Wednesday, December 2, 2015

Acceptance, Part I:

This post is the first of two parts on acceptance issues in therapy for sexual variations that are socially stigmatized.  This section focuses on the social context and role of the therapist.  The next looks at diagnosis, and presentation of acceptance issues.

If we take the work of Erving Goffman seriously, and applaud AASECT’s formal endorsement of the idea that kink is not inherently pathological, it is worth examining the role of acceptance and lack of acceptance in examining why kinky clients come in for treatment.  In this article, general remarks about stigma as a reality will be presented and what it means for a client-centered therapist to be accepting will be discussed.

Why is acceptance so important? 

Because acceptance is the social opposite of stigmatization.  The social context of any treatment of a kinky client includes the realities that sex and particularly sex variation take place against the background of social stigmatization.  Very few clients are unaware of this and even fewer are unaffected by it.  The general culture is not accepting, the client’s family might be rejecting, the client may well have lost valued sexual relationships over differences about kink, the client may be concealing aspects of their kink out of fear of judgment and rejection, and may have self-stigmatized out of identification with stigmatizing outsiders.   Stories of how weird kinky people can be abound.  They are suspected of criminality, get fired from jobs, must fight to retain custody and visitation with their children.  Sometimes they are denied political positions due to their private lives.  In the 1960’s the British government fell over the Porfumo Scandal in which Russian spies manipulated MP’s over their sadomasochistic desires with models Christine Keeler and Mandy-Rice Davies.  In another example from the year 2000, Kofi Annan, then United Nations Secretary General, had to take time out from managing the crisis of performing weapons inspections in Iraq to defend the objectivity of UNSCOM weapons inspector Jack McGeorge, a founder of Washington’s Black Rose Society, a prominent BDSM social organization.  The history of stigmatizing sexuality and kink is sufficiently great that security conscious businesses or governments naturally worry their officers might be susceptible to blackmail if their private sexual behaviors were discovered.  Homosexuality and kink were tops on the list of targets for such coercion.

John Porfumo resigned his position as British Secretary of State for War in the cabinet of Harold MacMillian in 1963.  His affair with Christine Keeler was kinky, but had national security implications when it was learned she was also seeing the Russian naval attache in London.

Jack McGeorge was a senior UNSCOM inspector in Iraq in the highly politicized period of weapons inspections in 2000.  A founder of  The Black Rose Society, his professionalism was attacked over his role as an out kinkster.  Secretary General Kofi Annan backed McGeorgre's role on the inspections, which  subsequently found no weapons of mass destruction. The US invaded anyway in 2002 and never found any.

The abrasive public action to stigmatize kink is sufficiently vigorous that the National Coalition for Sexual Freedom (NCSF) publishes a news feed of kink stories in the media.  For many years, 90% of these were local incidents where the authorities came down on some unfortunate people who were suddenly discovered to be kinky.  In recent years, the media coverage has become more favorable, but oppressive episodes persist.  NCSF also maintains a fund for helping indigent kinksters in legal cases.  That need has not slackened over time despite more favorable press. 

Stigma and acceptance issues may be reflected in real differences between clients and their partners about acceptance of specific behaviors, or clients may have faced some My-Kink-Is-Better-Than-Your-Kink attitudes or behaviors within their kinky community.  In a social climate within a general culture like ours, some confrontations with shame, social judgement and sanctions for unusual sexual behavior are inevitable even for the fervently closeted.  People get the message when they see others receiving social sanctions for kinky behavior.  The steady stream of political revelations that elected officials who supported anti-gay legislation but were later outed as kinky underscores this point.  Everyone, gay, kinky or conventional hears these social messages.

Any client entering psychotherapy for any problem, and who also happens to have a kink, is going to have a relationship to managing the consequences of all that stigma-inducing activity in the cultural context.   It is entirely possible that clients will have unrealistic ideas about acceptance too, but some concern about social acceptance is nearly inevitable.  Those defenses and adaptations have had years to develop before the client comes to the consulting room.  They will be the building blocks and obstacle to devising an effective therapeutic alliance and contract for treatment.

Having said this, I must caution that just because something is commonly true, it may not be universally true.  In the bad old days, inexperienced clinicians often hijacked psychotherapies in which the client came in with a different presenting problem and later learned the client was into kink.  These clinicians, assuming that the kink was pathological, proceeded to explain all of the client’s troubles with that ‘aberrant’ desire.  Not only is any unicausal explanation of a complex mental health problem often wrong, but focusing on kink as if it were the single cause of whatever problem was presented couldn’t help but result in adding to whatever stigma the client actually felt and crippling the therapist’s capacity to listen to the client.  So assuming that clients must be struggling for acceptance is not going to improve the therapeutic technique.  Some clients may be handling stigma with grace and aplomb.  Some are engaged in a self-destructive struggle over acceptance, but are not ready to admit it to themselves.  Yet others are resigned to feeling unaccepted socially, but are struggling with the other problems they came to the therapist to resolve. It is important to listen carefully to how the client handles acceptance and the problems social stigma poses and to be prepared to interpret its role if the client presents evidence that this is important.  If you are listening for this, you will often – but not always -- find it.

Do you have anything in black?

