Episode 2
His Penis Exploded: How much sex is too much sex?

<Disclaimer>

"His penis exploded." Words I never thought I would hear or read, let alone say, but ladies and gentlemen, here we are.

<PROLOGUE>

I'm sure you've heard it in one way or another. It's been said throughout history in many different ways:

"But it is an old sawe, that there is too much of a good thing: and it is true, that the best things, if they be too much used, doe much hurt." From Shakespeare to the cartoon Calvin & Hobbes, the message returns again and again. "Too much of a good thing can be bad." Unfortunately, sex historically has not been an exception.

In the 15th century, Urbino, Italy, was a small but remarkably vibrant and influential city nestled in the picturesque hills between the Apennine Mountains and the Adriatic Sea. At the heart of Urbino's cultural life was the court of Duke Federico da Montefeltro, a renowned military leader and humanist. His rule from 1444 to 1482 transformed Urbino into a beacon of Renaissance art, architecture, and learning. Federico was a man of vision who invested heavily in the arts and education, drawing scholars, artists, and architects from across Italy and beyond to his court. The court attracted luminaries like the painter Piero della Francesca, whose works in perspective and geometry were groundbreaking. It was also home to the young Raphael Sanzio, a young man who would become one of the most prolific and talented artists of the Renaissance era.

Raphael was born into a world of artistry. By the age of 17, he was already being hailed as a "master," a prodigy who would soon eclipse even the most celebrated artists of his time. He learned from the greats—Leonardo, with his enigmatic smile, and Michelangelo, with his sculpted visions—and before long, Raphael stood out as a shining star in his own right and it wasn't long before Raphael was pursued by very powerful people for his artistic talents.

It was Pope Julius II, a man of iron will and formidable influence, who would become Raphael’s greatest patron. The same pope who banished the Borgias out of Italy so thoroughly that he demanded, "all the tombs of the Borgias must be opened and their bodies sent back to where they belong - Spain." The same pope who absolutely refused to occupy the papal residence because he considered it so desecrated by the Borgia papacy, that he replaced the 1,000 year old cathedral to give the church a clean slate. This same pope had a soft spot for art and became the patron of several artists of the time, including Raphael.

Now, Pope Julius was a man of grand visions, and he saw in Raphael a kindred spirit. He summoned the young artist to the Vatican, where Raphael would embark on a journey of creation that would leave an indelible mark on the world. Over the next 12 years, Raphael poured his heart and soul into creating an astonishing number of paintings, tapestries, and architectural wonders for the Vatican. His work was so prolific, it seemed as though he was channeling divine inspiration itself. How could such a man have time for anything else in his life?

But he did, according to his biographer, Giorgio Vasari. Apparently, Raphael was engaged to be married to Maria Bibbiena, a Cardinal's niece. Yet, if you think their engagement was a love story, think again. Raphael postponed their wedding for six long years. Poor Maria died waiting, never to marry him. It’s a classic case of a man married to his job. Yet while Raphael strung Miss Bibbiena along all those years and enjoyed church patronage for his stunning works of art, behind closed doors his activities were delectably sinful.

Here is a snippet from a 2010 article in The Guardian about the rumors:

"The young, gifted, handsome and courtly artist, Vasari claims, was so enamored of his mistress that she had to be allowed to live with him in the Villa Farnesina in Rome while he was painting its frescoes. No sex, no frescoes. The story of Raphael's sensual relationship with La Fornarina, as Vasari names her, fascinated artists down the centuries. Raphael became an icon of lust."

Margherita Luti, as she was known, captivated Raphael instantly. His passion for her was so intense that he demanded their affair be permitted within the Vatican's hallowed grounds. During those years, Raphael created numerous paintings featuring Luti, but not a single one of Maria Bibbiena. Passion, it seems, makes for far more compelling art…especially when it is rumored to be the cause of your death.

