanced if we had more people speaking and writing multiple languages. Between the approximate ages of 2-14 years, children are in what psychologists call a “sensitive period”; during this time their minds are sponge-like in regard to learning languages. I think that we should take advantage of this innate biological ability and teach foreign languages in the nursery, grade, and junior high schools. Imagine a future United Nations conference with most of the countries able to speak to one another because we have taken advantage of our kid’s learning abilities. By giving the next generation increased language and communication skills we would be doing something positive for world relations. I love language. I see it as a creative tool to express an array of feelings, thoughts, and ideas. With language, we are free to create, either verbally or in writing, anything that we can imagine. I can turn thoughts into something we can see and hear. Language gives our thoughts a new tangible dimension. I love learning new words; all the more words to think with. 

Head Nurse

Purdue University

English Composition II – Eng 105

Fall 1988, Dr. Bolduc – (B)      

Head Nurse

Linda has been an R.N. for seven years now; she worked two years on a general medical-surgical floor and five years in an intensive care unit. She has a bachelor’s degree in nursing and is going for her Master’s in Nursing Management. She’s very bright, assertive and cares deeply for her critically ill patients.

She’s now near the completion of her master’s degree and her Director offered her a position as the Nurse Manager of the Coronary Intensive Care Unit. She’s enthused about the opportunity to use her newly obtained knowledge in participatory management. She’s learned that psychologists have studied management styles and found that people are more likely to comply with and feel invested in decisions that they helped to make. With this management style, the best leader doesn’t lead at all; she facilitates group solutions to problems and fosters the development of leadership within each group member.

On an individual basis, she makes herself aware of the special and unique contributions made by each staff member. She compliments these contributions and encourages each person to share them with the unit. For instance, one may be a good organizer of supplies, one may be good in bolstering morale, and one may be especially skilled with inter-department communication.

Through her intensive care experience, she’s also a role model. She shares her expertise in the technical aspects of critical care. She’s supportive of new nurses who are overwhelmed by the stressful situations that serve as their learning labs; she tells them “Yes, you can!”

The Administrator of the hospital has a Ph.D. in Hospital Administration. He has served as an administrator at 2 other hospitals (thus with a total of 10 years of experience). He has also worked in the accounting field and is especially skilled at corporate budgeting. He knows how to balance a budget and in a hospital, he knows where to cut spending: nursing, nursing, and nursing support services. He’s an opportunist and uses what he’s learned about nurses against them. Nurses are by majority dedicated to giving good care to their patients. They are generally passive with much less than optimum self-esteem. They don’t see themselves as having the power to improve their working conditions or salaries.

His abusive attitude allows him to take advantage of the nurse’s dedication and lack of self-esteem. He cuts the budget for the intensive care unit leads to unsafe conditions.

Federal law mandates that one nurse can only care for two patients in a critical care unit; Linda’s staff routinely care for three patients; many non-nursing tasks were also added due to the cut in nursing support services. This dangerous situation is occurring nationwide. Mr. Administrator may be qualified to administer, balance budgets and collect a 6-figure income, but he is not qualified to run the nursing aspects of a hospital. He does not know what nurses really need to do or how precious what they do is to their critically ill patients. Hasn’t Mr. Administrator heard of participatory management? 

The Catholic Church

Purdue University

English Composition II – Eng 105

Fall 1988, Dr. Bolduc – (B)

The Catholic Church

The Catholic Church discriminates against women. A woman is barred from becoming a priest and is not allowed to read the gospel during mass.

I recall a sermon about vocations. The priest was trying to recruit clergy. It was obvious to me that he was only interested in recruiting males to be priests; I was not surprised. I was surprised when my 6-year-old daughter asked me, “Why can’t I become a priest when I grow up?” after hearing the sermon. Having to tell my daughter that she could not become a priest made me realize what an unfair practice it is for the church to discriminate against women. The church represents God; how can the church tell little girls that they are not as good as little boys? How dare the church tell little boys that they are better than little girls!

The church, being one of this country’s major institutions, has a responsibility to serve as a role model with “equal” (male and female) Christianity. Children are developing their sexual identities, what is conveyed to them from God through the church affects our future society; the church is oppressing women.

Since the church is trying to recruit clergy, why not place an ad in the Sun-Times Job Mart:

HELP WANTED

         Young people sought who love God and have the ability to pocket their sexuality. The following are mandatory:

         1.      Penis and testicles

         2.      Absence of enlarged mammary glands

         3.      Facial hair

         4.      Voice with low decibel level

         5.      Ability to lift a prescribed dumbbell weight Modern employment applications now have questions such as sex, age, or marital status listed as optional; employers can get in trouble if they discriminate against applicants. Is it the separation of church and state that allows the church to continue this discrimination? Has it been proven that the five mandatory prerequisites listed in the ad are necessary to say mass, give sacraments, comfort the sick, teach theology, and collect donations? I see no logic to its discrimination. Unless I somehow become miraculously enlightened about what disqualifies a woman, I cannot see any logic in keeping women from serving God in an equal manner as men. I cannot imagine that God would be offended if I stood up in mass (without the previously mentioned qualifications) and read the gospel.  

Medical Technology:  What’s the Problem?

Purdue University

Medical Sociology, SOC 491C

Winter 1987

Grade – 10\10

Teacher’s comments: Excellent and sensitive discussion of a complex topic

Medical Technology: What’s the Problem?

Medical technology has not gone too far; the way in which we use that technology is the problem. There is a lag involved between scientific technology and the ethics involved in its humanistic use. We can physically keep a person alive with life support systems, but society has not yet provided a moral code for doing so; there are no norms or guidelines for medical practitioners to go by.

The science involved with the technology is actually the easy part; whether you’re talking about an antibiotic to kill a germ or a machine to force air into motionless lungs, the principles are concrete and appear to be quite humanistic. The ethics that become involved with science is very complex and very controversial.

Another major problem is the fact that the doctors who order this technology are no further advanced (and possibly further behind) than the rest of society. Medical school does not prepare doctors to deal with these delicate issues. Doctors become nomophobic (an irrational fear of the law) in medical school; they make decisions about the use of technology from a standpoint of fearing a lawsuit. This leads to the problem of medical technology going too far; doctors end up over-treating dying patients simply to avoid litigation. Technology should be used to help a patient.

By practicing defensive medicine doctors see the law as primary and ethics secondary. Legal thinking is to protect themselves; their goal, however, is to benefit the patient. Ethics goes beyond the law; many of us are not trained in ethics as a part of our education, but the fact that doctors aren’t is hard for me as a nurse to cope with.

The American Heart Association has said that CPR’s use on a terminal patient is a violation of his/her right to die with dignity.

The Vatican has spoken to this issue in its 1980 “Declaration on Euthanasia”. Roughly quoted the Vatican said: No one need to undergo treatment when its use would only secure a precarious and burdensome prolongation of life. If treatment doesn’t offer a reasonable hope of success if it only prolongs dying, it is worse than useless; it is an indignity against our humanity.

I can think of an example that will illustrate a case where interventions became intrusive. I was a new graduate nurse in an intensive care unit; I was assigned to a patient who had been in the unit for a month now with metastatic cancer. He weighed 72 pounds, was respirator-dependent, was being fed through a needle in his vein, and was in constant, excruciating pain. I had been aware of this patient’s case, but this was the first time that he had been my patient. I was afraid to have him as a patient because I feared that I could not ethically refrain from being honest with the family. When I first went in the room to care for him his blood pressure was 50\0; he was already on drugs to force him to have blood pressure. I called his wife and told her that he did not have enough blood pressure to maintain his life and the medications were at their maximum. I asked her if anyone had discussed emergency measures with her. She said no, but that she was too upset to bring the subject up herself; she begged me not to do anything to make him live any longer in this horrible way. I told her that she had to sign a paper to prevent his being resuscitated.    

I feared the loss of my job for doing what the experienced nurses and none of the doctors had done; I was honest about what we could do with our technology and what we couldn’t do to help this patient. I called the respiratory specialist (MD) to tell him that the wife was on her way to sign a DNR (do not resuscitate) for her husband. He said, “Gee, thanks, I’m glad someone finally took care of that”. I had prepared myself for being told that I’m just a nurse and had no right, to be honest with the wife. I then called the family doctor to let him know and he said, “Boy, I’m glad you took care of this; you know I’m not trained in these matters”.

Can you imagine the doctor’s defense if the wife were to sue for unnecessary cruelty to her husband? The doctors would say that they used the technology even though it would not help the patient and would prolong his suffering because they feared being sued for not using them – what a flimsy defense! I believe that doing what is ethically appropriate and goes along with the patient’s wishes is not only humane but serves as the best defense.

I think that interventions are intrusive whenever the patient is not fully informed and in charge of his/her care. I have seen many little old women from nursing homes come to my CCU saying that they don’t want all this stuff done to them. Their families tell the doctors that they want everything done to save Grandma. (They don’t know what “everything” means). It is assumed that grandma is senile, (even though my neurological assessment tells me otherwise) and they proceed to treat the patient telling her that they are only doing what is best for her. They (the family and the doctors) make Grandma feel guilty for not cooperating with all this generosity.

I recall a recent occasion when I acted as a patient advocate for an older woman and was able to elicit the assistance of a resident to see that we respected her demands. I was reprimanded by my head nurse; how dare I rock the boat and deprive this hospital of the funds collected for grandma’s care and for the opportunity for the doctors to practice their skills on her.

The manner in which DNR subjects are brought up to the patients and the families leaves a great deal to be desired. For one thing, we usually bring up an extremely difficult subject with people who are experiencing a major life crisis; the loss of their own life or that of someone whom they love. If you ask a family, “If your mother’s heart stops beating do you want us to help her”? could only elicit a response of “yes”. On the other hand, if you explain the terminal prognosis and that no technology can make the patient better and then ask, “What do you think she would want us to do for her?” The family will more than likely say to make her comfortable in her last days.

Some families may misperceive a DNR order as meaning no care; an order called, “comfort measures only” may be more psychologically palatable.

I think that health professionals have a duty to decrease the power disparity between the patient and staff and use their knowledge and experience to better meet the PATIENT’S needs; we should think in terms of the goals of the patient NOT those of the staff which may be to cure cure cure. The patient’s need may be to obtain support and comfort to cope with their death; I think we should be non-judgmental in assisting our patients.

Patients should be made aware of all their rights and options involved in their care; professionals should be held liable to respect their wishes.

The solutions to these very controversial issues are many as I see them. I once worked in an oncology unit where the subject of death and treatment choices were discussed on admission by the nurses. This worked well because the nurses had the support of the doctors in regard to putting patients in charge of their care. The nurse would document in her notes a patient’s wishes; the chart IS a legal document so it can be referred to later for reference if the patient becomes unable to direct his/her care; the family can fall back on the patient’s wishes without guilt and the staff can feel free of liability.

Because nurses spend more time with patients and are more educated in the social and psychological sciences, I think they are the natural ones to deal closely with these matters. Patients frequently feel free to talk to nurses; I have had many intimate relationships with my patients because they felt free to discuss difficult subjects with me.

Nurses are in an excellent position to do research on these issues, and I think they should do so and go public with their findings. There are literally no issues that aren’t discussed on TV, why not the issues involved with technology and its proper use.

Being honest and using language that a patient can understand cannot be overemphasized; frequently doctors leave the room, and a patient will say, “What did he/she say?” Education of doctors is definitely lacking in training to enable them to deal with humans and communicate compassion. I recently heard on TV that a leading medical school was changing its entrance requirements to include an assessment of qualities relating to the ability to show concern to patients. I found this very promising.      

Living Wills are not fully understood by doctors; they don’t seem to feel secure in feeling protected from liability with them. I have had patients with living wills prepared; they come to the hospital at death’s door, unable to speak for themselves and the family says they want all the technology used; the docs go ahead and use the technology.

At a seminar on this subject that I recently attended, the speaker recommended appointing a representative who would speak on your behalf if you were too ill to do so. You could discuss ahead of time the various issues in current technology. The speaker specifically and emphatically recommended NOT using a lawyer to fulfill this role; he said you could even spare your family by using a friend. This spokesman and you will prepare a legally binding document to be used if it ever becomes appropriate.

Twenty states now have N. D. A.’s (Natural Death Acts); these are a collection of legal documents recognized as a way for a competent person to express their wishes in advance. These documents guard against civil or criminal liability of health professionals; they also hold the doctor liable if he does not comply or transfer to a doctor who will comply with the patient’s wishes.

Recently, nurses are becoming involved in many areas of health care which involve non-traditional; they review charts to check DRGs and audit billing. Why not have nurses specialize in discussing and implementing a patient’s wishes regarding technology?

Of course, doctors need to become comfortable with death; this will be a major feat. The acceptance of death as a part of life is not a simple teachable concept; it would probably need to be filtered into all their education. 

Ideology and Myths: The Fuel of Woman Abuse

Patricia J. Anderson

Indiana University Northwest

Social Problems, Soc 163, Winter 1983

Grade: A (in class also)

Ideology and Myths: The Fuel of Woman Abuse

Wife abuse was first seen as a social problem by feminists in the late 1960s and early 1970s. By sharing their research and experience in helping battered women they are trying to pull society’s head out of the sand so that they can see what a devastating problem it is. In more than 14 years, these feminists have not yet succeeded in making wife abuse a commonly known and understood problem.

The problem affects Battered women, the batterers, their children and extended families, the police, (called in, in cases called domestic violence), the judicial system (offers little or no help to alleviate the problem), the clergy (who usually are confided in and in turn send the battered wife back to the batterer), and human liberation in general.

“A battered woman is one who is repeatedly subjected to any forceful physical or psychological behavior by a man in order to coerce her to do something he wants her to do without any concern for her rights. To be classified as such, a couple must go through the battering cycle at least twice”.  1     

“It is estimated that 50-60% of all women will be battered victims at some point in their lives”.  1, 2  

“The problem includes physical and psychological abuse; both types of violence exist in battering couples and cannot be separated”.  1 

Myths

Many myths function that keeps wife abuse from being dealt with in a positive and helpful way by society; a few of the most common ones are:

ONLY A SMALL PERCENTAGE  OF THE POPULATION IS AFFECTED.

Like rape it is an unreported crime; it usually takes place at night, in the home, without witnesses. It is estimated that only 1/10 of cases are reported. Of 500 divorce suits filed in New York in 1976 – 57.4% listed physical abuse as the cause.

BATTERING OCCURS MORE OFTEN IN LOW-CLASS OR MINORITY WOMEN.

All socioeconomic classes, educational levels, income levels, cultures, and races are victims of wife abuse. Middle- and upper-class women are less likely to report it for fear of embarrassment and exposure of their batterer, who is a “pillar of the community”. A study in England revealed a high incidence among police, doctors, and service professionals (lawyers, executives, college professors, and elected officials).

BATTERED WOMEN ARE MASOCHISTIC OR DESIRE TO BE BEATEN.  

Case histories show no provocation in the majority of cases at all, or the precipitating factor may be something like a dinner served 5 minutes late. Batterers lose control because of their own internal reasons; this myth robs responsibility from the male. Out of thousands of women’s stories not one showed any signs of masochism.

BATTERED WOMEN CAN ALWAYS LEAVE.

They do not have the freedom to leave; she knows that her man is capable of gross violence; he makes chillingly frightening threats about what he will do to her friends or family if she leaves – she believes him!  Frequently she knows no one who will believe her. He keeps her isolated a great deal so that her sphere of helpers is minimal – usually she has nowhere to go.

Characteristics

Common characteristics of battered women and their batterers are quite revealing:

1.      SHE: Has low self-esteem.                        

HE: Has low self-esteem.

2.      SHE: Believes myths about wife abuse. 

HE: Believes in myths about wife abuse.

3.      SHE: Is a traditionalist, who strongly believes in family unity, and prescribed feminine stereotyped role in the family.

         HE: Is a traditionalist, and believes in male supremacy and the stereotyped masculine role in the family.

4.      SHE: Accepts responsibility for his actions.

         HE:   Blames others for his actions.

5.      SHE: Suffers from guilt yet denies the terror and rage that she feels.

         HE:   Is pathologically jealous.

6.      SHE: Presents a passive face to the world but has the strength to manipulate her environment enough to prevent increased violence and/or being killed.  

         HE:   Presents a dual personality.

7.      SHE: Has severe stress reactions, with psycho-physiological complaints.

         HE:   Has severe stress reactions, during which he uses wife battering to cope.

8.      SHE: Uses sex to establish intimacy.

         HE:   Frequently uses sex as an act of aggression to enhance self-esteem in view of waning virility. May be bisexual.

9.      SHE: Believes that no one will be able to help her resolve her problem except herself.

         HE: Does not believe his violent behavior should have any negative consequence.

Some battered women grew up witnessing their mothers abused by their fathers; some were treated like fragile dolls by their fathers; these pampering fathers taught their daughters that they were incompetent and had to be dependent on a man – sex role stereotyping.

An overwhelming majority (if not all) of batterers were their father’s apprentices; fathers showed them how to beat up mom, and some even let their son get a few licks in early on mom too – for practice. Definitely a learned behavior.

The core of the problem lies in the ideology perpetuated by the traditional attitudes shared by the wife, the batterer, and society (police, courts, and clergy). He MUST dominate and keep his wife in line; she sees him as her ruler who has superhuman abilities.

During hospitalizations for fractured ribs or jaws (or both), she thinks to herself that he may have gone a little overboard, but the dinner WAS served 10 minutes late. The batterer dotes over his wife after the beating brings flowers and candy, tells her how much he loves her, and begs forgiveness.

The husband is not sanctioned for his violence by his wife or society. If police are called to an acute battering episode, they don’t see it as a crime, they merely tell him to calm down; they see domestic violence as a nuisance, but they don’t arrest the batterer or report it as a crime. The wife is too terrified of what would happen if she pressed charges: they usually have enormous trouble in proving it and judges are not interested in sticking their noses in either.