Acceptance by the Therapist:

The kind of acceptance needed for effective psychotherapy and sex therapy with kinky people is not fundamentally unlike the kind of acceptance for a general clientele:  you have to respect them as people and honor the difficulty of their struggle.  You do not need to do kink to do good therapy with kinky clients any more than you need to be dysphoric to treat depressed people.  The process of confronting your own stereotypes, expectations and preconceptions is fundamentally the same.  While it is possible to gain some insight by subjecting yourself to some of the experiences that kinky people undertake, such experiments hold both opportunity and risk.  Experiencing an effectively analogous experience to something your client faces can be a powerful source of emotional learning.  But trying something as an experiment you can easily walk away from is just one of a host of ways that you may differ substantially from the client, and it is easy to imagine that what you have learned is more useful than it is.  Interviewing kinky people who are not in therapy is a great way to understand more of what kink is about, but there is no guarantee that all of those great insights will apply to the client in front of you for today’s session.

Carl Rogers (1902-87) the founder of Client-Centered Therapy

Inexperienced clinicians often have the idea they need to ban all judgments in order to be effectively neutral.  Psychoanalysis, for example, teaches strict therapeutic neutrality.   The social constructionist view I am articulating here holds that complete neutrality is a utopian ideal.  The clinician is using therapeutic judgments when they diagnose, interpret, choose which of several questions to ask, or decide to remain silent and just listen to the client.  There is no galactic central coordinate from which neutrality is measured.  And your neutral therapeutic intent may not be perceived as such by your client(s).   But mostly your moral judgments are obstacles to a therapeutic process intended to bring clients into a constructive place from which to do their own moral decision-making.  They already live with moralism and stigma, so having a conversation that is relatively free of judgment holds a great deal more promise than reminding them of the obvious.  They already have deeply echeloned defenses, and there is not likely to be much therapeutic gain in assaulting them.

On the other hand, there are times when you may not be able to be neutral – and some when it may be better that you can’t be.  It is quite unlikely you will be able to remain entirely neutral to intense aggressive and sexually provocative material.  We are hard wired to have non-neutral reactions to pain and anxiety, shame and delight.  Kinks push boundaries, and sometimes its practices are unhealthy, self-destructive, disgusting and/or relatively dangerous.  It may be necessary to educate clients about real health and safety risks of their behavior.  So checking all your values at the door is not even an optimal strategy, were it practicable.  But you are being neutral enough if you stay within the limits of law and clinical practice, stick up for a therapeutic contract that keeps the strategic ends of therapy in the client’s control, and provide information that allows the client-informed choice, rather than trying to make the client chose the ‘correct’ one.  This is a crucial difference between therapy with clients engaged in consensually kinky behaviors and those who are perpetrating sexual offenses.  In the latter case, your contract requires that you attempt to prevent some illegal behavior.  In such therapies, you are acting as an agent of social control on behalf of the society that is doing all that stigmatizing and sanctioning behavior.  The kind of therapeutic alliance you can have while doing this is never predominantly between you and the client.

To be relatively therapeutically neutral requires a high degree of self-knowledge.  The more intense and provocative therapeutic material is, the more self-knowledge and emotional control is required of the therapist.  The very best way to gain this is through personal therapy, a tradition that goes back all the way back to the early days of psychoanalysis, the first type of talk therapy.  Sadly, in the past, even very intimate and intense personal therapies often did not delve deeply into matters of alternative sexuality.  In psychoanalysis, it was not unheard of for the clinical supervisors of therapists in training to be in close communication with their analysts.  Sometimes analyst and clinical supervisor were the same person!  The effect this had on openness in therapy can be readily imagined!  Modern training standards require post-graduate training and certification in sexology. The American Association of Sexuality Educators, Counselors and Therapists is the largest and oldest clinical training organization. and it requires affective and experiential sexuality education for certification.  This includes a Sexual Attitude Reassessment, a ten-hour experiential training that is intended to start professionals on the path of examining their values and feelings about sexuality, and features methods to model open and accepting discussions about sex.   These programs provide sexuality professionals an excellent start, but only a beginning, to understanding the feelings that working with clients, including kinky ones, can engender.

Again, an important corollary of these observations is that you need not be kinky to treat kinky clients, and if you are, what you know from your own experiences must be carefully tested against what clients are saying in the manner just described for open-minded clinicians trying out experimental behaviors.  The notion that you must be kinky, or deviant, or radical to do this work is flawed from the start, as there are so many ways to do those things.  Even therapists who are switches may need to stretch their empathy to relate to the special problems of people who only prefer one role, or who are devoted to a fetish the therapist finds boring.  Your chances of understanding aspects of BDSM or consensual non-monogamy from reading alone are pretty slim.  Even a blog like this which is at great pains to be empathetic and thoughtful, does not convey the bodily intensity that some kinky experience contains.  This experiential problem has not stopped sex therapy dead in its tracks when dealing with non-kinky sex, and it is not an insuperable barrier for treating kinky clients, either.  You do not have to experience top drop, or have been to sub space in order to deal with such material when it comes into treatment.  You are well advised to have researched such things so you can understand the relationship of what a client says about them in the context that others around the client understand them.  That may mean reading one of the “50 Shades” books whether or not you particularly like the writing style.  Or mean learning about sexual practices that make you uncomfortable.  (see also The Squick and the Dead: Intense Countertransference and BDSM, and  What if You Get Squicked? on this blog.)  It is important in our efforts to accept others to recognize the limits of our experiences, theoretical models and worldviews.