"Died from Excessive Passion". For centuries, this was how his biographer’s writings characterized the artist's death. Rumors swirled through the cobblestone streets of Rome, painting vivid images of Raphael's final days. Whispers spoke of a man so consumed by his desires that he abandoned reason. Some said he had been struck down by divine retribution for his sins, while others claimed his own reckless passion had been his undoing. The story goes that Raphael, after an unbridled day of carnal indulgence, found himself burning with a fever that no earthly remedy could quell.

His physicians, perhaps in awe of his talent or wary of his patrons, treated him with the medieval cure-all of bloodletting, a practice as perilous as the affliction itself. Raphael, weakened by both his illness and the "cure," slipped further into delirium. As his condition worsened, he admitted to having "overheated" himself, a confession shrouded in ambiguity and scandal. What exactly transpired in those passionate hours? The details remained cloaked in mystery, leaving much to the imagination of a gossip-hungry populace.

It was said that his insatiable lust caused an imbalance of humors, a theory that fit neatly into the Renaissance understanding of medicine. His biographer, Vasari, spun a tale of a man whose love of life and beauty was so intense, it ultimately consumed him. Raphael’s demise became a legend in itself—a cautionary tale of genius undone by excess.

Maybe Raphael really did collapse and expire from too much sex. It's not the first time sex has been portrayed as evil and deadly; and even the phrase "le petit mort" has roots in this fear of sex shuffling loose our mortal coil.

"Le petit mort" is a poetic euphemism for that sublime moment of release, that pinnacle of pleasure, that climax of carnal delight: the orgasm!

This French phrase, literally translating to "the little death," beautifully encapsulates the sensation experienced during the peak of sexual ecstasy. It's as if for a fleeting moment, time stands still, and one is transported to a realm of pure sensation, where the boundaries between self and other blur into a blissful oblivion.

But fear not, for this "little death" is far from morbid. It's the ultimate culmination of desire, and for many, the very essence of life's most intimate moments. In literature and art, "Le Petit Mort" has been celebrated as a symbol of transcendence, a metaphor for the ecstasy of the soul merging with the body. It's a motif that has inspired countless poets, painters, and philosophers to explore the profound connection between eroticism and enlightenment.

And while some of us quite enjoy getting lost in the throes of passion and reveling in it’s exquisite beauty, surrendering to the delicious agony of pleasure, somewhere in history, someone got it in their heads that too much sex was bad for your health and with each climax, a person (very specifically a man) was actually expending their life force. This is actually a myth that continues to circulate in cultures around the world to this day. Humans even concocted the myth of the succubi, a sexual female spirit who would visit men in their sleep and seduce them, stealing their semen to survive...a good explanation as any for nighttime emissions, I suppose. And for women, they got their version in the form of the Incubus, a male demon who would lay with them at night, but the result of the seductions were always the same: illness, insanity, and/or death. Not to mention that the more likely reality in these moments was at best vivid erotic dreams or at worst, actual sexual assault.

While we are on the subject of succubi, and the French, and death, let's talk about President Felix Faure. He died as president of France in 1899. And the cause of his death? Supposedly, receiving oral sex.

I don't think we as Americans are as scandalized as we might once have been at hearing a head of state got a little head while on the job. In fact, I think its pretty much a joke to us at this point. And even in 1890s France, the idea of any man having a mistress...was not that scandalous. "Wives are to produce heirs. For pleasure, men seek other women" was a commonly accepted idiom. This permissiveness waned towards the later half of the 20th-century in France, which might be why Mitterand, France's prime minister during the 90s, kept his relationship with his mistress a secret for 30 years...even though she not only openly attended his funeral but stood next to his wife at the man's grave. But for President Felix? Not an issue.

It was a crisp winter morning in Paris, and the grand halls of the Élysée Palace buzzed with the usual intrigue and machinations of the French Republic. President Faure, a man known for his charm and vigor, had a particularly challenging appointment that day. He was to meet with the Prince of Monaco, a rendezvous that promised more friction than diplomacy. The meeting was indeed a tempestuous one, with harsh words exchanged and frustrations mounting. As the clock ticked towards noon, Faure found himself drained and irritable.