His wife forgives him although during the acute battering incident he does not stop even when she is obviously severely injured. The wife has no legal action with any teeth in it to prevent another beating; police will not remove him from the house, so she must leave if she wants to get away from him.

I went to Haven House, a battered women’s shelter, in Hammond, In. The psychologist who runs it is Joan Cmar who was happy to share information with me because one of the solutions to help battered women is to spread understanding of the problem through as many people as possible.

Joan doesn’t hold much hope for the problem in Indiana. Since Reagan took office the federal funds that support the shelter have been cut drastically and she fears may be cut altogether. Donations are not enough to keep it open.

Right now Indiana offers no legal recourse or protection for the wife. The woman who manages to get out and get to the shelter can only bring what she can carry. The police will not go with her so that she may get her belongings. She faces starting life all over without clothes, money, or a place to live, (the head of the household all the money). 5

There is a bill now pending in the Indiana legislature that would allow women to press charges on their word alone and have the batterer arrested. A similar bill, when passed in Illinois, immediately brought out 1600 cases filed; only 2 batterers were prosecuted. 5 

She says the police do respond quickly if a batterer attempts to cause trouble at the shelter, so she feels safe.  5

The police and officials of the courts are mostly male, they frequently share some of the traditional ideas about a man’s right to dominate his wife; they help support the problem by turning their heads and blaming the victim – why doesn’t she just get divorced? 5

When I asked Joan about the clergy’s helpfulness (all denominations) she became quite angry. She says they are the worst! Most priests and ministers are also male (churches are quite traditional and sexist). They instruct battered women to return home, be better women and keep the family together at all costs. An extremely high percentage of batterers also engage in incest and child abuse toward their daughters. The clergy still think the family should stay together!  5  

She says there are no counselors in Northwest Indiana who are either knowledgeable about or trained to help violent men and their families. So even if the couple, by miracle, get into marriage counseling they have almost no possibility of ever having a violence-free relationship. Even in other parts of the country with expert counselors, almost no progress toward violence-free relationships – divorce is the only answer. If counseling were to work, the husband would need to give up a great deal of power, which is very unlikely. Also, unless the wife gets assertiveness training, she’s likely to marry another batterer.  5

A personal acquaintance of mine recently revealed that she is a battered wife. I was shocked because they own a very successful business and seem to be very nice people. She was beaten by her mother as a child; her husband and four of his brothers beat their wives just like their fathers did. This was my friend’s third abusive relationship.

I personally know a female anesthesiologist who is a victim of a battering husband. She had three babies in 30 months! Batterers don’t allow their wives to use birth control. The doctor lost her job because when she was called out on an emergency case the husband would sit at the nurse’s station in surgery and wait for her – he didn’t believe that some cases could take as long as they did. He ran into surgery one day to see if she left by the back door; this behavior let her secret out of the bag and the hospital couldn’t have him doing that again.

Society loses these women because they must gear every waking moment to seeing that life goes smoothly for their husbands so that they can avoid them getting upset and beating them again. Even if she works, he usually picks her up and takes her there; he doesn’t allow social relations with her coworkers. Most of the case histories that I have read reveal that whenever possible the men take their wives to work with them. (My personal acquaintance says that not only does she go to the business with him, but she can’t even grocery shop without him. To the outsider it looks like they are just so cozy).

Society as a whole is held captive to this pervasive ideology as long as it continues to invade the minds of the violent family’s children, thus ensuring another generation of oppressive batterers and their victims.

A great deal of money is spent and time wasted by the police having to go to “calm down” domestic violence.

Society loses these women because they must gear every waking moment to seeing that life goes smoothly for their husbands so that they can avoid them getting upset and beating them again. Even if she works, he usually picks her up and takes her there; he doesn’t allow social relations with her coworkers. Most of the case histories that I have read reveal that whenever possible the men take their wives to work with them. (My personal acquaintance says that not only does she go to the business with him, but she can’t even grocery shop without him. To the outsider it looks like they are just so cozy).

Solutions

-Continued and increased federal support for shelters.

-Laws to make wife abuse a crime. Mandatory 48-hour incarceration of batterers who have obviously beaten up their wives. This would involve police education and a change in attitudes to the problem. The batterer must be negatively sanctioned. Mandatory psychiatric help to those known to beat their wives.

-Hotlines for batterers, their children, and battered women. 2

-Educate educators about the problem and discuss its existence in schools; drug abuse is now taught in public schools. 2 

-Nurses and doctors should be taught to ask suspected cases if someone did this to them; this may very well open the subject to the victim, and it tells her that you would believe her and take it seriously. Records could be used later in court to prosecute batterers. 2

-The clergy need an educational overhaul to bring the problem to light with them.

-Movies about the realities can be enlightening. An increase in men’s liberation would help. Hopefully, awareness could be stimulated to encourage men to express their feelings more openly. Machoism really hurts and traps them too, with the traditional stereotypes.

-We could teach our children to be more expressive, especially boys – let them cry! Children are taught about why the clouds do what they do – why not teach them the psychology of why people do what they do?

-I would like to see more men like Rosie Greer in the public eye.

-Radical feminism is not the answer. The equal rights amendment will not change people’s minds or hearts. Women will not be free until men are too. I hope to see a new social movement for Human Liberation; men will be allowed to knit and cry, and women will be elected president or become pipefitters if they choose.

While researching this subject I learned about myself – I am a feminist, but I think the ones that are too radical have discouraged its real growth.

Bibliography 

1.      Walker, Lenore E. (1979). The Battered Women. Harper & Row.      

2.      Davidson, Terry. (1978). Conjugal Crime. Hawthorn.

3.      Roy, Maria. (1977). (Ed). Battered Women: A Psycho/sociological Study of Domestic Violence. Van Nostrand. 

4.      Personal acquaintance.

5.      Cmar, Joan. Counselor – Haven House, Hammond, IN.

6.      Personal friend, volunteer – Haven House, Hammond, IN.

Research Design: Touch and the Power to Heal

Indiana University

Principles of Sociology Soc 161, Fall 1982

Grade: Full Credit, 11 Points, “Good Paper”

A in Class; A Hypothesis

Physical contact (hugs, pats, shoulder squeezing, hand holding, etc.) affects the body in a positive manner both physically and psychologically; lack of physical contact has a negative effect on the body physically and psychologically.     

Observations

Football players are quite demonstrative with their physical contact. Anyone who has watched them get ready just before game time knows this to be true. These big tough macho men (who would be arrested for such behavior in any other circumstances) hug, squeeze, hold, hit, and embrace each other in groups of fifty or more. This physical contact with one another psyches up each individual and adds to team unity; their adrenaline is released which prepares them physically for rigorous activity.  1. During the game the physical contact continues with pats on the rear and hand slapping to keep spirits up, share the joy of a touchdown and stimulate another burst of adrenaline.

On the other hand, patients suffering from depression are not psyched up for life and are physically lethargic. Having worked with depressed patients, I have observed that they lack the ability to reach out to be touched; they lack receptiveness to others’ physical advances too. Depressed people seem unable to gather enough physical or psychological energy to respond. They isolate themselves because they feel isolated.

                                                     Test 1 

I would love to see what would happen if on a given Sunday half of the NFL teams refrained from all physical contact, other than what is needed to tackle and get the ball through their opponent’s defense. The opposing team would be allowed their usual pre-game physical bombardment of one another before the game.

Comparisons could then be drawn as to how the players felt about playing without their physical contact: were they as psyched up? Did they physically play as well? Were there more injuries than usual (compare statistics from previous play)? Do they feel that they should have beaten the team that they played? How much did they play up to their potential?

To ensure a spontaneous response from the team being tested they would not be told of the test procedure until arrived at the stadium prior to the game. After the game, the players would be questioned as to the differences that they observed with the elimination of the normal pre-game physicalness.

Statistics could be compared as to points scored, the number of fumbles, and the general effectiveness of the testing team. Hopefully, we could learn whether their physical contact really aids the team physically and psychologically.

                                                     Test 2  

I recommend doing touch histories on patients with depression. Family members and significant others who bring them to the hospital could be asked about the usual touching patterns in the families’ or patients’ life. Are they a family or a couple that is physically close? How do they touch? When? For how long? Is touching in a marital relationship only for sexual purposes? Have them make out a usual day-touching itinerary.

The patient could be questioned too. Comparisons here between what family members reported and what the patient reported may also be enlightening.

Ask the patient how his family was regarding touching during his childhood. Did he feel free to jump up on a parent’s lap? Perhaps one parent and not the other? Was there physical contact in the form of a pat on the head or maybe a bear hug? How would they like to be touched? Is it important for them to be touched? Was there a drastic change in their recent past (last 1-2 years) regarding their physical contact? Death divorce or other physical separation could decrease one’s physical contact behavior. Was there a substantial change in the amount of touching that was comfortable for the patient?

One true example a recall was a woman of 47 who had been married 26 years, had five children and described her family as quite physically expressive in their love: both parents hugged the children daily and the children frequently were seen with their arms around one another. When she had a radical mastectomy her husband and children were so frightened that they were unable to touch her as usual. The woman committed suicide before any help could be obtained for her and her family.

                                                     Test 3  

Psychiatrists and psychologists treating depressed patients could do a different study. One group of depressed patients could be given conventional therapy; the other group should be purposefully given physical contact along with conventional therapy. The counselors would need to decide how comfortable they felt with each type of physical contact and use it appropriately. A patient should be able to perceive it as sincere or the results would be tainted to say the least.

A sincere handshake could be initiated before the therapy session. The counselors should be positioned so that physical contact can be comfortably made during the discussion; squeezing of the shoulder, patting hand or knee and if possible a strong hug before leaving would serve well.

The two groups can be compared as to: did the touched patients show any signs of being more psyched up for life than the untouched? Can it initiate some adrenaline for them and thus increase their physical activity? As time goes on, the touched patient has the ability to respond to human contact. Can a team spirit feeling be generated in those without this feeling by having physical contact with them? Can we take a cue from football and use it to help the depressed patient?

                                                Hypothesis 

(Agree or Disagree)

I’m sure that without their usual touching behavior, the football teams could not function anywhere near their best. I’m sure that less team spirit could be assessed from them; without the team spirit and the adrenaline stimulation of their physical contact, they would win fewer games and have more injuries.

I think there would be a high correlation between the onset of depression and the lack of physical contact in depressed patients.

I don’t doubt that with proper controls and with therapists that felt ok about touching their patients, the patients who were purposely touched during the study would do better than those treated conventionally.  

                                                  Analysis 

If my research design were ever carried out, I hope that it would show in black and white just how important physical contact is. I hope people would THINK about how, why, when, and whom they touch. They may use it more often to express themselves at times when at a loss for sensitive enough words. Perhaps we could become more inclined to ASK for physical contact when we need it, realizing what it can do for us.

If fifty macho men (football players) can all hug one another why not encourage other groups to do the same? There are many groups that could attain cohesiveness with physical contact: a class of students studying for a big exam, a local chapter of Parents Without Partners, residents of a senior citizen home (staff could also join in), and any other group who could benefit from gaining a team spirit and increasing physical ability.

We know that newborns die without soft warm contact; the depressed patient’s situation would illustrate one of the things that can happen to adults with a lack of soft warm contact. If lack of soft warm contact can have such a drastic effect on the youngest of our species, then it MUST also affect even the oldest in some negative way.

Notes

1       Adrenaline – a neurotransmitter (chemical substance released at the neuromuscular junction) released in response to stimulation of the sympathetic nervous system. This is also sometimes referred to as the fight or flight response. This is a protective mechanism of the body that is elicited in conditions that are other than basal.

The physical contact displayed by football players serves to elicit a sympathetic response which results in the release of adrenaline. Adrenaline serves to prepare muscles to run, jump, tackle, and in being generally ready to play. It does this by elevating blood pressure, pulse, respiration, and general metabolism which brings more blood and more oxygen to the muscles that they need to increase activity. If this was not done and the muscles were not ready with extra blood and oxygen, I’m sure that they would be more inclined to injury.

Feminist “Scores:” Their Impact on Psychological Testing

Pat Anderson

Psychological Assessment I (LAP 501)

Spring 1997                         

Dr. Karen Jaffe

Feminist “Scores:” Their Impact on Psychological Testing

After testing nine thousand three hundred thirty seven people in his Anthropometric Laboratory in eighteen eighty four, Sir Frances Galton summarized his findings this way, “women tend in all their capacities to be inferior to men” (Lewin & Wild 1991, p. 582). Over a hundred years later, this erroneous type of belief still lies deeply internalized within the minds of many men and women.

In their essay, Miriam Lewin and Cheryl Ward include the findings of women psychologists whose findings dispute those of Galton. In eighteen ninety five, Mary Whiton Calkins and her student Cordelia Nevers repeated work done by Joseph Jastrow (a follower of Galton) on the “mental traits of sex” (Lewin & Ward 1991, p. 582). Calkins and Nevers results did not demonstrate female inferiority (Lewin & Ward 582).

Helen Thompson Woolley argued against the popular views of Darwin and Galton in her book, The Mental Traits of Sex (1903). A psychology student of Woolley, Leta Stetter Hollingworth also challenged male theories about women’s biological inferiority.

During the nineteen twenties work by Beth Wellman, Marie Skodak and Harold Skeels on intelligence testing had a vital impact by demonstrating the profound effect of social environment on supposedly static intelligence traits. Their work has been crucial to debunking sexist and racist thinking within psychological testing (Lewin & Ward 582).  

Rhoda Unger and Mary Crawford (1992) also discuss Galton’s work. Galton measured things like reaction time, grip strength and height because he thought these were innate and were a mirror to intelligence (76). The only people who questioned Galton’s theories were women, but because of their perceived inferior status, were not heard when they posited that opportunity and life experience were involved in intelligence (Unger & Crawford 76). Despite future testing that revealed no differences in variability, brain structures or intelligence between the sexes, the belief in women’s inferiority lives on to this day (Unger & Crawford 76). From the vantage point of today, it’s relatively easy to see how racism and sexism among past researchers might have led them to find justification for labeling women and people of color inferior (Unger & Crawford 77).

Despite the not doubt hard work of these aforementioned feminists, I have not found their names cited in any of the numerous books on psychological testing that I have been reading. The textbook for this class Psychological Testing (1997) makes no mention of these early feminists work that challenged Sir Frances Galton’s findings. Unless these harmful and erroneous findings are actively challenged traditional assumptions of female inferiority are left to linger in our brains. If the works of these women were included in psychology programs, along with the history of men like Galton, today’s students would be much more enlightened about the issues of sex differences and testing.

Lewin and Ward have provided an update on the progress, or lack there of, that has resulted since the recent inclusion of women’s voices in the field of psychological testing. They specifically discuss the Strong Campbell Interest Inventory and the Minnesota Multiphasic Personality Inventory (MMPI). 

There are many reasons why feminists have criticized psychological tests. One is that some measures discriminate against females. Some measures address things from the perspective of typical males in stereotypical male settings. Secondly, feminists have found that assumptions have been made (without adequate evidence) that women as a group have less of a particular characteristic if their scores were lower than men’s. No one considers males as lacking in any way when they score less of a stereotypical female trait. A third reason for feminist criticism are traditional concepts about femininity and masculinity, masochism, violence and rape as variables (Lewin & Ward 582). If not for feminist inquiry, new concepts such as androgyny, sexual harassment, date rape, and the Rape Myth Acceptance Scale wouldn’t be in existence (Lewin & Ward 582-3). Fourth, feminists posit that operational definitions must be of concern if the originating conceptual definitions are questionable. They offer an example in which femininity was measured via a criterion group of thirteen gay males without first proving that gay males were validating examples of femininity. Lastly, feminists have thought that biases within tests and measures resulted in women being denied admission to schools, denied jobs, and were improperly diagnosed with mental illnesses, when their actual problems stemmed from oppressive environments (Lewin & Ward 583).

Women’s historical not measuring up to male standards on tests created by males, has been used to prove women’s lower status and to justify men’s higher status and power in society. Feminists refute the notion that the standards that we should all be directed to or measured against are those that come from dominant males. Some feminists would go so far as to say that “their way” held the possibility of being “… even better than, the stereotypical male way” (Lewin & Ward 1991, p. 583). 

Lewin and Ward ask, “How can we approach truth”? (1991, p. 584). Surely truth cannot come only from male or female perspectives. Surely a combination that includes the experience and “knowing” of women can come closer to “truth” than historic masculinist models.

The most widely used psychological test is the MMPI. It’s most extensive revision the MMPI-2, was put out in nineteen ninety. Scale 5, Mf (masculine-femininity) was validated for femininity in nineteen fifty six by a criterion group of thirteen gay males. Original descriptions of the scale clearly attest to the fact that their attempt to measure “sexual inversion” was a failure (Lewin & Ward 1991, p. 585). However, this fact was less prominent in test manuals (Lewin & Ward 585).

Feminists had minimal success in effecting change within the MMPI. Only four of the sixty items on the Mf scale were deleted due to their offensive nature. New norm samples were drawn on the United States population to get new means, percentiles and scale score distributions. Despite these new means the basic Mf scale 5 was never validated by correlating to any type of criteria (Lewin & Ward 585). Among revisions made on the F scale of the MMPI, one was done because of sexist language (Rothke, et al 1994).   

The new MMPI-2 now includes scales that can be used for both sexes; the Gm (masculine gender role scale) and the Gf (feminine gender role scale) were taken from items on the old scale. These new scales include only items that seventy percent of one sex respondents label true and no more than sixty percent of the other sex respondents agree. Items are scored for extremes only. Lewin and Ward give the example of how the question, “I like to read mechanics magazines” is scored: Because men split about half in agreeing with this item, men will get no point no matter how they answer this question; when a female answers false to this question gets point in favor of femininity due to the fact that seventy percent or more of women in the sample answered false (585-586). The authors rightfully question whether we can gauge femininity and masculinity in this manner (Lewin & Ward 586). Also couldn’t one be feminine and like to read mechanics magazines? Couldn’t a man be masculine without enjoying mechanics magazines? These measures serve to trivialize the meaning of both genders.

