The title of the book in question was originally Men ON Women but as author Barbara Silkstone got into interviewing over 500 men on their opinions about women, sex, and relationships, the men relaxed in her one on one chats and became emotionally naked with her, hence she changed the title to 527 Naked Men and One Woman: Adventures of a Love Investigator, which you can buy here.

Barbara Silkstone

I found the book fascinating (as a psychiatrist) for the wide range of nuttiness found in the men’s attitudes about love and sex, which seemed to boil down to either I am looking for my life partner and that one wasn’t it, or she just stayed at home with the kids and had no goals and I want a woman with goals, and on and on. Men shared their confusion about what they thought they wanted and how unhappy they were when they actually got it.

I recently interviewed the author through email and here are some snippets:

DOUG: How did you come up with the idea of the book?

BARBARA: I was just coming off of a second divorce and felt like I was taken financially by my ex. I was sure he had a hidden agenda. I have a lot of really great guy friends and I thought there must be some guys out there who marry for true love and don’t just worry about the money. I started with a list of eight guys willing to be interviewed about their relationships. When the word got out that there was a woman who wanted to hear about their thoughts on relationships and wasn’t judgmental, the word spread through the guy-network and then around the country. I traveled for six years just listening to men. Can you imagine?

DOUG: Was there anything that surprised you about the interviews?

BARBARA: Some of the men’s attitudes about relationships were a lot worse than I had expected. It got pretty hard to listen to after a while. It took a toll on me emotionally.  There were many days went I spent the mornings with men who were having mulitiple affairs and justified them and then afternoons with single men who were helping married women cheat and those single guys had all sorts of justifications. Few of the men ever  used the word love.

DOUG:  Was there a certain answer that ran through all the interviews?

BARBARA:  I would ask the men if they would be willing to die for the woman they claimed they loved. Only 14 men out of the 527 said yes and yet half the men were married.  Their response was usually…’You’re not gonna use my name, right? Then, ‘Of course I wouldn’t lay down my life for my wife. She has no goals. I still have things to do with my life.’

It got me wondering whatever happened to those romantic guys from days of old who marched off to defend their women folk? How did we lose them?  Where did they go?

DOUG: I was surprised at how many men looked at relationships from primarily a self centered perspective, or that worried about things like not getting bogged down with a ’stay at home mom’. And yet they were so unhappy.

BARBARA: Yes it is pretty remarkable. I started out with a plan to interview 1000 men in one year. But after six long years and a couple of melt-downs I had to stop at 527 guys.  I had no more emotional strenght left – and I’m a pretty storng lady.

DOUG: Has this affected your own view of dating?

BARBARA:  I haven’t dated since I finished the last interview. I’m a perfect example of biting off more than you are trained to digest. Since I finished the interviews. I became THE WOMAN WHO KNEW TOO MUCH.  What I did was an excellent job of biting off more than I could chew. I had no way to put all this knowlege into prospective. I am my own collateral damage.

DOUG: What are you working on now?

BARBARA: I’ve just completed a novel titled THE SECRET WORLD OF ALICE IN WONDERLAND, AGE 42 AND THREE-QUARTERS. I discovered that we all live in some version of Lewis Carroll’s reality. If we can just learn to laugh at ourselves we’ll survive and get a few giggles along the way.  My Alice has some crazy quirks – she suffers from Alice in Wonderland Syndrome and nibbles on little pink pills to keep her cool. She’s dying to live in England and almost does. Gangsters pursue her and she runs into the arms of a charming British conman. It’s a bit like A Fish Called Wanda.
 
DOUG: Barbara has agreed to hang around and answer questions about love and relationships on the comment section. Thanks for agreeing to being interviewed!

BARBARA: Thanks for having me!

I have been writing about the DSM process which isn’t always easy to do because the head of DSM-5, David Kupfer, MD, runs a pretty tight ship with his committee members, making them sign confidentiality agreements and not take any notes. Well since he said that there would be a “paradigm shift” and the sky is the limit for coming up with new diagnoses, there has been a lot of interest in the process.

David Kupfer, MD, Head of DSM-5

I recently wrote about the editorial by Allen Frances MD, head of DSM-4, criticizing the current process of DSM-5, and now there is a nasty response from the DSM-5 group, authored by Alan Schatzberg MD, James Scully MD, David Kupfer MD, and David Regier MD, that psychiatry blogger Daniel Carlat MD offered to edit for them to make it more respectful. Lol. A blogger offering to help the leaders of academic psychiatry tone down their language. Lol again.