In the midst of this political maelstrom, Faure sought solace in the arms of his confidante and lover, Marguerite Steinheil. Marguerite, a woman of striking beauty and even more striking ambition, had long captivated the President’s heart. It is said that she possessed secret entrances to the presidential palace, a testament to the clandestine nature of their affair. On that fateful afternoon, Faure telephoned Marguerite, asking her to visit him later. "Come by the palace," he said with a weary sigh, "sit on my lap, and we’ll talk about whatever comes up."

Miss Steinhall would invariably write her own version of the events which transpired that day and I am absolutely sure they are factual as she had nothing to gain by sensationalizing her last moments with the President (/s). In an entirely different document titled, "The Odious Legend of the Death of President Felix Faure," (that I roughly translated using Google Translate) Miss Steinheil is said to have claimed the President loved her so much that she maintained secret entrances to the presidential residence. Considering her reputation, she was no stranger to the whispers and raised eyebrows of society and her meeting with the President that day was not so much a secret. They met in the office of the undersecretary, a room that would soon become infamous and about thirty minutes later, President Faure stumbled out, his face pale and his steps unsteady. He managed to ask for help to sit down before collapsing into a chair. At this point, rumors vary with the best version painting a picture of a confused President emerging from the room with his pants still around his ankles and Miss Steinhall hurriedly replacing her clothing to the most scandalous version which features the mistress completely naked, on her knees, and the president actively expiring with a fistful of her hair still caught in his rigid fist. In any version of the event, Miss Steinheil was observed looking "distraught" but was summarily dismissed by the staff and told never to return.

The summary of this document was less than flattering, branding Marguerite as a "mythomaniac of well-known immorality," who had faced prosecution for the murder of her husband and mother, among other sordid affairs. Yet, regardless of the doctors’ conclusion that President Faure died of a stroke, Marguerite’s version of events suggested something far more scandalous. She implied that her "oral prowess" was the President’s final earthly experience, a claim that made her both infamous and highly sought-after in certain circles. Indeed, following the scandal, Marguerite's allure only seemed to grow. She became the mistress of many other notable men, until her eventual conviction for the aforementioned double homicide.

As for President Faure, his final days were marked by declining health. His personal physician noted that Faure had been complaining of various ailments in the days leading up to his death. The morning’s stressful meeting with the Prince of Monaco likely exacerbated his condition, making him a man already on the brink. The fateful encounter with Marguerite, whether filled with passion or merely companionship, was simply the final chapter in the life of a man who lived at the intersection of power and desire.

Let's be clear, folks. Sex is a physical activity. If there are physical conditions that contraindicate sexual activity, you should listen to your doctor. This being said, sex, oral or otherwise, is not likely to cause a stroke by itself. There are usually accompanying risk factors that are more indicative of stroke and there is no clinical evidence to date that sexual activity exacerbates any of those risk factors. Does that mean its impossible? Who can say? In Felix Faure's case, it seems like the rumors of his untimely death being a result of getting oral sex from his mistress are more likely tied to his position as president, cheap posthumous shots from political rivals as well as an opportunistic mistress hoping to be immortalized by the scandal.

Oh, but I can almost hear the collective cry of vindication from centuries past, full of crackpot physicians and religious zealots, all wagging their fingers in unison and screaming, "We told you so! See what sex for pleasure gets you. Repent, repent!" The correlation between excessive sex and bad outcomes so far is unwarranted. Correlation is not causation. All I see so far is bad medicine and bad timing. But let's explore one more example. Something a little more recent.

<Intro to Joy to the World/Jeremiah was a Bull Frog>

The trio of sex, DRUGS, and rock and roll have existed together since rock & roll began. And Three Dog Night vocalist Chuck Negron was at the wild center of all three of those during his fame. In 1999, he would actually write a book called "Three Dog Nightmare: The Chuck Negron Story" where he candidly shares his experiences as a cautionary tale.