Kink events and clubs can play an important part in therapy, or not, depending on the client's needs.
Acceptance of kink as a therapist also does not mean that you should immediately connect your isolated clients up with the hot local BDSM social organization.  This is a therapeutic strategy that definitely belongs in your repertory, and often it will be a constructive step for clients.  But not every kinky client is going to benefit from such contacts despite the valuable education and community they can provide.  Accepting the client means recognizing the client’s goals and fears and their reasons for using the problematical solutions they have come to therapy to change.  If they are too socially inept, afraid of exposure, uncomfortable with the voyeurism or exhibitionism of BDSM social groups, or too anxious and lacking in good safety skills, such groups, which are wonderful for others, may not be right for them.

Likewise, it is not a responsibility of therapeutic acceptance of kink to encourage clients to “out” themselves.  Coming out can be a life and values affirming step.  It should definitely be among the things you are prepared to contract to accomplish with clients who express this as a therapeutic goal.  I will discuss coming out in a later post, but suffice it to say that there are various levels of being out, and it is more useful for clients to consider how those connect to their values and goals.  For many, openness about their kink is crucially dependent on context.  One does not need to be out at work to try some new things in bed with partners.  If, as a therapist you are out and kinky, and recognize how each out participant strengthens the community, it is important to curb your enthusiasm about what is best for the community so as to focus on what is best given the client’s values.
Acceptance does not mean liking everything the BDSM community does, having the same risk tolerance that others do, or minimizing the real health risks of some behaviors.  Being an ally does not mean, contrary to the stance of some advocates, that you check your values at the door and let disadvantaged and marginalized people do all the talking.  But you must let your client do the talking -- not you.   And the acceptance you need to provide does mean tolerating the discomforts that come from someone who is important to you and to whom you have a serious set of professional obligations, yet has different values, morals, ideas, loves, and risk tolerance than you do.  That is a major undertaking, and a true test of professionalism to not attempt to substitute your values for the client’s in the name of acceptance.

Finally, therapists and clients do their best in the face of human vulnerability.  It is an important tenet of genuine acceptance that if you err, you admit it, take responsibility for it, and apologize.  Your goal is to empower the client to make choices about matters like health and risk on an informed basis, and as freely as human fallibility allows.  If you overstep boundaries trying to help a client not make a risky choice, you will cripple your ability to help them take full responsibility for its consequences later.  So it is a powerful sign of acceptance, and great modeling of self-acceptance for the client, when you apologize for overstepping your professional role out of your own anxieties.

Little of what I have said in this section is arcane, or particular to kinky clients.  While the content of what needs to be accepted may be different at times, the process of acceptance is the same for everyone.  Educating yourself to the client’s life and problems, and listening with interest to their concerns, and helping them frame the decision processes about how to better cope with their dilemmas is the same for the kinky and the conventional alike.

© Russell J Stambaugh, December 2015, Ann Arbor MI, All rights reserved

Tuesday, December 1, 2015

Coping with Top and Sub Drop: A Safety Kit!

This link is written by Mistress Adobe.  None of it is my work.  It is too important not to include, here.

The topic of depressive states that arrive sometimes after play is generally called 'sub drop' in the BDSM community.  Actually, play can be intense on either side of a scene, and tops can get it too.  There is, as of this posting, no quality academic research describing and defining this state despite the fact that it is widely recognized in the communities.  It is one of many excellent reasons that seasoned participants carefully include planned aftercare in their scenes.

But the best laid schemes 'gang aft agley,' as Robert Burns famously said , and sometimes the circumstances of play do not afford optimal aftercare.  Kinksters and their therapists should know about tools like this to include in players' personal safety kits.

A field mouse, whose best laid plans are all too fragile.

Thank you, Mistress Adobe!

Sub Drop Safety Kit by Mistress adobe

Tuesday, November 17, 2015

AASECT Position on Sexual Expression including Orientation and Identity

Sexual Expression including Orientation and Identity: 
Treatment and Education Foundations

It is the position of the American Association of Sexuality Educators, Counselors, and Therapists that we oppose any and all therapy models and interventions as well as any educational programs and curricula that seek to pathologize, dictate, or prescribe a person’s sexual orientation, identity, and/or consensual, sexual expression, whether or not it is conventional or atypical.  Regardless of how such clinical interventions or educational programs are labeled or named, AASECT recommends all helping and educating professionals to utilize best practices and culturally relevant resources for foundation and reference.

Furthermore:  AASECT affirms that sexuality is central to the human experience and sexual rights must be honored in order for sexual health and overall well-being to be obtained.  Informed by the best empirical research, AASECT recognizes human sexual experiences as diverse and supports the acceptance of sexual diversity while embracing consensual sexual expression within the framework of human rights and social justice.

AASECT accepts the evidence that human sexual experience includes a vast spectrum of sexual expression, orientation, and identities. These sexualities, between consenting adults when agreed upon, with permission, and assenting, are typically not psychopathological behaviors. Indeed, recent peer-reviewed research on these sexual experiences shows no correlation to pathology.

AASECT further asserts that all people seeking treatment and education about consensual sexual behavior, identity, or orientation deserve accurate information.  AASECT accepts that the empirical evidence is reasonably complete on reparative and conversion therapies that attempt to change sexual orientation or identity and shows that these techniques are experimental at best and overwhelmingly ineffective, with harmful consequences for clients widely documented.

