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Sigmund Freud and His Impact on Our Understanding of Male Sexual Dysfunction


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Sigmund Freud was one of the most influential thinkers and theorists of the 20th century. His groundbreaking work laid the foundation to many concepts and theories relevant to modern sexual medicine. To evaluate Freud's approaches to the understanding of male sexual dysfunction both in their historical context and with respect to their significance for contemporary research and therapy of sexual problems. After a brief biographical sketch, two of Freud's writings, the widely acclaimed "Three Essays on the Theory of Sexuality" from 1905, and a short article entitled "The Most Prevalent Form of Degradation in Erotic Life" from 1912, were analyzed, especially for their relevance to present treatment concepts of male sexual dysfunction. In Freud's clinical practice "psychical impotence" was a highly prevalent complaint. In his view, this dysfunction was caused by an inhibition due to an unresolved neurotic fixation leading to an arrest of the libidinal development. The result is a splitting of the tender and the sensual dimension of sexuality, most notably in the so-called madonna-whore complex. The degree of this dissociation (total or partial) determines the severity of the ensuing sexual dysfunction. In Freud's rather pessimistic view, the erotic life of civilized people tends to be characterized by some degree of this condition. While some of Freud's theories are obsolete today, many parts of his work appear to be astonishingly modern, even in the light of current neurobiological research and recent models of sexual dysfunction. Above all, Freud was an extremely gifted observer of human behavior who shows us that in many cases, sexual dysfunctions are no isolated phenomena, but have their roots in biographically based intrapsychic or interpersonal conflicts.
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Sigmund Freud and His Impact on Our Understanding of Male
Sexual Dysfunctionjsm_1332 2332..2339
Uwe Hartmann, PhD
Hannover Medical School, Clinical Psychology, Clinic of Psychiatry, Social Psychiatry and Psychotherapy, Hannover,
DOI: 10.1111/j.1743-6109.2009.01332.x
Introduction. Sigmund Freud was one of the most influential thinkers and theorists of the 20th century. His
groundbreaking work laid the foundation to many concepts and theories relevant to modern sexual medicine.
Aim. To evaluate Freud’s approaches to the understanding of male sexual dysfunction both in their historical context
and with respect to their significance for contemporary research and therapy of sexual problems.
Methods. After a brief biographical sketch, two of Freud’s writings, the widely acclaimed “Three Essays on the Theory
of Sexuality” from 1905, and a short article entitled “The Most Prevalent Form of Degradation in Erotic Life” from
1912, were analyzed, especially for their relevance to present treatment concepts of male sexual dysfunction.
Results. In Freud’s clinical practice “psychical impotence” was a highly prevalent complaint. In his view, this
dysfunction was caused by an inhibition due to an unresolved neurotic fixation leading to an arrest of the libidinal
development. The result is a splitting of the tender and the sensual dimension of sexuality, most notably in the
so-called madonna–whore complex. The degree of this dissociation (total or partial) determines the severity of the
ensuing sexual dysfunction. In Freud’s rather pessimistic view, the erotic life of civilized people tends to be
characterized by some degree of this condition.
Conclusions. While some of Freud’s theories are obsolete today, many parts of his work appear to be astonishingly
modern, even in the light of current neurobiological research and recent models of sexual dysfunction. Above all,
Freud was an extremely gifted observer of human behavior who shows us that in many cases, sexual dysfunctions
are no isolated phenomena, but have their roots in biographically based intrapsychic or interpersonal conflicts.
Hartmann U. Sigmund freud and his impact on our understanding of male sexual dysfunction. J Sex
Med 2009;6:2332–2339.
Key Words. Sigmund Freud; Etiology of Male Sexual Dysfunction; Madonna-Whore-Complex; Intrapsychic Con-
flict and Male Sexual Dysfunction; History of Sexual Medicine
In 2006, the 150th birthday of Sigmund Freud,
and, in 2005, the 100th anniversary of the pub-
lication of Freud’s famous “Three Essays on the
Theory of Sexuality” [1], for many one of his
boldest and most impressing contribution to sex-
ology or sexual medicine, were celebrated. It was
Freud’s intention to establish the psychoanalysis
not only as a part of the medical science, but as a
comprehensive heuristic method that should make
a new and unique contribution to the understand-
ing of the conditio humana. By its transversal
approach, psychoanalysis could contribute new
concepts to many fields of knowledge and per-
formed a profound influence on literature, phi-
losophy, and forming art. Freud’s thinking is thus
deeply interwoven into the texture of modern
culture [2], and in a certain way, we are all
Freudians when we speak of neurosis, repression,
narcissism, or Œdipus complex.
Although Freud’s groundbreaking work took a
profound influence on science and culture, for
most of the researchers and therapists involved in
J Sex Med 2009;6:2332–2339 © 2009 International Society for Sexual Medicine
contemporary sexual medicine, Freud’s theories
and treatment strategies appear to be hard to
understand, strange, sometimes even antiquated,
or lacking in practical relevance. This applies
particularly to those colleagues who have no psy-
chological or psychiatric background. In this con-
tribution, an attempt shall be made to evaluate
Freud’s approaches to the understanding of erec-
tile dysfunction both in their historical context
and with respect to their significance for modern
sexual medicine. After taking the reader on a short
walk through Freud’s life, some of his most impor-
tant theories, concepts, and discoveries pertaining
to male sexual dysfunction will be focused.