Face validity is also questionable as far as the meaning of the concepts rated. Women get positive femininity on items such as, “I like to talk about sex”, “I am worried about sex” when they answer false to these questions; males gets points for answering true to these. What do these concepts mean (Lewin & Ward 586)? Could it not be that men and women like to talk about and worry about sex? 

Lewin and Ward call into question the manual’s explanation of characteristics used to gauge femininity and masculinity. The manual claims that males scoring highly feminine are likely to be sensitive, aesthetic, passive and may even have a low heterosexual drive in contrast to males who score low and are deemed to be aggressive, crude adventurous, reckless with narrow interests – no evidence is offered to substantiate these claims about these traits. Despite the fact that the authors of the MMPI-2 have admitted that the Mf scale is ambiguous, people who use the test may not know this (Lewin & Ward 586).

This leaves feminists to ask whether this test ought to be used to screen people looking for jobs. Employer bias could occur in either direction. Masculine men may be thought unlikely to be happy in a creative type job and a woman who scores high on femininity may be questioned as far as her ability to fire someone if she were in management. There is a class action suit pending in California against a department store that used the old MMPI as a hiring tool (Lewin & Ward 587).

The Mf (MMPI) scale isn’t a valid measure of sexual preference or of how masculine or feminine a person is. The fact that femininity was measured against responses from gay males speaks for itself (Lewin & Ward 587). The fact that test creators would even consider using gay men to measure women demonstrates the extent to which men are consistently used to develop “norms” that women are expected to measure up. The criterion also wrongly assumes that gay men are feminine. 

According to Friedman, expert on the MMPI, Scale 5 (masculinity-femininity) of the MMPI-2 was originally used to detect homosexuality. Today it’s used to measure interest patterns (Friedman 1997). Friedman says that low scores on this scale reflect the fear of being cared for and the missing joy of being card for (1997). He used a fellow author and friend to demonstrate how a male can be married with kids, but also love fashion and shopping (Friedman 1997). Clearly his description of the Mf scale does represent evidence of feminist influence. His description gave me hope that, at least within psychology, stereotypical attitudes about gender are being challenged.  

Friedman (1997) also says that the MMPI can detect men who would commit date rape. As a feminist, I immediately ask myself why the test hasn’t been used to weed out potential rapists? What use of testing could be more important than the protecting women from harm? If the test can detect date rapists, then the test could also be used to detect therapists who would take advantage of their clients by having sex with them. Since rape is about control and power, not sex, therapists in essence do rape clients when they have sex with them. Why isn’t this test being used to prevent harm?

One of the major causes cited for malpractice claims against therapists is sexual misconduct. Occurrence rates for sexual intimacies and harassment inflicted by therapists are shocking and have been increasing (Corey 1996, 74). Corey credits better reporting procedures and increased public awareness with these increases (1996). With shocking rates of sex occurring between therapists and clients wouldn’t it make sense to use a psychological test that could weed out potential client abusers? 

Feminists have yet to make a dent in the way people are assessed for Post Traumatic Stress Disorder. Not a single study used women to develop the measures. Women rape or incest victims, or army nurses could have been used in the seventeen studies done with male combat veterans and prisoners of war (Lewin & Ward 587).

Lewin and Ward also talk about the Strong Campbell Interest Inventory as an example of where feminist critique has had a positive result. Here feminists asked whether women should be judged by what a typical male feels about his occupation. After studying sex bias in the inventory, the American Measurement and Evaluation in Guidance Commission found that the fourth edition had been much improved. The fourth edition was found to have only five out of two hundred and seven occupations lacking in samples taken from men and women (Lewin & Ward 588).

The evolution of the Standards for Educational and psychological Testing is evidence of the inclusion of women. It’s nineteen eighty five revision says that there is a concern about the role of testing in the attainment of social goals. New developments such as, gender specificity, cultural bias, validity generalizations, interpretations done via computer and scores flagged for those with disabilities are some cautions that were brought out (Lewin & Ward 589). The previous nineteen seventy four standards didn’t address gender issues; the nineteen eighty five revision does address differences in gender, bias of certain items and differential predictive measures. The Code of Fair Testing Practices in Education (1988) agrees with the nineteen eighty five revision, along with all majors testing organizations in education (Lewin & Ward 589). 

Women score lower on the Scholastic Aptitude Test (SAT) than men, but these tests fall short of predicting how women will perform in college because women are known to get better grades in higher education (Unger & Crawford 87) . On the actual abilities gained from courses reflected on the tests girls continually attain higher grades (Unger & Crawford 93).  As a result of women’s lower test scores they loose out on many scholarships; more than seven hundred and fifty organizations award scholarships according to a test score. Women also loose when they are wrongfully denied inclusion in gifted programs. These concrete losses are compounded by the fact that lower test scores effect women’s sense of confidence about their ability to succeed in school (Unger & Crawford 87).  

The Educational Testing Service mandated a sensitivity review process in nineteen eighty. Its effect resulted in changes in the SAT Verbal tests to a more balanced referencing of males and females. Items that were thought to be related to being male or female specifically were dropped from scoring (Lewin & Ward 590-591). There has also been an increase in the number of women on test committees. In nineteen seventy-seventy one, there were only six percent women on the testing committee for the Graduate Record Exam (GRE), compared to twenty nine percent in nineteen ninety-ninety one. Other programs demonstrate moves in the same direction (Lewin & Ward 591). 

Unger and Crawford (1992) explain that it’s language that has described women and men as “opposite sexes” (67). The journal Psychological Abstracts reported 16,416 articles on sex differences between nineteen sixty seven and nineteen eighty five. They claim that the differences thought to be discovered between women and men are rarely related to biology. They refer to sex differences as carrier variables in personal history and experience. Thus feminist psychologists describe differences found as gender-related  (Unger & Crawford 1992 p. 67).

Feminist critique the very definition of gender-related differences, the problem of measuring them, and understanding the results due to issues of interpretation and values. Feminist researchers discovered that historically women’s unequal status was justified by differences documented as scientific facts. Finding new differences between the sexes neglects to explain the societal influences that led to the differences. Feminists argue that differences between women and men are far less actual commonalties (Unger & Crawford 67). The notion of statistical significance can be far removed from the practical meaning of the word significance. “… Statistical significance is not the same as importance” (Unger & Crawford 69).

Unger and Crawford use the image of looking through a microscope as way to explain how researchers perceive their hypothesis in terms of results. If the researcher gazes through the microscope and views what was expected the hypothesis is deemed correct. If the view down the microscope shaft is blurry or shows nothing, the methods are blamed, the procedures are tried again, instead of concluding that the hypothesis was wrong to begin with (Unger & Crawford 70).

Within studies of gender-related differences many times researchers have studied only one of the sexes and posited the results as difference between the sexes. Measuring only hormonal differences as they correlate with mood among women, and then saying that only females experience this phenomenon (Unger & Crawford 71). Feminists also question taking samples for many research studies from college students. These female and male students may have equal levels of formal education, but may differ greatly on the types of classes taken from the start of high school and will frequently be very different while in college. These differences may be crucial to women’s lives (Unger & Crawford 72).

My own experience serves to validate what Unger and Crawford have said. The Miller Analogies Test that had little face validity for me. I never had a college math, philosophy or literature course. I studied nursing, physical and social science and medical ethics. Despite the fact that I graduated with honors from my nursing associate degree program, held a 4.0 GPA (four point scale) in the rest of my baccalaureate studies, and had already obtained A’s on five graduate courses at DePaul University, I failed this test. Out of one hundred questions, I got twenty eight correct, placing my score within the twenty fifth to thirtieth percentile. I can now see that the courses I chose to study did indeed explain why its face validity prepared me for failing. Thanks only to my feminist education and due to the last ten years of excellence in undergraduate and graduate school, my self confidence was not affected by this apparent failure.

My experience validates the claim of Unger and Crawford that, “A valid psychology of gender difference must account for how individual experiences and situational variables interact with sex (Unger & Crawford 74). Even new sophisticated techniques of meta-analysis do not lead us to any conclusions about the causes of differences historically found in published studies (Unger & Crawford 75). Traits usually connected with people of color and women, when compared to those of the “reference group,” are less affirming and desirable. “… Separate but equal …” stratifications remains illusive (Unger & Crawford 77).

Most psychological research measures behaviors outside of their social environment, which feminists question as far as then extrapolating real world validity; taken out of context, objectivity faces a mirage (Unger & Crawford 98). According to testing specialist, Phyllis Teitelbaum, standardized tests are androcentric in their epistemology in that they fail to measure skills such as creativity, intuition, verbal and non-verbal communication, cooperatives, sensitivity and supportiveness, all of which reinforce the androcentric model’s values and way of seeing the world. When something’s not tested it’s less valued than items included on tests (Unger & Crawford 98).

Because of feminist inquiry some psychological tests have been revised for the better. Sexism is more likely to be challenged today because of the work of feminists, despite the failure to promote change on the MMPI-2 Mf scale. The field of psychology and testing will evolve slowly along with the increasing presence of women in the field (Lewin & Ward 593). 

Work Cited

Anastasi, Anne., and Urbina, Susana. (1997). Psychological Testing. Prentice Hall: New Jersey.

Corey, Gerald. (1996). Theory and Practice of Counseling and Psychotherapy. Fifth Edition. Brooks/Cole Publishing Company: New York.

Friedman, Alan. (1997). Lecture on the MMPI Test. National-Louis University, Wheeling Campus. May 5.

Lewin, Miriam., and Wild L. Cheryl. (1991). “The Impact of the Feminist Critique on Tests, Assessment, and Methodology.”    

Psychology of Women Quarterly, 15, (pp. 581-596). 

Rothke, Steven E., Friedman, Alan F., Dahlsrom, W. Grant., Greene, Roger L., Arredondo, Rudy., and Mann, Anne Whiddon. (1994). “MMPI-2 Normative Data for the F-K Index: Implications for Clinical       

Neuropsychological, and Forensic Practice.” Assessment. vol 1, number 1, pp. 1-15.

Unger, Rhoda., Crawford, Mary. (1992).  Women and Gender: A Feminist Psychology. New  York: McGraw-Hill, Inc.

Miller Analogies Test Report (MAT)

Psychological Assessment I, LAP 501

Dr. Karen Jaffe

Spring 1997

Presentation

Developed by W. S. Miller at the University of Minnesota in 1926, the MAT is a mental ability test to used differentiate between high-ability applicants (Ivens). 100 multiple-choice items are presented in the form of analogies with 4 possible responses (Ivens). Subject matter is classified into 9 categories: language usage, math, physical science, history, biological sciences, social sciences, literature-philosophy, fine arts, and general information (Ivens). It proports to measure adequacy of educational background and problem solving ability (Frary).

A.    Describe Standardization sample.

       The norms are limited in that they suffer from lack of specificity, especially in disciplines as the natural sciences or humanities, doctoral and masters candidates were combined, the norms only relate to applicants who elected to take the MAT, not to all those anticipating graduate study (Frary). 

New norming was based on all domestic examinees who took the test for the first time in 1991-1992 (Frary). Categories were then developed according to projected major (Frary). The scores are presented containing percentile ranks using 5 point intervals (Frary).

Compared to the 1981 edition, the 1994 manual contains quite a bit more verbiage about score interpretation much of which is appropriately cautionary regarding things such as: no fixed cut of point for admission, using a variety of evidence to establish candidates adequacy, consideration of standard error of measurement, and that the norms were based on self-selected examinees (Frary).

Summary statistics on the 1991-1992 examinees could not be ascertained from the data the authors have provided, making one wonder whether group x form analysis of gender and ethnicity was done, which would have been useful (Frary).

In regard to the 1991-1992 norm establishment procedure (as already described by Frary), Iven says these reference groups aren’t technically norms and the publisher cautions users that the percentiles may not be representative of all graduate applicants, similar cautions are NOT clearly stated in materials for examinees (Ivens).

In The Candidate Information Booklet of 1991, examinees are encouraged to eliminate options before guessing and to guess even if baffled (Frary). However, in the actual test instructions they’re told, “If you are not sure of an answer mark the response you think is correct (Frary).

The Guide for Controlled Testing Centers and Directions for Examiners offer clear and prescriptive seating arrangement, and test forms, leave nothing to chance and ensuring a level playing field (Ivens).

B.    What is the Reliability? Is it test/retest, split half or other?

       Frary says reliability is good, but says that previous reviewers found a problem with norming scores and with the methodology for equating its forms (Frary). Seven forms of test allow for retesting candidates (Frary).  Alternative Form reliability utilized.

A new section of the 1994 technical manual contains data concerning score changes on retake (Frary). A substantial portion of the retestees are retaking due to getting a lower score the first time, so it may be a motivating factor causing a 5-6 point increase in retake scores on average (Frary). This remained consistent across time between initial and subsequent retesting with presumably a different forms of the test. (Frary). The correlation between the 2 scores, a sort of hybrid test-retest/parallel-form reliability coefficient, was only 0.73 which is much lower than the KR-20’s of over 0.9 reported on various forms of the MAT (Frary). Discrepancy no doubt reflects variation in time differences between retesting as well as content difference between forms (Frary). The effect of coaching wasn’t mentioned (Frary). Both the 1981 and the 1994 technical manual, Form V21, appears to be the test to because it appears to be much easier than others. One should expect better from the publishers (Frary).

Ivens criticizes a publication entitled, Miller Analogies Test Technical Manual—A Guide to Interpretation which is supposed to help university deans, faculty and administrators with their decision making process (Ivens). The publisher says the various test forms are similar, thus are comparable. However, comparable does NOT mean equivalent and the publisher is remiss in not providing empirical evidence (Ivens). Surprisingly the manual does not address race, ethnic or gender bias except through uninterpreted tables (Ivens).

C.    What is the Validity? If there is none, what explanation is given?

Frary’s assessment concluded that the MAT’s content was well constructed, but does offer that other reviewers found validity inadequate as presented in the technical manual (Frary).

The 1981 technical manual provided over 40 corrections between MAT scores and graduate GPAs (Frary). This was criticized for failure to specify circumstances underlying each coefficient (homogeneity of the groups, difficulty of courses, etc.) (Frary). The new technical manual simply aggregates data collected in 1992 from over 50 grad departments that had at least 8 students with MAT scores, undergraduate GPAs and first year grad GPAs (Frary). The reader is left in the dark about the number and characteristic of universities involved, subject areas of departments, the total number of students involved, and the time period represented by the data (Frary). Correlation between MAT scores and first year grad GPA is only 0.23 (Frary). Multiple correlation using undergraduate GPA and MAT scores to predict first year grad GPA is 0.37, whereas the correlation between undergraduate and first year grad GPAs is 0.29 (Frary).

The technical manual contains a warning data may not be representative of all grad departments and points to likely restriction in range of both predictor and criterion due to selection and grad school grading practices (Frary). In other words, accepting the validity of the MAT for informing about admissions decisions is more or less an act of faith (Frary).       

Given the MAT’s low predictive power, it’s likely that it’s continued use will be justified as a hands means of checking whether someone has the mental capacities judged adequate for the subject matter at hand (Frary). One could quickly eliminate extremely low scores and spend less time on the qualifications of candidates with high scores (Frary). Purist would denounce this, but if used conservatively it’s very unlikely to cause inappropriate or unfair admit decisions (Frary). 

The concept of validity is discussed but the evidence of content validity is not presented (Ivens). One correlation matrix based on aggregated data from over 50 graduate schools/departments is presented as evidence of predictive validity (Ivens). The correlations (already stated by Frary), mean that the resulting incremental validity for the MAT over undergraduate GPA is 0.08 (Ivens). Grade inflation, restriction in range, and inconsistencies in grading practices within and across schools and departments, make GPA a less than ideal criterion variable to predict (Ivens). The MAT would have been better served had the publisher disaggregated the data and displayed predictive validity coefficients separately by school/department (Ivens).Ivens warns that the onus of confirming the tests assumptions rests with each school/department that requires the test (Ivens).

The publisher says, “An applicant to graduate school will typically have been exposed too much, if not all, of the information necessary to complete each analogy” (manual p. 4) (Ivens). However, as many examinees will attest, exposure to the necessary information is not  a sufficient condition for successful completion (Ivens). The cognitive complexity of the items is due in large part to the nature of the relationship among word pairs (Ivens). The 50 minute time limitation encourages people to select the first plausible answer, if not done carefully will be wrong (Ivens).

The Candidate Information Booklet says that fluency with the English language, broad knowledge of the topics (included above), and the ability to reason out relationships, may contribute to one’s results (Ivens). Although a minor point, the auxiliary verb “may”  is most curious because if the aforementioned factors don’t help with performance – what does (Ivens)?      

D.    Give Revision information.

       The MAT was first published in 1926 and has undergone revisions up until 1992. The technical manual was completely revised and  published in 1994 with little change in the problems discussed above, except for some improved norming (Frary).

E.    Who may Administer this test and under what circumstances?

       The test distribution is restricted and is administered to a group in a licensed test center (Frary). The test can be scored on site to facilitate rapid results and decision making.

Frary, Robert. B. Buros. pp. 617-619.

Ivens, Stephen H. Buros. pp. 619-620.

F.    Your Thoughts on this test.

       I immediately picked up on the tests lacking face validity.

Despite the fact that I had already done very well in actual graduate school courses, I failed the test dreadfully. My real-life experience with the MAT validates the assessment of both reviewers. It’s not a worthwhile tool in predicting graduate school performance.

Book Review – The Last Time I Wore A Dress

By Daphne Scholinski

By: Pat Anderson, Winter 2000 (1-29-2000)

Workshop: Supporting Gay, Lesbian, Bi-Sexual and Transgendered Youth. National-Louis University,  Instructor: Melissa Maguire                 

Scholinski, Daphne., with Meredith Adams. (1997).  The Last Time I Wore A Dress.  Riverhead Books: NY.

