Why Is Sex Important? A Seminar on the Impediments to Adult Love
Why Is Sex Important? A Seminar on the Impediments to Adult Love Seminar Number: SM0336 Director: Stephen Levine, M.D. Date: Monday, May 18, 2015 Time: 1:00:00 PM - 5:00:00 PM Location: Chestnut East-West Sheraton Centre Toronto Hotel AMERICAN PSYCHIATRIC ASSOCIATION th 168 ANNUAL MEETING psychiatry.org/annualmeeting Toronto, Canada ·May16-20,2015 AGENDA AMERICAN PSYCHIATRIC ASSOCIATION th 168 ANNUAL MEETING psychiatry.org/annualmeeting Toronto, Canada ·May16-20,2015 Schedule First 75 minutes: What is love and how does it work? Second 75 minutes: Why is Sex Important and Three Compendia Of Love’s Impediments 15 minute break Third 75 minutes: The iconic psychopathologies of love: love/lust split, infidelity, jealousy, problematic sexual excess (sexual addiction) Last hour: Integrating concepts into practice—general discussion Adjourn OUTLINE AMERICAN PSYCHIATRIC ASSOCIATION th 168 ANNUAL MEETING psychiatry.org/annualmeeting Toronto, Canada ·May16-20,2015 The entire seminar will be given by the director, Stephen B. Levine, MD SLIDES AMERICAN PSYCHIATRIC ASSOCIATION th 168 ANNUAL MEETING psychiatry.org/annualmeeting Toronto, Canada ·May16-20,2015 5/26/2015 What is Love? Stephen B. Levine, MD Clinical Professor of Psychiatry Case Western Reserve University School of Medicine The Two Nurturant Systems in Adult Sexual Relationships Psychological Intimacy—the ability to create and recreate a sense of emotional connection through conversation. It is the pathway to love! Sexual Behaviors—largely a nonverbal process that reveals the two individuals to aspects of the other—nakedness, arousal, orgasm, power to give sensual pleasure, capacities to tolerate sensual pleasure, after-sex affection. Facilitate emotional interconnection Establishes the other as special—provides a unique status The Speaker’s Role To attempt to share his or her private subjective experiences with the listener Three requirements 1. Must know what one thinks and feels 2. Must be willing to say it to another 3. Must have language skills to express thoughts and feelings with words 1 5/26/2015 What the speaker shares need not be elegantly said, lofty in content, or unusual in any way It just needs to be from the inner experiences of the self The Listener’s Role To respond to the speaker with: 1. An uncritical acceptance of what is being said 2. An awareness of the importance of the moment to the speaker 3. A grasp of what is being said 4. The sense of the privilege of listening Psychological Intimacy Creates a bond Provokes erotic interest Improves a person’s self regard Generates a sense of hope and optimism 2 5/26/2015 Love is Not One Thing! When new: It is a powerful preoccupying state of mind brought about by an intensely hopeful investment in another person Once established, it consists of a shifting, nuanced private set of feelings about diverse aspects of the other When all is said and done, love is a unique attitude towards the selected another [Grammatically, love is an abstract or conceptual noun like justice or equality that is typically used as a verb] Five Recognizable Elements of Adult Sexual Love 1. Interest in the other 2. Pleasure from other’s being 3. Periodic sexual desire for the other 4. Dedication (caring, devotion) to the other 5. Faith that something good will come of this for us The Five Elements Within a person, fluctuates over time both Predictably Unpredictably Between persons, the degrees of these five elements varies. We do not all experience the same intensities of pleasure, interest, desire, devotion and optimism Within a couple there are typically discrepancies between how each person compares with the other 3 5/26/2015 Nine Meanings of the Conceptual Noun Love The nouns of love 1. Love is an Idealized Ambition The cultural origins of the ambition are so strong and widespread that few people can grow up without privately longing to experience its highly advertised full blown version Three alternative ways of explaining the ambition The most succinct summary I will have a partner who will accompany, assist, emotionally stabilize and enrich me as I evolve, mature, and cope with life’s expected and unexpected demands 4 5/26/2015 Love is an Idealized Ambition The sense that the right partner has been found triggers a great and lasting excitement As long as nothing major or repetitively adverse happens over time, those who sense that they have realized the ambition experience a sense of mental stability and say that they are deeply satisfied The Two Strong and Persistent Faces of Love’s Ambition To experience positive feelings for the person To experience the behaviors based on positive feelings from that other person The two sides of the same coin So strong is the ambition, that when relationships fail, people do not change the ambition; they may change the partner. The Ambition/Capacity/Potential to Love is Hardwired Cultures modify its forms of expression, but In all cultures, love is the ambition to attain a recurrent sense of unity, oneness, or wholeness that ends separateness and diminishes narcissism Zeki, S. (2009)The splendors and miseries of the brain, Wiley-Blackwell, Oxford, UK 5 5/26/2015 2. Love is an Arrangement --a Deal All adult sexual relationships are quid pro quo exchanges of hopes, expectations, and assets A social process arranges the deal Dating or courtship Parental arrangement Religious authority arrangement A clandestine relationship During courtship, the mind is preoccupied with “How will this person enhance my life?” Love is a Deal Each Person Brings: 1. Social assets and burdens 2. Economic opportunities and limitations 3. Familial relationships 4. Aesthetic pleasures or disappointments in terms of Beauty Taste Values compatibilities and incompatibilities 5. Politics Religious Moral 6. Recreational interests and capacities 7. Sexual interests and capacities Physical and mental health and their limitations 8. Anticipated time to significant illness Anticipated time to death Love is a Deal: Making the Arrangement The crucial issue is how well a person is able to do his or her analysis of the assets and limitations of this partner Four heterosexual outcomes No deal Short term deal Longer term deal Marriage (and increasingly, homosexual) 6 5/26/2015 Love is an Arrangement/a Deal Inexperienced young people tend to dislike acknowledging the due diligence of the deal With more experience--after a breakup, divorce, death, or an extramarital affair, people are more able to admit that they, of course, think about these matters Love is an Arrangement Each person perceives at least some aspects of the deal that is being offered Perceptions vary in accuracy and in breadth Clear thinking is made difficult by the excitement stimulated when a deal seems to be good on several fronts Clear thinking is also made difficult by the awareness that one may not have another chance 3. Love is an Attachment (A Bond) As the deal is worked out, people become attached Weave their psyches together Begin to feel a hunger to be with one another more Establish a “we” identity as belonging to the other Sex is highly desired The bond—the internal sense of couplehood— begins early in the relationship though not necessarily at the same rate or to the same extent 7 5/26/2015 3. Love is an Attachment (A Bond) Having sex and orgasm together facilitates the bond The early attachment is expected to induce strong motivation—dedication--to attain love’s ambitions A newly established bond rearranges the self 4. Love is a Moral Commitment The clergy teach the couple that love is a commitment to try to realize love’s grand ambitions The marriage or commitment ceremony, a public promise to honor and cherish each other through all of life’s vicissitudes, emphasizes love as a moral commitment Ceremonies instantly restructure life and generate a new strong set of obligations for a lifetime Guilt and Moral Commitment Guilt is a powerful force that maintains marriage Those who are serious about their vows will feel painful and persistent guilt when they don’t behave well and when contemplate extramarital affairs and divorce Agony is felt when the unhappily married grapple with the dilemma between their commitment to provide