A Short Walk through Freud’s Life
Sigmund Freud was born on May 6, 1856 in
Freiberg, Moravia (today Pribor, Czech Republic)
as the first of eight children. His father was a wool
dealer by profession and considerably older than
Freud’s mother. Due to economic difficulties, the
family moved to Vienna in 1860, where Freud
spent almost the remainder of his life.
In 1873, he started to study medicine in Vienna
and completed his studies in 1881 with a doctor-
ate. After a research stay in Triest, he worked for
several years at the institute of physiology of the
Viennese university and was engaged in various
neurohistological studies. He obtained his habili-
tation in 1884, and was appointed as a university
lecturer in 1885 (Figure 1).
After marrying Martha Bernays from Hamburg,
Germany, Freud set up as a neurologist in Vienna.
Freud received essential impulses for his further
work during a study visit 1885/1886 at the clinic of
the eminent neurologist Jean-Martin Charcot in
Paris. Here, Freud’s interest in the fascinating syn-
drome of hysteria was awakened, and his shift of
emphasis on the areas of neuropsychiatry and psy-
chotherapy began to take shape. After having
tested several methods of treatment (including
hypnosis) with his hysterical patients without
success, Freud developed the basis of psychoana-
lytical treatment technology with the method of
free association. By giving up or bypassing con-
scious censorship, Freud thought it possible to
advance into a deeper truth and to uncover the
unconscious conflicts which are responsible for the
emergence of the neurotic symptoms (Figure 2).
The interpretation of dreams became another
corner pillar of Freud’s theoretical and therapeu-
tical concepts, besides the postulate of an uncon-
scious, the meaning of sexual motives, and the
phenomenon of transference. After having experi-
enced considerable hostility and isolation within
the scientific community, Freud was finally
appointed extraordinary professor in 1902, and
was able to gather an increasing number of sup-
porters around him. With some of the most
eminent of them, notably Alfred Adler and Carl
Gustav Jung, Freud later broke on matters of psy-
choanalytic theory, while others like Karl Abraham
or Sandor Ferenczi remained faithful companions
(Figure 3).
Figure 1 Freud and Martha Bernays in 1855, 1 year before
their marriage.
Figure 2 Freud at about the time the “Three Essays” were
Freud and Male Sexual Disorder 2333
J Sex Med 2009;6:2332–2339
In 1923, he published “The Ego and the ID,”
the text where his highly influential structural
theory is introduced, and the old topographical
classification of conscious, preconscious, and
unconscious is partly abandoned. In this funda-
mental reconceptualization, Freud emphasized
that not only processes in the id, but also much of
the ego and super-ego are unconscious, not the
only line of Freud’s thinking which has in some
way been confirmed by modern neuroscience
(Figure 4).
Freud left Vienna in 1938 and went into exile to
London in order to escape persecution by the
National Socialists. In 1939, he died in London at
the age of 83 years of the results of a jaw and palate
cancer from which he had suffered for many years.
Freud’s Central Sexual Concepts and Theories
Due to the limited scope of this contribution, only
two of Freud’s writings, the “Three Essays” from
1905 mentioned earlier and a small text with the
remarkable title “The Most Prevalent Form of
Degradation in Erotic Life” [3], published in 1912,
actually one of the few publications in which Freud
deals directly with male impotence, are focused
It was the “Three Essays on the Theory of
Sexuality” in which Freud presented his theories of
infantile sexuality and libido development for the
first time in a comprehensive manner and in which
the conflict between drive impulses and defense
mechanisms was recognized by him as constitutive
for man. Together with the interpretation of
dreams, the “Three Essays” are the second pillar
on which the psychoanalytic theory rests. The
essays dealt with sexual aberrations, infantile sexu-
ality, and the transformations of puberty. As with
some other concepts, Freud was neither the only
one nor was he the first one to recognize the
importance and power of sexuality, and in his
essays, he credited the work of Havelock Ellis,
Iwan Bloch, Magnus Hirschfeld, and some others
[4]. But he was the first one who, like so often, tied
up loose ends and made the link to clinical symp-
toms. It took Freud several years before he fully
accepted infantile sexuality, and he continued to be
two minds about this cornerstone of his develop-
mental theory. As usual, Freud tried to derive from
his clinical experience a design for a general psy-
chology and pulled both neuroses and perversions
from the exotic and degenerated to a psychody-
namically understandable and very common con-
sequence of unmastered developmental conflicts.
For Freud, neurosis is essentially a condition in
which the person has regressed to his early unre-
solved conflicts in an attempt to dispose of unfin-
ished business. The resulting compromise then
leads to the formation of neurotic symptoms.
Neurotic symptoms are the outward, observable
manifestation of internalized, conflicting, but
unconscious object relations, putting their stamp
on a person’s sexual experience and sexual behav-
ior. Consequently, all internalized object relations
have a sexual dimension. It is important to note
that in neuroses, the libidinal or sexual energy
happens to be more or less absorbed by the neu-
rotic dynamics and is no longer available to a crea-
tive, including erotic, fully functioning way of
Thus, Freud carved out a line from early devel-
opmental conflicts or deficits to the mental distur-
Figure 3 Freud (second from left) and his psychoanalytic
“comité,” among them Karl Abraham (third from left), Sandor
Ferenczi (third from right), and Ernest Jones (second from
Figure 4 Freud at his desk in London in 1938.