Before …

Daphne Scholinski was a local girl who grew up in several different communities around Chicago: Schaumburg, Roselle, and Lombard. She might have lived next door to any of us, she may have played with our children, or she might have actually been any of us.

 We are all aware of the basic gender rules that we so often take for granted. Most of us have internalized them so deeply that unless our consciousness’ are raised about just how strong they stringently limiting they are.  Daphne’s experience demonstrates just how far some people will go to enforce gender dictates.   

Only recently her mother told her that when she was an infant she was riding on a bus with her going over a bridge. Her mother looked over the rail and thought, “I could just throw her off the bridge.” Daphne responded with, “Oh, really,” as if she didn’t care. She remembers that everywhere she went she looked for people who might take her in. Learning this recently is a start in explaining why she might have spent years looking for a sense of home. 

She was restlessness in school, she wanted to skip ahead in books, but was told to keep quiet and follow along with the other kids. As far back as first grade a teacher told her to sit still and not roam around the room.  She’s not sure what happened, but around second grade she stopped feeling things. One time a teacher asked her to say something and asked whether or not she felt anything.  In response she slid her finger tip beneath a stapler and pressed down hard. It didn’t really hurt, but the teacher looked at her as if she was whacked.  She stopped raising her hand in class and when teachers called on her she acted as if she hadn’t heard them. It never occurred to her that they really wanted to hear what she had to say.

By the time she was in third grade her mother was considering suicide.  Her mother never told her with words, but she was always aware of it because her face was always very sad.  The sadness made her mind wander even while she looked you in the eye. She worried that she might come home from school and find her mother dead. Her third grade teacher, Miss Martin, liked her. She said she thought she was a sad child and sent her to a school counselor, Mrs. Stein.  When they played a career game with the school counselor Daphne choose the policeman and construction worker. This was the first time the gender thing came up. Mrs. Stein told her she thought she wanted to be a boy.  Daphne didn’t really know if she wanted to be a boy, but she did like to go shirtless in the summer and play rough. She hit harder than all the boys so why would she want to be one? She wasn’t inspired by compliments on how pretty she looked when her parents tried to get her into frilly clothes. She couldn’t wait to get back into the tee shirts and jeans that left her free to run.

She remembers going to the bathroom in a grocery store with her father. As she walked out a balding clerk grabbed her and with a look of hatred on his face hauled her over to her father saying, “We found your son in the women’s bathroom.”  He father said, “that’s not my son,” and explained to the clerk that she was a girl. The clerk apologized to my father, but no one apologized to her. Everything felt bad inside at that moment and lumped together into the fact that she didn’t look right.  This kind of event happened many more times. After the first episode her father would simply slap her hand and say, “Bad boy, I told you to stop doing that.”  She didn’t know what to think of that.

As far back as she could remember she had a powerful sense of her badness and feeling powerless to redeem herself.  When she was very young her parents made it clear they would just as soon she go off by herself and not bother them. Her mother told her after age eight a child should be on their own. She says her badness grew out of boredom. She cut school, stole gold chains and cans of Dinty Moore stew. She recalls girls at school pinning her to the ground and forcing red lipstick on her and then laughing. The school social worker told her she was wrecking her family and if her bad behavior kept getting all the attention, her parents might loose her little sister Jean. She knew she was bad, but she wasn’t crazy.

She was kicked out of Sullivan High School for threatening to blow up the math teacher’s car because he insulted her mother. She knows she would never have done it. A therapist then said she needed a more disciplined environment, so she was sent to live with her father and his girlfriend. A high school counselor gave her the MMPI and told her father that she was out of control and had a criminal mind. He believed it without doubt. Her mother’s initial concerns were escalating fights, stealing, deteriorating school work, truancy, and involvement with drugs and alcohol,  all of which got worse after her parents separated. The final straw for her mother was when she felt provoked to hit her. On June twenty third nineteen eighty one, a therapist at the Northwest Mental Health Center recommended she be sent away for long term psychiatric treatment. Her mother’s response was, “What else can we do? I can’t handle Daphne.” Her father said, “ She’s out of control.”

Daphne went through extended evaluations at the Doyle Center in January of nineteen eighty one. The conclusion was that she was confused about her role in the family and in family structure, she was responding to unclear expectations, responsibilities and rules, and was struggling to set up a structure for herself. Much of her behavior was thought to be directed at attention seeking, and for appropriate feedback about limit setting.  The behavior problems went into the classroom as well, and it was postulated that she was carrying much of her family’s anger; they speculated that patterns of violence from her parents families of origin were continuing through Daphne. 

Michael Reese Hospital

Daphne recalls leaving Arlington Heights Illinois with her father on September 10, nineteen eighty one. They shared a silent ride along I-90 to Michael Reese hospital. She was fourteen and her father had been physically abusing her. She always knew he wanted a quiet, obedient daughter like her younger sister Jean. Her mother told her that her father was never the same after he came back from Viet Nam. He had experienced a bloody incident where his fellow soldiers were blown to bits, his back was broken, and filled with shrapnel. He had lost the ability to warm up to his wife and later her mother used this to explain why he was abusive to her. 

Her father knew exactly where and why he was taking her to Michael Reese, but she had been told they were merely on an exploratory mission to the psyche ward. It had actually already been decided that she would be admitted. At age fourteen, she had no idea she was on her way in with no way out.   

When her parents got divorced her mother moved to Rogers Park in Chicago.  Her mother didn’t know her father was hitting her. Her mother became involved in parties, marijuana, and arguing over foreign films. Her mother never noticed her involvement with a man named Frank who carried a handgun under his arm and in an ankle holster. He said he was a hit man. At thirteen she didn’t know it was possible to say no to a man with a gun, especially one who was nice to her.  She has a clear memory of being naked in his bathtub and his large thing in her hand. She thought about this as she rode up in the elevator at Michael Reese – with her background, perhaps Michael Reese was a stab of hope.

Once in Michael Reese she saw Dr. Browning, who she called Dr. Sigmund Fraud when she got bolder. She never liked doctors because of their condescending attitude. He made her feel like she was a specimen he could study. As she told him about her father beating her and her mother not wanting her around, he just scribbled away.  She exaggerated her use of drugs and alcohol because she knew doctors liked to hear about youth and drugs. She asked what her diagnosis was, knowing it was a major deal.  It was like being a Disciple or a Latin King, it was your identity in the hospital. When a doctor looked at you he saw your diagnosis, not you. He told her she had multiple diagnoses: Conduct Disorder, Mixed Drug Abuse, and Gender Identity Disorder, Grade 3. He explained that this meant she wasn’t an appropriate female. 

She didn’t mind being called a delinquent, a truant, a hard kid who smoked, drank, and ran around with a knife in her sock,  but she didn’t like being called something she wasn’t.  The gender screw-up thing wasn’t cool. It meant the boys in Little League who called her tomboy, and the girls who pinned her down and forced lipstick on her were right, she was a freak, she was … not normal.  Dr. Browning’s labeling her was worse because it made it official and meant that every mean thing that had ever happened to her was her fault, because of this gender thing.  She knew she walked tough, sat with her legs apart, and didn’t defer to men or boys, but she was a girl in the only way she knew how to be. She was now aware that this matter was settled and that anything she said now would be put in her chart as defensive behavior.  It was also noted that she was unhappy, frightened, with a great deal of secondary depressive affect, primitive rage, a permissive superego, and grandiose expectations.

The mental health professionals at Michael Reese also diagnosed her family. They said her parents weren’t able to establish limits, there were several psycho-social stressors with the parent’s separation, and they emotionally abandoned Daphne. 

So … she spent endless days watching one soap opera after the next.  Units 3 West and 3 East were scary because of the older people who were predictors of her future if she didn’t behave. There was a woman in a wheelchair who would defecated and urinated on herself, there were adults who just stared in to space, there were pacers and screamers, and patients who thought they were someone famous. She found it interesting that none of the crazy people knew they were insane. She’d sit around thinking, I’m so sane in comparison to these people, and then a flicker of thought would enter her brain, maybe she didn’t know she was insane? They don’t know they’re insane, so why should she know, maybe she wasn’t aware that she was walking around saying she’s Patsy Cline?

The nurses let the patients borrow the DSM-third edition (the bible of psychiatric diagnosis) when they got bored. Patients would laugh about the various diagnosis. She never told the other patients about the gender thing, she only mentioned the conduct disorder. They even placed bets on being able to get a new diagnosis added to their charts (which they also had easy access to).  You did have to be careful though, not go too far.  Having anorexia added or multiple personality was one thing, but you had to limit hallucinations or you’d end up with big time drugs. She doubts if they had looked up Gender Identity Disorder that anyone would have tried to fake that and get it on their chart. They knew the rules, pacing, screaming, hallucinating, and vomiting were ok, but a boy with a scarf in his hair, or a girl like her, who wore only jeans and a tee shirt and who felt uncomfortable in a dress, were not ok.  The doctors came up with the idea of her being, “an inappropriate female” – that her mouthy ways were a sign of a deep unease with her female nature. If she learned about eyeliner and foundation she’d be better off. 

Once she was locked up she lost interest in having a meaningful conversation with her parents. Her mother didn’t care at all whether she wore make up or girly clothes. Her father would have liked to see her hair tied back with a pink barrette, but it wasn’t his main concern – he wanted her out of the house before the violence between them exploded.  Once a counselor asked her father if he had any questions about her treatment. This was at a time she had already experienced a suicide attempt, had a guard hold her down with his foot on her head and had another patient run his hands over her body when she was forced to sleep in restraints. (There was also her legacy from home which led to her flinching if anyone came too close.) The one question her father asked the counselor was, “Can you tell me, why she won’t wear a dress?”    

Her psychiatrist labeled her problem as, “failure to identify as a sexual female.”  Her treatment goals included: becoming more obsessive about boys, becoming skilled with makeup, dressing like a girl, curling and styling her hair, and learning “girl things” with other teenage or young adult patients. The hospital used a current in vogue label called, Gender Identity Disorder. This sentence meant that instead of living a normal  high school student’s life, Daphne faced: frequent doses of sedating drugs, seclusion, physical restraint, and being locked away with people who really were crazy. 

Daphne actually lost points if she came out of her room in the mental ward without makeup and feathered hair.  She also got points for affirmations such as, “I like my blue eye shadow,” “I love looking pretty.”  Without points she couldn’t go to the dining room, or walk from her classroom back to the unit without an escort; without points her teacher would hand her off to an attendant whose manner and tone of voice communicated to her that he thought it was pathetic that a girl didn’t have enough points to travel one hundred feet alone. The staff was consumed with evaluating how well she adopted femininity, including the way she walked, the way she combed her hair, and how she related to males. She hated either choice, but a half moon of eye shadow was her best choice so she did it. To this she said, “This was how I learned what it means to be a woman.”  About this she asked, “Ever lied to save yourself? Ever been so false, your own skin is your enemy?”

Daphne says, “ … one might say, these are trivial matters, but they’re trivial matters in which the soul reveals itself.” She asked us to try changing these things. Try it: wear an outfit that is utterly foreign, a narrow skirt when what you prefer is a loose shift of a dress, or torn-up black jeans when what you like are pin-stripped wool trousers.  See how far you can contradict your nature. Feel how your soul rebels.” 

She couldn’t count on her parents to visit or even call when she was hospitalized. She told one nurse, Kay, of feeling depressed and abandoned after her mother didn’t show up for the third time, her father lied about trying to call her, and she was worried because couldn’t contact her little sister.  She often told this nurse she needed mothering and tenderness and that she hoped she would adopt her.

When she told her therapist about her mother’s violent boyfriend from Iraq and how he was threatening to kill the family if her mother didn’t go to Iraq with him they, marked in her chart – paranoid thinking.  Soon after that he did try to kill her mother, but she narrowly escaped. He was later in the front page for hijacking an airplane and threatening to kill the stewardess.

One roommate, Francine, got shock treatments. She tried to get her out of them and actually succeeded until they got wise and separated them. You did have to be careful because you knew they had the power to perform those shock treatments on you too.

She had been sent downstairs to 2 West where the hallways smelled of urine, vomit and, unwashed armpits when she got fresh with a counselor. The patients looked as if their bodies and minds had been separated so long that all communication had been broken down.  Skewed clothes, wild hair, faces twisted with all the terror that wanted to spill out. The first time she experienced this unit she thought, “This is how the outside world sees me: insane.”  2 West meant plastic silverware, no shoelaces and seclusion. No one slept well there and if your own anxiety didn’t keep you awake someone else’s did.  One time while she waited for the three big male guards to take her up to 2 West she ran in the bathroom and covered herself with baby oil.  Eventually they caught her and a nurse shot her with Thorazine. Despite being aware of the inevitability of being caught, she like the free feeling of running away. She says it felt similar to when she ran from her father as he yielded his belt.

Her counselor and psychiatrist had continually tried to get her to wear a dress, but she kept refusing. On 2 West there was no choice, a dress  was the seclusion garb – a hospital gown was all you were allowed to wear.  The seclusion room was nine square feet of whiteness except for a yellow mattress on the floor. This was the last time she wore a dress.   In seclusion she had to be escorted to the bathroom with a male guard. She can’t even describe how she felt when she had her period.  She learned to hold her pee for very long times and as a result developed many urinary tract infections.

Escape was something patients talked about a lot. It was a sign of sanity; it was a statement, I am not one of these people, I am not a mental patient.  She was restricted from art therapy once because she painted a ceramic dog plaid, with thin blue and red lines. They only allowed to let her back when she agreed to do art in an acceptable manner.  

After six months, Michael Reese decided to discharge Daphne because of the unworkable situation with her parents, who lacked cooperation, and Daphne’s continued non-compliance with hospital rules and staff limits. Dr. Browning told her the only way she could stay was if her parents became involved and they refused. The struggle to develop a working alliance prevented actual treatment. Daphne became so depressed when she learned of the decision she had to be on suicide watch for a few days.  She felt the hospital was kicking her out. She thought, “… who gets kicked out of a mental hospital?”  Her parents said they were coming to family sessions at the hospital, but the hospital told her they weren’t cooperating. Her parents said the psychiatrist told them she was way out of control, disruptive to the unit, and that the hospital couldn’t help her because she was too far gone. There was also some question in her mind about whether the insurance money had run out. Even the craziest of patients wasn’t kicked out of a mental hospital. She thought she must be psycho and not even know it. The art therapist told her that her parents lacked the commitment to care for her – what she heard was worthless trash.

Forest Hospital

In April, nineteen eighty two, after seven months at Michael Reese, she was transferred to Forest Hospital In Des Plaines, Illinois.  Her presenting problems there were: depression, substance abuse, childhood physical abuse by her father, doing poorly in school, stealing, lying, running away. Their notes said she presented herself in a tomboyish manner.  Although she had highly exaggerated her substance abuse, she was placed in a substance abuse unit. The admissions counselor writing up the admission information ended by saying, “At this point it is difficult to see any assets that might be present.” She later realized that bragging to an admissions counselor about drug abuse in a hospital that had a nut house ward and a drug and alcohol rehabilitation unit that advertised, “we get results,” was like making a bomb joke at an airport.

Rehab had several things going for it. Drug users were chic, far more chic than the mental patients, and her non-drug problem was a distraction from what she anxiously wanted to avoid – the gender screw up thing. Another appeal of rehab was that she wanted to be a drug addict because it seemed like a blanket of forgiveness. It was a disease, it wasn’t her fault, and it would absolve her parents from blame. It was a lot more understandable and easier to explain to the world than, my daughter won’t wear a dress, my mother doesn’t want me around, my father beats me, and she’s plain out of control.  She thought she could act the part of an addict. She could do this to deal with her feeling of being the biggest mental hospital drop out in history.   

Eye contact was very important in rehab. The doctors and the counselors are not really interested in what you think, they want you to give them the right answers so they can walk away smiling and pleased with the progress they’ve instigated. She wasn’t about to give the right answers. The truth was she’d tried drugs with her gang friends in Rogers Park, but they just hadn’t done it for her.  When she got to the AA meeting she wasn’t able to say, I’m Daphne and I’m an alcoholic and a drug addict. She could justify lying to the doctors, but not the other patients.  As she heard all their sad stories she thought she didn’t have the drugs as an excuse for her behavior so it must be her badness that made her the way she was. When she finally admitted in one AA meeting that she wasn’t an alcoholic the counselor wrote on her chart, massive denial. 

She was the youngest patient on rehab, she wasn’t really an addict, and the patients here weren’t having any fun. They needed a few good screamers. She missed the patients at Michael Reese, she missed nurse Kay’s smile, Danny’s deep voice singing a Luther Vandross ballad, Jesus with his lengthy plans for the apostle’s reunion, Heather writing notes to her – at least these patients had liked her. She got herself transferred out of the rehab unit by pretending to be anorexic.

During a family session a counselor asked her mother, “It seems to me Daphne is looking for a mother. Is there enough room in your life for a mother-daughter relationship?” Her mother said, “No.” She wouldn’t cry in front of her mother, she wouldn’t cry, even lying in her bed at night her eyes stayed dry.

Dr. Browning said she was not appropriate, she hated him for that. However, she did feel different. She remembered roller skating with a girl, no one in particular, a blend of all of them, their hair flying loose and the tingle in her stomach. She knew if anyone found out she liked to roller skate with a girl she’d be locked up in the psycho ward forever. She wrote in her journal that she was tired of trying to tell them the truth about not drinking because they didn’t believe her anyway. She decided to play the game the way they (staff) wanted her to.  She added a p.s. – I think I like girls.

She knew the staff read her journal because she read it in her chart a few days later. She feared that this knowledge meant the staff would have something on her.  She also tried suicide while she was there by taking Sea Breeze and lighter fluid. She wanted to simply disappear.  She couldn’t find a place for any aloneness that she could escape to. There was no privacy.