In an interview earlier this year, Negron referred to himself as an awkward guy when it initially came to the groupies. He admits he just wasn't that guy women wanted to party with and get crazy with, not at least while he was sober and being himself. Drugs and alcohol seemed to provide just enough social lubrication to lead to a great time. And a great time for Chuck Negron eventually meant having a lot of sex.

When it came to sex in those first few years of fame, Negron likened himself to a rabbit. He said, "I was having so much sex that my penis actually had abrasions on it, it was swollen and getting bigger and bigger." Being young and full of good ideas, he initially chalked it up to your run of the mill muscle growth. The dick is a muscle so the more you use it, the bigger its gonna to get, right? And that is actual insight into Young Chuck Negron's reasoning from older and wiser Chuck Negron and he himself acknowledges it was...stupid.

But something eventually gives him pause. It just doesn’t seem right so he goes to a doctor. The doctor, learning from Negron that he is not just any red-blooded young American male, but a vocalist in a hugely successful rock and roll band, gives him direct, point-blank advice. The doctor says, "I've got to tell you--you're in a lot of trouble here. You have a major problem. The blood is not leaving your penis. It's staying there. You have to stop having so much sex." Negron would eventually use the line "You have to stop having so much sex" as the title of this specific chapter. Chuck Negron is not happy to hear this diagnosis and thinks the doctor is overselling it. Then the doctor says the words that prophesy the performer's fate. "If you don't stop, it's going to get so big, it's going to split open."

Negron sees the doctor is serious and concedes. Message received, he says. No more sex.

Until the next time he has sex, at least. And not that he can remember her name but he recalls her beauty, that she was some kind of pageant queen out of somewhere in the Midwest. They were right in the middle of penetrative sex, his penis fully inside her, when it happened. Exactly what the doctor said would happen. Negron’s fully engorged penis, somehow still capable of becoming even more aroused, had finally reached its limit and his penis exploded. The skin around the shaft could no longer contain the building pressure of blood that was trapped inside it and the skin split open.

Now, it seems no official diagnosis is mentioned in or out of Negron’s book but from his description, it sounds like he was experiencing priapism. Combined with his endorsement of illicit drug use during this time, that makes the most sense. I want to assume that most adult males understand why having an erect penis for extended periods of time is bad but as Chuck Negron has shown us, I don’t think it's safe to assume what the average man knows about his body. Now I could sit here and tell you why its bad, but I think you’d rather hear an Australian tell you why its bad, because everything sounds better with an Australian accent.

https://www.youtube.com/watch?v=xrazcv3Tq90

And if you want extra credit, there is even a YouTube video you can watch of how a prolonged erection is drained with a syringe. The link will be included in the show transcript or you can just google it.

https://www.youtube.com/watch?v=KWf5MAobWoM

Now back to Chuck Negron. I took a drama class once...in 7th grade. I think I did well. That being said, I don’t think I can do the sound Negron wrote into this part of the story any kind of justice. He describes literally hear the tearing of the flesh in addition to feeling it. He would also later describe the absolute embarrassment of having to walk into a hospital emergency room with a jacket wrapped around his wounded member and having to explain what happened to multiple people and then additionally having to suffer the indignity of getting the shaft of his penis stitched up while feeling the snickering gaze of everyone around him. If that was embarrassing, I can’t imagine the woman who now had to process everything that happened. The fact that we don’t know who this mystery woman is to this day tells us it was likely an experience she would rather forget as well.

The Evil of Sexual Revolution

This isn't the first time a musical genre has become associated with a loosening of sexual mores, like Jazz and the Roaring 20s. But the 60s and 70s saw a sexual and cultural revolution that wasn't going to be cut short by a great depression. The sexual revolution of the 1960s and 1970s was a seismic shift in attitudes towards sex, love, and relationships. It was a time of breaking free from the constraints of traditional morality and embracing a newfound sense of sexual liberation. And what better soundtrack to accompany this revolution than the raw, rebellious energy of rock and roll?