I mean the damn editorial hasn’t even been published yet.

In their response to Frances Kupfer et al make dubious claims that “attorneys” had advised them to have committee members sign confidentiality agreements to protect “intellectual property”. They also charge Frances (as well as Robert Spitzer MD, who founded DSM and has been making the email rounds with criticism of the current process) with greed in wanting to retain royalties from a book he wrote about DSM-4 which would become outdated after the release of DSM-5. I mean anyone in the business knows that book royalties pale in comparison to the hundreds of thousands of dollars to be had doing pharmaceutical industry consulting and speaking. In fact one could even argue that doing things like editing books (which have essentially no revenue, because hardly anyone buys them) is a feather in the cap that helps you get those more lucrative gigs.

One of the diagnoses on the table is Female Sexual Dysfunction (FSD), a “disease” that if accepted would surely drive the drug companies to “identify and treat” these poor lassies with drugs like the testosterone patch (see “Wow A Drug To Have Sex Once More a Month? Sign Me Up!“) or Viagra or whatever psychotropic they could drug out of the medicine cabinet.

Turns out the medicalizing women’s sexuality may not be such a good idea. There is a long and jaded history of evil meddling by medical doctors in this area. The publication of the book Feminine Forever, whose thesis was that post-menopausal women become shriveled asexual crones due to an estrogen deficiency led doctors to put an entire generation of post-menopausal women on hormone replacement therapy (HRT), which in turn was later found to have caused tens of thousands of deaths from heart attack and other problems.

Then there were Masters & Johnson, the famous sex research team who concluded that women had more frequent orgasms than men.

Masters & Johnson on Meet the Press

This “research” however was based on looking through peep holes at brothels, and later their “research sessions” they conducted with each other. Virginia Johnson was Dr. William Masters secretary, and they “partnered” to have sex on a nightly basis for “research” purposes for years. Their report on 67 patients with unwanted homosexuality showing a 70% conversion to heterosexuality using “conversion therapy” was later disclosed as a fraud when noone could find any evidence of the patients. This bizarre “research team” should hardly be taken seriously about women’s orgasms.

Turns out that the DSM-4 has ‘Female Hypoactive Sexual Desire Disorder’ and ‘Female Hypo Orgasmic Disorder’ (I mean did the guy try going down on her?) as well as Dyspaerunia (painful sex). As a recent editorial pointed out, maybe the 43% of women with some type of so-called sexual dysfunction are acting “appropriately”.

I mean, maybe they’re with jerks and don’t feel like doing it?

The American Journal of Psychiatry has been soliciting editorials on the DSM-5 process. Too bad they rejected the editorial by Robert Spitzer MD who founded the DSM, and for FSD they have only this lame piece by a trio of MDs whose pharma disclosures read like a phone book. Lol. Sort of.

Ray Moynihan had a good piece in bmj on FSD (“FSD: The Making of a Disease”) in which he outlines how industry has moved in a serious way to pour cash in the “research and education” of this newly minted disorder, the rife conflicts of interest in the field, and the attempt by drug companies to medicalize female sexuality.

I am sitting in a lecture by Larry Young PhD of the Yerkes Regional Primate Center here in Atlanta, GA. His research is on the neurobiology of social bonds. Since many of the readers of the Drug News and Health Safety News often wonder about how things that happened in early childhood affect how things go in later life I thought this would be of interest.

He studies an animal called the prairie vole (Microtus ochragaster), which is unusual amongst mammals for forming life long mating bonds, like humans (well, sometimes). Interesting, the meadow vole (Microtus montanus), a critter I studied as a med student that lives in the mountain meadows in the West, is genetically very similar to the prairie vole, differing only in having fewer brain receptors for the neuropeptides oxytocin and vasopressin.

The meadow vole spends about half its time cuddling with its mate.

Don't forget to take out the garbage, honey.

 While the meadow vole, and the vast majority of other mammals, mates and then hits the road, spending most of its life alone.

70% of prairie voles who lose a partner never acquire another one. If they are separated from their partners, they show depressed like behavior, like floating in water with struggling, or being immobile in a maze.

Which doesn’t mean they never mate with other voles… they just come back to their wives.

All this raises the question… why did monogamy evolve in some animals? I have also been reading about this in a book called The Well Dressed Ape, by science writer Hannah Holmes.