She couldn’t stay at Forest Hospital because they specialized in short term treatment and the doctors said she needed long term. She was transferred to the Wilson Center in Minnesota. Her father was freaked out about trying to get her accepted into the Wilson Center. She’d have to go through four days of interviews to see if they would accept her. Her father told her, “This is really important. You’ve got to get into Wilson, do you understand?” He seemed like a deranged parent trying to get his kid into the best prep school. She’s have to wow them with her mental illness.  Dr. Freeman said if she didn’t get into Wilson they might be able to keep her at here for three years. She thought she would be able to tolerate the makeup and hair routine because it was short term, but the thought of it for three years made her think she’d fall apart. That’s what had led her to decide she’d rather be a drug addict than run around with crap on her face.

The Wilson Center

On June 14th, 1982, she went to the Wilson Center in Minnesota. Wilson Center was a residential facility in the middle of a corn field and was specifically for teens. They had their own small rooms and lived more like other teens. It was not totally a hospital environment. They could drive around town and have beer parties as long as they were behaving reasonably well. She had her first best friend (female) relationship while she was there. The staff tried to separate them because they assumed it was sexual, but later relented and let them be friends.

She felt a lot of the staff liked her here, which especially shocked her parents. Staff even let her do new patient orientation. Because of her past experience with mental facilities she could honestly tell them that at least you could have some fun here.  No one here tried to get her to be feminine and her best friend had even referred to her as normal  which she said made her feel changed inside just to hear the words.  After her best friend tried to commit suicide twice Dr. Madison told her, “We feel there is a pathological aspect to your pairing off with a female patient who has had two suicide attempts.” With nine adults surrounding her – what response was appropriate?  All she could say was, “She’s my friend.”  She knew what pathological meant. It meant sick. Like Frank, who had steered her hand to his zipper, creepy men, and like Gloria a childhood babysitter who made her feel icky when she lifted her tee shirt up. They were saying she was like them – a sicko. Once in trying to convince her best friend’s psychiatrist that they weren’t physical she said the thought of being physical with a woman turned her stomach. The psychiatrist responded, “When something turns my stomach, I find that exciting.”  

The psychotic made life interesting. One boy Peter’s mind was full of facts, dates, state capitals, wars won, treaties signed. The psychotics were ok one on one, but in group therapy they were scary. She was raped by a fellow patient, but didn’t even tell her therapist because she knew she would have asked her why she didn’t want to have sex with a cute boy like him.

While at Wilson she and some other patients were allowed to attend regular high school classes at the local high school. They got a chance to mix with the normals. This was cool except that everyone knew you were a mental patient. 

Her insurance ran out on August 5 (her eighteenth birthday), she was discharged August 10th nineteen eighty four.  Dr. Madison told her everything was in remission, except for the gender thing.  After she was out for awhile she wondered why they didn’t treat her depression, why no one noticed she’d been sexually abused, and why the doctors didn’t believe she came from a physically violent home? The only thing they focused on was her not being feminine enough. The shame is that the effects of depression, sexual abuse, and violence were all treatable – where she landed on the feminine/masculine continuum was not. When she was in college no one wanted to hear about her experience in mental hospitals. She doesn’t know how to explain that she’s an ex-mental patient who never had a mental illness. There’s no use insisting you’re not crazy. All ex-mental patients are lumped together schizophrenics, manic-depressives, whatever.

Eventually she got to tell her story to an audience who wanted to hear it. The International Gay and Lesbian Human Rights Commission paid her way to go to the United Nations Fourth World Conference on Women in China. After she spoke she got the only standing ovation of the day.

Daphne has now gone to graduate school to study art and has found it to be her life saver. In one of her first art classes the assignment was to create a life-size self portrait. She built a wooden box, one foot square. Then she put in sand and dumbbells that equaled her weight. All of her one hundred thirty pounds crammed into this box. Her professor was ecstatic and told her she had found her place and to keep creating.  She’s created over three thousand paintings and actually earns a living at it today. Today she lives in San Francisco with her partner.   

Her treatment, in girly lessons, in three mental hospitals over three years (1981-1984) cost one million dollars and resulted in a high school diploma from a psychiatric facility for adolescents (she never shows this to anyone). At this cost she ponders whether they might have called in Vidal Sassoon instead of using other teen mental patients as tutors.

Frightening, she was released in nineteen eighty four, only sixteen years ago. I had no idea this type of treatment was taking place in our country. Recent 20/20 episodes have portrayed Daphne’s and another teenage girl’s stories of being put away in mental hospitals for being different, not being feminine enough, or for being gay. Thank God, only sixteen years later, I’m actually able to take a workshop called, Supporting Gay, Lesbian, Bi-Sexual and Transgendered Youth. A brief look back can brilliantly illuminate the progress that has been made.

Book Review – Ageless Body, Timeless Mind: The Quantum Alternative to Growing Old

By Deepak Chopra

Deepak Chopra is a practicing endocrinologist who was born in India. He combines Eastern spirituality, traditional medicine, and physics to provide a holistic view of health and aging. He demonstrates the true connectedness of nature by combining physical science and spirituality. Who would have seen these two seemingly separate topics as one package complimentary knowledge?

We humans have always sought to unravel the secrets of aging. According to Chopra, we’ve spent most of our collective planet time looking in the wrong places. Scientists have long pried and examined the body seeking answers to eternal questions about the mystery of aging. Chopra suggests that the answers lie in our consciousness, not in our bodies. Teacher comment: Excellent point. Like Dorothy in the Wizard of Oz, we’ve had the power and the answers within us all the time. It’s empowering just to imagine the power over our physical and spiritual lives within us.

Dr. Chopra combines mind-body medicine with current anti-aging studies to demonstrate how aging’s negative effects can be prevented. Over the last thirty years, hundreds of research findings have verified the fact that aging is very individual and that there’s no definite line between psychology and biology. He says we can learn to redirect how are bodies metabolize time. If we want to intervene in aging process, we must do it “at the level where belief becomes biology,” here, we can attain our “unbounded potential.” Teacher comment: Interesting position.  The secret to diminishing the signs and symptoms of aging lies simply in our perception.

It’s our social conditioning, our collective worldview, “the old paradigm,” (3) our way of seeing things that he calls, “’the hypnosis of social conditioning’, an induced fiction in which we have collectively agreed to participate.”(3). Our bodies are aging as we have programmed them through our collective conditioning. We can actually rewrite our own developmental software and by reprogramming our perceptions of reality.

“Our cells are constantly eavesdropping on our thoughts and being changed by them.”(5). Falling in love can boost the immune system. Our immunity can be destroyed by depression. Teacher comment: True. Despair increases the risk for a heart attack or getting cancer, where as, joy keeps us healthy and extends life. Just the act of remembering a past  stressful event stimulates the flow of destructive hormones, the same reaction caused by the stressful event itself. We have the ability to speed up, slow down, or even reverse aging with our minds.

Your entire world can change, including your body, by a simple adjustment in your perception. Teacher comment:  Yes.  Mandatory retirement can be deadly for many men. The day before your sixty five you’re valued and seen as socially useful, the very next day  your a societal dependent. The incidence of heart attacks, cancer, and early death in previously healthy men soars within the first few years after retirement. On the other hand, in societies where old age is accepted and valued, elders stay vigorous.  Teacher comment: No doubt.

Our current assumptions about aging don’t define our reality, they were interventions of the human mind that we converted into rules. If we’re going to challenge aging we have to change our worldview because nothing holds more power over our physicality than our beliefs. The underlying reason that old people feel marginal, devalued, and cut off from mainstream activity is because they lack positive images of aging.

Quantum physicists, like Einstein, have known for almost a hundred years that our perception of the physical world is wrong. It reminds me of the very old belief that we clung to for so long, the belief that the world was flat. It took a very long time for the human race to evolve away from that false belief. Our worldview creates our individual world that’s unlike anyone else’s. We are squeezed into a body and a lifetime, by the rules of cause and effect that we accept.

In actuality, life is unbounded. At the deepest level our bodies are ageless, our minds are timeless. Einstein realized that time and space were products of our senses. He and his colleges were able to see beyond this mirage. They reassembled time and space into a new geometry without beginning, end, edges, or solidity. They discovered that every solid particle was a bundle of energy vibrating in a huge void. The advantage of this worldview is that it is infinitely creative.

Chopra thinks that it’s liberating to know that you can change your world and your body via a perceptual adjustment. Old cells serve as maps of your experience, your suffering gets imprinted on your cellular memory  along with your joy. Stresses you forgot about consciously still send signals like imbedded microchips that make you anxious, tense, or fatigued because they cross the mind-body barrier – they become a part of you. By seventy, experiences processed and metabolized by your tissues and organs are seen externally in cellular changes.  Teacher comment: Interesting concept.

The act of paying attention to your body’s functions, instead of leaving them on autopilot, will change how you age. When we love the miracle of who we are beyond social classifications we create health for our mind and body. One example is biofeedback and meditation that has been used to teach people to lower their blood pressure or their stomach acids. Teacher comment: Good point.

Quantum physics tells us that our atoms are 99.9999 percent empty space. Our subatomic particles are just bundles of vibrating energy that carry information, not solid matter. Since the Big Bang the quantum field holds the universe in unexpressed form, similar to how are we hold thousands of words silently in our memories. All the essential stuff of the universe, all that we can see, feel, and hear, including our bodies, is actually non-stuff. It’s not ordinary non-stuff, it’s thinking non-stuff.

The basic emotion fear, isn’t just an abstract feeling, it’s also a tangible molecule of adrenaline. Teacher comment: True. Without the hormone there’s no feeling, without the feeling there’s no hormone. Transmitting pain works the same way, there won’t be any pain without nerve signals to transmit the pain. There’s no pain relief without endorphins to block the signals. Mind-body medicine was based on the discovery that where ever a thought goes, a chemical goes with it. This helps to explain why a recently widowed woman is twice as likely to develop breast cancer and why people who are chronically depressed are four times as likely to develop physical illnesses. Both examples illustrate how psychological pain can be converted into the biochemicals that lead to dis-ease. This knowledge points to the vitalness of our work as counselors in helping our clients feel better emotionally, we are also helping them maintain healthy bodies.  Teacher comment: Yes.

The placebo effect allows a sugar pill to relieve pain the same way a real narcotic does. The same thing has been done with chemotherapy for cancer patients. Patients with advanced malignancies have gone into remission after receiving only sterile saline solutions, but were told it was a powerful anti-cancer drug. Our bodies are capable of producing any biochemical response if the mind is given the correct suggestion. The power of the placebo is in the suggestion that is converted into the body’s intention to cure itself. Chopra suggest, why not skip the sugar pill and go directly to the intention?

We could trigger the intention not to age and the body would carry it automatically. Intention is actively partnered with attention, which can enable us to convert automatic processes into conscious ones. We age the way we do because we all expect to do so. We’ve unwittingly set up a self-defeating intention with our unwavering belief that our mind-body automatically carries out. These intentions have created obsolete programming in us, but we can reprogram our intentions consciously.

The image of our bodies in Western medicine is that they’re mindless machines, despite unquestionable evidence that this is not true. It has been proven that death rates from cancer and heart disease are higher in people with psychological distress. A Yale study found that breast cancer spread fastest among women with repressed personalities, felt hopeless, and were unable to express negative emotions. There have been similar findings with asthma, arthritis, intractable pain and other disorders. A Stanford psychiatrist studied eighty six women with advanced breast cancer. Half received weekly psychotherapy and lessons in self-hypnosis. It had been thought, what could a woman do to combat a fatal disease in an hour’s therapy a week, shared with other patients? After following these women for ten years Dr. Spiegel was stunned to learn that the group receiving therapy survived on average twice as long as those without therapy. Doubly telling was the fact that only three of the women were still alive – all had been in the therapy group. This study is amazing because the researcher didn’t expect any effect at all. Over the last decade many other researchers have come up with similar findings.  Teacher comment: Unquestionable evidence.

Medical journals overwhelmingly preach about the inherent biology of disease, thoughts, feelings and attitudes are just along for the ride. The new paradigm teaches us that emotions aren’t just fleeting events isolated in mental space, they’re expressions of awareness – the fundamental stuff  of life. All religions teach that the breath of life is spirit. To raise or lower one’s spirits means something fundamental that the body must reflect.

Perception is a learned phenomenon. Our bodies are the physical results of all the interpretations we’ve learned to make since birth. Transplant patients describe participation in donors memories. One woman who received a heart/lung transplant awoke craving beer and Chicken McNuggets that she had never craved before. She also dreamed a man named Timmy would come to her. She tracked down the donor’s family and learned that he was killed in a traffic accident on his way home from McDonalds. He was also very fond of beer. Our experience becomes our bodies. This women that Chopra spoke about was on the Oprah Winfrey show. They referred to this phenomenon that happens to many transplant recipients as cellular memory.

Defiant of medical science which says that growth hormone is preprogrammed in DNA, children who have felt unloved have stopped developing. A condition called, psychological dwarfism. Severely abused kids convert lack of love into a growth hormone deficiency. The cure – loving foster parents who transform the child’s beliefs which can produce bursts of the hormone. Learning to see themselves differently is reflected in their bodies. Teacher comment:  Yes.

Awareness can heal and destroy depending on how it’s trained. We have been conditioned to think that we have no choice to see aging differently. Our bodies conform to unconscious messages in our heads that say, “I must age”. We grow old and die because that’s what we see others do. This physical process is so universal it appears to be inevitable. Aging is how our bodies respond to social conditioning. If aging is something that’s happening to you then you’re a victim of it, but if aging is learned, then we can unlearn this behavior.

Many different kinds of studies have shown that the support of family and friends can make a difference in our health at times of stress.  Teacher comment:  Yes. Auto workers who received support were less likely to develop physical or mental symptoms. Pregnant women experience ninety one percent less serious complications of pregnancy when they have support. Gerontologists put a group of elderly nursing home residents, ages eighty seven to ninety six, on a weight training program. Within eight weeks wasted muscles came back three hundred percent, coordination and balance improved and their overall sense of an active returned. Beyond the physical, they regained dignity.

A Harvard psychologist studied one hundred eighty five men (students at Harvard during WWII) and monitored their health for forty years. Those who reacted poorly to stress (i.e. depression) were more likely to die prematurely. Aging was retarded by good mental health and accelerated by poor mental health. The results of mental health show up in the fifties, a perilous time when premature heart attacks, high blood pressure and cancer show up. Teacher comment: Yes.

Giving birth generates a flood of powerful hormones that provide a surge of energy through the body. If a woman has healthy memories of childhood this energy is used in establishing a strong bond to the baby. Sad childhood memories triggers old programming which changes the joy into apathy and fatigue. Postpartum depression is the result of outworn memories seizing a new lease on life. Chopra doesn’t recommend anti-depressant drugs because when the drugs are taken away the depression returns. He suggests psychotherapy even though it takes longer and requires more insight and courage.  Teacher comment: Interesting point.

A US study tested female runners to see if hard exercise prevented osteoporosis. The best prevention is not calcium or hormone replacement, but building bone density with exercise in the younger years with exercise. A study of runners also showed increased bone density in their arms. At the quantum level, the whole skeleton got the message to deposit more calcium to the bones. The whole body knew exercise was happening.

A scientist named Backster found that cells removed from the body and placed in another room react to the same stimuli that the person does. He applied a polygraph on cells scraped from the inside of the mouth and they reacted in the same way as the person did in another room. At the source of intelligence, there’s little difference between thoughts and molecules. Another demonstration of cellular memory!  Teacher comment: Really?

Words, unlike the promise of childhood songs, can and do hurt us because they cause hormones to be secreted in response. Words of love transform us. Child psychologists have learned that children are more deeply influenced by ascriptive statements such as, You’re a bad boy”, or “You’re a liar”, than prescriptive ones such as, “Wash your hands before eating.” Telling her what she is, makes a deeper impression than telling her what to do. The mind-body system is actually organized around such verbal experiences. Wounds delivered can create for more permanent effects than physical trauma, for we literally create ourselves out of these words. Teacher comment: True.      

Words have the power to program awareness, so it’s important to avoid passively accepting negative connotations that the word old  carries. (I might add words and phrases like: faggot, dumb blonde, girl talk, nigger, kike, bull dyke, whop, polock, all the societal images that harm some aspect of humanity).

Chopra thinks that nothing makes people age more than fear, second only to grief. Every doctor has witnessed the appalling deterioration of a spouse that has been widowed. It’s not that death is a fiction, but that our belief in it creates limitations where none need exist. Teacher comment: I agree.

Meditation’s use for stress held little appeal for Western medicine until the early seventies when physiologists at UCLA proved that along with its spiritual implications, it had profound effects on the body and creates changes in breathing, heartbeat and blood pressure. This researcher also showed that long term practice of meditation actually reversed the effects of aging.

Psychologists are beginning to verify that human development extends into old age through higher states of awareness, such as wisdom.  Many believe the notion that any decline in the brain’s physicality with age is offset be new mental accomplishments. Creativity researchers say artists can come up with more ideas in their sixties and seventies than in their twenties and the later you take up the creative pursuit the more likely you are to pursue it into old age. PET scans show increased blood flow to the brain during periods of creative thought illustrating that creative experience may enhance brain structure itself. Julia Child came to television when she was past mid-life.

A Harvard psychologist studied the physiology of love. A group of people viewed a movie of Mother Teresa doing her work among the sick and poor which displayed a profound outpouring of love. While they watched, their immune systems increased, SIgA or a salivary immunoglobulin antigen which indicates a high level of immune response. (Also characteristic of people who have recently fallen in love). Teacher comment: The philosophy of emotion.  Despite the fact that all audience members had this positive immune response, some expressed objections centering on differences such as religious or being disturbed by the sight of starving children. Their physical response to love was more powerful than their rational attitudes. It brings to my mind the question, what effect does racism, sexism, homophobia and violence have on our immune system? What are the effects on aging to those us who life in a culture separated by stratifications that include issues such as gender, race, and class? Surely these separations in our humanity lack an outpouring of love.  Teacher comment: Good questions.