Rock and roll and the sexual revolution were like two peas in a pod, grinding cheek to cheek in the smoky halls of underground clubs and the sprawling fields of music festivals. The music itself became a rallying cry for sexual freedom, with lyrics that celebrated love in all its forms — from the innocent crushes of teenage romance to the steamy encounters of one-night stands.

Bands like The Rolling Stones, The Doors, and Led Zeppelin became the prophets of this new era, preaching a gospel of free love and self-expression through their electrifying performances and provocative lyrics. Their music wasn't just about making you dance; it was about making you think, making you question the status quo, and maybe even making you blush a little. But it wasn't just the music that aligned with the values of the time; it was the entire rock and roll lifestyle. From the hedonistic excess of sex, drugs, and rock and roll to the androgynous fashion of glittering glam rockers, the world of rock became a symbol of rebellion against the stifling conformity of the past.

And let's not forget the role of rock and roll in breaking down barriers of race, gender, and sexual orientation. It was a genre that welcomed misfits and outcasts with open arms, providing a safe haven for those who didn't fit neatly into society's boxes.

So of course social conservatives would say that good old American values suffered during Rock & Roll's popularity. Feminism, the contraceptive pill, and civil rights were destroying the nuclear family and allowing homosexuality to run wild, with drugs and sex everywhere and no consequences for any of it. Oh, it grieves the heart of God, don’tcha know.

Kinda reminds me of this scene from the first Austin Powers film in 1997:

https://www.youtube.com/watch?v=XHCfLtAAEzM

DR. EVIL: Isn't it ironic that the very things that you stand for, free love, swinging, parties, are all, now in the nineties, considered to be...evil?

AUSTIN POWERS: No, man. What we swingers were rebelling against were uptight squares like you, whose bag was money and world domination. We were innocent, man! If we'd known the consequences of our sexual liberation, we would have done things differently. But the spirit would have remained the same. It's freedom, baby, yeaaaah.

DR. EVIL: Face it! Freedom failed. 

AUSTIN POWERS: No, man, freedom didn't fail. Right now, we've got freedom AND responsibility. It's a very groovy time. 

Negron discovered freedom as a rock star but without responsibility, the combination of sex and drugs culminated in an extreme consequence of the two. But if any of the previously discussed scandals had happened today, it might invoke a topic that has become very divisive over the last 20 or so years.

Sex Addiction vs. Hypersexuality vs. OCSB

https://www.youtube.com/watch?v=5OweDpDU2qs (first 6 seconds)

https://www.youtube.com/watch?v=8UQYWmAH2SI (first 21 seconds)

https://www.youtube.com/watch?v=q4nG8HsGmTA (first 19 seconds)

There is no actual diagnosis for sexual addiction. Not in the DSM and not in the ICD-11. The more commonly used terminology is Out of Control Sexual Behavior or Compulsive Sexual Behavior Disorder. In 2012, the APA assembled a task force to conduct a field study intent on investigating the “clinical utility, reliability, and validity of diagnostic Hypersexual Disorder criteria in clinical settings” for possible inclusion in the DSM-5 as a diagnosis. They wanted to assess the possible etiology, clinical course, as well as proposed specifiers and their consequences when it came to Hypersexual Disorder. Essentially, what they were looking for was inter-rater reliability. Boiling it down a little further, if two or more clinicians look at an individual’s set of behaviors, will their assessments agree within an acceptable margin of error?

I think we all agree we want our psychologists, psychiatrists, doctors, and therapists to be able to agree on a diagnosis when we present them with the same set of problems and that diagnosis should be in some sense standardized. I’m not going to sit here and pretend that when it comes to mental health that everyone always gets it right 100 percent of the time. It’s not like we can take a scan of your brain, point to an area and say, “Yup, that’s depression.” Unfortunately, that is not an option. A doctor can very clearly see a broken bone on an x-ray but trauma, anxiety, and mood disorders are a bit trickier.