Although not all animals are monogamous, all females show maternal behavior. This is regulated by the neuropeptide oxytocin, which induces labor, is released from the brain during nursing to promote milk release, and stimulates maternal bonding with pups. For instance, you can inject sheep with oxytocin and that facilitates them becoming dependent on their own lambs via oxytocin. You can also get sheep to bond with foreign lambs using oxytocin injection. Drugs that block oxytocin also block maternal behavior. You can get similar effects for pair bonding of mating voles. These oxytocin receptors are located in parts of the brain involved in emotion, like the striatum and medial prefrontal cortex.

For males, the neuropeptide vasopressin is more prominent. It is involved in aggression, male sexual behavior, territorial behavior, and paternal care. A variation in the vasopressin receptor 1a in humans is associated with a doubling in likelihood to have a marital crisis in last year, have a partner that is less satisfied, and to be less likely to marry.

Prairie voles raised by a bonded pair (that’s right, good ole mom and dad) have more attachment to their partners when they grow up and are more maternal than voles raised by single moms. They also have lower levels of oxytocin.

But don’t worry, there is a drug for everything. And it is… you guessed it! Oxytocin in a nasal spray called Liquid Trust! Their claim?

Liquid Trust Enhanced has been specially designed to give a boost to the dating and relationship area of your life. This upgraded formula still contains the same great Oxytocin formula, but now includes the powerful pheromones Androstenone and Androsterone.

So if you don’t feel ridiculous spraying this up your date’s nose, or your cheating husband, here you go.

Trust in a bottle

Mrs. Bremner and I are at the American Psychosomatic Society (APS) Annual Meeting in Chicago this week where the most interesting presentation other than our poster and talk on brain and heart mechanisms mediating the increased risk for mortality in people with heart disease and depression, is this late breaking data showing that statins have a negative effect on orgasms.

In “Statins Reduce Orgasm: Results from the UCSD Statins Study” Dr. Beatrice Golomb and colleagues from the University of California-San Diego reported today on their 1,067 men and women without heart disease with a LDL cholesterol of 119-190 mg/dL who were randomized to either pravastatin (Pravachol), simvastatin (Zocor), or placebo for LDL cholesterol reduction with the purpose of prevention of heart attacks. Orgasm was self rated on a scale of 1 (”much worse”) to 5 (”much better”) with 3 for “no change”. Overall statins had a negative effect on orgasms, with a reduction of 0.63 for men and 0.57 for women, which was statistically significant only for men, and only for Zocor.

Previous studies have shown that the more you reduce LDL cholesterol the more you lower your risk of heart attack. It has also been shown that you increase your risk of cancer more, and now this study shows that the more LDL cholesterol goes down the more it messes up your orgasm. So we have a drug that doesn’t reduce overall mortality in men without heart disease (as in the current study) and has no beneficial effect at all for women without heart disease, and that increases risk of cancer, that not only makes you stupid, but that messes up your orgasm.

Dr. Golomb’s quote to USA Today about the study was that:

It takes a lot of energy to have an orgasm.

Nice quote, Beatrice. She says that statins can interfere with Coenzyme Q and do other things that may impair energy utilization.

Mrs. Bremner’s comment on the study is that they probably thought that statins would improve orgasms through their anti-inflammatory effect.

Today I am listening to presentations (and writing as I listen) from the Study of Women’s Health in the US (SWAN) study on women in mid-life, we learn that Chinese women have less osteoporotic fractures (7 year incidence of 4.8) than black (4.5) and caucasian women (8.1), however mid life women in general feel that they are wiser and have a stronger sense of purpose than they did in their younger life, and that going through menopause is associated with a temporary increase in hot flashes and forgetfullness, but no significant increase in depression. Also the Mid Life in the US (MIDUS) National Study, which was funded by the MacArthur Foundation, asked the question, what is well being? And what effect does it have on people throughout the lifespan. Aristotle defined well being, or ”eudaimonia”, thus:

The highest of all human goods is realization of human potential

In the MIDUS study, autonomy, personal growth, feelings of purpose in life, positive relations with other, environmental mastery, and self acceptance, increased over time for people in mid life or did not change for people 55-74, while they didn’t improve or went down for those younger or older than this group. These qualities were also associated with better health outcomes. They also predicted lower lipid levels, better metabolism, and other goodies.

What is well being?