When we accept our parents belief system about aging, we agree to fear death, because its thought of as the end. But, perhaps there is no ending. Birth and death are time-space events, existence is not. If we look inside us, we find a faint but certain memory that we have always been. No one remembers not existing. The deepest questions about who we are and what life means are wrapped up in our notion of existence. It’s fear reaches much further into our lives than our conscious minds are willing to admit. When you say you fear death, you’re saying you fear you haven’t lived your true life, which cloaks the world in silent suffering. When the spell of mortality is broken we can release the fear that gives death it’s power. Seeing ourselves in terms of timeless, deathless Beings, has the power to awaken every cell to a new existence.

This new paradigm provides us with a concept that connects body, mind, and spirit into a unity. The later years should be a time when life becomes whole. The circle closes and life’s purpose is fulfilled. In that regard, active mastery is not just a way to survive extreme old age—it’s the road to freedom.  Teacher comment:  I like that!  

Aging can also be said to be a self-fulfilling prophecy. You expect to be withdrawn, isolated, and useless when you age and you create the very conditions to justify these beliefs.  Teacher comment:  Yes! Our deepest assumptions are triggers for the physical changes we know so well.

He wrote the book with the hope of taking the subject so fraught with fear – aging, and turning it into a vehicle for fulfillment. Humans aren’t really trapped in time, squeezed into the volume of a body and the span of a lifetime, we’re voyagers on the infinite river of life. He recommends using love as our mirror of timelessness, letting it nurture our certainty that we are beyond change, beyond memory of yesterday and the dream of tomorrow.

Chopra’s ideas give me hope for humanity. I’m hopeful that if aging is a product of social learning, then it’s also possible that concepts such as racial, gender and sexual inequality are learned myths that can also be reconceived in ways that will prevent them from artificially separating humanity. Surely the wisps of intelligence that Chopra envisions harbor true global family values, such as tolerance, non-violence, acceptance, egalitarism, altruism, values that offer hope to heal all of humanity. If we can come to see ourselves differently, surely we can also see others differently than we do. I believe that his ideas about the possibilities of human development will find ways to overcome man’s inhumanity to man.

We  Must Discard These Ten Assumptions:

1.   There is an objective world independent of the observer, our bodies are an aspect of this objective world.

2.    The body is composed of clumps of matter separated from one another in time and space.

3.   Mind and body are separate and independent from each other.

4.   Materialism is primary, consciousness is secondary.  In other words, we are physical machines that have learned to         think. 

5.   Human awareness can be completely explained as the product of biochemistry.

6.   As individuals, we are disconnected, self-contained entities.

7.   Our perception of the world is automatic and gives us an accurate picture of how things really are.

8.   Time exists as an absolute, and we are captives of that absolute. No one escapes the ravages of time.

9.   Our true nature is totally defines by the body, ego, and personality. We are wisps of memories and desires enclosed        in packages of flesh and bones.

10.   Suffering is necessary—it is part of reality. We are inevitable victims of sickness, aging, and death.

Ten New Assumptions:

1.   The physical world, including our bodies, is a response of the observer. We create our bodies as we create the experience of our world.

2.   In their essential state, our bodies are composed of energy and information, not solid matter. This energy and information is an outcropping of infinite fields of energy and information spanning the universe.

3.   The mind and body are inseparably one. The unity that is “me” separates into two streams of experience. I experience the subjective stream as thoughts, feelings and desires. I experience the objective stream as my body. At a deeper level, however, the two streams meet at a single creative source. It’s from this source that we are meant to live.

4.   The biochemistry of the body is a product of awareness. Beliefs, thoughts and emotions create the chemical reactions that uphold life in every cell. An aging cell is the end product of awareness that has forgotten how to remain new.

5.   Perception appears to be automatic, but in fact it is a learned phenomenon. The world you live in, including the experience of your body, is completely dictated by how you learned to perceive it. If you change your perception, you change the experience of your body and your world.

6.   Impulses of intelligence create your body in new forms every second. What you are is the sum total of these impulses, and by changing their patterns, you will change.

7.   Although each person seems separate and independent, all of us are connected to patterns of intelligence that govern the whole cosmos. Our bodies are part of a universal body, our minds an aspect of a universal mind.   

8.   Time does not exist as an absolute, but only eternity. Time is quantified eternity, timelessness chopped up into bits and pieces (seconds, hours, days, years) by us. What we call linear time is a reflection of how we perceive change. If we could perceive the changeless, time would cease to exist as we know it. We can learn to start metabolizing non-change, eternity, the absolute. By doing that, we will be ready to create the physiology of immortality.

9.   Each of us inhabits a reality lying beyond all change. Deep inside us, unknown to the five senses, is an inner-most core of being, a field of non-change that creates personality, ego, and body. This being is our essential state—it is who we really are.

10.   We are not victims of aging, sickness, and death. These are part of the scenery, not the seer, who is immune to any form of change. This seer is the spirit, the expression of eternal being. 

Ten Keys to Active Mastery:

1.  Listen to your bodies wisdom, which expresses itself through signals of comfort and discomfort. When choosing a certain behavior, ask your body, “How do you feel about this?” If your body sends a signal of physical or emotional distress, watch out. If it sends a message of comfort and eagerness, proceed.

2.  Live in the present, it’s the only moment you have. Keep your attention on what is here and now. looking for the fullness in every moment. Accept what comes to you totally and completely so you can appreciate it, learn from it, and then let it go. The present is as it should be. It reflects infinite laws of Nature that have brought you this exact thought, this exact physical response. This moment is as it is because the universe is as it is. Don’t struggle against the infinite scheme of things; instead, be at one with it.

3.  Take time to be silent, to meditate, to quiet the internal dialogue. In moments of silence, realize that you are recontacting your source of pure awareness. Pay attention to your inner life so you can be guided by intuition rather than externally imposed interpretations of what is or isn’t good for you.

4. Relinquish your need for external approval. You alone are the judge of your worth, and your goal is to discover infinite worth in yourself, no matter what anyone else think. There is great freedom in this realization.

5.  When you find yourself reacting with anger or opposition to any personal circumstances, realize that you are only struggling with yourself. Putting up resistance is the response of defenses created by old hurts. When you relinquish this anger, you will be healing yourself and cooperating with the flow of the universe.

6.  Know that the world “out there” reflects your reality “in here.” The people you react to most strongly, whether with love or hate, are projections of your inner world. What you most hate is what you deny in yourself. What you most love is what you wish for yourself. Use the mirror of relationships to guide your evolution. The goal is total self-knowledge. When you achieve that, what you  most want will automatically be there, and what you most dislike will disappear.

7.  Shed the burden of judgment—you will feel much lighter. Judgment imposes right and wrong on situations that just are. Everything can be understood and forgiven., but when you judge, you cut off understanding and shut down the process of learning to love. In judging others, you reflect your lack of self-acceptance. Remember that every person you forgive adds to your self-love.

8.  Don’t contaminate your body with toxins, either through food, drink, or toxic emotions. Your body is more than a life support system. It is the vehicle that will carry your on the journey to your evolution. The health of every cell directly contributes to your state of well being, because every cell is a point of awareness within the field of awareness that is you.

9.  Replace fear-motivated behavior with love-motivated behavior. Fear is the product of memory, which dwells in the past. Remembering what hurt us before, we direct our energies toward making certain that our old hurt will not repeat itself. But trying to impose the past on the present will never wipe out the threat of being hurt. That happens only when you find the security of your own being, which is love. Motivated by the truth inside you, you can face any threat because your inner strength is invulnerable to fear.

10.  Understand that the physical world is just a mirror of a deeper intelligence. Intelligence is the invisible organizer of all matter and energy, and since a portion of this intelligence resides in you, you share in the organizing power of the cosmos. Because you are inseparably linked to everything, you cannot afford to foul the planet’s air and water. But at a deeper level, you cannot afford to live with a toxic mind, because every thought makes an impression on the whole field of intelligence. Living in balance and purity is the highest good for you and the Earth.

Taken From:

*Chopra, Deepak. (1993). Ageless Body, Timeless Mind: The Quantum Alternative to Growing Old. New York: Harmony  Books, pp. 4, 5-7, & 258-260.

Work Cited

Chopra, Deepak. (1993). Ageless Body, Timeless Mind: The Quantum Alternative to Growing Old.  New York: Harmony  Books.

Book Review – Real Boys: Rescuing Our Sons from the Myths of Boyhood

By William Pollack

Trish Anderson

Workshop: Youth and Violence: The High Cost of Alienation

November 6, 1999

Instructor: Melissa Maguire

Pollack, William.  (1998).  Real Boys: Rescuing Our Sons from the Myths of Boyhood. 

Henry Holt & Co: New York.

Statistics and Studies Show …

Suicide, in the United States, has tripled among fifteen to twenty four year olds between nineteen fifty and nineteen ninety; it’s now the third leading cause of death in this age group. Male suicide is four times that of females among Americans of all ages. Dr. C. Wayne Sells, a specialist with the Department of Pediatrics at the University of California says that the major causes of mortality and morbidity among teenagers has shifted from infectious to behavioral etiologies. Young people actually have more to fear from their own behavior than from disease!

A Danish study demonstrated that boys who suffered both birth complications and early childhood separation or rejection were most likely to become adult violent offenders.

The National Association of School Psychologists estimates that in the United States, one hundred sixty thousand children miss school every day because they fear being bullied.

Inside the educational system:

              -Boys are twice as likely as girls to be labeled learning disabled;

              -Boys make up sixty seven per cent of “special education”classes;

-Boys are up to ten times more likely to be diagnosed with serious emotional disorders, especially Attention Deficit Disorder.

       Outside the educational system:

-Boys rates of depression are shockingly high, they’re four to six times more likely to commit suicide, and three times more likely than girls to be victimized by violent crime.

The American Medical Association determined that one in ten boys has been kicked in the groin by age sixteen (one fourth of which caused injury). Most boys don’t tell their parents and within a year of the injury about twenty five per cent of them showed signs of depression. These boys didn’t consider a kick in the groin to be simply a routine part of boyhood – it really bothered them. They felt shame and were disturbed by the violence, but felt they couldn’t talk about these feelings.

These statistics and studies can be found in William Pollack’s insightful and provocative book called, Real Boys: Rescuing Our Sons from the Myths of Boyhood (1998)  (Real Boys).  The first time I heard of William Pollack was on an Oprah Winfrey show that came about in response to recent school shootings perpetrated by grammar school to high school age boys. Pollack explained that, “… boys don’t cry tears, they cry bullets.” I was taken by this because it fit with what I had always believed as a feminist – that sexism, with it’s inherent and inappropriate stereotypical gender roles, harms boys as much as girls.  Real Boys has eloquently validated my gut belief. 

Pollack is a clinical psychologist and co-director of the Center for Men at McLean Hospital, an assistant clinical professor of psychiatry at Harvard Medical School, and a founding member and Fellow of the Society for the Psychological Study of Men and Masculinity of the American Psychological Association.  Much of Real Boys was taken from a recent study by Pollack and his colleagues at Harvard Medical School called, “Listening to Boys’Voices.”  Much of this research supports his experience as a psychologist with men and adolescents boys. 

According to Pollack, boys are in a desperate crisis. Even normal  boys are being confused by societal mixed messages about what’s expected of masculinity. This has resulted in many boys who have a sense of disconnection and sadness that they aren’t likely to have the ability to name. Recent research shows that boys aren’t doing as well in school as they had before, and when compared to girls. Boys self-esteem has recently been found to be remarkably low with rates of depression and suicide that are rising in a frightening manner. 

Pollack says despite feeling desperately lonely and afraid, boys hide behind a mask of masculinity that hides their true feelings in order to present an image of toughness, stoicism, and strength. Behind the mask of masculinity is the shame and trauma of separation They’re held captive in gender straightjackets that limits their emotional range and even their ability to think and behave as freely and openly as they could. By perpetuating these macho stereotypes, society is judging boys behavior against outmoded notions of masculinity that lack relevance in today’s world. Most of us are at a disadvantage talking about boys because all our views have been distorted by the societal myths we’ve internalized. These powerful stereotypes affect boys in profound ways; they hinder their development and their ability to function optimally. They affect our parenting of boys and our relationships with them.

Pollack believes that boys are separated emotionally from their mothers prematurely (usually around six and again in adolescence) because mothers are expected to “cut the apron strings” that connect her to her son and with his family. This forced premature separation is so common that it seems normal. As early as age five or six, boys are expected to be independent in situations they aren’t ready to handle, such as school or camp.

Teenage boys are given a second shove into new schools, competitive

sports, jobs, dating, travel, and more before many are ready. In the teen years society also becomes concerned and confused about the mother-son relationship. We’re unsure about how intimate a mom should be with her sexually mature son. As a result, parents are encouraged by society to push boys away from their families, especially the nurturing female realm. Society believes this separation is needed and good for boys; if they aren’t pushed out of the nest they’ll never fly.

Pollack thinks that both sexes should be allowed to separate from their mothers and families at their own natural pace. Boys will make the leap when they’re ready and will do it better if they feel there is someone there to catch them in case they fall. We have expected them to be independent of the family too abruptly, with too little preparation, too little emotional support, not enough opportunity to express their feelings, and frequently without the option of going back or changing course. We frequently don’t tolerate stalling or whining because it’s believed that this disconnection is essential for boys to “make the break” in order to become men. Pollack thinks this separation is so profoundly harmful to boys that he calls it an emotional trauma. We don’t expect the same of girls, and if we treated girls this way, most of us wouldn’t question it’s being traumatic.

Pollack believes that boys have been made to feel ashamed of having feelings of vulnerability and so they mask their emotions and true selves. This unnecessary disconnection from their family, and then from their selves, causes boys to feel alone, helpless, and fearful.  Society’s prevailing myths leave no room for such emotions, as a result boys feel they’re not measuring up. They don’t have a way to talk about their perceived failure, and thus feel shame, but aren’t able to talk about either feelings.  As a boy internalizes society’s hardened image of masculinity, he looses touch with himself because his sensitivity is forced to submerge. At the very same time, modern society exerts contradictory expectations of being sensitive in relationships. They’re told they need to be “new men,” show respect for girls, share their feelings, and shed their “macho” assumptions about male power. The double standard says be sensitive nice “New Age” guys, but still be cool aloof dudes. They’re confused about how to be manly, yet empathic, cool but open, and strong yet vulnerable. Society facilitates these messages through what Pollack calls, the Boy Code,  that is so ingrained in society that it’s invisible. All behavioral qualities we normally attribute to girls, empathy, sensitivity, and compassion – are also basis male traits. The use of shame in the toughening up process gives boys the message to be ashamed and guilty about feelings of vulnerability, weakness, fear, and despair.

At birth and for several months afterward, boys are actually more emotionally expressive than girl babies. Researchers showed that twenty one month old boys have well developed natural, hard wired abilities to feel empathy for others who are in pain. By age five or six most of this emotional expressiveness has been forced underground and they’re much less likely to express hurt or distress to parents or teachers. They’re far less attuned to feelings of hurt and pain in others, and began to loose their capacity to express their own emotions in words.

Society’s pressure to avoid feelings and behaviors that might bring them shame pushes them to wear a mask of bravado – this self-hardening process is what makes boys violent.  Most violent behavior is and always has been the work of males, both cross-culturally and trans-historically because anger has been the only emotion acceptable for males. Boys phobia about revealing their shame leads them to overcompensate by showing the opposite. Throughout boyhood the strings are pulled tighter and tighter so that either the straightjacket snaps or the boy does.

This shaming of boys for emotionality is controlling, pervasive and corrosive to their spirits. The process of shame-hardening includes: discipline, toughening up, acting like a “real man”, being independent, keeping emotions in check with powerful phrases like – “big boys don’t cry,” and threats about being seen as a “mama’s boy.” Even when these messages aren’t said directly, they dominate the subtle way boys are treated and as a result, how they come to perceive of themselves.

Even when girls feel their voices stifled in public, they generally feel comfortable speaking in private to one another about their pain and insecurity. Despite boys seeming bravado they find it hard to express their genuine selves even with friends and family. No matter how loud they brag about their abilities, boys may not be expressing what’s really in their hearts and souls. It’s a common joke that males don’t reach out for directions when they’re lost. It’s not funny that many boys feel they can’t reach out for the emotional compass they desperately need.

Girls are sensitive to shame, but boys are shame-phobic; they’re exquisitely, yet unconsciously, attuned to any signal of “loss of face” and will do about anything it takes to avoid shame. Rather than expose themselves to potent embarrassment, they engage in a variety of behaviors that range from avoiding dependency to impulsive action, from bravado and rage-filled outbursts to intense violence.    

Pollack claims that when boys “act out” by using disorderly conduct, they’re dealing with the pain of separation and shame. He believes that an overwhelming number of elementary school boys diagnosed with conduct disorders or with attention deficit disorder are misbehaving, not because they have a biological imbalance or deficit, but because they’re seeking attention to replace the void left by being separated from their parents. Problems paying attention or regulating impulses may not be “faulty wiring” or “testosterone poisoning,” but accumulated emotional wounds and years of paralyzing shame. Boys aggressiveness and violence is often expressing something far from a macho desire for power or vindication, but a longing to be nurtured, listened to, and understood.  They need to engage in all the needy, dependent behaviors they’ve been told are girl-like and forbidden. The diagnosis of hyperactivity is frequently made on the basis of a check list of behaviors that in reality reflect boys grief over loosing emotional connection – a loss that cannot be fully expressed or mourned, but expresses itself through action and anger. Through the language of these behaviors, boys are trying to give us a wake up call to their pain and desperation. Their feelings will not be cured with medications or behavior modification.

What “real” boys really need from infancy forward –  and what mothers in their hearts are longing to offer – is complete and unconditional empathy and understanding for a full range of their emotions.  When boys become hardened, they become willing to endure emotional and physical pain – even to risk their lives, if it means winning approval of their peers. They can become so hardened that they are literally anesthetized against the pain they are coping with.

