1
Abstracts
Nordic Association for Clinical Sexology, NACS
29th Annual Meeting
Göteborg, Sweden, September 7 – 10, 2006
Symposium on Love (beginning)
P O Lundberg, Neurocentrum, Akademiska Sjukhuset, SE-75185, Uppsala, Sweden
Introduction
Love is seldom a topic at sexological congresses. There are three reasons why we now have chosen love as the subject for this symposium. Firstly, during the last ten year a lot of new data concerning love has appeared through joint sexological research between psychologists and neuroscientist. Secondly, during recent years there has been a clear tendency of a separation of the scientific field of sexology into two parts, one psycho-sociological and the other medical. This is shown by the appearances of different scientific organisations and journals each with a content mainly or exclusively aimed at one of the two sides. I think now is time to counterbalance such tendencies by so to speak closing the ranks. The third reason is that the public, led by the media, usually associates sexology and serologists with just physical activity, very famous people or with the darker sides of human sexual behaviour. It is important to underline that love is an essential part of human life, in fact necessary for the survival of mankind. The sexologists should consider it our mission to support love whenever this is needed.
Shakespeare and the Nature of Love
Dr. Marcus Nordlund, Department of English, Göteborg University
For most people who are not Shakespeare professors, actors, or habitual theatre-goers, the words “Shakespeare” and “love” are more or less synonymous with two other words: “Romeo” and “Juliet”. We immediately think of young men and women who fall passionately in love with each other, deliver some high-flown and distinctly old-fashioned poetry, and then proceed to kill themselves on stage because their parents do not understand
them.
In reality, however, Shakespeare’s treatment of love was far more nuanced and multi-faceted than this. In his numerous plays and poems, romantic love is explored from a great variety of perspectives, including comic
celebration, satirical mockery, and profound disillusionment. (Sometimes we find all of these viewpoints in the very same play). Shakespeare also took a strong interest in related topics such as love between parents and children (how deep an aspect of human nature is parental love, and how vulnerable is it to environmental or cultural interference?) and the dark and potentially destructive passion known as sexual jealousy.
The purpose of this lecture will be twofold: to describe some of this amorous diversity on Shakespeare’s part, and also to briefly suggest how it may compare to modern research into the nature of love. It can, I think, be
argued that modern psychological research is moving in a direction that allows for a more meaningful dialogue with Shakespeare than was possible only a few decades ago.
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An L-arginine-rich Food Supplement in Impaired Sexual Desire and Function
Olle Haglund, MD, Macronova AB, Sundsvall, Sweden. – Corr: att. Susanna Johansson, Macronova AB,
Box 754, SE-85122 Sundsvall, Sweden
In the 1980s investigators found that a substance produced from the semi-essential amino acid L-arginine played a very central role in the regulation of an increased blood flow in the body. The substance was nitric oxide (NO), a very small gaseous molecule. Later, Louis Ignarro demonstrated that this substance caused the local strongly increased blood flow leading to erection in men and women. Ignarro and two other investigators were 1998 awarded the Nobel Prize in Physiology or Medicine. Incidentally, some other scientists later found that inhibition of the degradation of a substance formed by NO often caused an improved erection in men with erectile dysfunction. This was the discovery of Viagra, later followed by Cialis and Levitra with a similar mechanism of action.
Because the amino acid L-arginine, via formation of NO, is so central for erection, we tried to supplement gram amounts of this amino acid. As NO is destroyed by free radicals we added several antioxidants and some other substances such as magnesium. The new food supplement was called L-Argiplex, which exists in a male and a female variant with a similar composition.
L-Argiplex has been demonstrated to improve erection in many men and women. Somewhat surprisingly, many also experience increased sexual desire. This is different from above mentioned drugs. L-Argiplex also exists as a gel for local treatment.
On Conditions of Swedish Women’s Sexual Well-being. An Epidemiological Approach.
Summaries of Uppsala Dissertation
Katarina Öberg 2006, Centre of Andrology and Sexual Medicine, Karolinska Huddinge University Hospital, Stockholm, Sweden
Objectives: To identify conditions of Swedish women’s sexual well-being by focusing the association between women’s idiosyncratically reported levels of 5 sexual functions/dysfunctions (sexual interest, lubrication, orgasm, dyspareunia and vaginismus), and their socio-psychological situation and aspects of their own and partner’s sexual history. Level of sexual functions/dysfunctions per se and distress, are also related to level of sexual satisfaction.