2334 Hartmann
J Sex Med 2009;6:2332–2339
bances of adolescence and adulthood. And in this
line, sexuality plays a central role. Normal was no
longer normal, since Freud insisted that normal
heterosexuality is also an achievement, the end
point of a long and winding road and not a natural
phenomenon. This alone was a subversive line of
thinking for Freud’s time.
What made the “Three Essays” so outstanding
was not the “discovery” of infantile sexuality, but
rather that Freud succeeded for the first time to
bring different forms of expression of human sexu-
ality (infantile, paraphilic, neurotic, mature) in a
developmental perspective and in a systematic
context [5].
Eventually, the three essays remained a work in
progress for Freud. Not more than a small booklet
of some 80 pages on their first publication, they
grew to 120 pages by 1925 when they reached
their last edition during Freud’s lifetime.
The Most Prevalent Form of Degradation
in Erotic Life
Seven years after his revolutionary “Three Essays
on the Theory of Sexuality,” Freud applied these
theories in his article “The Most Prevalent Form
of Degradation in Erotic Life” to a syndrome that
he interestingly enough describes, besides the
multifaceted anxiety, as the most common disor-
der on which he was consulted by his patients. In
this article, which without any doubt belongs to
the classical writings on erectile dysfunction [6],
Freud introduced the term “psychical impotence”
into his writings and stressed the high prevalence
of this condition which is manifested by “a refusal
of the sexual organs” to execute the sexual act.
This is not only specific to the sexual act (before
or after the attempt the man may be fully func-
tional), but this failure may also happen only with
certain women. Consequently, this inhibition
seems to be due to some quality in the sexual
partner. It is no chance that this essay is part of
the cycle “Contributions to the Psychology of
Love,” as in Freud’s view, psychical impotence is
essentially a disturbance of the capability for love
(Figure 5).
In his reasoning, the disorder was due to the
“inhibiting influence of certain (unconscious)
complexes in the mind,” which are mainly charac-
terized by an unresolved fixation on the mother
leading to an arrest of the libidinal development.
Freud pointed out that, in order to be fully capable
of love, “two currents have to unite,” which he
describes as the “tender” and the “sensual”
current. In the ideal development, the adult man
still chooses his partners (in Freud’s technical
diction: objects) after the pattern of the infantile
ones, but confronted with the obstacle of the incest
barrier that has in the meantime been erected, tries
to shift his feelings to partners with whom a satis-
fying sexual life can be realized. Subsequently, he
can attach his tender feelings to the new object,
thus enabling a unity of tenderness and sensuality.
When this process is successful, “the greatest
intensity of sensual passion will bring with it the
highest mental estimation of the object.” Two
factors can obstruct this success: (i) the degree of
frustration encountered in reality with the new
object choice, and (ii) the degree of attraction that
is still exercised by the infantile objects. If these
two factors are sufficiently powerful, an unresolv-
able intrapsychic conflict emerges, and the general
mechanism of neurosis formation will come into
When “the whole current of sensual feeling”
remains unconsciously fixated to incestuous
objects, total impotence will result. In less severe
conditions, the sensual current finds some outlet,
but the sexual functioning is “capricious, easily
upset, clumsy and not very pleasurable.” Above all,
the erotic life of these men remains dissociated and
divided between the two currents, which brought
Freud to the famous formula: “Where such men
love they have no desire and where they desire
they cannot love.” In this “solution” of the devel-
opmental conflict, the principal compromise is
the degradation of the sexual object: As soon as
the sexual object fulfils the condition of being
degraded, sensual feeling can have free play, con-
siderable sexual capacity, and a high degree of
pleasure can be developed. Here, Freud alludes
to the so-called Madonna-whore-complex as the
principal form of compromise emerging from this
dissociation. In this constellation that in our own
clinical experience and in more or less attenuated
forms, is still highly prevalent in today’s patients;
sexual arousal is only possible with a sexual partner
who has in some way been degraded (the whore)
while the adequate and respected partner cannot
be fully desired (the Madonna).
Why do some men suffer from this kind of
psychical impotence while others can obviously
escape that condition? In answering that question,
Freud maintained that psychical impotence is far
more widespread than is generally supposed, and
that some degree of this condition does in fact
characterize the erotic life of civilized people.
Accordingly, Freud concluded that “it must be said
Freud and Male Sexual Disorder 2335
J Sex Med 2009;6:2332–2339
that whoever is to be really free and happy in love
must have overcome his deference for women and
come to terms with the idea of incest with mother
or sister.” Here, Freud is certainly not arguing in
favor of a disrespectful behavior toward women,
but instead he tries to highlight the fact that a truly
and lasting satisfying sexual love requires that the
“wrong respect” for the other sex, e.g., in the form
of idealization, may not be too compact. Although
some kind of idealization is, on the one hand,
required to fall in love, but on the other hand, it
must be so permeable that the touch of aggression
necessary for true sexual excitement can be allowed
If this is not possible, the love life gets boring
in the best case, but more frequently, sexual dys-
functions will be the likely result. This also
implies that freedom in life and happiness in love
are bound to the “overcoming” of the Œdipus
complex that has to do more with the triangular
processes of this developmental phase than with
the contents originally stressed by Freud. For the
first time, the child must now emotionally knot
three simultaneous relations. It starts a separate
relation to every parent, and at the same time,
perceives itself excluded from the parental rela-
tionship. It must correspondingly learn to
bear ambivalence [7]. Therefore, the individual
Figure 5 Front cover of the Jahrbuch
für Psychoanalytische und Psychopa-
thologische Forschungen (Year-Book
for Psychoanalytic and Psychopatho-
logical Research) from 1912.