The phrase “boys will be boys” actually says they’re prisoners of their biology, that their behavior is pre-determined and an inherent part of their nature. “Typical” boy behavior is assumed to involve insensitivity and risk-taking.  Sadly, “… boys will be boys” is not used when a boy sits with a dying parent, feels guilty for breaking up with a girlfriend, or gives his crying mom a hug.

Pollack’s research shows that in adolescence boys are ambivalent about becoming men because of mixed massages about masculinity from society, peers, and their families. They are told to be cool, confidant, and strong, and at the same time, egalitarian, sensitive, and open with feelings. They’re unsure whether becoming a man is going to be such a great experience. They might not see role models that appeal to them or that they feel is within their reach. Models might include men who were either slaved at hated jobs in order to support a family, or that ran away from family responsibilities all together. The confusion boys feel is hidden beneath macho posturing and under the weight of all of our misconceptions of toxicity about boys.

Failing to talk to teenage boys about what’s bothering them forces them to separate rather than giving them support as they learn to individuate. For some boys, retreat behind their mask can be so complete and consistent that it becomes hardened and fixed. Some may eventually find themselves unable to remove the mask and actually loose touch with their own genuine feelings.   

The mask makes it hard to discuss sexuality, and masculinity’s double standard pushes boys to prove themselves sexually, and then castigates them when they do. What’s worse this makes it more likely that a boy might take risks with alcohol or drugs. The mask makes it appear that everything is fine and may prevent parents from seeing (or accepting) that a boy is in fact already taking risks with drugs and alcohol to numb painful emotions.

When boys do adopt the required macho behaviors, many boys find that rather than being admired for their manly comportment, they’re actually rebuffed or rebuked. The result is adolescent boys who are on the defensive, sensing that others see them as insensitive, violent, and uncaring. These conflicting messages leave boys open to learning disabilities, severe depression and impulse and compulsive behaviors that range from substance abuse to unsafe sex, from acting out, violence or suicide. One teenage boy said it well, “People act like guys my age are up to no good half the time.” Another teen relates, “I guess it’s hard being a guy because there are so many things that a normal  person would do, that you’re not allowed or expected to do.” Adolescence is about individuation not separation. Teens want to discover a mature self in the context of loving relationships – stretching their psychological umbilical cord rather than severing it. 

Pollack sees violence as the final link in the chain that begins with disconnection.  Violence is about shame and honor. For many boys failing to “know how to fight” or refusing to fight when challenged – may be seen as disgraceful, as a sign of dubious masculinity. Striking out against others who are weaker, younger, or less skilled is about respecting the Boy Code rules that require him to do everything possible to protect their honor and prevent shame. Ironically, violence in boys also sometimes represents a vain attempt to reconnect with others, to make and keep friends, either by impressing peers, helping other boys to beat up another kid, or actually joining a gang. Violence may give some boys a false impression that they’re somehow closer to another boy; they actually have a sense of bonding through individual or collective acts of violence.

Pollack thinks that today’s bully is often, but not always, tomorrows violent offender. On the other hand, sometimes the quiet victim, the shy loner, or the troubled bystander suddenly turns violent in an unexpected eruption of rage.  Pollack believes that shame is what makes a boy snap. When enough shame collects inside him – when he feels disconnected, unpopular, less than masculine, maybe even hated – the boy tries to master his feelings and reconnect with others through violence. There is generally a triggering event for any violent act – a threat, a betrayal, or an insupportable loss. A boy’s risk for violence is often fueled by a reservoir of anger, fear, and shame, that gradually accumulated over the years since the trauma of separation from his parents.

While observing boys surrounding violent video/computer games, Pollack noted that as they watched the mayhem, other than a loud “yes” when a player got an enemy, there wasn’t much talking between the boys. They appeared entranced by the screen. The odd contrast he noted was that the boys seemed very connected to one another, were supportive of the player, and non-judgmental about his performance – in other words they were behaving very differently than the “big boys” on the screen!  Pollack posits that the reason boys like play revolving around frontier, outer space, and war games is because they’re admired for physical strength and emotional courage and ridiculed for physical weakness and emotional vulnerability.

Research at the National Institutes of Mental Health found that when kids watch kindness on TV they imitate it. Surely they’ll also imitate James Bond, the Terminator, Freddie Kruger, Beavis, or Darth Vader. Boys who watch a great deal of violence become desensitized to it and it seems like a “normal” part of life and does heighten the possibility that they will tolerate violence among their friends or from themselves.  Despite recent connections made between violence in movies and violence done by young people, Pollack warns against making a direct link to media violence and the inclination to personal violence. Sometimes exposure to media violence can satiate a natural appetite for it. Actually witnessing violence may frighten and even sicken or repel a boy and turn him away from it. Pollock doesn’t believe that a boy who is connected and loved and who is in a safe setting where he can express his emotions will be motivated to violence by that seen in the media.

Pollack’s Solutions & Tips

Pollack recommends we teach boys to release pent up anger and aggression through catharsis in a warm caring presence. Give them permission in an appropriate private space to vent his feelings openly and with inhibition. In your presence, invite them to scream, shout, cry, or voice whatever they need to as loudly or as vigorously as they need to purge painful feelings. Punching pillows or muffing sounds with a pillow can be used if noise is an issue. 

Violence prevention will be found in connection with friends, family, and parents. A boy who’s cared about will be more likely to care about others. When boys feel empathy for others and diminished personal shame, they can feel less shame about their own vulnerabilities and are less likely to commit violence. Boys need “violent-free zones” where they can safely remove their masks and speak about violence and fighting without fear of suffering shame, belittlement or retaliation.

Sports and non-violent high energy physical activity can be a transformative healthy expression of feelings as long as strict limits are set and proper safety equipment is utilized. It offers boys a positive healthy way to express a wide range of emotions, bond as friends, and boost their self-esteem; violence is a futile attempt to obtain similar these social benefits they desperately need. We must teach them that power need not mean power over others, but power with others. To do this we need to acknowledge the pain they’ve suffered, allow them to speak their feelings, and rid them of the seeds of shame that too often grow into the thorns of violence.

Tips to parents and families:

       -Discuss the complexities of adolescence honestly

       -Make regular “dates” with your son

       -Don’t wait to talk to him about sex, drugs, or other tricky subjects

       -Provide frequent affirmations

       -Show that you understand the adolescent crucible, share you own adolescent feelings of vulnerability

       -Listen empathetically

       -Make your home a safe place

       -Give boys your undivided attention at least once a day

       -Encourage the expression of a full range of emotions

       -When a boy expresses vulnerable feelings, avoid teasing or taunting him

       -Avoid using shaming language

       -Look beyond anger, aggression, and rambunctiousness

       -Express you love and empathy openly and generously

       -Let boys know they don’t need to become “sturdy oaks”

       -Create a model of masculinity that’s broad and inclusive

To mothers:

       -Talk openly about the Boy Code and teach others about the problem of the Boy Code

       -Teach your son about masculinity by talking about men you love and why you love them

       -Rotate parenting responsibilities

       -When your son is hurting, don’t hesitate to ask him whether he’d like to talk

       -Avoid shaming your boy if he refuses to talk, honor his need for timed-silence

       -When your boy seeks reconnection, try your best to be there for him

       -Experiment with connection through action

       -Don’t hold back

To fathers:

       -Stay attached no matter what and reconnect after separation

       -Stand by mom

       -Remember it’s who he is rather than what he does

       -Develop your own style of fatherhood

       -Don’t be a policeman dad

       -Show, rather than tell

       -Be aware of your own “father longings”

       -Real men show emotions

Viagra: What Does the Future Hold for the Relationships of Older Americans?

National Louis University

Research Evaluation & Methodology

Summer 1998

Dr. Christopher Clemmer

Group project by: Joyce Sweeney, Trish Anderson, Linda Israel, Marissa Green, Debbie Anthony

Introduction

The problem:  will Viagra have a negative impact on the emotional relationships of older Americans? AARP discourages the use of the term elderly and uses, instead, the term older Americans, young seniors, and older seniors. This concept is also supported by Journals on Gerontology. This project has taken us into some old and new territory. We chose this topic because of its challenge, and our belief in the value of working collaboratively to mirror an actual research project.  We were not disappointed.

Sex in the “golden year” has been a mystery, if not a surprise. Today’s older Americans grew up in a time when sex, at any age, was a secret. As gerontologist Ruth Weg states, “Anyone can be sexually responsive given adequate stimulation, but genital response is only one measure of the total sexual experience” (1). In other words, physiologically aging need not hamper sexual activity, more sexually significant may be one’s feelings about one’s self and one’s mate, one’s expectations, general physical condition, alcohol and drug intake, mood, living situation, ability to communicate about sex, and whether one has a partner.

“Sexuality is very much tied to the rest of the culture,” states anthropologist Jay Sokoowski, of the University of Maryland, “Among the Asisataic Indians, where women are repressed, sex represents male domination and women embrace menopause as an excuse not to engage in sex. On the other hand, he states, in socially equalition cultures, such as the South Pacific Islands, sex is openly discussed from childhood, it is engaged in for pleasure as well as procreation, and it continues, for both men and women throughout life” (2).

In our society, sexuality, in older people, has been the object of ridicule and pity. The underlying assumption is that continued sexual desire is pathetic and inappropriate, since sexual function, we have assumed, is diminished and unsatisfactory. In the late 1940’s Kinsey blew this myth wide open and opened the door to questioning this concept, through his Kinsey Report. In 1970, Masters and Johnson, emotional issues rather than organic problems are the main cause of impotence. Their treatment programs focused on appropriate sex information and facilitating verbal, emotional, and physical communication with the older sex partners. Health problems of older individuals have often been dismissed as unavoidable by products of aging, or treated with drugs that have had a negative impact on the psyche or have led to impotence – generally considered insignificant in older people by the medical professions.

Our paper will explore the available research on Viagra and the theoretical underpinnings of our question, “will Viagra have an impact on the emotional relations of older people?” Our research, via a review of the literature, and interviews with people in the medical field, has provided us with a historical sketch of Viagra since it became available to Americans in March of 1998.  We find that our research has raised more questions than it has answered and strongly indicate a need for additional study. As time progresses, and we have the opportunity for analysis of further research, we will have more credible statistics to support or disprove our hypotheses, that Viagra does have emotional consequences for older Americans. The data, available at this time, indicates that some harm is apparent and is consistent with the need for supplemental investigation.

Literature Review

Myths & Taboos

Meredith E. Drench and Rita H. Losee (1996) explored sexuality, psychosocial issues, and sexual capacities of older adults (sixty five and older) in connection with the rehabilitation nurse’s role in providing sexual counseling. Despite many deeply ingrained stereotypes, many elders can and do have sexual enjoyment (Drench & Losee 1996; Richardson 1995). Our society has internalized images of older adults as slow moving and sweet (Drench & Losee 1996).  Joan P. Byers (1983) discussed a survey of health professionals in which they used the following phrases to describe sex among the elderly: hard to imagine, nonexistent, discouraged by society, normal, impossible, slow, healthy, and, not very often. People erroneously assume that older adults: don’t desire sex, couldn’t do it if they wanted to, are too fragile physically and might hurt themselves, are unattractive and undesirable sexually, and the thought of older adults being sexual is perverse (Byers 1983). Elderly men are the blunt of jokes and often referred to as dirty old men (Byers 1983; Semmens 2 1997). Women who were once considered attractive girls, and mature interesting women are cast into sexual oblivion after fifty (Byers 1983; Richardson 1995).

Older adults who deviate from internalized taboos against their having a continuing appetite for and ability to maintain sexual relations are seen as abnormal or foolish (Drench & Losee 1996). This lack of understanding and insensitivity can lead to frustration and conflict among older people (Drench & Losee 1996). The notion that aging automatically means a loss of sexuality distorts our attitudes, norms, and values and can cause older adults to miss out on the physical contact they need (Drench & Losee 1996). Some older adults may repress their sexual feelings simply to avoid the disapproval and rejection as a result of taboos and stereotypes (Drench & Losee 1996).

In the nineteen sixties and early seventies, many long term care facilities actually restricted contact between the sexes to public areas so they could be monitored by staff (Byers 1983). Even married older adults were separated and if a spouse visited they were seldom allowed privacy (Byers 1983). These practices were unjust and required older adults to conform, give out their sexuality, and suffer with feelings of guilt because of remaining sexual feelings (Byers 1983).

Medicare guidelines now require nursing homes to provide private spaces for married couples (Drench & Losee 1996; Byers 1983). Some long term care facilities provide privacy for men and women whether they’re married or not (Drench & Losee 1996). Despite this progress, the sexuality of older clients still sometimes conflicts with attitudes of healthcare workers (Drench & Losee 1996).

Women’s Physical Changes

Aging brings a gradual decrease in the duration and intensity of physiological responses to sexual stimulation requiring more and longer stimulation during intercourse (Byers 1983; Richardson 1995). However, all four phases (excitement, plateau, orgasm and resolution) of sexual response still occur (Byers 1983). Orgasms may be shorter, less intense and might take longer to accomplish (Drench & Losee 1996; Richardson 1995). Unlike the male refractory period which increases, women can become aroused again without delay (Drench & Losee 1996).

Masters and Johnson’s studies showed that the main physical changes that aging females experience is due to losses of estrogen (Byers 1983; Semmens 1 1997). With age vaginal mucosa thins, lubrication diminishes, the vagina loses some elasticity and expansion, and shrinks in length and width (Drench & Losee 1996; Byers 1983). If intercourse is infrequent it could be uncomfortable (Drench & Losee 1996). Hence use it or lose it does apply here.

To continue sexual activity one needs to maintain regularity, be interested, and have emotional involvement among the partners (Drench & Losee 1996). Maintaining sexual relations also has some positive physical effects for older women: it helps maintain muscle tone, reduces the incidence of mild urinary incontinence, and regular sexual experience helps to retain their ability for multiple orgasms (Drench & Losee 1996). 

Men’s Physical Changes

Although the decrease in testosterone is slight compared to women’s great drop in estrogen, reduced secretions from the seminal vesicles and the prostate gland causes the semen to thin and reduces the amount of ejaculate (Drench & Losee 1996). Sperm remain active and can still be present in advanced age (Drench & Losee 1996). Older males have less ejaculatory tension, sexual flush, and perspiration which may lessen the intensity of pleasure, but doesn’t prevent sexual function even to age ninety (Drench & Losee 1996).

Older males need increased physical stimulation and time to get an erection (Drench & Losee 1996; Richardson 1995). After sixty, men are slower to get an erection, in penetrating a partner, and in ejaculating (Byers 1983). Erection is also lost faster after orgasm (Drench & Losee 1996. There is a greater time delay for recovery (hours or days) before older males are able to become erection again (Drench & Losee 1996; Richardson 1995). As men age there’s a greater frequency of intercourse without ejaculation along with less powerful ejaculation (Drench & Losee 1996).

According to the National Institutes of Health, erectile dysfunction is a myth of aging (Drench & Losee 1996). Potency is measured by erection not ejaculation and males don’t loose this ability solely through aging (Drench & Losee 1996). Men without partners are more likely to experience potency problems, many widowers regain their erectile function when they remarry (Drench & Losee 1996). Masters and Johnson found that the changes in aging males are quantitative rather than qualitative when compared to younger males (Byers 1983). The advantages are that older men can have better control of ejaculation and because arousal is slower, foreplay can be more leisurely (Byers 1983; Richardson 1995). From a partner’s point of view this can be a positive change. Men’s sexual responsiveness does decline, but the availability of partners and retention of youthful attitudes are significant factors in maintaining interest and activity (Drench & Losee 1996).

Psycho/Social Factors

Psychological factors in decreasing potency include: guilt or feelings of inadequacy, self-doubt, lack of knowledge, worries about masturbation or infidelity, fear of failure, fatigue, depression, boredom, worry over money, and the pressure to conform with cultural taboos about sex and aging may impact potency (Drench & Losee 1996). The mistaken notion about sexual activity being harmful after a heart attack, a hysterectomy, or a prostatectomy may also put a damper on one’s sex life (Byers 1983; Semmens 2 1997; Carter 1997).

Sexuality isn’t only about the physical act itself, it’s about love, caring, sharing and warmth expressed from one person to another; it helps us feel secure and comfortable (Byers 1983). Sexual appeal isn’t just about physical attraction, it’s includes assurance of one’s worth, validity, and ability to be loved (Drench & Losee 1996). These feelings can be extremely meaningful to older adults who have experienced many losses (Byers 1983).

A older adult experiencing depression is likely to have a decline in sexual interest and potency, but may erroneously attribute these symptoms as a natural part of the aging process (Drench & Losee 1996). For others, the nearness of or the risk of death may actually heighten sexual desire, which can then lead to guilt and shame (Drench & Losee 1996). A common cause of stopping sexual activity is the loss of a partner (Drench & Losee 1996). Enduring grief can preclude the pursuit of a new partner combined with the loss of confidence and familiarity, making new relationships threatening (Drench & Losee 1996). Many widows and widowers might not have been sexually active with their deceased partner for a long time, making it that much harder to start a new sexual relationship (Drench & Losee 1996). Older adults have had long experience with sexual taboos which can make it hard for them to talk about their sexual desires (Drench & Losee 1996). However, older men have had time to overcome inhibitions and have gained experience with lovemaking skills (Byers 1983).

Many factors can be involved in erectile dysfunction: lack of practice, unfamiliarity with a new partner, guilt, performance anxiety, diminished vascular flow, or delayed neurological reflexes which can then result in decreased self esteem and confidence (Drench & Losee 1996). Older widows have less sex after the loss of their partner than younger widows, but the sexual desire doesn’t differ by the age when one is widowed (Drench & Losee 1996).