their children with two live-in parents and the wish to be free of unhappiness with their partner 8 5/26/2015 5. Love is a Management Process Where does a couple’s love reside? In the mind of community—family, friends, others In the privacy of each partner’s mind In between the two attached adults as they relate publicly and privately in ways unique to couples Love is a Management Process We protect our partner from many of our positive and the negative mental processes Under ordinary circumstances, we wisely, diplomatically, do not share too much of our anger, disappointment or joy Love is a Management Process A person needs the illusion that it is not a struggle to love him or her The irony—we struggle to love although we perceive it is not a struggle to love us! If our partners knew how much we struggled to contain our anger, disappointment, and regret over the deal we made, they would worry too much and fear the devastating impact of abandonment 9 5/26/2015 The Day-to-Day Management Process The management goals are to: 1. remain prudent about what one says 2. remain diplomatic about how one says it 3. maintain perspective about the bigger things in one’s life 4. prevent the partner from realizing what is actually transpiring within one’s mind What is Managed? Every marriage contains two separate subjective states his marriage her marriage Every coupled person has an internal sense of self and an internal sense of the partner. They are not the same. Honesty sounds good as a rule, but sharing how one experiences the other can be dangerous 6. Love is a Force of Nature It creates a unity out of two individuals It casts our fates together, organizes reproduction, and remains vital to our adult growth and development and to the maturation of our children It is the skeleton that supports the sexual and nonsexual processes of our lives We have a sense that we are part of a grand biological plan with special human options 10 5/26/2015 Love is a Force of Nature We are unaware that it is acting upon us most of the time It is most pleasingly discussed at the beginning of relationships when people are happily amazed at the transformations in their lives It can be seen at the end of the lifecycle when people stay together because they have always been together even though all the forces that brought them together have long since vanished and there is no pleasure, interest, sexual motivation or optimism Love is a Force of Nature After a number of years, a person may recognize that he or she can never be psychologically free of the partner Nature—the underlying force that socially brought them together, gave them culturally approved tasks that kept them together, and now having slowly attenuated their capacities--has had its way with them 7. Love is a Transient Emotional State Love is not a feeling! It is, at least, a combination of variable degrees of pleasure, interest and sexual desire/arousal. Investment in a partner and identity as part of a couple are more processes than feeling I love that book and I love that person share processes and feelings. 11 5/26/2015 An Array of Feelings When a woman learns that her newly beloved thinks about her in the same terms and declares his wish to marry her, her feelings might consist of Pleasure to the point of joy Interest to the point of fascination Pride in being highly valued Gratitude Sexual arousal Awe “She is happy” fails to capture her separate feelings, changing intensities, and time courses Feelings about Feelings Two children are taught about envy #1 has a simple feeling called envy #2 has an emotion called envy-guilt-anxiety Love is a Transient Emotional State A religious man averts his gaze when he sees an attractive woman, feels guilty and anxious, and tries to redirect his thoughts to his wife. He explains that this is the proper way of handling his sinful response to another woman. His mere aesthetic appreciation of another woman—a simple feeling of pleasure from someone who is visually pleasing--has become a complex emotional process. 12 5/26/2015 Love is a Transient Emotional State People may spend years anxiously waiting to experience the feeling of love. They privately are uncertain what love is, yet they assume others experience it. They may be tempted to fake love and mislead their partners about their degree of pleasure and interest in them. Love is a Transient Emotional State It is liberating to understand the ordinary complexity of love as a changing array of emotions Love is the label we give to a range of transient emotional experiences. Love is always complicated by past, present, and future considerations. 8. Love is an Illusion We want to think positively about love We want to believe in it We want to assume that we are loved by our partner We want to believe it is ONE THING We want to think that we love our partners 13 5/26/2015 Love is an Illusion In order to maintain these beliefs, at times we need to create certain distortions or illusions for ourselves and our partners Love as an illusion refers to: The fact that we create love by internal private processes Maintain it by prudent diplomatic dishonesties Can lose it for our partner without the partner knowing it Self-perceptions as loving and as beloved can prove to be transient and inaccurate Love is an Illusion We need courage to face the fact that the processes of love require defensive distortions of a person’s feelings, thoughts, and perceptions in order to remain in an intimate relationship Love is at least part illusion, although there are some that believe it is simply illusion Love is an Illusion It means that society, though its educational and religious institutions, through its celebrations of love in song, and though its academic discourses on the topics, fosters simplistic notions about love that encourage us to behave as though we all know what it is 14 5/26/2015 9. Love is a Stop Sign Many people are baffled, tongue-tied, or stumped to explain themselves when asked why they love their partner ? A simple unwillingness to answer the question ? An unwillingness to think about the question The stop sign is a defense against self discovery. “I don’t want to pursue the subject further!” protects the person from confronting the illusory aspects of his or her love. Love is a Stop Sign Love is the word we invoke when we don’t want to examine our motives for our interpersonal behavior in a sexual relationship Love, the stop sign, ends the inquiry Love is a Stop Sign Doctor: Why do you put up with that behavior from your spouse? Patient: Because I love him! Doctor: What does that mean? Patient: I don’t know. 15 5/26/2015 Love is Not One Thing It is a force in It is an ambition It is a deal It is a bond It is a moral commitment nature It is a transient emotion It is an illusion It is a stop sign It is intrapsychic work Love is Not One Thing! When new: A powerful preoccupying state of mind brought about by an intensely hopeful investment in another person Once established, it consists of a shifting, nuanced private set of feelings about diverse aspects of the other Love over the life cycle is a unique, in the details, evolving attitude towards the another Adult Love is Conditional Appraisal is the assessment of the partner's behaviors, particularly their recurrent patterns Partners do not simply and constantly feel positively about us Partners notice our behaviors, give them meanings, and depending on what they perceive, feel pleasure, admiration, disappointment, or anger 16 5/26/2015 Adult Love is Conditional Appraisal vs. Bestowal Bestowal is the granting of cooperation When our behaviors create positive feelings, our partners are more cooperative, affectionate, and enjoy us. These behaviors shore up their idealized internal image of us as loved. Money in a bank As positive experiences accumulate under diverse conditions over time, our partners treat us as though we possess a good character. Continuing Negative Appraisals Interfere with our partners’ pleasure from and interest in us They rob our partners of their sexual interest in us and attenuate their commitment to love us by eroding their internal image of us as respect-worthy Continuing Negative Appraisals Our partners then find it difficult to bestow affection and cooperation. At