2336 Hartmann
J Sex Med 2009;6:2332–2339
destiny of sexuality is always simultaneously a
destiny of love.
Freud’s Impact on Modern Sexual Medicine
Looking at Freud’s significance for today’s sexual
medicine, one can easily quote his biographer
Peter Gay [2], who said that Freud is “inescap-
able.” Not only the discovery and development of
psychoanalysis as an important psychotherapeutic
school combines with his name, but by his complex
and multilayered work, Freud became one of the
most influential thinkers and theorists of the 20th
century. The complex construct of psychoanalysis
could contribute new concepts to many fields of
knowledge and performed a profound influence on
literature, philosophy, and forming art. Freud’s
thinking has thus become an integral part of
modern culture.
More than a 100 years after Freud’s first pio-
neering publications (above all the “Studies in
Hysteria” and “The Interpretation of Dreams”),
modern matter of courses like the existence of
unconscious emotional processes and contents
(which could recently be confirmed in a fascinating
way by advances in neurobiology and conscious-
ness research) or the fact that the human sexuality
does not take their beginning only with puberty or
adolescence can be hardly understood in their
explosive force at the time of their discovery by
Freud. This applies particularly to the infantile
sexuality, as well as to the role of sexuality in the
formation of neurotic symptoms. For his emphasis
on the meaning of sexual motives, Freud was fre-
quently accused of promoting a “pansexualism,” a
reproach which, at more exact knowledge of his
work, proves to be an unjustified oversimplifica-
tion [8]. In fact, Freud’s work is even characterized
by a certain ambivalence toward his bold insights
and theories, especially in the area of sexuality.
Accordingly, Freud never became a “sexual libera-
tor” like some of his followers, and did not believe
that the unrepressed expression of sexual needs
would be the ideal way to happiness or mental
health. Instead, he thought that a certain degree of
disappointment in love is unavoidable, and he was
rather convinced of the two-sidedness of sexual
repression and frustration as being the source of
dissatisfaction and—by the mechanisms of subli-
mation and renunciation—also the source of some
of the highest human cultural achievements.
Overall, Freud remained skeptical of the potential
therapeutic efficacy of sexual reforms.
However, we now know that Freud’s theories
have a number of serious flaws and are obsolete in
some respects. His thinking was revolutionary in
many ways, but conventional in others. Especially
in his writings on female sexuality, Freud proved to
be a child of his time rendering most of his con-
cepts in this field obsolete for modern sexual medi-
cine. We also know that not all sexual dysfunctions
are due to deep-rooted neurotic conflicts or ego-
structural deficits. Instead, the causation of sexual
disorders is much more varied and often simpler,
originating from sources like performance anxiety,
spectatoring, sexual myths, relationship problems,
and somatic factors. In addition, unresolved
Oedipal feelings do not have the ubiquitous role
assigned by psychoanalytic theory, but seem to be
one factor among others.
In other aspects, however, Freud’s work appears
to be astonishingly modern. It is of note that it has
largely been disregarded that Freud had worked as
what we would today call a neuroscientist for
almost 20 years before he set out to develop psy-
choanalysis. He then abandoned the popular
attempts to relate clinical syndromes to anatomical
brain structures in favor of a functional system,
which is “represented dynamically between differ-
ent brain areas.” He also thought that the outside
world is represented in our central nervous system,
and he spoke of two “perceptual surfaces.” For
Freud, the reality we perceive was always the
reality of our brain or of our inner world, a
remarkably modern perspective. One of today’s
most promising models of sexual dysfunction is the
dual-control model developed by John Bancroft
and Erick Janssen [9–11]. This model basically
says that sexual responses and the vulnerability to
sexual dysfunctions depend on dual-control exci-
tatory and inhibitory neurobiological systems. As
individuals vary in their propensity for inhibition
and excitation, an adaptive balance is crucial to
sexual functioning. Questionnaire studies yielded
one excitation factor, and, interestingly, two differ-
ent inhibition factors: (i) the first factor is a more
complex and intrinsic dimension reflecting the
basal “inhibitory tone” of a person or the degree of
inhibition the whole system is set at; and (ii) the
second factor refers to the perception of an exter-
nal threat and reflects the inhibitory responsive-
ness to perceived threats or distracters.
In an attempt at linking this model to Freud’s
thinking, one can say that both Freud and the
dual-control model propose that sexual dysfunc-
tions are due to a dominance of inhibitory forces,
and the first inhibition dimension described by
Freud and Male Sexual Disorder 2337
J Sex Med 2009;6:2332–2339
Bancroft and Janssen might reflect the inhibitory
tone the sexual system of a person is set at. Isn’t it
possible that this dimension may also be some-
thing like the substrate of Freud’s famous “Trieb-
schicksal,” i.e., the destiny of an individual’s sex
drive, of his sexual longings and needs?