Within our youth focused culture, older adults, especially women, are perceived as having lost sex appeal and are labeled as asexual (Drench & Losee 1996). Thus older women become self-conscious about their bodies which makes them avoid sexual contact (Drench & Losee 1996). Our society has focused on older adults who are sick and poor, rather than on the majority who are productive and healthy (Byers 1983). Youth oriented culture scorns signs of aging, seeing it as pathological rather than natural process, with hope that they can somehow prevent it in themselves (Byers 1983).

Drench and Losee (1996) assert that rehabilitation nurses play an important role in helping clients cope with age related changes. Sexual counseling provided for younger clients also needs to be provided for older adults (Drench & Losee 1996; Byers 1983). The rehabilitation nurse needs to be knowledgeable about sexual physiology, sexual needs, myths about elderly sexuality and be aware of their own and their older client attitudes and values around sexuality because older adults can be influenced by the attitudes of health professionals (Drench & Losee 1996; Byers 1983). (An implication for counseling is easily seen in this regard.) Patient education in a psychologically safe atmosphere is vital to discuss intimate issues such as fantasies, masturbation, and homosexuality which may need to be dealt with (Drench & Losee 1996; Byers 1983). A major role of the health professional may be in dispelling myths (Drench & Losee 1996) and assuaging guilt or moral apprehension (Byers 1983). Sexuality and its expression can enhance quality of life and is beginning to be recognized as an important part of the interpersonal relationships among older citizens (Drench & Losee 1996).

Studies

Byers (1983) discussed research done by Kinsey and others at the Center for the Study of Aging at Duke University. Although the elderly were only a small part of Kinsey’s study, they found that at sixty most males were capable sexually and women weren’t found to decline sexually until very late in life (Byers 1983). Longitudinal studies at Duke examined two hundred and fifty people age sixty to ninety four every three years over more than twenty years (Byers 1983). Fifteen percent of these people actually increased their sexual activity and interest as they aged (Byers 1983). Masters and Johnson’s research included interviews and observation of sexual acts (Byers 1983). Both researchers found that people in good health were able to enjoy sex beyond their seventies (Byers 1983). An older couple with a history of a good sex life is more likely to maintain vigor and interest, and is more likely to continue sexual activity with aging (Drench & Losee 1996; Byers 1983; Richardson 1995).

When a problem of sexual functioning does occur its cause usually fits within the following categories:

       -monotony in a repetitious sexual relationship

       -mental or physical fatigue

       -overindulgence in food or drink

       -preoccupation with career or economic pressure

       -physical or mental issues with one of the partners

       -performance anxiety relating to any of the above (Byers 1983).

One episode of impotence can alarm an older man so much that it discourages further attempts (Byers 1983). A prolonged illness of either partner can contribute to impotency (Byers 1983). Widowers may feel too guilty to remarry after the loss of their wife which may cause sexual difficulties (Byers 1983).

Although there are only a few studies of sexuality among older adults, one interesting study was done in nineteen eighty eight among upper middle class residents in ten California life-care communities (Richardson 1995). To be eligible for the study respondents couldn’t be on any regular medications or have daily medical or nursing needs (Richardson 1995). Although the average age of participants was eighty six, seventy percent of the males and fifty percent of the females thought often or very often about being close to or intimate with the opposite sex (Richardson 1995). Despite the fact that twenty nine percent of the men and fourteen percent of the women were married, fifty three percent of men and twenty five percent of women had regular sex partners (Richardson 1995).

Another study, with two hundred and fifty residents in fifteen nursing homes, found that although ninety one percent of the residents hadn’t been sexually active in the previous month, seventeen percent wanted to be, if they had a partner and the privacy to be active (Richardson 1995).  Despite some physical changes, older adults can and do continue, sexual interest and capacity even into the their nineties (Drench & Losee 1996).

The Meaning of Life

Patricia M. Burbank’s nineteen ninety two exploratory study explored the meaning of life among older adults. Most of us think of the meaning of life as an important, but elusive concept from the  domains of philosophy and theology (Burbank 1992). However, the meaning of life is a major concern to many nurses. Burbank (1992) cites J. Fitzpatrick (1983), “Those who have no meaning do not continue to live” (3) and posited that the meaning of life is intimately connected to our health. Studies have found a positive connection between depression and the loss of meaning in life which the authors view as a mental construct and a primary motivational life force (Burbank 1992).

The theoretical framework that guided Burbank’s (1992) study was symbolic interaction, which is a broad perspective within social psychology, useful in understanding people’s behavior in society. Meaning is seen as the central notion in symbolic interaction and refers to the meaning of symbols and situations (Burbank 1992). Rather than simply responding to events and situations, people give them meaning, and our responses are based on those meanings (Burbank 1992).

Burbank (1992) administered a questionnaire to eighty one older adults over sixty two (most respondents were White females in their mid seventies) who were affiliated with a senior center, some were home bound and required assistance to complete the questionnaire (The Fulfillment of Meaning Scale which is a likert type scale) (Burbank 1988). The study found that within a symbolic interaction perspective relationships are vital (Burbank 1992). Interaction with others is how we define situations and our meanings stem out of these situations, thus making relationships and interaction crucial to how we give and maintain meaning to situations (Burbank 1992). The majority of participants said relationships were what gave meaning to their lives (Burbank 1992). Burbank (1992) recommends that nurses become more aware of what’s meaningful to older adult clients and plan nursing interventions in ways that support or improve meaning for their clients (Burbank 1992). If life holds meaning through relationships, what happens when Viagra is added to the relationships of older adults?

And Then There Was Viagra …

Viagra, whose chemical name is sildenafil citrate is manufactured by Pfizer Labs, Inc (Pfizer 1998). Viagra is indicated for erectile dysfunction (Pfizer 1998). At recommended doses, Viagra has no effect without sexual stimulation (Pfizer  1998). It’s metabolized by the liver and is excreted mostly as metabolite in feces (Pfizer 1998). It’s absorbed orally with maximum plasma concentrations in thirty to one hundred twenty minutes (Pfizer 1998). If taken with a high fat meal absorption is slower (Pfizer Labs 1998). In eight double blind, placebo controlled crossover studies with patients with organic and psychogenic erectile dysfunction, sexual stimulation resulted in improved erectile ability as assessed by penile plethysmography after Viagra compared to placebo (Pfizer 1998). Most studies tested after sixty minutes (Pfizer 1998). Single doses of up to one hundred milligrams failed to produce electrocardiographic changes in normal male volunteers (Pfizer 1998).

Clinical studies assessed its effect on the abilities on men with erectile dysfunction to engage in sex and in many cases specifically to achieve and maintain an erection sufficient to perform satisfactory sexual activity (Pfizer 1998). Clients using Viagra demonstrated statistically significant improvement when compared to placebo in all twenty one studies (Pfizer 1998). At the end of the long term study (one year) eighty eight percent reported improved erections (Pfizer 1998). A review of the population subgroups showed efficacy regardless of baseline severity, etiology, race, or age (Pfizer 1998). Viagra was effective in patients with histories of coronary artery disease, coronary artery by pass surgery, high blood pressure, peripheral vascular disease, diabetes, radical prostatectomy, prostatic trans-urethral resection, depression and antidepressant or antipsychotic drugs, spinal cord injury, and antihypertensive, or diuretic drugs (Pfizer 1998).

A thorough medical history with physical exam are recommended to diagnose erectile dysfunction, determine its cause, and identify appropriate treatment before prescribing (Pfizer 1998). There is a degree of cardiac risk involved in sexual activity, thus it is suggested that physicians consider cardiovascular status prior to prescribing Viagra (Pfizer 1998). The most common side effects were reported from long term (over one year) studies in order of frequency are: headache, flushing, dyspepsia, nasal congestion, and urinary tract infection (Pfizer 1998). 

For most patients the recommended dose is fifty milligrams, taken as needed, one hour before sexual activity, but may also be taken from thirty minutes to four hours before sex (Pfizer 1998). Dosage may be increased up to one hundred milligrams or decreased to twenty five milligrams (Pfizer 1998). The maximum dosage frequency is once a day (Pfizer 1998). 

Popular Media Coverage

Popular magazines, newspapers, television, and talk radio shows abound with information and articles on Viagra. A New York Times article (May 1998), suggested that marriage and sex counselors are uneasy about men overhauling their sex lives without any guidelines regarding the potential earthquake they may be introducing into their emotional lives (Nordheimer 1998).

A Washington Post article (May, 1998) suggested that Viagra may have a downside for some couples (Wee 1998). One woman said she and her husband had sex five nights a week in their twenties, but after thirty three years of marriage, they might have sex on Saturday nights if they’re not too tired (Wee 1998). Although they may go weeks without sex, they still enjoy it once they get going (Wee 1998). They now have a deep and comfortable relationship without the sex (Wee 1998). The article relates the view of urologist, Myron Murdock, National Medical Director of the Impotence Institute of America (involved in Viagra clinical trials), who warns, that as time passes, we’re going to see some complex psychological things happening in the relationships of patients using Viagra (Wee 1998). Murdock predicts that some impotent men will discontinue Viagra due to the increased stress and anxiety that sex adds to their relationships, stress and anxiety they’re not able to cope with (Wee 1998).

A Chicago Tribune (May 1998) article questions what effect the “Viagra frenzy” (4) might have in marital bedrooms where sleep has been the primary activity for years (Condor & Black 1998). For the men Viagra has helped and for Pfizer stockholders, Viagra is a sweet miracle (Condor & Black 1998). But the article asks, as we do, what issues about aging and sexuality in our American culture is Viagra bringing out and how will it effect our senior’s relationships (Condor & Black 1998)? Which brings us to the kinds of questions we would like to ask about Viagra’s effect on the relationships of our grandparents, parents, our future sexual selves, and to our children. 

Hypothesis

The main object of our exploratory study is to determine the psychological effects that taking Viagra would have on relationships in elderly couples. The hypothesis is that taking Viagra will have psychological effects on older Americans’ ages 65 and older. Up to date there have been many studies done on the medical and or physical side effects of Viagra. In many of the articles we read the researchers talked about possible physical side effects such as heart problems and possible side effects of taking Viagra in combination with other medicines. From what we found however there has been very little research done on the possible psychological effects Viagra could have on older Americans’ relationships. The psychological effects of a drug are just as important as the physical ones are.

The aging process can be difficult for both men and women, but research has shown that men generally have a more difficult time adjusting to these changes.  Men are conditioned throughout their lives to be strong, in control and independent.  Men can be particularly devastated by the losses associated with aging, especially their capacity to have a sexual relationship.

Prior to the development of Viagra, older couples just took it for granted that they would no longer have that youthful, passionate sexual experience.  Now, Viagra offers these couples a “new lease on life,” or at least some of that lost passion. There are some concerns in the elderly community with regard to health risks as well as mental health risks and taking Viagra.

Dr. Steven Lamm, a teacher at the New York University School of Medicine and is author of The Virility Solution states, “this drug touches the core of malehood” (5).  He also states that “some couples are going to be disappointed that this hasn’t enhanced their intimacy, and for many that will throw their relationships out of synch” (5).

There are many possible psychological  effects that could take place after taking Viagra. Couples that have not been able to perform sexually for years many times learn to be intimate in other ways other than just sex. In many of the articles we read the couples referred to their relationship as a strong companionship that they have grown to love on a new level. Putting Viagra on the market adds a pressure to one or both partners about having sex again. Many women may also feel pressure to abide by this because of a fear that their husbands may stray from the marriage and have an affair. Another possible psychological outcome could be a great disappointment on the actual effects Viagra will have on a couple.

Another words many people may think that by taking this “magic” pill many of their intimacy and or sexual “issues” will just vanish. Unfortunately a pill can not do that, any underlying intimacy or communication problems that were there prior to taking Viagra will still be there after the fact. If these types of issues are not addressed to couples prior to taking this drug it could potentially cause great anxieties and new “issues” in the relationship.

It does seem hopeful that the psychological effects of Viagra on relationships could in fact be the next step. In one of the articles we read it talked about this being the next step in research. For individuals to truly benefit from this drug the psychological as well as the physical effects should be studied

Our approach is a holistic one that would place equal importance on the mind and body working together. Couples who are thinking of taking this drug need to be aware of the potential negative effects it could have on their relationship if they are taking it for the wrong reasons. For instance if they think that it will help underlying sexual issues of any kind, it won’t. Couples should have a realistic understanding of what Viagra will and won’t do for their marriage. That is not to say that Viagra’s effects are all negative. In fact it is quite the opposite as long as couples know the possible effects. Many experts agree that taking Viagra could in fact be magical, for committed caring couples whose sex life has been put on hold for many years.  A way to test our hypothesis would be to give confidential questionnaires to older Americans after taking Viagra. We have documented how we would go about doing this in the next section.

Methodology

We have selected the use of questionnaires as our form of research and data collection. We feel the nature of our questions are very sensitive and people might feel less threatened and more prone to giving accurate information. We will request the medical professional administering the Viagra give an open-end form of the questionnaire to the patient upon initial prescription of Viagra. This will be used as a pretest to form the more closed-end questions we will be using on the research questionnaire. We will request the health professional follow up with the research questionnaire approximately six months to a year after the treatment begins and request their cooperation. They would be accompanied by a post-paid, addressed envelope for return. This would help insure patient confidentiality and anonymity. We will be using two identical questionnaires, one to be completed by the male prescribed Viagra and one completed by his partner. They will be consecutively numbered 1a, 1b, 2a, 2b, etc, so that information can be tracked by couple. By using this split-ballot type questionnaire, we hope to get an accurate picture of the relationship changes, if any, from both perspectives.

Questions will be both closed-ended and open-ended, with a comment section provided at the end of the questionnaire for elaboration. Information requested will include relationship and general health problems prior to Viagra use, and relationship and specific health problems after Viagra use. We will also request information regarding any new effects on health or relationship since Viagra. Questionnaire respondents will be asked if they would be willing to participate in any future interviews conducted. A representative sample of the questionnaire is included at the end of this paper.

SONG

What goes up must come down

If I take Viagra will my life turn around

Talkin bout my troubles is a crying shame

That’s why this Viagra gonna give me some fame

You got no passion … you got no hope

Praying for a miracle so I can cope

Talkin bout my troubles and I never learn

Give me some Viagra, let my maleness return

Chorus:

What if my wife tells me not tonight

When I finally get this erection

What if I can’t perform tonight

I’ll end up in a deep depression …………

Someone is waiting just for me

If it’s not my spouse I’ll pay a fee

Could be a problem, don’t you see

Research for Viagra should include psychology …..…

This is my story, I wanted you to know

What can happen if it starts to grow

I hope and I pray there’ll come a day

When Viagra gonna work for me in every way

Chorus:

What if my wife tells me not tonight

When I finally get this erection

What if I can’t perform tonight

I’ll end up in a deep depression …………

What goes up must come down

If I take Viagra will my life turn around

Talkin bout my troubles is a crying shame

That’s why this Viagra gonna give me some fame

End Notes

1     Weg, Ruth (1989, Sept/Oct).  The Biological Facts: Myth Versus Reality. Geriatric Nursing. p. 305.

2     Sokolowski, Jay. (1982, July/Aug). Sexual Behavior of the Aged.  Gerontologic Review. vol. 15, pp. 214-215.

3     Burbank, Patricia M.  (1992, Sept). An Exploratory Study: Assessing the Meaning of Life Among Older Adult Clients.  Journal of Gerontological Nursing. pp. 19.

4     Condor, Bob. & Black, Lisa. (1998, May 3). Couples Adjusting to Life with Viagra. Chicago Tribune. Sec 1, p.5, col 5.

5     Berkowitz, Harry., Vincent, Stuart., & Talan, Jamie. (1998, May 3). Little Pill Big Stir: As Demand for Potent Viagra Grows, So Do Concerns. Newsday, Internet.

Work Cited

Burbank, Patricia M. (1992, Sept). An Exploratory Study: Assessing the Meaning of Life Among Older Adult Clients. Journal of Gerontological Nursing. pp. 19-28.

Byers, Joan P. (1983, Sept/Oct). Sexuality and the Elderly. Geriatric Nursing. pp. 293-297.  

Carter, Ann, M.D. (1997). Sexuality and Age: How Does Age Affect Sexuality? First Search: HealthRefCtr. Clinical Reference Systems Ltd, p. 2235.

Condor, Bob & Black, Lisa. (1998, May 3). Couples Adjusting to Life with Viagra. Chicago Tribune. Sec 1, p.1, col 5.

Drench, Meredith E. & Losee, Rita H. (1996, May/June). Sexuality and Sexual Capacities of Elderly People. Rehabilitation Nursing. vol. 21, n 3, pp. 118-123.

Nordheimer, Jon. (1998, May 10). Some Couples May Find Viagra a Home Wrecker. New York Times. sec 9, p.2, col 1.  

Pfizer Labs, Inc. (1998, May). Viagra  (sildenafil citrate) tablets. Drug Information Insert. Description, Clinical Pharmacology, Indications and Uses, Contraindications, Precautions, Adverse Reactions,        Overdosage, Dosage and Administration, and How Supplied.

Richardson, James P. (1995). Sexuality in the Nursing Home Patient. American Family Physician. v 51, n 1, pp. 121 (4).

1-Semmens, P. James, M.D. (1997, Dec). Older Adults and Problems with Sexuality. First Search: HealthRefCtr. Clinical Reference Systems Ltd., p. 2153.

2-Semmens, P. James, M.D. (1997, Dec). Psychological and Social Problems of Midlife Sexuality. First Search: HealthRefCtr. Clinical Reference Systems Ltd, p. 2624.

Sokolowski, Jay. (1982, July/Aug). Sexual Behavior of the Aged. Gerontologic Review. vol. 5, pp.  214-215.

Wee, Eric, L. (1998, May 6). Viagra? Not Tonight, Dear. For Some Couples, the Anti-impotence Drug Has a Downside.  Washington Post.  Sec D, p. 1, col 3.

Weg, Ruth (1989, Sept/Oct). The Biological Facts: Myth Versus Reality. Geriatric Nursing. p. 305