a certain point, these negative appraisals come to dominate all thinking about the partner. This may then trigger new mysterious anxiety, panic, guilt, or depression as the person confronts the question,“Now, what am I to do?” 17 5/26/2015 Continuing Negative Appraisals For a while, people prefer to think of their new symptoms as a mystery. They may take some psychotropic medication. Eventually they come to realize that it is only in their best interests to keep the source of their feelings from their spouse Some temporarily wait for a better day with the partner and seek a calmer acceptance of their partner’s capacities and style Others, however, privately decide to terminate the relationship. Five Vital Considerations for Staying in Love 1. Competence--a consistent pattern of absence of hostility, the presence of warmth, respect, support, and a willingness to engage with the partner to solve mundane problems. The sense of friendship prevails even in the face of disagreement. (Gottman, 1998) 2. Staying Balanced—Not Losing Perspective Staying in love is in large part the result of what happens in the privacy of one’s conscious mind Struggles within the privacy of one’s mind are frequent We have values, ambitions, and a sense of what is realistic that is kept largely private from the partner. 18 5/26/2015 3. Emotional Genuineness Staying in love requires the re-meeting of two people at their emotional genuineness The important differences among us may be our abilities to face our individual and joint challenges together as a supportive sympathetic team. Genuineness means sharing with our partners our thinking, emotions, and the pleasure or pain from the consequences of our decisions 4. Overcoming Narcissism 1. It is important that each person develop the ability to put him or herself second at times. 2. Overcoming narcissism means increasing devotion to the partner, couple, and family—putting the needs of the partner, the couple, or the children ahead of one’s own. 3. Partners notice the degree to which this is accomplished; we can more easily bestow cooperation when our partner’s selfinterest is put aside. 4. It also adds to the loving internal image of the partner—i.e., it puts that psychic money in one’s private mental bank. 5. Negotiation Skills 1. 2. More matters are negotiated than meet the eye Some people are autocratic and feel entitled to make the decisions for the couple. Even this seeming unbalanced“pathological” circumstance is the result of some form of prior negotiation The partner who does not like confrontation, disagreement, or directly representing personal interests decides to go along and often find spheres of activity that the other person is not interested in controlling 19 5/26/2015 How To Behave Poorly In Established Love Relationships 1. Routinely escalate angrily or withdraw in the face of interpersonal conflict 2. Avoid genuineness—lie frequently and don’t share too much about yourself 3. Put yourself first in choices with your spouse and children 4. Assume you have a right to decided all matters important to you 5. Practice outrage when others find a way to protest your decisions Part Two LOOKING AT THE PATHOLOGIES OF LOVE Ways Of Viewing The Pathologies Of Love • By WHEN THE IMPEDIMENTS MANIFEST • Before courtship, during courtship, after relationship is established • IMPEDIMENTS THAT IMPAIR A PERSON’S LOVABILITY • Longstanding or new physical, mental, behavioral, sexual limitations • IMPEDIMENTS WITHIN THE SELF THAT LIMIT INVESTMENT IN THE PARTNER • Distrust, narcissism, self-hatred, inability to have respect and desire for the same person 20 5/26/2015 COURTSHIP IMPEDIMENTS PREVENT OR LIMIT LOVE FROM DEVELOPING Major physical disabilities Major cognitive disabilities unaware, unreachable, or unavailable Major mental illness Gender Identity Disorders Character pathology Rejection Falling in love with the Refusal to commit to marriage Loss of sexual interest in increasingly committed relationships Select paraphilias Lifelong sexual dysfunctions An Important Distinction In The Impediments To Loving Partner’s view of the index person Loving a person is made difficult by any number of the index person’s traits, behaviors, thinking, reactions to others, and capacities Index person’s own characteristics Investing and maintaining kind supportive behavior towards one’s chosen partner can be limited by character traits, values, decisions, internal and interpersonal conflicts and ambitions Impediments that Diminish a Person’s Lovability Incompatible Sexual Identity Variations Acquired Sexual Dysfunctions Sexual Excess Patterns Paraphilias Character traits that alienate Aggressive Behaviors New Major Mental or Physical Illness Violation of fundamental assumptions—infidelity, harming children, criminality 21 5/26/2015 Impediments That Limit the Person’s Ability to Express Love Discovery of One’s Alternative Gender Identity/Orientation Acquired Sexual Dysfunctions Sexual Excess Patterns Alcoholism and other forms of drug addiction Paraphilias Problematic character traits Aggressive behaviors New Physical or Emotional Illness Loss of respect for partner Partner loss Sexual adventuring Understanding Character Traits Character traits that alienate Recurrent inability to problem-solve together Unacceptable differences in honesty, religiosity, political sensibilities Fatigue over differing cultural interests and pleasures Differing concepts of what are acceptable boundaries for the relationship—e.g., friendship patterns, flirtation, extra-dyadic sex Realization of the limits of a partner’s capacities Partner’s endowment of: Emotional expressiveness; Intelligence Vocational effort Sexual capacity Athleticism Sociability/interest in others Gradual realization of divergent life goals Traditional Ways of Looking at Relationship Problems 1. Power struggles 2. Gender roles 3. Unrealistic expectations 4. Intimacy barriers 5. In-law relationships 6. Money However one looks at the processes that bedevil intimate adult relationships, we can agree that our understanding of it is incomplete 22 5/26/2015 The Partners Of Those Who Love Poorly The partners for a while think that they love you but no longer am in love with you = Love As A Moral Commitment and Love As A Management Process. There is very little pleasure, personal interest or sexual desire for you. The MHP will be told love has become a bad deal and will endorse love as an illusion They will complain of feeling empty and may claim to not understand their fantasies of having a fresh start. They are even given to infatuations They will spend money surreptitiously on consultations with divorce attorneys 15-MinuteBreak Barriers to Loving: A Clinician’s Perspective is available for purchase during the break Iconic Situations that Destroy Love Jealousy Sexual addiction-problematic sexual excess Love-lust splits or Madonna-whore complex Infidelity Levine, SB. Barriers to Loving: A clinician’s perspective, Routledge, 2013 23 5/26/2015 Jealousy Mate guarding Attachment anxiety—separation anxiety Low self-esteem Ranges from ordinary forms to psychosis Problematic Sexual Excess— Sexual Addiction Involves infidelity but is dominated by the commercial aspects, multiplicity of episodes, the sense that the man lacks control of his behavior and continues after he realizes that it is self-destructive Up to 30% of these men are paraphilic Madonna-Whore Complex Inability to love affectionately and desire the same person. Presents shortly after engagement or marriage Patient (can be a woman) is averse to intimate contact and unable to have intercourse or orgasm with partner but is fine with others Freud thought it due to a oedipal fixation to mother or sister but today it is known to have a diversity of remote causes in both males and females, heterosexuals and homosexuals 24 5/26/2015 Infidelity: Monogamy Promises to Preserve 1. 2. 3. 