So what can the practitioner who is challenged
with the therapy of patients with sexual problems
at the beginning of the 21st century learn from
Freud? As an extremely gifted observer and analyst
of human experience and behavior, Freud contin-
ues to show us in his laconic way that sexual func-
tion or dysfunction are not isolated processes and
very often are more than simple organic failures.
His writings clearly point to the necessity of con-
sidering and addressing intrapsychic and interper-
sonal conflicts in evaluating and treating male
sexual dysfunction. These conflicts of which some
of the most eminent are described in “The most
prevalent form of degradation in erotic life” have
not disappeared in the sociocultural transforma-
tion processes of human sexuality; they have only
changed their contours and guises since the time of
Freud. In clinical practice, it is not always manda-
tory to focus on these more deep-rooted factors
because, as is suggested by Helen Kaplan’s widely
acclaimed dual-level model of the etiology of
sexual dysfunctions [12,13], the immediate factors
causing the dysfunction in the here-and-now have
to be focused and dealt with first. In those cases,
however, where there is resistance to treatment or
who turn out to be so-called “nonresponders” to
either pharmacotherapy or behavior-oriented sex
therapy, the sexual health professional should be
alert to the biographically rooted conflicts ana-
lyzed by Freud.
Freud also was a highly talented and entertain-
ing writer, and it still is a fascinating and exciting
experience for the reader to learn that the history
of our sexuality is interwoven deeply in the fabric
of our life and specifically in our interpersonal
experiences. Only if we try to understand, together
with our patient, this complex course of desires
and basic needs, will we be able to truly help him,
independent of the therapeutic option we choose
to employ.
I would like to thank Dr. Dirk Schultheiss (Giessen,
Germany) for his ideas, his helpful suggestions, and his
patience. Adapted from an oral presentation at the
History Session of the ESSM Congress 2004 in
London, UK.
Corresponding Author: Uwe Hartmann, PhD,
Hannover Medical School, Clinical Psychology, Clinic
of Psychiatry, Social Psychiatry and Psychotherapy,
Carl-Neuberg-Str. 1, 30625 Hannover, Germany.
Tel: +49 511 5322407; Fax: +49 511 5328407; E-mail:
Conflict of Interest: None.
Statement of Authorship
Category 1
(a) Conception and Design
Uwe Hartmann
(b) Acquisition of Data
Uwe Hartmann
(c) Analysis and Interpretation of Data
Uwe Hartmann
Category 2
(a) Drafting the Article
Uwe Hartmann
(b) Revising It for Intellectual Content
Uwe Hartmann
Category 3
(a) Final Approval of the Completed Article
Uwe Hartmann
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... It was hypothesized that men who endorse this polarized perception of women express affection and respect for women they perceive as modest, despite not actually being drawn to them. Conversely, they are attracted to women they consider promiscuous, yet simultaneously despise and devalue them (Hartmann, 2009;Tanzer, 1985;Tavris & Wade, 1984). ...
... Specifically, heterosexual men who endorse the Madonna-whore dichotomy were found to have reduced relationship and sexual satisfaction, as indicated by self-report measures (Bareket et al., 2018;Kahalon et al., 2019). These results support the psychoanalytic literature on the Madonna-whore dichotomy, which discusses it as a potential troubling experience for heterosexual men which in turn might result in relationship dysfunction (Hartmann, 2009;Josephs, 2006;Silverstein, 1998), and an inability to maintain sexual interest within a committed relationship (Kaplan, 1988). This result is in line with the feminist view that sexist attitudes have negative consequences for heterosexual dating (Alba et al., 2023) and romantic relationships (e.g., Hammond & Overall, 2013). ...
... Since men who more strongly endorse the Madonnawhore dichotomy view promiscuous women (i.e., whores) in a derogating and objectifying manner (Bareket et al., 2018;Kahalon et al., 2019), it is likely that they will care less about the sexual pleasure of these women (in comparison to the context of a serious relationship). Yet, men who endorse the Madonna-whore dichotomy may also care less about women's sexual pleasure in the context of committed relationships since they perceive them as chaste (i.e., Madonna) because they do not view women as sexual beings with needs and desires of their own (Hartmann, 2009). Therefore, an alternative prediction is that men who more strongly endorse the Madonna-whore dichotomy will also see women as less entitled to sexual pleasure independent of the context. ...
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In two pre-registered experiments with German samples, we tested the role of endorsement of the Madonna-whore-dichotomy and the relationship context (sex in a committed relationship vs. casual sex) in the devaluation of women’s sexual pleasure. Using the context of dating apps in Study 1, men who reported higher endorsement of the Madonna-whore-dichotomy believed that other men would be less interested in fulfilling a woman’s sexual desires, show her less respect, and be less likely to wear a condom independent of relationship context (i.e., casual hookup dating app vs. a dating app for a serious relationship). In Study 2, men who reported higher endorsement of the Madonna-whore-dichotomy rated their partner as less entitled to sexual pleasure than men lower on Madonna-whore dichotomy endorsement. In addition, women who reported higher endorsement of the Madonna-whore dichotomy devalued their own pleasure by rating their partner as more entitled to sexual pleasure than themselves, compared to those lower on the Madonna-whore dichotomy. Although relationship context and Madonna-whore dichotomy endorsement did not interact, they were both found to negatively predict women’s sexual pleasure. These results provide further support for the potential costs of enacting traditional, patriarchal gender roles for women’s experiences of sexual pleasure and safety.
