In terms of our understanding of the human mind, it is important to remember that we are only ever getting there. Not so long ago, after all, a woman who enjoyed sex was likely to be branded as a nymphomaniac.
When I was seventeen I had an acquaintance called Amelia who claimed to be a nymphomaniac. Amelia told me she had had sex with 35, 42, 54 men - the number varied wildly - and that her notches included wealthy strangers, her father's friends, and even her psychiatrist.
It was only many years later that I realised two things. First, that Amelia had almost certainly been lying, or at least exaggerating, to get a reaction from me. I was an uptight, virginal convent girl, and although I had shed the Catholicism, I had yet to slough off the bonus gifts of guilt and repression. Secondly, there is no such thing as nymphomania- or rather, nymphomania is the result of a social factor and not a physiological or psychological one.
It is true to say that mental health and sexuality are intertwined. Anyone who has suffered from depression, anxiety, or stress can find their desire for sex diminishing. The same thing can happen after the death of a loved one; or alternatively, grief can stimulate the libido. Our satisfaction, or lack thereof, with a relationship, a job, or indeed life in general, can all affect the desire for sex too.
There is nothing wrong with having a high libido, a low one or something in between. All of these are perfectly normal and don't require psychological help. Nor is there anything wrong with your desire being buffeted by the vagaries of life - that's normal too.
Having said that, mental health problems can cause significant changes in sexual behaviour. However, there is a caveat - unless these changes are having a negative effect on your life, or harming others, then they are not necessarily a problem. What I mean is this - if a person is suffering from a bipolar disorder and has lots of casual safe sex during a manic period, it's the manic period that's the problem, not the sex.
Over the last few decades society- and many medical professionals - have begun pushing back against categorising various kinds of sexual behaviour as disordered. The most famous example of this is the removal of homosexuality as a "mental disorder" from the Diagnostic and Statistical Manual in 1973. The DSM is the bible of mental health disorders, and it is updated on an irregular basis as psychology develops and changes. The latest installment, the DSM-5, was published in 2013. The DSM-5 caused much controversy in psychological circles because of the decision not to include "sex addiction" as a mental disorder.
That, to my mind, is a good thing. Of course, some people engage in obsessive sexual behaviour without pleasure and in ways that are destructive, and yes, they may need psychological help. But for far too long any sexual behaviour that fell outside what was regarded as "normal" was seen as diseased and possibly dangerous. Thankfully that has changed.
Many scholars believe that sex addiction is basically a label for sexual behaviour that deviates from today's accepted norms. More conservative thinkers attack the concept on moral grounds, claiming that it undermines individual responsibility and acts as a "get out of jail free" card. Think Tiger Woods checking into rehab for sex addiction after he was found to have cheated on his wife. Many people were sceptical. After all, whatever your feelings about infidelity, it's hard to accept it as a mental health disorder.
The unwillingness of many mental health professionals to accept sex addiction as a disorder is a step forward. For one thing, there is no proof that it is a mental health problem; for another, it is necessary for psychologists to proceed with caution, given the history of psychology and sexuality. It's not a pretty history, particularly for women, gay men, trans folks and anyone who did not conform to prevailing ideas about gender and sexuality.
From the late 19th century, the newly emerging fields of psychiatry, sexology, and criminology paid close attention to sexuality- particularly sexualities that could be seen as disordered. Bear in mind that this was a time when marrying a teenage girl was acceptable, but consensual sex between two men or two women was not.
By the early 20th century, psychoanalysis was the favoured tool for theorising about sexuality. Homosexuality was viewed as pathological, and as a disease that could be cured - often without the consent of the "patient". Some thinkers like Sigmund Freud and Havelock Ellis, figured homosexuality was "unavoidable", but they stopped short of regarding it as "normal."
Freud, one of the most influential figures of the 20th century, had a very narrow conception of healthy, adult sexuality. He believed that in the normal course of events, a sexually mature woman transferred her feelings of sexual pleasure from the clitoris to the vagina - a biologically impossible feat, but whatever! Freud argued that a woman who persisted in experiencing clitoral pleasure suffered from a "masculine complex."
From today's perspective, these attitudes seem almost quaint in their Victorian prudery, but they resulted in horrific brutalisation in the name of "medical" treatment.
A variety of behaviours could see a woman classed as a nymphomaniac. These included enjoying sex, even with her husband; masturbation; or giving men "lascivious glances." Other fairly common behaviours were seen as having the potential to lead to nymphomania: eating chocolate or rich food, reading novels or having "impure" sexual thoughts.
It was common for women suffering from "nymphomania" and gay men to be locked away in asylums if they proved "incurable." Treatments often amounted to torture Ð blood letting, borax on the genitals, clitoridectomy and so forth. Some even led to death.
There is a particular significance here for Ireland. The last Magdalene laundry closed in 1996, and for a long time these, mother and baby homes, industrial schools and mental health asylums were used as internment camps for unwanted family members. During the 19th and 20th centuries, Ireland had a higher percentage of the population locked up in State or religious institutes than comparable Western countries or even the Soviet Union.
For many, their crime was flouting sexual conventions - such as engaging in premarital sex. You didn't even need to "misbehave" to be incarcerated. The scholar and activist Goretti Horgan notes that in the early 20th century, poor teenage girls could be sent to industrial schools for being "sexually aware" or because of their mothers' sexual behaviour.
Given this, it's not surprising that discussions of sexuality and mental health were both taboo. Even today, these are topics many of us find difficult to talk about. Thankfully that is changing. Irish attitudes towards sexuality have become increasingly open and more progressive in the last two decades.
Talking about mental health is perhaps more problematic because psychology was used as a punitive discipline. That is no longer the case. However, admitting to having a problem still holds a vestige of shame for many people. Luckily, in the last few years, a number of high profile Irish people have been willing to talk about their mental health problems. This includes author Marian Keyes, GAA player Alan O'Mara, DJ Nikki Hayes, and musicians Niall Breslin and Michael Pope.
We may have a long history of not talking about mental health, about sexuality and about taboos. But if there is one thing our history has taught us itÕs this: being silent about difficult topics is far, far worse than talking about them.
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