AASECT takes the position that social justice plays an essential and foundational role in the organization’s mission.  Individuals have the right to be free as possible from undue constraints (e.g. discrimination, stigmatization, oppression and violence) along with the freedom to consensual sexual expression. Destigmatizing human sexual expression and experiences as well as creating and maintaining safe space for those who have been traditionally marginalized are essential practices for AASECT members who are predominately mental health practitioners and educators.  This overarching goal compels AASECT to disavow any therapeutic and educational effort that, even if unwittingly, violates or impinges on AASECT’s vision of human rights and social justice.

We are here to make sure that you don't think AASECT wrote the remainder of this post!  And don't forget to read our fine print:  Of course you may use parts of this  post to improve therapy for kinky folk anywhere in the world you serve them!  Attribution is nice!

On November 12, 2015, the AASECT Board of Directors unanimously adopted this position statement as recommended by its Public Relations, Media, and Advocacy Steering Committee.  I was one of a large group of interested people in AASECT who participated in this process.  The policy statement is obviously the official position of the entire organization.  The remarks immediately below are my interpretations, not official AASECT policy:

Alfred Kinsey (1894-1956).  His pioneering research on American Sexuality revealed its diversity was far greater than conventionally imagined then, and even now.

With this passage of this position, AASECT is officially on record as supporting BDSM, cross dressing, fetishism, erotic role play, polyamory and consensual non-monogamy as potentially sexually healthy lifestyle choices and behaviors.  This constitutes full implementation of Kinsey’s ideas about the broad range of sexually healthy behaviors.

This statement does not mean that sexual variability is always healthy, and it does not mean that it is usually without risks, but it does mean that educators and clinicians have the responsibility to remain neutral about these possibilities until given clinical data to question otherwise.   I would advise doing so even when sexual behavior is a specific axis of complaint in a client’s reasons for coming to treatment. 

This statement also bars devising treatments or educational programs specifically designed or marketed to stigmatize, marginalize or derogate unconventional but consensual sexual choices.  Society will continue to criminalize some forms of sexual conduct, and the clinical community must remain responsive to law, but the statement only applies to consensual activities.

The explicit target of this statement is reparative or conversion therapies, and it was crafted to include other therapies used for reparative purposes, regardless of how they are otherwise labelled or used.  A great example would be any measure of compulsive sexual behavior or ‘sex addiction’ that uses assessment measures that list such activities as polyamory, swinging, or BDSM to generate a score used to confer a diagnostic label.  While BDSM might be problem sexual behavior, any measure that automatically labelled it as such would be defective under the intent of this policy.   This targets the same bias that changes in the DSM – 5, published in May of 2013, partially implemented in the Paraphilias section.  There, a distinction was drawn between non-pathological variation, ‘paraphilias,’ and paraphilias that were non-consensual or the focus of client complaints; paraphilic disorders. Variant behavior is not pathological in and of itself.

Likewise, it would be an unethical and defective business practice to advertise that one changes sexual orientation, variant behavior, or sexual desire per se, even though one might ethically contract with an individual patient who complained that variant orientation or behavior was a problem.  Such advertising is doubly defective, in that it is not only stigmatizing of behaviors or identities that deserve protection as sexual human rights, but it is scientifically defective given that reparative and conversion therapies have repeatedly been found ineffective in rigorous scientific evaluation.  Thus it is also a violation of this statement to undertake a therapy to change orientation, desire or behavior without explicitly contracting up front with the client that such an attempt involves therapeutic techniques which are experimental and unproven for such purposes.

Note, however, that this is a position statement.  It does not specify how AASECT might deal with the problems of dual certification if an individual practitioner affiliates with an organization which has members that do any of these unprofessional things.  A Member might complain to AASECT Ethics Advisory Committee (EAC) about another Member who was perceived as violating the position statement, and the EAC might issue an advisory opinion to the Membership about such behavior.  In serious cases that could not be resolved by negotiation, the Board might choose to discipline a member who was found to be violating our Code of Ethics or practice standards.  This is an advocacy statement, not a disciplinary policy.

Anyone who encounters advertising, practitioners, or organizations that claim to be working in the fields of sexual health and education that seem to be violating this policy should contact them and request that they stop.  If they persist, The National Coalition for Sexual Freedom, the Woodhull Foundation, and/or the major LGBTQ organizations should be contacted.  All have reparative therapy policies in place, and actions they can take.  A few states have passed legislation specifically barring gay reparative therapies, and the list is growing.  Licensing and certifying bodies in those jurisdictions will be resources in stopping these practices. Similar legislation does not commonly protect consensual non-monogamy or BDSM practices.

Members and the public are correct to feel that such a position changes the practice landscape.  The statement begs for extra care in making sure that kinks are the main problem that clients want to become the focus of treatment.  It pushes us to check to see if problems of occupational and life functioning stem primarily from the kink itself, or are primarily the consequences of identity problems associated with assuming a stigmatized social status.  It acknowledges that diagnostic labels function both ways; sometimes allowing access to treatment and as a source of reassuring meanings, yet also conferring shame, promoting dependency, and marginalizing some clients.

It is hoped that AASECT will challenge our partner sexual health organizations in the North American Federation of Sexuality Organizations (NAFSO) and The World Association of Sexual Health (WAS) to adopt this or similar language, and to bar sexuality organizations that decline to do so.  For this is an excellent, and much needed step in advocacy efforts to promote quality sexual health care for kinky clients, but it is far from the last step necessary to secure these ends.

Thank you AASECT!