... Секс -це не лише спосіб продовження свого роду, але і засіб отримання задоволення, зняття психологічного напруження. Вчені всього світу стверджують, що сексуальна активність позитивно впливає як на розумову активність, так і на психо-емоційну діяльність [4,5,15]. ...
... Дані сучасної сексології не підтверджують теорію сублімації Фрейда, згідно з якою статевий потяг може бути задоволений несексуальним способом, наприклад, шляхом переключення на якийсь вид діяльності (праця, творчість). Таке перемикання сексуальної енергії без шкоди особистості можливе лише як тимчасова міра в органічних межах [4,7,11]. ...
... Основним питанням залишається: якість наданої інформації, її правдивість, доцільність, медична та психологічна обгрунтованість. "Сексуальна освіта передбачає висвітлення наукової, дійсної та об-'єктивної інформації не лише про анатомію статевих органів та репродуктивне здоров'я, а й про емоційні стосунки із сексуальним партнером/партнеркою, відповідальне планування стосунків та інші аспекти сексуальної поведінки людини" [4]. Сексуальна освіта визнана важливою та базовою у багатьох країнах і є обов'язковим предметом у школах, ВУЗах, а в деякий країнах Європи -навіть у дошкільних навчальних закладах освіти. ...
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Annotation. Sexuality is closely related to a person's personality, determines his behavior, affects self-esteem and psycho-emotional state. The criteria of sexual norm are based on the concept of mental health, based on the tendency to development and self-realization, the ability to manage their actions and deeds in accordance with personal values, the ability to adequately perceive themselves and others, as well as learning based on personal experience. The aim of the research is to study the sexual education and the main problems associated with it among 4th year students of National Pirogov Memorial Medical University, Vinnytsya (NPMMU, V). We conducted an anonymous survey of 308 medical students of the fourth year of NPMMU, V with the help of a questionnaire created by the authors and included 20 questions about various aspects of the respondents' sexual life. The analysis of the obtained results of the study was carried out on the basis of the computer program Statistica 6.1 using nonparametric methods for assessing the results obtained. It was found that among medical students there is a rather low level of education in terms of sexual topics, the age of sexual debut in the overwhelming number is 18-20 years; but the percentage of virgins is also quite high (22.2%).
... Clinical trials implementing individual or group therapy based on the psychoanalytical model for the treatment of ED are lacking. In fact, evidence for the use of a psychoanalytic approach in the treatment of ED is only supported by anecdotal reports [245]. Sigmund Freud's psychoanalysis has established numerous notions and hypotheses that are still relevant to contemporary sexual medicine. ...
... Freud's pioneering work has, however, progressively revealed lacking practical relevance to treating ED. The only exceptions are those clinical circumstances in which a psychoanalytic approach to analyze psychic conflicts, potentially underlying ED, may be indicated for patients with an ED "resistant-to-treatment" condition (i.e., unresponsive to pharmacological treatments or behavioral sex therapy for ED) [245]. It cannot be excluded, however, that neurotic traits or personalities may obtain general psychological advantages from psychoanalysis which may indirectly produce sexual benefits. ...
PurposeErectile dysfunction (ED) is one of the most prevalent male sexual dysfunctions. ED has been in the past mistakenly considered a purely psycho-sexological symptom by patients and doctors. However, an ever-growing body of evidence supporting the role of several organic factors in the pathophysiological mechanisms underlying ED has been recognized.Methods The Italian Society of Andrology and Sexual Medicine (SIAMS) commissioned an expert task force involving several other National Societies to provide an updated guideline on the diagnosis and management of ED. Derived recommendations were based on the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system.ResultsSeveral evidence-based statements were released providing the necessary up-to-date guidance in the context of ED with organic and psychosexual comorbidities. Many of them were related to incorrect lifestyle habits suggesting how to associate pharmacotherapies and counseling, in a couple-centered approach. Having the oral therapy with phosphodiesterase type 5 inhibitors as the gold standard along with several other medical and surgical therapies, new therapeutic or controversial options were also discussed.Conclusions These are the first guidelines based on a multidisciplinary approach that involves the most important Societies related to the field of sexual medicine. This fruitful discussion allowed for a general agreement on several recommendations and suggestions to be reached, which can support all stakeholders in improving couple sexual satisfaction and overall general health.
... A separate group of factors consists of students' personal difficulties, namely the problem of insufficient self-determination [6,21,25]. ...
... Sexually active young men have higher academic rating compared to sexually active young women. 6. Sexually active young people study much better compared to sexually inactive ones. ...
... The Madonna-whore dichotomy has a rich history in psychology (see Hartmann, 2009) and describes a polarized conception of women where their dual roles within the family system (i.e., being both nurturing and sexual) are incompatible. Tacit associations of "goodness" with chastity and "badness" with promiscuity have been documented in Western cultures since Hellenistic Greece and appear in multiple forms of media in contemporary culture (Kahalon et al., 2019). ...