The reason for this is that there is no data that has been studied or established that has been able to identify changes in the brain that react to sexual behavior the way the brain reacts to illicit substances, which isn’t to say that they haven’t tried or that such a phenomenon has not been observed in the human brain. In 2006, researchers scanned the brains of people actively orgasming and concluded the scans of these individuals “resembled” the brain scan of people experiencing a heroin rush. When researchers push the sex addiction narrative, they essentially equate heroin, a substance that is artificially introduced to the system, with dopamine, a neurotransmitter and hormone our body produces through very natural processes that have become dysregulated.

Ultimately, the task force that was established in 2012 to assess the reliability and validity did conclude the diagnosis could be reliably applied to clinical populations though the same report included limitations and recommendations, including how this area would benefit from further research. You may be asking now, if the Task Force concluded the diagnosis was reliable and there are scans that demonstrate brain changes, why the resistance to including Sex Addiction as a legitimate mental health diagnosis?

Despite these apparent green lights, there have been numerous criticisms of the task force, the way their data was collected, the politics of the APA, as well as criticisms of the motivations behind the field study itself. The concerns regarding false positives, the reliance on self-reported data, the capacity of clinicians to accurately and consistently assess for a disorder while also accounting for comorbidity are all essentially criticisms that have been levied against all mental health diagnoses including pathologizing what may be a variant of normal human behavior. And they’re not wrong. What constitutes mental illness? What are the thresholds that need to be met with regards to frequency, duration, and severity? And the reason I ask is this: Who then gets to decide how much sex is too much sex? I believe it should be the patient or client but that is not the problem. The diagnostic criteria does not adequately differentiate between high sex drives and pathological levels and activities. I personally believe there are too many organizations, both political and religious, in the world today that have a vested interest in controlling human sexual behavior. Having the power to set the social and moral bar for what is and is not acceptable as far as sex is concerned is a slippery slope and one that is not worth navigating for the sake of getting one more diagnosis into the DSM. You may think this sounds paranoid but I’m not so sure considering the recent changes to the political protections marginalized minority populations used to enjoy. There are numerous court cases attacking access to basic contraceptive medicine, comprehensive obstetric care, and not to mention recommendations for future legislation from various think tanks and political pundits to limit or completely eradicate access to explicit sexual materials (pornography). Arguments that I believe would only be bolstered by the legitimacy implied in the availability of an official diagnosis of Hypersexual Disorder. How many people suffered during the years Homosexuality existed as a mental health diagnosis? Despite Gender Dysphoria being more about the distress experienced by individuals experiencing a disconnect between their biological gender and their expressed gender identity, they are often accused of having a mental illness and having a high barrier to gender-affirming care as a result. I don’t think it's unreasonable for medical professionals to want to tread carefully anytime pathology and human sexual behavior or identities are mentioned in the same breath.

Not to mention that there are any number of diagnoses already available in the DSM and ICD-11 that could potentially cover the behaviors of hypersexuality because it's not particularly well-understood whether hypersexual behavior is a pathology on its own or merely a symptom of other psychological distress. Mood disorders, anxiety disorders, adjustment disorders, substance use disorders, impulse and conduct disorders can all have a dysregulating effect on sexual expression. Once again, I don’t think it's unreasonable to expect additional research to establish clarification.

I understand this distinction provides little consolation to individuals who genuinely feel their sexual behavior is out of control. While many experts argue, myself included, that compulsive sexual behavior shouldn’t be considered an addiction, the media and the public have embraced “sex addiction” as an informal term, so it’s generally accepted regardless of whether it’s clinically accurate. In fact, there is a call to carve out a "process" addiction consideration, an umbrella term that could encompass issues like problematic gambling, gaming, and perhaps sexual behaviors but nothing official is in place yet. Going back to the study of biology and neuroscience and how the mesolimbic dopamine system hijacks and disrupts other human functions, there is a lot of data they are still looking at and it is very compelling. What the researchers cannot control is how the general populace, government, and media essentially take that research and bastardize it to cover all manner of behaviors. To quote a presentation by Stefanie Carnes, PhD and marriage and family therapist, “Just because someone has had affairs, used prostitutes, attended a strip club, uses porn recreationally….does not mean they are a sex addict. It is just as important to determine who is not a sex addict as it is to determine who is.”