© Russell J Stambaugh, May 2015, Ann Arbor MI, All rights reserved, but permission is granted for sexual health advocacy purposes.


Tuesday, November 3, 2015

Erving Goffman: The Presentation of Kink in Everyday Life

Erving Goffman (1922-82), Canadian sociologist

The Social Constructionist view was a product of the merging of sociology and psychology that resulted in sociology broadening its focus from social organizations to interest in the ways individuals participate in social life.  By far one of the most influential single contributors to this movement was Erving Goffman.

Goffman was born in rural Canada, his parents Jewish Ukrainian immigrants.  He worked on the stage and in film before starting his academic career.  He thus brought lessons of an outsider from the world of acting to his academic work as a sociologist.  So much so, in fact, that his discipline was often called dramaturgical analysis.

George Herbert Mead (1863-1931)  American sociologist and principle contributor to role theory, and the concept of 'self.' 
There already existed a powerful tradition within sociology to look at society in terms of social roles, the legacy of the early twentieth century sociologist George Herbert Meade.  Meade launched role theory as a consequence of his investigation of social structure.  He recognized that industrial society had an increasingly diversified division of labor, and the rules of work life varied tremendously depending on the kind of work role an individual held.  Managers had different roles than production workers, who had different roles than sales workers, etc.  By the 1950’s, however, sociology began to look at the idea that roles were important in private life as well as public life, in part influenced by the rising social and economic recognition that people were important social contributors not just in the roles as workers and voters, but as consumers.  Partly this reflected rising influence in sociology from Freudian ideas, and efforts to understand the rise of authoritarian political systems following World War I.  And partly it reflected the rise of radio and television in persuasive communications.  People were being investigated not just in their work roles, but as parents, neighbors, club members, consumers and voters.  So the renaissance in microsociology was partly a reflection of academic recognition that private life and public life followed some similar social laws.  Goffman arrived at the proper moment to articulate some of those.

The stage as metaphor for context for role performances in dramaturgical analysis.

Role theory terms people ‘social actors’ when they occupy a particular role, and dramaturgical analysis takes that term ‘actor’ literally.  Dividing role performance as ‘on stage,’ ‘off stage,’ and ‘backstage,’ Goffman looked at role performance as if role performance was all about social context.  When onstage, actors perform roles to manage audience expectations.  Backstage, the audience is not present, and actors engage in behaviors that are unsafe on stage for fear of damaging their performance.  Goffman also defined space outside the stage altogether, where the audience might be fragmented, and the actor might assume different roles with different goals and performance criteria.   For Shakespeare, ‘all the world’s a stage’; for Goffman, it is a whole series of stages.  Unifying all of this was the over-arching necessity to present a good performance in the eyes of the self, and all those audiences.  In dramaturgical analysis, Goffman defines a psychological dynamic of pride and shame that was the primary currency at stake in role performances.

In the Presentation of Self in Everyday Life, Goffman’s most influential work, he went on to expand this theory beyond its application to the theater and from the analysis of cons, games, and scams, to mundane social interaction.  This was an important improvement over the symbolic interactionist approach because the concept of self and desire of social actors to maintain a positive self-presentation unified many of the previous flaws in pragmatism that symbolic interactionism was designed to address.  Behavior became easy to explain when viewed as efforts to save face, rather than as materially pragmatic.

Insight into just how deeply and ruthlessly Goffman understood this can be achieved from a personal story about him.  Goffman had been invited to the University of Michigan to deliver its most famous annual lecture in social psychology.  After the successful presentation, a group of senior faculty met to accompany the speaker on a celebratory dinner at the hot new Szechuan place, which happened to have a package liquor policy that let you bring your own wine.  So the faculty assembled outside the party store next door, and Goffman took the opportunity to wager on the very theory he had just expounded:  he would get the wine, and he declared in advance he would be able to obtain it at a substantial discount.

So Goffman, accompanied by a rapt observer, went in and selected a fine bottle of wine and took it to the proprietor.  Goffman proceeded to closely question the gentleman about the vineyard, the vintage, the details of the terroir, sediment in the bottle, and the year, disagreeing and discrediting the proprietor’s defense of the wine at every turn, and eventually discrediting him for even trying to sell the bottle at half its listed price!  Goffman left with the wine at 40% off, just as he had predicted.  What he had failed to anticipate was the private reaction of his professorial audience.  They were shocked that an esteemed professor of sociology whose fame was world-wide at the time, and whose reputation was so great he had been invited to deliver the lecture in the first place, would feel the need to trash talk an immigrant business owner out of a measly bottle of wine!  They thought he was a sociopath!

Goffman was very interested in scams, shills, cons, and games.  His outsider mentality, and ruthlessly strategic view of social interactions was powerfully predictive of how con artists and their victims behaved.  And his willingness to criticize such performances was to revolutionize psychiatry.  In Asylums, Goffman took up the persistent problem of institutionalization just as the community public health movement was getting started.  Due to institutionalization, criminals in prisons and psychiatric in-patients faced great difficulties in adjusting to their release to everyday life.  Goffman explained institutionalization as adjustment to the complementary roles imposed by institutional life. Of course they were ill-prepared for release, explained Goffman, they obtained release by playing the role of good in-patients.  The qualities that made one a good role player in a mental ward constituted catastrophic role failure in life outside the institution.  The pressure of role failure outside led many to seek readmission.  And psychiatry was complicit in all of this.  By playing their roles well of diagnosing and labeling these patients and rewarding them for submissive, institutionalized behavior, they were not improving anyone’s mental health, only promoting smooth institutional functioning and furthering their careers.