... The sentiments Daniels and Zurbriggen captured with their interviews regarding social media posts nearly match exactly those that Herold et al.'s (1994) noted among the minority of Australian women who expressed opposition to women's legal right to public toplessness. Moreover, these sorts of attributions are predicted by the policing role of other women in objectification theory (Riley et al., 2016;Szymanski et al., 2011) and the Madonna-whore dichotomy (e.g., Hartmann, 2009;Kahalon et al., 2019). ...
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Multiple United States federal courts have recently drawn inferences regarding community sentiment as it pertains to public female toplessness. Despite citing common social factors in their rulings, the courts have rendered conflicting decisions to uphold (Ocean City, MD) or to overturn (Fort Collins, CO) female-specific bans. Regional differences in attitudes toward toplessness may in part explain these discrepant legal outcomes. Participants (n = 326) were asked to rate their general impressions of photos depicting topless women in three different public settings. Geographic region was unrelated to reactions toward toplessness, however, participants from states with prohibitive or ambiguous statutes rated the photos differently. Consistent with a body of theoretical and empirical work on cultural objectification of women, female participants, on average, were more critical of the photos of other topless women. Other demographic and attitudinal predictors showed a pattern that suggests moral objections as a likely source of unfavorable reactions. Ascribing morality with the practice of toplessness echoed some of the commentary that surrounded the above legal cases and further substantiates prior objectification research (i.e., Madonna-whore dichotomy). Overall, attitudes toward public female toplessness appear to be driven more by individual opinions than by context (e.g., beach, park) or structural factors (e.g., region or state-legality).
... Freud described the Madonna-Whore complex as a "splitting of the tender and the sensual dimension of sexuality." The dissociation or splitting between the virtuous mother pattern and the virulent women of ill repute can be moderate, or it can be extreme; and in the extreme, it is said to lead to sexual dysfunction (Hartmann, 2009). As Kramer (2009) states, Freud then spoke of resolution via marrying a respectable woman and imposing upon her, lascivious fantasies. ...
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The Madonna-Whore complex is a product of male psychology that constrains female sexuality. Exaggerating actual differences, males categorize females as chaste “Madonnas” or promiscuous “whores.” This complex is a form of sexual dissociation according to Freudian dogma, proceeds from power imbalances according to feminist theory, and is a Western cultural feature of patriarchal oppression as per postmodern critics. While the Madonna-Whore complex does indeed violate the reality of female sexuality, it may be a feature rather than a bug. As herein argued, it is an evolved psychological outgrowth of paternal uncertainty. Paternal uncertainty forces male mating into short- and long-term strategies. Understanding its biological underpinnings allows us to place the Madonna-Whore complex in an evolutionarily informed matrix of sexual conflict. Therein considered, one can see the outsized threat of cuckoldry to the male. To the extent that males oppress females when dichotomizing their sexuality, females threaten males when engaging in short-term, extra-pair copulations. Thus, from seeing a one-sided oppression of a socio-cultural origin, we progress to an understanding of mutual conflict naturally extending from the biological realities of human mating among males and females with different interests.
... Ці перші враження впливають на формування характеру, поведінки та психіки. У терміні 28 тижнів плід проявляє чітку міміку, якою він виражає задоволення чи невдоволення смаком їжі, а також позитивні та негативні емоції [1,2]. ...
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Annotation. Autonomic dysfunction syndrome is one of the most common disorders, which has a wide range of interpretations among specialists of different profiles. The autonomic nervous system (ANS) occupies a significant place in the development of somatic pathology. The course and manifestation of all pathological conditions is associated with autonomic dysfunction. Together with vegetative disorders, depressive disorders are also widespread among students. The aim of the study: to identify the clinical psychopathological features of somatized depressive disorders and autonomic dysfunction among sexually active students in comparison with students without a sexual debut of 4th year of study at Vinnytsya National Pirogov Memorial Medical University. A survey of 308 medical students was carried out. Obtained data were analyzed using the program “Statistica 6.1” using nonparametric methods of estimation of the obtained results. It was found that among medical students is a very high percentage of depressive disorders (96.1%) and disorders of autonomic function (69.8%). However, the manifestations of vascular dysfunction in young people are not related to their sexual activity. Mild and minimal manifestations of depressive disorders are also not associated with sexual activity. Symptoms of very severe depression are more prevalent in virgin girls than in sexually active girls and boys.
The Madonna/whore dichotomy categorizes women into two polarized types, the Madonna – the “good woman,” and the whore – the “bad woman.” Originating with research put forth by Sigmund Freud, the Madonna/whore dichotomy continues to have an impact not only in general society, but also in the criminal justice system. However, there are arguments that there may be disparity in how women are typified based on race.