But I can see where pathologizing behavior and getting it swept under the addiction consideration could be beneficial. For example, if one were famous and powerful and had a lot to lose if their proclivities were to become common knowledge, then being able to say, “I couldn’t help it, I have a condition” would land a lot better from a PR or legal standpoint than, “I didn’t want to help it and I’m definitely going to do it again once all this heat dies down.” The latter perspective wouldn’t pass the screening portion of out of control sexual behavior anyway as it indicates a more predatory, sexual offending component. Something that may align more with narcissistic behavior or antisocial characteristics. Those are a whole different ballgame. But having enough clout and money, you can choose one of the plethora of bougie “sex addiction” treatment centers that will label you anything your publicist needs you to be labeled with in exchange for a really nice check.

Undoubtedly I will touch on out of control sexual behavior again in a future episode, but within the context of the “cautionary tales” previously presented, how does excessive passion relate to the world of today?

The clearest answer I can give to that question is there is no clear answer. And yet, there is a question that many adults grapple with: "How much sex is too much sex?" This question is not just a casual inquiry but a significant concern in contemporary discussions about sexual health and behavior. In a world where sexuality is increasingly visible and openly discussed, many adults find themselves questioning what constitutes a healthy sexual appetite. With the rise of digital media and the ubiquity of online content, sexual norms and expectations are constantly evolving which has led to a broader dialogue about sexual frequency and its impact on overall well-being.

Yes, sexual activity, while a natural and healthy part of life, can become problematic when it interferes with daily functioning, causes physical harm, or leads to emotional distress. Adults often worry about whether their sexual habits are indicative of a deeper issue but this kind of worry may be entirely inappropriate and personal history and present context are super important to conceptualizing the issues at play. It's no wonder there is confusion and anxiety about what is considered normal or healthy when we are constantly bombarded with mixed messages, making it all the more difficult to discern a balanced perspective on sexual frequency.

Raphael Goes to Therapy

Let’s play with this a little bit and use one of our historical friends as a theoretical patient. Raphael. Let’s say he’s taken a break from painting to consult with a mental health clinician who specializes in sexuality. He’s completed his intake paperwork and under chief complaint, all he’s written is, “Unhappy with recent life choices.” Noted. So he’s in my office and he’s sharing with me how the Pope himself has commissioned work from him and because he runs in these papal social circles, he befriended a local cardinal who introduced him to his niece. Raphael says, “She was nice and I’m sure she was someone’s type, but I wasn’t interested in her like that. But before long, people start talking. They’re like, Why isn’t he married yet? I thought he was a good Catholic boy. My mom keeps calling me and asking me when am I going to give her some grand-babies. And before I know it, I’m engaged to this cardinal’s niece and I don’t even like her! So here I am painting these frescoes and drafting architectural plans all day and all of a sudden, I see her. I ask around and I found out, she’s the local baker’s daughter. You have to believe me, I couldn’t think about anything else. My work suffered because I couldn’t focus and I knew I’d never get anything done if I couldn’t get to know her better. Her name is Margherita, by the way. She moves me in a way no else ever has and I am actually a better painter because of her. But I know it’s wrong. I’m supposed to be married to Maria. I know its the right thing to do but I keep finding reasons to postpone our marriage and the whole time I am fucking someone else! And, there have been others, too. I work for the Vatican. I am supposed to be married to a Cardinal’s niece. I shouldn’t be fornicating but it’s what makes me happy, even if I find myself weakened after every session of lovemaking. I keep going back to it. What is wrong with me?”

I wish I could say all clients are as forthcoming. Usually their initial conceptualization is not this clear but eventually, you as the clinician are given glimpses into their competing motivations.

In this fabricated case, is sex the problem?