4. The couple’s mental, physical, social and economic health over time The structure of family in order to facilitate children’s emotional development The continuity of parents’, siblings’, extended family’s and friends’ lives The belief in the possibility of marital happiness among the children 5/26/2015 Monogamy Does Not Always Deliver on Its Promises of the individual/couple’s mental, physical, social or economic health 2. Limits some children’s emotional development 3. Alienates family and friends 4. Leads to children’s cynicism about possibility of marital happiness 1. Deterioration Expectations—Love’s ambitions Then there is reality ① Happiness ② Monogamy ③ Sexual fulfillment ④ Psychological intimacy ⑤ Caring support ⑥ Respectful understanding ⑦ Happy capable children ⑧ Financial stability ⑨ Agreement on important issues 25 5/26/2015 There Is No Single Motivation For Infidelity A search for 1. 2. 3. 4. 5. 6. 7. Coping With Love Conventional sexual pleasure Paraphilic sexual pleasure Homosexual experience Defiance Adventure Distraction from personal pain 8 Low self esteem 9. Sense of Entitlement 10. Gender identity confusion 11. Uncertainty whether to divorce 12. Separation, war, prison 13 Disabled spouse There Is No Single Definition of Infidelity Where is a Partner 1. Masturbation 2. Pornography to Draw a Line ? 6. Flirtation 7. Friendship lacking evidence of sexual contact Sending pictures of breasts and genitals to another 3. Strip club attendance 8. 4. Lap dances at strip clubs 9. Commercial partner sex 5. Chatting with others about 10. Casual situational sex marital dissatisfactions 11. Love affair Do You Think Infidelity Can Be Normal? Adaptive? Morally acceptable? Reasonable? 26 5/26/2015 Difficult to be Nonjudgmental about Infidelity Verbs are negative Cheating Betraying Deceiving Sexual adventuring Swinging Swapping Nouns are negative Cheater Philanderer Womanizer Slut Tart Whore Floozie Lexicon: Wide Range of Infidelities Affair vs. affair of the heart or love affair Fling, dalliance, indiscretion, one-night stand Adultery Casual sex Acting out Sex addiction People Have to Decide about Fidelity Negotiated Nonmonogamy Polyamory An arrangement Open marriage Swinging Menage a trios Troilism A night out Swapping Polygamy Non-negotiated Nonmonogamy The unilateral decision to have another sex partner Would my partner ever agree to what I desire? Would knowledge of my desire harm my partner and our marriage? Would an agreement to allow it victimize me? What are my risks of disgrace, humiliation and divorce? 27 5/26/2015 Dichotomous American View on Infidelity Public Monolithic opposition Any contrary view = moral depravity, psychobabble, or rationalization Almost everything that is ever said about it conveys social opprobrium Tarnishes reputations Arts Nuanced views in Comedy, Fiction, Theater, Music, Poetry, Film, Biography, Essays Accepted as common Not invariably negative Cross cultural and class aspects Historic aspects Dangers are not ignored *Laura Kipnis, Against Love: A polemic, Vintage, New York, 2003 and Susan Squire, I Don’t! A contrarian history of marriage, Random House, New York, 2008. Six Meanings of Acting Out 1. Disapproved of behavior 2. Behavior which expresses a fantasy 3. Behavior which has negative consequences 4. Behaviors that are created by individual psychopathology 5. Behaviors that are motivated by unconscious fantasies 6. Behaviors that arise from the person’s incapacity to put into words what he or she is actually experiencing Countertransference When we hear infidelity stories, our shock and emotional stirrings threaten our ability to remain nonjudgmental, calm, nondirective, and clear thinking 28 5/26/2015 What Will We Feel If We have never known this in our family of origin We are currently having an affair We already have had several Our spouse has been unfaithful Our parent’s marriage was characterized by infidelity Infidelity can be exhausting for the therapist! Seven Conceptual Tools Distinctions between 1. 2. 3. 4. 5. Privacy and secrecy Guilt, shame, humiliation Problem, dilemma, conundrum Values, meanings, feelings Apology, remorse 6. Crisis= Danger + Opportunity 7. Judgment changes over time Values---> Meanings--->Feelings Values organize meanings Meanings generate emotional responses Patients usually share their feelings directly but not their implied meanings and values Therapists assist in the articulation of meanings and values 29 5/26/2015 Meaning Makers In a Discovered Affair Unfaithful one Aggrieved partner Paramour Therapist in the room Adolescent and older children Parents and in-laws Sibs and friends Maturation Changes Values It is difficult to remain faithful to any value system for a lifetime Political Professional Religious Child rearing Honesty Sexual Three Values Positions on Fidelity 1. 2. An inflexible basic requirement for love to grow An ideal that cannot ever mentally, or, often behaviorally attained for a lifetime – – 3. To be understood in a nuanced and flexible matter Compatible with loving and sometimes enables it Stifling to pleasure, against biological tendencies, an invitation to boredom, and the social source of many woes 80% of American and British: it is morally wrong! Thorton, Young-Demarco.Four decades of trends in attitudes…J Mar.& Fam 63:1009.2001 30 5/26/2015 Third Position Many people who hold this value position used to have position #1 or #2 Rarely shared except with intimates Typically not volunteered to the therapist unless nonjudgmentally asked Male fidelity was not expected until 17c is not expected in many cultures today May be far more common that women appreciate Therapist’s Role with Newly Discovered Infidelity To maintain our personal balance, to think clearly, to clarify what the patient is experiencing To prevent a rush to a decision about the marriage—that is, to separate the reactions to infidelity from the matter of divorce To be a force of stability . Expectations of the MHP To understand that extramarital sexual behavior benefits men and women in ways that cannot be easily spoken about in public To know that some people highly value their extramarital experiences and do not experience major regret over time To recognize that many unfaithful males report that they know of no married peers who abstain from all forms of extramarital sex To recognize that many married women have been unfaithful 31 5/26/2015 Four Recurring Swirling Cognitions in Newly Discovered Infidelity 1. What is the meaning of the infidelity to me? 2. What is the best way I can respond to it? 3. Will I be abandoned? 4. Why did this happen? Affective Processes 1. Storms of separate feelings making eating, sleeping, concentration, and usual activities difficult 2. Feelings are: Sadness, anxiety, fear, anger, guilt, doubt 3. Indecision about sharing the situation with others Modifiers of the CognitiveAffective Experiences Age + maturity + values = sensibilities Character structure What one knows about the topic Partner’s past infidelity Prior experience in family of origin Personal experience as an unfaithful person The degree of infidelity 32 5/26/2015 Two-Person Crisis 1. Anxiety about restructuring of the family a. b. c. d. e. Separation anxiety, panic about being alone, return of old anxieties The intensity of the spouse’s reaction is often surprising to the unfaithful one Everything is more difficult to transact Spouses no longer feel in control of their destiny Each feels like a personal failure Beyond Two-Person Crisis Children react to the changes in parents When family members get involved, bonds are suddenly changed Friends can take sides and pass harsh judgments How to be Helpful 1. Do not personally panic—remain calm and in good control of your personal reactions 2. Resist being a friend; watch your boundaries 3. Explain the patient’s affective storms in terms of reactions to the four issues 4. When another storm occurs, clarify which of questions was its source 33 5/26/2015 How to be Helpful 5. Articulate that while the storms are occurring is not the time to make decisions about the future of the relationship 6. Be supportive and empathic about the patient’s plight 7. Do not condemn the partner as a supportive tactic 8. Remain interested and curious about the patient’s evolving meanings of the infidelity How to Help the Unfaithful Person Ask about what is being felt and considered Remain interested in motives for the affair and return periodically to the issue Promote truth telling within limits of partner’s pain Empathize with the complexity of the situation Urge delay of major decisions until more affect/meaning is worked through Equal attention to Fully explaining the partner’s experience Understanding the unfaithful person’s post discovery experiences Forgiveness Is Not…… Forgetting Condoning Excusing Trusting that it can never happen again Forgoing Reparation Insuring health/safety of the aggrieved 34 5/26/2015 Two People Seek Forgiveness The Supplicant Fruits of Forgiveness Ends the righteous sense of superiority 1. What I did was wrong 1. 