Methods: Data were gathered in 1996 on a randomised cross-sectional national sample of 1335 women aged 18-74, using a combination of a structured interviews and questionnaires/check-lists. Trichotomies of a 6-grade scale characterising level of sexual dysfunctions during the last 12 months, into No/Mild/Manifest were used.
Main Results: Mild sexual dysfunctions were generally much more common than were manifest for both categories of sexual dysfunction (per se and distress). Across all 5 sexual dysfunctions distressing dysfunctions were found to be less common than dysfunctions per se. All dysfunctions, and in particular orgasmic dysfunction were closely associated with level of sexual wellbeing. Having been a victim of sexual abuse constituted a significant factor for all sexual dysfunctions, especially the ability to achieve orgasm. Many of socio-demographics and socio-psychological life conditions were significantly co-occurring with the different sexual functions/dysfunctions. However the most prominent variables were satisfaction with partner relationship and partner’s levels of sexual functions.
In conclusion: many different socio-psychological aspects must be taken into account to optimise treatment modalities and resources when dealing with women’s sexual dysfunctions in order to secure a good level of sexual well-being.
Keywords: Women, sexual dysfunctions, Sexual abuse, Life satisfaction, Epidemiology
Genital Vibratory Perception Thresholds (VPT) Measurements in Women with Sexual Dysfunction and/or Sexual Pain Disorders
Hulter, B., and Lundberg, PO., Department of Neuroscience, University Hospital, Uppsala , S-751 85 Sweden. (email: )
VPT can be measured on any area of the human body surface. The vibratory frequency is fixed (100 Hz) but the amplitude is slowly increased from zero up to the point where the person in question feels it. The technique compensates for the weight of the probe in such a way that the readings are expressed in tents of a µ (micron).
Material and results:
Eight volunteers aged 27-44 years (mean 35) re-examined 8-11 times during different phases of the menstrual cycle. Results: Mean for clitoris 0.27 (SD 0.10); no correlation with menstrual phases.
95 women aged 35-45 years (mean 41) on a waiting list for hysterectomy. Results: Mean for clitoris 0.58 (SD 0.70). No correlation with estradiol levels. No significant changes after surgery.
38 women with diabetes mellitus aged 28-50 years (mean 39) compared to age matched controls. Results: DM: Mean for clitoris 0.83 (SD 0.88) and for perineum 3.65 (SD 5.80). Controls: Clitoris 0.50 (SD 0.30), perineum 2.46 (SD 5.68). Difference statistically significant for clitoris.
67 women aged 20-72 (mean 35) with decreased sexual desire (A) compared to 57 women aged 18-40 (mean 25) with vestibulitis and/or vaginismus (B). Results: Clitoris A 0.52 (SD 0.38), B 0.34 (SD 0.14), perineum A 1.56 (SD 2.69), B 0.73 (SD 0.66). The differences are highly statistically significant.
For non-diabetic patients the VPT values showed a statistical correlation with age.
Among 150 further women with sexual dysfunction or sexual pain disorders high to very high values of VPT were found in women after severe lacerations during labour (19), diabetes mellitus (7), disc hernias (6), lichen sclerosis and other skin diseases (5), multiple sclerosis (5), congenital malformations (5), pelvic fractures (4), trauma to the clitoris (4), surgery of the vulva (3), faraonic circumcision (2), polyneuropathy (2), dressage riding (2), spinal cord tumours (2), rheumatoid arthritis (2), spinal cord injury, retroperitoneal tumour, and cancer of the vulva.
References.
Helström, L., Bäckström, T, Sörbom, D., Lundberg P.O., Sacral nervous function, hormonal levels and sexuality in premenopausal women before and after hysterectomy. Acta Obst Gyn Scand 1994;73:570-574.
Helström, L., Lundberg P.O., Vibratory perception thresholds in the female genital region Acta Neurol Scand 1992;86:635-637.