In this case, my fictional representation of Raphael tells me he acknowledges his religious priorities that are echoed by family members he does not want to disappoint, in this case, his mother. He has a social expectation in that he is betrothed to a woman publicly but is actually stringing her along instead of cutting her loose and letting her find happiness with someone else. I could only imagine the guilt that may follow her untimely death. Her uncle is a Cardinal and as Raphael’s work is being commissioned by the Vatican, it could hang in the balance if he bites the hand that feeds him. But he feels so much passion for Margherita, passion that he does not feel for his actual fiancé and he does not want to let that go. And in this vignette, Raphael very much feels the disconnect between who he feels he is supposed to be and who he is acting like, to the point that he wonders, “What is wrong with me?”

And that question is invariably always present one way or another. And we have a word for this. It’s called shame. It's essentially when someone says, “I have done or am thinking about something that does not align with my other values and it kills me. Something has to be wrong with me or why else would I do it?”

Shame: Both painful and useless

Shame is such a useless feeling. Shame used to be a very important tool in ensuring conformity within a group. A thousand years ago, if we got kicked out of a community for not upholding their values, it very often meant dying alone. Even though that isn’t the case anymore, the mechanism in the brain that generates anxiety and stress when the majority disagrees with us, still functions today. Once it’s activated, the stronger the urge to seek relief from that anxiety and pretend we're something we’re not. The alternative is unimaginable to us. Excommunication. The threat of divorce and a custody battle. Getting fired. Fines or a mugshot and jail-time. Or any combination of these consequences.

In 1963, Silvan Tomkins wrote: “While terror and distress hurt, they are wounds inflicted from outside which penetrate the smooth surface of the ego; but shame is felt as an inner torment, a sickness of the soul.”

The fear is real and society relies on that fear to enforce “acceptable behavior”. But punishment in the form of being shunned in relationships, social groups, and religious affiliations is the opposite of what people who feel out of control need. And from a treatment perspective, it is also highly unethical to hang these consequences over the client’s head. So as clinicians, our efforts need to be motivational, not punitive. Not offering clients a space to understand, explore, and contend with all aspects of their sexuality is problematic and contributes to the shame that makes out of control sexual behavior possible.

So is sex the problem? No. It is his use of sex within the context of all the other variables he highlights. His sexual behavior does not align with his values and it causes him emotional distress. I know people will accuse me of splitting hairs or they’ll say, That’s just semantics, but I can’t disagree enough.

Sexual behavior is not a one-size-fits-all experience and imposing morality on human sexuality has never worked…in the history of the human race. Raphael Sanzio likely did not die after a long bout of sex and was just as likely killed by his doctors’ treatments. President Faure was not in good health and likely had a stroke (not the sexual kind) before he died. And Chuck…well, don’t combine cocaine and sex and listen when the doctor tells you to stop having sex! No you won’t go blind or grow hair on your palms if you masturbate too much. No you don’t gradually erode your life expectancy with every seminal emission. No sex is not purely for procreation and a woman’s vagina does not become more loose with an increase in sexual partners. No, it's not difficult to be monogamous after having casual sexual relationships. Yes, sex releases dopamine...but so does playing golf and eating chocolate. No, women don’t seek to control men through sex and women are just as capable of enjoying sex for pleasure as men are. And no, men are not insatiable sex-consumed maniacs who are incapable of controlling themselves. All the ridiculous excuses we make up to try and control who people can have sex with, when, and how often are bullshit. They always have been and they always will be.

I’m going to play a different clip from one of the audio bites I played before. This woman felt out of control in her sexual behavior because she never took the time or was given permission to understand her sexual behavior within the context of her identity, in order to eliminate the shame.

[Audio Clip]

It’s such a beautiful and succinct way of saying, I was being who I wanted to be but I didn’t know I had that right so it felt wrong for too long. And being able to have that freedom from shame is part of a healthy sex life. Maybe that is what Raphael and President Faure found for themselves. If history judges them as something else, what does it matter to them at this point? So if history judges you as having excessive passion, as long as it is safe, sane, and consensual…who cares?

This has been another episode of Going Down on History, a Knowledge is Pleasure production and my vote will always be for the promotion of safe, sane, and consensual sex while leaving room and respect for the conscientious objector. Until next time, stay sexy friends.

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