The power of social roles with extreme power differences:  The Stanford Prison Experiment unwittingly replicated  at Abu Gharib prison in 2004.  
Goffman was soon to achieve confirmation in the laboratory.  In one of the most famous social psychology experiments, Stanford University Professor Philip Zimbardo conducted his 1971 prison simulation in the basement under Stanford’s social psych offices.  Merely by arbitrarily dividing his volunteers into guards and patients, the role play had so escalated in violence that some of the inmate volunteers were showing severe anxiety symptoms and the experiment had to be stopped in less than one week on ethical grounds.  Although Goffman advocated qualitative methods in sociology, and many of his observations were not easily and ethically put to empirical tests by a field that was increasingly struggling to achieve greater legitimacy through quantitative methods, Zimbardo had demonstrated the power of Goffman’s observations.  This ugly scenario repeated itself at the notorious Abu-Gharib prison in Afghanistan in 2004.

That randomly assigned student volunteers would do violence to one another served as a powerful challenge to both Freudian and Kraepelinian models of mental illness at the time, and remains a powerful challenge to the DSMs and social discourse that mental illness is an attribute of a person, rather than primarily an interaction between individual and context.  Asylums would become a cornerstone of efforts to reform psychiatry, pressure on The American Psychiatric Association to revise the Diagnostic and Statistical Manuals from a nosology based upon the construct validity of Freudian theory to one of symptom-based diagnosis achieved through inter-rater reliability.  While this change did not completely solve the problem of whether behaviors were an attribute of personality types or social context, it began the rollback of spreading definitions of sexual perversion ascendant in psychology since Krafft-Ebing invented the concept back in 1869.  Homosexuality, in the later versions of DSM-II, and then all sexual diagnosis beginning in 1972 with DSM-III, received more limited and behavioral definitions.

A Pieta by 16th century painter Luis de Morales prominently emphasizing Christ's stigmata.  Goffman's social stigma are wounds to the self.
By far the most important gift of Erving Goffman, however, was the pervasive recognition of the importance of social stigma.  It followed from his analysis of everyday interaction that if shame at role failure was a pervasive social motive, social stigma was a crucial analytic concept.  The term ‘stigma’ is derived from the Latin word for wound.  It was in pervasive use before Goffman with reference to the wounds—stigmata--of Jesus Christ incurred during his torture and crucifixion, and pervasively represented in artistic depictions.  These wounds, symbolic in Christianity of the offense of sin against the teachings of God, and graphically represented in art and central in doctrine stressing the magnificence of God’s forgiveness, were the perfect term for Goffman’s social interactions since they evoked the shame of social failure analogous to Christianity’s shame at moral failure.

This is precisely what I am referring to in this blog when I allude to the social stigma that attends open expression of sexuality, and of social discrimination against BDSM’s diversity of sexual expression.  Because sexual variation is stigmatized, the dominant cultures in which it occurs have norms, mores, laws, rules and stories that legitimate social sanctions against BDSM.  All of this makes social discrimination against kink easy to understand, even if it remains hard to combat.
But stigmatization does not just function in the larger society to limit and marginalize kink, but it functions within the kink community as well.  Every potential kinkster must struggle in some manner against their own internalization of social stigmatization that is prevalent in the larger social arenas in which they participate.  This has variously been represented as homophobia, transphobia, and kink phobia, but often the fear in these ‘phobias’ is the fear of stigma, rather than the fear of specific behaviors.  Many people who have never had any meaningful contact with sexual variation are afraid of the social consequences, rather than afraid of pain, anal sex, variant gender expression or other behaviors they would not otherwise have considered because they prefer not to think of themselves as the type of people who do such things.  This is precisely the cause of a steady stream of government officials who daily preach sexual conventionality while indulging in vigorous alternative behaviors in their private lives.  Such stories always raise questions about these officials’ personal beliefs, but it is not hard to understand their reluctance to pay the price of actively confronting social stigmatization when most people are doing much the same by keeping private and public life separate because of conflicting role demands. Often those internal conflicts bring kinksters into therapy, and in those cases, the kink itself may be less of a problem than the problems of stigmatization.

But stigma works within the community to.  Although many in the BDSM communities are open-minded about precisely the sexual behaviors the surrounding societies most often judge, the community itself participates in setting up the role definitions of roles like top, bottom, switch, service Dom’s, and tourists.  These have varying degrees of legitimacy, and there are role prescriptions about how to do them properly.  ‘Smart ass masochists,’ ‘topping from the bottom,’ or people who ‘betray’ the community by outing people are all examples of behaviors that are somewhat stigmatized within the community as it provides its own system of guidelines about ‘proper’ kinky behavior.  Kink is sometimes a performance, and subject to the painful consequences of role stress, role failure, and the problem of needing to subordinate selfish goals to communitarian demands that Goffman talked about, even if he didn’t write specifically about kink.