Hulter, B., Berne, C., Lundberg P.O., Sexual Function in Women with Insulin Dependent Diabetes Mellitus. Scand J Sexol 1998;1:43-50
A Different Kind of Love. The Meaning-making of BDSM* for Practising Women.
Ingrid Gelderman, certified clinical psychologist, e-mail:
This presentation is based on a study designed to further our understanding of the psychology of BDSM by analysing experiences of meaning-making by practising women. Nine women, six self-identified “submissives” and three self-identified “dominants”, were interviewed in depth about their perceptions of BDSM. The women, who were between 20-50 years of age, were recruited from BDSM-clubs and web-communities. Four main themes evolved from the interviews and were structured as follows: (1) Meaning and functions of BDSM concerned what the informants felt they obtained from practising BDSM. This theme included issues of preserving and letting go of control, physical pain and psychological dominance, sexual pleasure and joy, a different state of consciousness, feelings of significance, achievement and subsequent acknowledgement, and expanding self-knowledge. (2) Conditions for “safe, sane and consensual” BDSM where expressed as clear boundaries, good communication, and psychological stability. Consequences for exceeded boundaries were also presented. (3) Relational aspects concerned experiences of the significance practising BDSM had for the conception of self, for the couples´ relationship, for the BDSM-practising community, and for people not involved in BDSM. (4)Connections between now and then focused on how psychological and sexual development possibly could be connected to the interest of BDSM. This theme included experiences from childhood, psychological difficulties, feelings of shame and shamelessness, and issues around gender identity.
*Bondage & Discipline, Dominance & Submission, Sadism & Masochism
Keywords: BDSM, sado-masochism, women.
Symposium on Love (cont.)
P O Lundberg, Neurocentrum, Akademiska Sjukhuset, SE-75185, Uppsala, Sweden
Love
Act I.
Literature and history.
Different kinds of love stories
Love exists in all present cultures studied by the anthropologists. The many different forms of love have been described in the literature as long as we have had written language. Narratives and poetics also from ancient cultures are very important to help us understand how different and complex love can be. Thus reading about Heliodora and Meleager, Cloe and Daphnis, Heloise and Abelard, Beatrice and Dante, Laura and Petrarca, Isolde and Trisdan, Julia and Romeo, Blanche and Denis, Alice and Lewis, Singoalla and Erland, Monica and Bill a s o is important to modern love scientists. One and each of these narratives are representing a different love story or romance.
Besides we need the philologists and linguistic scholars to help us understand what people exactly understood when expressing different emotions and behaviour during varying periods of human history. Has the feeling of love changed over the last 5000 years? How have male and female roles altered in relationships during history?
Act II
Psychology:
Romantic love and attachment
Two of the most important psychologist who has studied the different forms of love scientifically is Elaine Hatfield and Dorothy Tennov. For them, it is quite clear that “sexual desire”, is not the same as “love”. Hatfield has created the concept “passionate love” defined as “the desire for union with another” in contrast to “sexual desire” expressed as “the desire for sexual union with another”. She describes “passionate love” as a state of mind characterised by intense longing for being together with another person. If love is reciprocal it will be emotionally associated with fulfilment and ecstasy. Unrequited love results in emptiness, anxiety and despair.
Tennov has invented the term “limerence”. Limerence is by nature demanding. Obsessive thinking and emotionally dependence also belong to the picture. Most people have probably noticed that love is not an eternal and constant state of mind. Tennov means that limerence lasts maybe just a few months up to a year and a half in contrast to the more long lasting romantic love which, however. very often ends by divorce of a marriage after a mean period of 4 years. This does not mean that the relationship is over. The two persons are still attached to each other.
Most recent researchers use the concept romantic love, which is well defined, or the word attachment for the whole period of being more or less together. Anyhow, passionate love and limerence are the strongest within a spectrum of emotions. A “Passionate Love Scale” has been evaluated. Passionate love can pas over into erotomania (de Clérambault´s syndrome) often without the love had ever been reciprocated or even observed by the object in question.