The Madonna/Whore constellation of fantasies often underlies well‐recognized and pervasive misogynistic attitudes in our culture. These common and disturbing ideas about women serve to validate continued societal acceptance of the degradation of those people who are identified as female. The author suggests that there is a dynamic connection between the often‐unconscious Madonna/Whore complex of fantasies and consciously recognized misogyny. The author suggests that this set of fantasies is driven, in part, by overwhelming (i.e., traumatic) annihilation anxiety. It is argued in this paper that men who have felt overstimulated by women both emotionally and sexually as they develop are likely to feel helpless, anxious, and powerless in relation to women as adults. To defend against these feelings, some men wish for omnipotent control and place women into the binary, dichotomous categories of Madonna or Whore. These fantasies serve to solidify masculine identity and a male sense of superiority. The author proposes that the prevailing norms in our culture that reflect male supremacy not only reflect shared patriarchal beliefs but also function to justify these particularly dangerous hateful beliefs ‐ as if they were appropriate and even necessary to maintaining superior male status.
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Traditional gender values appear to typify less industrialized societies, while the modern cultural opinion of industrially advanced societies seems to have wrested only a slight hold on traditional gender values. Thereby, it seems as if the gender ideals of common opinion evolve in accordance with the evolving complexity of societal infrastructure, policy, and democratic ideology. As such, the gender roles seem to have expanded to include public aberrations not widely condoned when held in comparison to its historical context. Aberrant gender behaviors seem to be indicative of pleasure-based principles, while traditional gender roles are defined on the basis of survival, whose complexity simply regards virtue and the implementation of consistent order to promote an unobfuscated community structure.
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A theoretical model of dual control of male sexual response is considered, based on the balancing of central excitation and inhibition, with individuals varying in their propensity for both sexual excitation and inhibition of sexual response. A questionnaire method for measuring propensities for sexual excitation and inhibition has been developed (SIS/SES questionnaire), resulting in one excitation factor (SES) and two inhibition factors (SIS1 and SIS2). Evidence for the existence of both inhibitory and excitatory tone is discussed. The first inhibition factor (SIS1) may be related to level of inhibitory tone and is associated with fear of performance failure. The second inhibition factor (SIS2) may be related to external threats (e.g. from within the sexual relationship). The implications for the treatment of centrally mediated erectile dysfunction are discussed, with predictions that high SIS2 individuals will respond to psychological treatment, whereas high SIS1 individuals will respond better to pharmacological methods of treatment.
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This study involves the development and initial validation of a questionnaire measuring the propensity for sexual inhibition and excitation in men: the Sexual Inhibition Sexual Excitation Scales (SIS/SES). The underlying theoretical model postulates that sexual response and associated behavior depend on dual control mechanisms, involving excitatory and inhibitory neurophysiological systems. The scales and their discriminant and convergent validity and test-retest reliability are described. In a sample of 408 sexually functional men (mean age = 22.8 years), factor analyses identified three higher-level factors: two related to sexual inhibition and one to sexual excitation. Multigroup Confirmatory Factor Analyses revealed that the factor structure provided an acceptable fit to the data obtained in a second (N = 459; mean age = 20.9 years) and third (N = 313; mean age = 46.2 years) sample of men, with similar distributions and relationships with other measures. Theoretical issues and areas for further research, including male sexual dysfunction and risk taking, are discussed.
This first English edition of "Drei Abhandlungen zur Sexualtheorie" has been translated by James Strachey. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
This paper traces the development of Freud's views on sexuality and its relation to society from his early to his later writings. He shows that, although Freud provided important arguments for sexual reform, he also provided equally compelling arguments about its dangers and limits.
Introduction. It is generally assumed that modern sexual medicine was founded by German psychiatrists and dermatologists. Fequently mentioned are, for example, Richard von Krafft-Ebing and Iwan Bloch. History of modern sexual medicine began, indeed, decades earlier so that nowadays we look back over 150 years—not 100 years—of research, praxis, and teaching. Aim. The goal of this report is an acknowledgement of the achievements of the Italian professor of pathology and anthropology, Paolo Mantegazza (1831–1910). Methods. In several European countries, literary historical studies about the history of sexual science and sexual medicine have been conducted for over more than 30 years. Results. It became evident that Paolo Mantegazza possesses already the whole width of modern sexual-medical activities, from laboratory experiments to cultural-critical and ethnological studies. Curiously enough, his books, translated in many languages, were almost completely forgotten after his death. Conclusions. Modern sexual medicine originates in the second half of the 19th century, decades before the studies of Albert Moll, Havelock Ellis, Sigmund Freud, Iwan Bloch, or Magnus Hirschfeld. But its present name was coined generally only three or four researcher generations later. Sigusch V. The birth of sexual medicine: Paolo mantegazza as pioneer of sexual medicine in the 19th century. J Sex Med 2008;5:217–222.
A theoretical model for central inhibition of sexual response is proposed, postulating individual variability in the propensity for such inhibition. Whereas such inhibition is typically adaptive, individuals with high propensity may be vulnerable to sexual dysfunction, and those with low propensity to high risk sexual behavior. Evidence of the existence and localization of such inhibitory mechanisms from both the animal and human literature is reviewed. Evidence of central neurotransmitters with sexual inhibitory effects is substantial, though in most cases the inhibition is not specific to sexual response or behavior. Recent studies have identified centers in the brain stem and lateral hypothalamus which appear to have specific inhibitory effects on sexual response. A variety of adaptive mechanisms involving inhibition of sexual response are considered, some involving perception of threat, others occurring more directly as consequences of previous sexual activity. These different adaptive functions may well involve different inhibitory mechanisms. This theoretical model opens a new agenda for experimental research into adaptive sexual behavior, both human and animal.