2. I chose to do for my own reasons—which I can now or later try to tell you 2. Dissipation of anger and vengeance 3. I now realize that I hurt you in these ways 3. End to picturing the spouse in sex acts with another 4. I now regret what I did and apologize 4. Beginning of judging the partner on some other basis than the infidelity 5. I evidence continuing remorse 5. Seen of being merciful Four Steps for the Forgiving Person 1. Hearing the whole story of what was done 2. Grieving for what happened 3. Turning away from interactions that amplify or needlessly replay the story 4. Acknowledging that the partner has some good traits— is more than his or her poor behavior Post, Neimark. (2007)Why Good Things Happen to Good People. .Broadway Books, New York Motives for a Second Chance 1. Infidelity was not the most important consideration: $, children, family, stability, career more important 2. Partner has reinvested in us and seeks a higher level love than we previously had 3. I, too, have made mistakes 4. We have exhausted the subject and are exhausted by it 35 5/26/2015 Why Some Divorce After Infidelity 1. Possess a conviction about the first values position 2. They have a sense of the partner’s character from the story of the infidelity. “You are not a good enough person for me.” 3. The infidelity was an opportunity to have a socially acceptable reason to leave Discussion 36 BACKGROUND AMERICAN PSYCHIATRIC ASSOCIATION th 168 ANNUAL MEETING psychiatry.org/annualmeeting Toronto, Canada ·May16-20,2015 SB Levine, (2006) Demystifying Love: Plan Talk for the Mental Health Professional, New York, Routledge. Chapter 1 The Nouns of Love Love is a noun and a verb, a thing and an action, a concept and an organized set of behaviors, and a subject that clinicians generally avoid. This avoidance is strange to me because love seems to be vital to us at every stage of our lives. I find it impossible to think about human developmental psychology, mental health, and psychopathology without making reference to maternal love, paternal love, friendship, sibling love, love of God, and love of recreation, vocation, learning, food, or music. The range of love is vast and its processes inherent in our fundamental essence as human beings (Lewis, 1960). This chapter and the rest of the book are about love relationships that aspire to a lasting sexual relationship, an arena in which I have spent all of my professional life. If anything that derives from my consideration of this confined topic proves applicable to the other forms and processes of love, it will be an unintended bonus. Romantic love has been carefully studied in behavioral science for several decades (Hatfield & Rapson, 1993; Regan, 2000). Its neurophysiology has more recently begun to be examined with imaging techniques(Aron et al., 2005; Bartels & Zeki, 2000), neuroendocrine measurements, and speculations about pathway activations (Esch & Stefano, 2005). Despite these and other impressive modern works (Gilligan, 2003) and enthusiastic journalistic interpretations of them (Gottlieb, 2006; Slater, 2006), sexual love, perhaps because it is supposed to last most of a lifetime, is too complicated for the current reach of science. Science is a bit weak kneed before love because of its intrinsic subjectivity and because so many variables seem to shape its outcomes(Lee, 1988). What follows is not the product of a scientific process of hypothesis generation and testing. It is merely the synthesis of one person’s obsession informed by reading, clinical work, and personal experiences. What is This Thing Called Love? The Nine Nouns of Love I can provide at least eight answers, perhaps nine, to this fundamental question, none of which is the right or most important answer. Taken together, however, the dark mystery of this elusive thing called love begins to be illuminated. Like those academics who have tried and failed, I have no hope of defining love in a succinct sentence (Watts & Stenner, 2005). Each of these meanings of love can be periodically sensed during all stages of adult life. LOVE IS AN IDEALIZED AMBITION Love is so intensely celebrated in culture (Jankowiak & Fisher, 1992) that few people can grow up without longing to experience its highly advertised, full-blown version. Along with this aspiration to fall in love comes the ambition to reap love’s many promised long-term rewards. Here are several alternate ways to articulate the specific ambitions inherent in love (Levine, 1998). 1. Love is an ambition to attain a lasting state of interpersonal harmony that will insure enough contentment that the person will be able to focus on other important matters such as raising healthy children, having a good job or successful career, or enjoying life. 9 2. Love is the ambition to live a life characterized by mutual respect, behavioral reliability, enjoyment of one another, sexual pleasure and fidelity, psychological intimacy, and a comfortable balance of individuality and couplehood. 3. Love is the ambition to find a partner who will accompany, assist, emotionally stabilize, and enrich us as we evolve, mature, and cope with life’s demands. When individuals sense they have found the right partner to attain their ambition, they experience a great and lasting excitement. They are often eager to begin a new phase of life as a couple. When they have lived for a long time with someone and feel their lives are close to ideal, they experience a sense of mental stability and say that they are deeply satisfied. What they feel about their partner and about life in general derives from these private meanings. Despite their enviable situation, most people know their situation can change. The ambition of love has two faces: to be loved and to be able to love another. The strength of these ambitions should not be underestimated. They can persist for a very long time after a partner continues to disappoint. Optimism that tomorrow will be a better day sustains the ambition. Even when the love relationship has been declared a failure, the twin faces of the ambition often continue to operate. The ambition to love and to be loved is not readily exchanged for a lesser set of expectations — although sometimes the partner is exchanged. LOVE IS AN ARRANGEMENT — A DEAL All adult sexual relationships are deals — quid pro quo exchanges of hopes, expectations, and assets. The social process for arranging such a deal is called dating or courtship. During courtship, the minds of the two people are often privately preoccupied with the answers to the question, “What will this person bring to my life?” The question can be asked about many dimensions: social, economic, aesthetic, recreational, sexual, medical, time-to-death, and more. Young people in their first relationships generally do not prefer to think in these terms. They think more romantically and are often too embarrassed to admit that they thought about the specific assets of the partner. Their embarrassment dissipates with age and the accumulation of experiences in subsequent relationships. Love as a deal can be clearly perceived after a relationship is ended by breakup, divorce, or death and the person begins with someone new. During the second (or third or fourth) time around people are often able to weigh the factors that will determine their involvement. Not only do they carefully consider potential partners’ assets, they are able to discuss their analysis of the potential arrangement with friends. When we refer to love as a deal, we mean that the person accepts the arrangement — the exchange of assets. Each person perceives what has been offered by the partner. Of course, perceptions vary in accuracy. While there can be a lot of excitement in anticipation of making a deal, once the deal is formally accepted, people often feel a celebratory degree of pleasure, interest, sexual desire, and