Goffman would go on to inspire many other important contributors to kink theory.  He contributed to the practice of viewing gender as performance, and his work underlay advocacy by Jean Kilbourne and her Killing Me Softly series of documentaries on gender performance in advertisingThis gave rise to the modern media education movement and influenced Lenore Teifer, PhD to launch the New View Campaign to deconstruct the medicalization of female sexuality.
Goffman profoundly influenced Michel Foucault who has deconstructed the idea of sexual repression in Western society as a myth primarily serving to legitimate the professionalization of sex and to marginalize homosexual expression.  Foucault, like Goffman, is a mainstay of the movement to deconstruct psychiatry and efforts to prevent the medicalization of everyday life.

As Goffman aged, his work progressively widened to scope of the social contexts of interaction.  While he denied being a Social Constructionist, his focus on context is characteristic of that school and has led many later observers, including this one, to so-label him anyway.  His interest in social games, deception and bluffing made him a natural to try to wed social constructionism with game theory, and his final major work, Frame Analysis continued this ambition to transcend categorization.  We will never know how far he might have taken this, Goffman died at the peak of his career, having been elected President of the American Sociological Association.  He died of stomach cancer in 1982, leaving a very rich legacy to those of us interested in mental health, social deviance, sub-cultures, and variant social expression of all kinds.

Act Up in the streets.  Sexual advocacy worked because of the sacrifices of activists, and Goffman and others had prepared society to deconstruct traditional institutions.

Kink is largely personal behavior conducted off stage in the realm of private life.  Much of the work to create above-ground BDSM social organizations that can advocate for the legitimacy of kink lifestyle choices is the legacy of prior work by gay and lesbian organizations whose struggles have partially legitimated these lifestyles.  But they succeeded in this context because of work deconstructing psychiatry and mental health diagnoses, and by challenging the legitimacy of conventional social discourse about sexual variation.  Goffman played a crucial role in the rise of this discourse, and made social activism fruitful. 

Monday, October 26, 2015

Pink Therapy Event Guidelines for Organizers and Participants

Pink Therapy is a British kink education and therapy group.  They have been known to attend the Community-Academic Consortium for Research on Alternative Sexualities annual conference, which will next meet immediately prior to the 2016 Folsom Street Fair in San Francisco, September 24. 2016..  

They have produced excellent educational materials about the handling of power and the ethical obligations of participants, leaders, facilitators, educators and therapists.  I get questions all the time from therapists in training about their responsibilities at kink events.  Should they even go?  Do they need to sacrifice their personal sex lives to serve their clients?  How long after a therapeutic relationship stops is it safe to be seen by a client at an event?

These documents, which do not answer all questions, do outline the ethical responsibilities of informed consent among participants at different levels of power and experience.

Pink Therapy has produced two sets of guidelines that can be downloaded from their website:

Guidelines for Community Members Attending Parties or Events, downloadable here:

Guidelines for Community Members

Guidelines for Facilitators, Organizers and Community Leaders, downloadable here:

Guidelines for Leaders

How needed are these?  The 2014 Consent Violations Survey reported that over 30% of the over 4000 respondents who volunteered to complete the survey had experienced a violation.  This must not be confused with all kink event participants due to a self-selected sample, and we have no way of knowing what percentage of kinksters saw our survey, and how many of those decided to respond. But 20% of the violations involved kink event organizers or leadership in the event sponsorship.  This violations were perceived not just as mistakes, but abuse of institutional authority within the community.  

Please feel free to reproduce these, distribute them, and modify them as best suits your community.

Pink Therapy can be found on the web at: 

Saturday, October 24, 2015

Sexual Deviation in the Renaissance

Mehmet II using canons in the Siege of Constantinople, 1452

When, in 1453, Sultan Mehmed II brought canons to Constantinople, he did not intend to bring the Middle Ages to a close.  This was not even the very first use of newfangled firearms in the West.  These had been brought from China, which had been using them for years.  But at Constantinople, they proved decisive.  In just seven weeks they battered the previously impregnable vertical walls that had propped up the Roman Empire for almost 1500 years.  Ever since, it has been hard for historians not to credit this event with a sea change in Western Civilization.

The term ‘renaissance’ literally means rebirth.  Just as the old Roman Empire was dying, Italy was discovering interest in its classical roots.  The dis-unified, contentious, innovative Italian city states were nothing like their powerful Roman predecessors, but they were built on those ruins, the evidence of antiquity was all around them, and their new found curiosity about that classical world was part of a re-framing of everything from the medieval world.

The story of Joan of Arc’s heretical transvestism from the earlier post is actually a great transitional Renaissance story.  In it, Joan’s state of mind is of central interest.  This is the primary difference between the Middle Ages and the Renaissance.  In the Middle Ages, the states of mind of kings, bishops and popes matter, but commoners do not.  St. Joan is unique in being a commoner whose state of mind was worthy of official notice.  Even then, it was only noteworthy because warring elites were citing her behavior as proof of divine intervention.  In the Renaissance, inquiry and interest in everyone begins to matter.  This change was not brought about by the Fall of Constantinople, nor by the use of canons, although that technological change is important.  Canons are not a class of weapon wielded by aristocratic warriors, but by commoner technicians whose technical skills in chemistry, metallurgy and physics have become decisive on the battlefield.  In the military, as in religion, and in sexuality, what commoner specialists know makes all the difference.  And that led to renewed interest in the classical philosophers, and a tectonic shift in which institutions centralized the authority to decide what reality was.