Act III
Endocrinology
Scene I
Sexual desire
Ît is obvious and generally accepted that human reproduction, sexual development and sexual functions are controlled by hormonal factors. Thus, we are not going to discuss this topic here. As regards sexual desire we know that the steroid hormones belonging to the group estrogens and androgens are essential.
Scene II
Maternal love
The most important form of love is maternal love since it is absolutely necessary for the survival of the child and essential for the development of this child. Maternal love is also to a large extent dependent on hormonal factors, which will be dealt with in next paper by Kerstin Uvnäs-Moberg.
Act IV
Neuroscience
We have known for more than 50 years that lust or sexual desire is “localised” to certain areas of the brain (pathology and “therapy”). We also have had some knowledge about which areas of the brain that are activated during cerebral sexual arousal. Up to the last 6 years no one has tried to find out which parts of the brain that are active during maternal love, romantic love, passionate love, jealousy a s o
What is actually going on in the brain during sexual stimulation and sexual arousal a s o can “easily” be followed with PET using FDG indicating glucose consumption or 15O-labelled water indicating changes in blood flow or with functional MRI (fMRI) measuring activity. With PET it is thus possible both to study the afferent function, (attraction and stimulation), the activity in the desire centre in the hypothalamus (cerebral arousal) and the efferent functions (genital arousal) such as erection, lubrication, secretion, ejaculation and also the feed back to the brain (satisfaction, decrease of anxiety)
Based on psychological knowledge on different forms of love, maternal love and romantic/passionate love fMRI has been used in the first place. The person in question placed in the fMRI gantry is presented a series of images or film clips with different motives and the self-assessed emotional reactions are registered simultaneously with the changes in activity (blood flow) in different areas of the brain. With such a technique can also the anxiety and despair characterising grief and jealousy be followed. We can also measure difference between different people, different men and women, during different phases of the menstrual cycle, during pharmacotherapy a s o
In this review a series of such studies performed in UK, USA, France and the Netherlands will be presented.
Reference:
Lundberg PO. Tre kärlekar - förutsättningen för människosläktets fortbetånd. Läkartidningen 2005;102:-3901-3905
Love in Ancient Greece.
Ingela Nilsson, PhD, Ass. Professor, Institute of Linguistics and Philology, Uppsala University, Box 635, SE-75126 Uppsala, Sweden.
Even though we tend to think of ancient Greece as the origin of most aspects of Western culture, it is clear that the ancient society with which we identify would appear utterly foreign were we actually to be confronted with
it. Poets like Sappho and philosophers like Plato have indeed been enormously influential, but is that enough to explain why ancient descriptions of love still feel so relevant? How can we reconcile this familiarity with our post modern notion that love is no absolute concept, but a socio-cultural construction? And how does it relate to theories of love and sexuality as defined by contemporary neurologists?
Maternal Love
Kerstin Uvnäs Moberg, Department of animal environment and health, SLU, Skara, Sweden
The term maternal behaviour has been used to describe the behaviour that is displayed by mammals towards their young. It includes nursing, nest building, and various types of sensory interaction and protection of the young. Maternal behaviour is regulated by neuroendocrine mechanisms. Suckling and other sensory stimuli are of importance for the initiation of maternal behaviour and the hormones oxytocin and prolactin have been demonstrated to play an important role in the control of maternal behaviour by mechanisms exerted in the brain as well as in the periphery. The role of these hormones seems to vary between species. In sheep only oxytocin seems to be involved in the regulation of maternal behaviour, whereas in pigs prolactin is involved in nest building whereas oxytocin regulates farrowing and lactation. Prolactin has also been shown to play an important role in the control of maternal behaviour in rats and in certain monkeys prolactin levels rise when the infants sit on their fathers and mothers.
If ewes and lambs stay in close contact after birth they learn to recognize and prefer each other within hours and the mother allows the young to suckle. Administration of oxytocin antagonists or peridural anaesthesia blocks the development of this behaviour suggesting that oxytocin is involved. Oxytocin interacts with dopaminergic mechanisms when it stimulates the formation of bonds or attachment.
It has been suggested that another aspect of maternal behaviour is that oxytocin reduces maternal fear of the newborn, an effect that is exerted in the amygdala. Oxytocin is, however, also involved in the control of maternal aggression by actions in the amygdala.