think that life is good. In some cultures, parents make the deal. The adolescent or adult children only court after they know who their spouse is to be. They then hope to fall in love through courtship and the early processes of marriage. LOVE IS AN ATTACHMENT Once the deal has begun to be worked out, love comes to mean a bond or attachment. People weave their psyches together and begin to feel a hunger to be with the other person more. They think of themselves as belonging with and to the other. Mental couplehood begins in the minds of two individuals early in the relationship though not necessarily at the same rate or to the same extent. Sexual activities, particularly those that involve orgasm, facilitate the private sense of attachment, and the attachment induces strong motivation to attain love’s ambitions. LOVE IS A MORAL COMMITMENT Society has a great interest in love. After the deal is made, most people seriously think about marriage and a marriage ceremony. The rituals which sanctify marriage emphasize love as a moral commitment. While the clergy may be uncertain that the ambitions of love can actually be attained on earth, they teach the couple that love is a commitment to try to realize love’s grand ambitions. The charming emotions that occur in the bride and groom and their families during the ceremony are only the internal music that 10 accompanies the public promise of two people to honor and cherish each other through all of life’s vicissitudes. The ceremony officially raises the bar of expectations; the new spouses are expected to honor their vows. Whether religious or secular, the ceremony instantly restructures life and generates a new set of obligations. Love as a moral commitment begins as a strong set of obligations for a lifetime. People vary in how seriously they take their vows. Those who are very serious will feel painful and persistent guilt when they contemplate extramarital affairs and divorce, even many years after the marriage ceremony. The moral nature of the commitment is more excruciatingly felt when unhappily married parents grapple with the agonizing dilemma between their commitment to provide their children with two live-in parents and the wish to be free of unhappiness with their partner. LOVE IS A MANAGEMENT PROCESS While a couple’s love exists in the mind of community (“They are a couple”) and between the two attached adults as they relate publicly and privately in ways unique to couples, the most important place that love exists is in the privacy of each partner’s mind. Many of the positive and, particularly, the negative mental processes involved in loving another person must remain private from the partner. Under ordinary circumstances, we wisely do not share too much of our anger and disappointment about our partner. We intuitively realize that our partner needs the illusion that we do not struggle to love them. It is ironic that both partners tend to believe that it is not a trying struggle to love them, even though each is quite aware how often he or she struggles to love the partner. If our partners knew how much we struggled to contain our anger, disappointment, and regret over the deal we made, they would worry too much and fear the devastating impact of abandonment. We protect them. Love as a management process is the practical day-to-day work of love. The usual immediate goals of this work are to remain prudent about what one says, to remain diplomatic about how one says it, to maintain perspective about the bigger things in one’s life, and to prevent the partner from realizing what is actually transpiring within one’s mind. Absolute honesty sounds good as a rule, but its interpretation has to be refined in order to not create interpersonal chaos. A husband’s and a wife’s marriage are two separate subjective states — his marriage and her marriage, each of which exists in the privacy of the person’s own mental world. Love is good self-management in relationship to the beloved. Much of adult life is spent with an awareness of the gap between our private sense of ideal love and our actual experience of our self and our partner in a relationship. The gap is a source of existential distress and, like all subjective distress, is buffered by an array of competing life demands (“I have children to raise”), defense mechanisms (“I keep telling myself that no partner is ideal”), and self-management techniques (“Take a deep breath and focus on your work!”). When the buffering system works, one's love relationship, while not continuously or completely harmonious, is good enough. The private mental struggle to maintain cooperative, kind behaviors exists in all people, even the happily married. LOVE IS A FORCE OF NATURE Love is a force in nature that creates a unity out of two individuals. At a certain time in life it casts our fates together, organizes reproduction, and remains vital to our adult growth and development and to the maturation of our children. This love is a skeleton that supports the sexual and nonsexual processes of our lives (Lear, 1990). It is not unlike the forces that organize reproduction in other animals. It can be studied both in terms of an individual’s biologic processes and in terms of how collections of individuals behave (Crews, 1998). We humans, after all, have a great deal in common with each other. This force of nature acts upon us without a constant awareness of its presence. It is most pleasingly discussed at the beginning of relationships when people are happily amazed at the transformations in their lives that their new arrangement has brought about. But it can also be seen at the other end of the life cycle when people stay together because they have always been together, even though all the forces that brought them together have long since vanished. Older people often recognize that their partner is now an inextricable part of themselves and that they can never be psychologically free of the partner. Nature — the underlying biological force that brought them together socially — gave them culturally approved tasks that kept them together, and now having slowly attenuated their capacities, has had its way with them. 11 LOVE IS A TRANSIENT EMOTIONAL STATE Love is not a feeling but a combination of two, and sometimes three or more feelings. The basic two are pleasure and interest. The third more variable feeling is sexual arousal. When I declare that I love the book I am reading, you can assume I feel pleasure and interest in it. When I sincerely state that I feel love for a person I may mean that I sometimes have sexual inclinations as well. In order to understand love as a transient emotional state rather than a feeling, we must understand that the words feeling and emotion are not synonyms. A feeling is a simple experience of sadness, anger, disappointment, aversion, pleasure, or interest. An emotion is built from feelings but is more complex and consists of two or more simultaneous feelings. Feelings and emotions alert us to the meanings of events and processes within our relationships. They are our first warning system for the changes in our external and interpersonal environment. Two separate patterns explain emotions. First, emotions exist because events typically create more than one feeling. Anything important to us typically creates an array of feelings. When a woman, for instance, learns that her newly beloved thinks about her in the same terms and declares his wish to marry her, her feelings might consist of pleasure to the point of joy, interest to the point of fascination, pride in being highly valued, gratitude, sexual arousal, and awe. Yes, she may be described as having the feeling of happiness, but this simple summary does not capture the separate feelings that she is experiencing, their fluctuating intensities, or their individual time courses. Second, emotion is created because we humans have feelings about our feelings. Consider this example: A child of a certain age can experience envy. But, when a child is taught that it is wrong to feel envy, the subsequent experience of envy may evoke anxiety from the guilt of feeling something of which parent disapproves. If the parent is watching while envy occurs, the child may experience shame as well. In this child, an initial simple feeling of envy has become an emotion comprised of envy, anxiety, guilt, and possibly shame. All of us can experience the simple feeling of envy. The emotion of envy, however, varies among us based on our attitude toward envy. Your envy may be an unencumbered feeling while mine can be a complex guilt and anxiety-provoking array. Here is a second example of how family and culture create emotion out of simple feeling. A religious middle-aged man averts his gaze when he sees an attractive woman, feels guilty and anxious, and tries to redirect his thoughts to his wife. He explains that this is the proper way of handling his sinful response to another woman. His mere aesthetic appreciation of another woman — a simple feeling of pleasure from someone who is visually pleasing — has become a complex emotional process. The emotions of love are particularly complicated. Feeling intense pleasure and interest in a potential new partner quickly stimulates some internal reaction to this incipient love. It may stimulate apprehension, eagerness, or guilt, for instance, depending on the circumstances of the person’s past or current life. When one person contemplates saying “I love you” to another, anxiety appears. The speaker often feels danger because he or she realizes it will have an important meaning to the listener. Sincere first declarations of love are very anxious moments. They inform the listener that important transformations have already occurred in the speaker. How will the listener respond? Pleasure and interest in the partner at that moment are often overshadowed by trembling fear. Sexual interest and arousal are often associated with the intense pleasure and interest in a new partner. The sexual arousal continuum varies from slight genital tumescence to profound, preoccupying bodywide sexual arousal (Levine, 2003). Since “I love you” can create sexual arousal in the listener, the phrase can be used when the primary pleasure and interest in the person is the anticipation of sex. The meanings and motives for expressing love change all the time. When a person says to us, “I love you,” we have to discern both its meaning and motive. Sometimes it means only, “I want to have sex.” A genuinely felt “I love you” expressed immediately after sex may reflect an intense psychological pleasure experienced during the previous moments. But such statements may be made out of politeness rather than being genuine. Most people do not understand the difference between a feeling and an emotion. As a result, they may spend years anxiously waiting to experience the feeling of love. Privately, they are uncertain what love is, yet they assume others experience it. They may be tempted to fake love and mislead their partners about their degree of pleasure and interest in them. Although it may initially be shocking to learn that love is not a feeling, it can be liberating to understand the ordinary complexity of love. Love is the label we give to a range of transient emotional experiences. Love is always complicated by past, present, and future considerations. 12 LOVE IS AN ILLUSION We want to think positively about love. We want to believe in it as a concept. We want to assume that we are loved by our partner. We want to think that we love our partners. In order to maintain these beliefs, at times we need to create certain distortions or illusions for both ourselves and for our partners. Love as an illusion refers to the fact that we create love by internal private processes, maintain it by prudent diplomatic dishonesties, and can lose it for our partner without the partner knowing it. We can courageously face the fact that the processes of love require defensive distortions of a person’s feelings, thoughts, and perceptions in order to remain in an intimate relationship. Defense is the psychiatric term for an illusion. As individuals gain experience, many can look back and see that many of their assumptions about love were self-serving illusions. Some dismiss their entire relationship with “What was I thinking?” They usually don’t literally mean that they never experienced any transient emotions of love for the partner, they mean that now they can perceive that they created illusions so as not to admit to themselves the depth of their disappointment with their partner or themselves during the relationship. Love as an illusion does not mean that there is no such thing as love or that all felt love is an illusion. It only means that self-perceptions as loving and as beloved can prove to be inaccurate. It also means that society, through its educational and religious institutions, through its celebrations of love in song, and though its academic discourses on the topics, fosters simplistic notions about love that encourage us to behave as though we all know what it is. LOVE AS A STOP SIGN This ninth meaning of love is a first cousin to love as an illusion. The stop sign is visible to clinicians and others as well. While many people state that they love their partners, they are baffled, tongue-tied, or stumped to explain themselves if asked “Why?” While this can be simply an unwillingness to answer the question, the motive for the stop sign is often an unwillingness to think about the question: The stop sign is a defense against self-discovery. The statement, “I don’t want to pursue the subject further!” protects the person from confronting the illusory aspects of his or her love. The word we use when we don’t want to examine this arena of ourselves is love. Love, the stop sign, ends the inquiry. Example 1 Lover A: I love you. Lover B: Why do you love me? Lover A: I don’t know, I just do! Example 2 Doctor: Why do you put up with that behavior from your spouse? Patient: Because I love him! Doctor: What does that mean? Patient: I don’t know. Example 3 Patient (crying): She’s using crack again, she ignores our children, she got pregnant last year during her long visit with her parents and had an abortion without telling me, and now she is running around with her drug dealer. She simply cries every time I mention how long it has been since we were together sexually. Everyone says I should divorce her. Doctor: And why do you not? Patient: I still love her. (Sobbing increases) Doctor: What does that mean? Patient: I have no idea…. I feel we could be so good together… I still vividly remember the day when I was 11 and my father left us with his suitcase in hand. He saw me crying and said he would be back soon. I did not hear from him for three years. Our motives for entering a particular love relationship and staying in it are intensely private matters. Much of what clinicians assume to be unconscious in this regard may be a mixture of unconscious and 13 quite conscious but private awareness. The patient may think of these motives as the darker side of love — that is, the social, material, future economic, or psychological considerations. In any particular conversation, the person may see fit to hide these motives because the clinician is not yet trusted with such personal information. Thus, “I love my partner” is a stop sign, a functional part, conscious or unconscious, of the eighth meaning of love. It says, “Allow me to maintain my illusions please.” Lurking behind the stop sign may be the belief that the person’s love for his or her partner is not genuine. The person may not understand that love is ordinarily part illusion. The stop sign may be a reflection that he or she does not understand the nature of love. Final Thoughts I have a suggestion for how to use this chapter: eavesdrop. The next few times you hear or read the word love, professionally or privately, see if you can discern which of the following noun meanings of love is being invoked. Is it love: the ambition; the deal; the attachment; the commitment; the management process; the force of nature; the emotions; the illusion; the stop sign, or something else? Then consider whether you think the speaker or writer demonstrates any awareness of the range of possibilities of meanings of this word. Finally, I want to acknowledge a limitation of the metaphor of love as a noun. While the noun title headings are static sounding, my descriptions of each of the nine nouns is quite dynamic. The nouns have an ongoing, ever changing impact on our mental lives. The nouns of love create the verbs of love. After we have considered the processes or the verbs of love in chapter 2, I hope we will agree that love is a series of things and behaviors across the life cycle. Love is not a set of nouns or verbs, it is both, and each needs the other to be understood. References Aron, A., Fisher, H., Mashek, D. J., Strong, G., Haifang, L., & Brown, L. L. (2005). Reward, motivation, and emotion systems associated with early stage intense romantic love. J. Neurophysiology, 94, 327-337. Bartels, A., & Zeki, S. (2000). The neural correlates of maternal and romantic love. Neuroreport, 11, 3829-3824. Crews, D. (1998). The evolutionary antecedents to love. Psychoneuroendocrinology, 23, 751-764. Esch, T., & Stefano, G. B. (2005). The neurobiology of love. Neuroendocrinology Letters, 26(3), 175-192. Gilligan, C. (2003). The birth of pleasure: A new map of love. New York: Vintage Books. Gottlieb, L. (2006, March 2006). How do I love thee? Atlantic Monthly, 297, 58-71. Hatfield, E., & Rapson, R. L. (1993). Love, Sex, and Intimacy: Their psychology, biology, and history. New York: HarperCollins College Publishers. Jankowiak, W. R., & Fisher, E. F. (1992). A cross-cultural perspective on romantic love. Ethnology, 31, 149-155. Lear, J. (1990). Love and Its Place in Nature: A philosophical interpretation of Freudian psychoanalysis. New York: Farrar, Straus&Giroux. Lee, J. A. (1988). Love-styles. In M. L. Barnes (Ed.), The Psychology of Love (pp. 3867). New Haven, Ct.: Yale University Press. Levine, S. B. (1998). Sexuality in Mid-Life. New York: Plenum. 14 Levine, S. B. (2003). The nature of sexual desire: A clinician's perspective. Archives of Sexual Behavior, 32(3), 279-285. Lewis, C. S. (1960). The Four Loves. New York: Harcourt Brace. Regan, P. C. (2000). Love Relationships. In F. Muscarella (Ed.), Psychological Perspectives on Human Sexuality (1st ed., pp. 232-282). New York: John Wiley & Sons. Slater, L. (2006, February, 2006). True Love: The chemical reaction. National Geographic, 209, 32-49. Watts, S., & Stenner, P. (2005). The subjective experience of partnership love: A Q methodology. British Journal of Social Psychology, 44, 85-107. 15 REFERENCES AMERICAN PSYCHIATRIC ASSOCIATION th 168 ANNUAL MEETING psychiatry.org/annualmeeting Toronto, Canada ·May16-20,2015 References 1. Levine SB. (2013) Barriers to Loving: A Clinician’s Perspective. Routledge, New York, 2. Kernberg OF. (2012) Love and Aggression., American Psychiatric Press, D.C. 3. Sternberg R, Weis K. (2007) The New Psychology of Love, New Haven, Yale University Press 4. Fisher H, Aron A, Brown LL. Romantic Love: An Fmri Study Of A Neural Mechanism For Mate Choice. J Comp Neurol. 2005 Dec 5;493(1):58-62. 5. Freud, S. (1912). On The Universal Tendency To Debasement In The Sphere Of Love. In J. Strachey (Ed.), The Complete Psychological Works of Sigmund Freud (Vol. XI, pp. 178-190). London: Hogarth Press. 6. Hatfield E. & Rapson R. L. (2009). The Neuropsychology Of Passionate Love And Sexual Desire. In E. Cuyler and M. Ackhart (Eds.). Psychology Of Social Relationships. Hauppauge, NY: Nova Science. 7. Levine SB. (2006) Demystifying Love: Plain Talk For the Mental Health Professional. Routledge, New York. SELF ASSESSMENT AMERICAN PSYCHIATRIC ASSOCIATION th 168 ANNUAL MEETING psychiatry.org/annualmeeting Toronto, Canada ·May16-20,2015 Self Assessment Questions 1. Love as a stop sign refers to A. The bonding function of courtship stops people from being interested in others B. The commitment to love in keeping with culture’s deep grasp of love’s expectations over the lifecycle stops aggression from being directed at the spouse C. The tendency to employ the term love as an explanation for behavior when a person does not want to discuss deeper motivations D. Love’s capacity to enable one to conquer one’s narcissism in relationship to one’s spouse or mate E. The implicit warning to go slow when one is considering a partner as a potential life mate 2. It is reasonable to be wary of flowery speeches about love for a partner because A. Love is primarily felt by the partner as a kind action taken to cooperate, to help, to make life easier or nicer; words without these caring behaviors become disingenuous B. The term love has no specific meaning so a listener can interpret in numerous ways C. The term love has four meanings; which one is being referred to in a speech? D. Love is primarily a grand cultural illusion E. The motives behind declarations of love are always hidden 3. Falling in love A. Begins as a two-person behavioral phenomena with enormous sexual energy B. Begins as subjective one-person phenomena C. Predicts at least five years of marital happiness D. Is provoked by sexual intercourse E. May begin because of a perception of shared understanding and apparent compatibility 4. Staying in love is facilitated by A. Overcoming narcissistic entitlement in relationship to the partner B. Good negotiation skills C. Emotional competence to dampen one’s hostile impulses in face of disagreement D. Emotional genuineness E. All of the above 5. The nurturance systems in a long term relationship are A. Functional conversation and sex B. Shared intense emotional experiences and sex C. Recurrent psychological intimacies and mutual sexual pleasure D. Money and sex E. Common childhood traumas and shared environmental pleasures 6. A. B. C. Infidelity Has many neutral sounding synonyms Is a hallmark of those who call themselves Polyamory Has a prevalence that varies broadly from study to study such as 3 to 85% depending on specific definitions used for the term D. Occurs ~once a year in 35% of educated American couples less than 50 years of age E. Is a reliable sign of significant individual psychopathology 7. When a spouse discovers that her husband is having sex with another woman she typically experiences all of these affect laden questions within the first two weeks except A. How much money can I get in a divorce settlement? B. Am I to blame for this? C. How shall I respond to this? D. Will I be abandoned? E. Am I losing my mind? 8. Compendium of love’s problems A. Replaces the need for a DSM-5 B. is one theorist’s attempt to demonstrate the relevance of love to psychotherapists C. has four major divisions D. emphasizes the apprehension of partner’s deficiencies above all other factors in love E. does not include changes in sexual identity over the life cycle 9. Love/lust split (All are correct but one) A. is likely to be a normal transient developmental phenomenon of adolescence B. is a deathblow to continuing sexual activity within marriage C. occurs among heterosexual and homosexual individuals D. was described a century ago by Freud E. is always due to incestuous fixation on opposite sex parent 10. The benefits of forgiveness are all of the following except A. Forgetting the extramarital affair entirely within several years B. Ending the righteous sense of superiority C. No longer imagining the partner having sex with another person D. Begin to judge partner on a different basis than the affair E. Gaining the respect of the forgiven for one’s compassion and mercy Answers 1. C 2. A 3. B 4. E 5. C 6. C 7. A 8. B 9. E 10. A 8/7/2014 9:10:00 PM CERTIFICATE AMERICAN PSYCHIATRIC ASSOCIATION th 168 ANNUAL MEETING psychiatry.org/annualmeeting Toronto, Canada ·May16-20,2015 Course/Master Course/Seminar – How to claim certificates 1. Go to the following URL: https://ww2.aievolution.com/apa1501 2. Enter your username and password and click the blue Sign In button. Attendees ‐ Please enter your badge number (badge number is your username and password) to sign‐in. Faculty/Speakers and Abstract Submitters ‐ If you submitted an Abstract for the meeting, or are a speaker at the 2015 meeting, you already have a profile in this system; please enter the username/password assigned to you during the submission process. 3. To begin to claim certificates, click on the blue “View Course/Seminar” button and locate by date/title/time and click on the blue link “Claim Certificate” and follow the prompts. NOTES AMERICAN PSYCHIATRIC ASSOCIATION th 168 ANNUAL MEETING psychiatry.org/annualmeeting Toronto, Canada ·May16-20,2015
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