A modern replica of Johannes Gutenberg's printing press

The other crucial event that is often said to demarcate the boundary between the Middle Ages and the Renaissance is the invention of the printing press.  This example is a case study in social construction.  For the printing press was not invented in the Middle Ages, it had been around since antiquity in the form of the wine press, where it spared everyone the labor-intensive practice of stamping grapes into juice with bare feet.  Sometime in the 7th century, the Chinese made the first woodblock printed books.  In the 11th century, the Koreans had invented wooden movable type.  But Chinese bureaucratic class structure was not transformed by this innovation, and Johannes Gutenberg’s 15th century use of metallic movable type and the printing of the Gutenberg Bible was transformative.  The technical and trading classes of Europe who had been making incremental technical innovations in the thousand years since the fall of the Western Roman Empire had developed the literary skills to read, and a technology that could put books in their hands en mass changed everything.

Cochem, Germany, as viewed from Reichsberg Castle

Which brings us to the town of Cochem on the Moselle River, some 75 miles from bustling Mainz where Johannes press first started the mass production of the Bible.  This sleepy little wine town is nestled on the narrow flood plain of the Moselle between the steep vine-covered slopes that have been devoted to its primary craft for the last 2000 years.  Before us is a fountain of a goat being crushed in a wine press.  Lest you think its resident’s unduly harsh and bloodthirsty, the story of this fountain is actually proof of the importance of wine and of their piety.

Cochem's Goat Fountain (photo by the author.)

For the town has always observed that, in the last week of the growing season, when the grapes are most sweet and tempting, the vines are off limits to residents and animals alike.  It is death to be found stealing from the vines during the crucial final period of greatest ripeness.  Yet a boy and a goat have been found in the fields.  The boy has gone in to retrieve his pet.  He is a good and god-fearing son of a vinter whose disclaimer is to be believed by all.  But how is the animal’s innocence to be determined?  The vinter finally suggests the goat be placed on the press.  If the goat is guilty of eating grapes, his blood will flow purple with the color of the juice.  If he is innocent, his red blood will flow clear of corruption.  Eventually the goat dies, his blood flowing clear, verifying the boy’s story and proving the goat was a good animal and had not partaken of the grapes, and the citizens are satisfied of the sanctity of their crops, the boy and the goat.  All is well in Cochem!

Reichsberg Castle as seen from Cochem (photo by genuine professionals!)
Overlooking the town is Reichsberg Castle.  Originally built in the 11th century, Louis the XIV knocked most of it down in 1689 during his devastation of the Palatinate during the War of the League of Augsburg.  In the mid-19th century, Reichsberg Castle was rebuilt in the neo-romantic style, with only the Hexenturm, or ‘Witches Tower’ preserved from the original 11th century ruins.  This tower got its name from the practice of trying witches by throwing them from the 40-foot-high window.  Since no mortal could survive the fall, a suspect was obviously acquitted if she died from the fall.  Those few who survived were immediately put to death for witchcraft.

The Hexenturm is on the left, a Neo-Romantic turret occupies the center.  Witches were thrown from the arch. (photo by the author.)
The similarity of these two Cochem stories, with their devotion to a less-than-modern conception of empiricism, reads as Pythonesque today.  But like the Spanish Inquisition, which sentenced prisoners to death as the inevitable choice between two goods; the inquisitors contrived to preserve the protagonists soul, not their lives.  An innocent was consigned directly to Heaven, and their purity preserved.  The guilty were dispatched to hell and the purity of the community preserved.  Intention and adherence to law mattered more than life itself.
"And how do we know she's a witch?" (still from Monty Python and the Holy Grail -- 1975)
It is not surprising at this time that people became less tolerant of sexual variations that previously did not provoke much notice.  Sex stopped becoming a merely animal matter, or a simple function of power, and started to attain symbolic significance not unlike the Augustinian battle against paganism.  Before the Renaissance, behavior proved belief.  Pagans were converted or put to death because of their behavior.  Now that belief mattered, the boundaries changed, and you could be persecuted for thinking the wrong thing.

Not that the church found sex behavior beneath its notice after paganism had largely been replaced by Christian belief.  Thomas Aquinas declared it unnatural in his disquisition on natural law, and church doctrine had been vaguely opposed to sensuality since St Augustine.  But, like St Joan’s heresy of wearing armor, church doctrine around variant sexual expression was there as a basis for prosecution if a dissident defied Church teaching.
The first recorded execution for sodomy was in the 13th century in Ghent.  This etching, a contemporary of the printing press, probably depicts persecution of anabaptists.  Anabaptists, including Mennonites, Amish, Hitterites and other Protestant sects, believed in deferring baptism until the age of consent.  This was objectionable to Catholics and other Protestants who believed children went directly to Hell if they died having not first been baptized. 
It is quite difficult from the vantage point of the early twenty-first century to recognize the extent of the cataclysm this would provoke.  The 30 Years War, the French Wars of Religion, The English Civil War, and, and Spanish attempts to subdue the low countries were catastrophes that depopulated the Rhine, bankrupted major powers, and drove emigration to the New World.  An increasingly urbanized population had more opportunities for sexual deviance, but the rising power of states and decreased privacy meant more opportunities for sexual pogroms and repression.  And both the church and the state cared about what one thought, not just how they behaved.

A contemporary production of Romeo and Juliet  "It was the nightingale and not the lark, that pierc'd the fearful hollow of thine ear!"

The new liberalism and repression are evident in the work of William Shakespeare.  Full of bawdy references, Shakespeare is ribald enough today that social conservatives are often made uncomfortable teaching it in high school.  But Shakespeare and all London theater went through periods in which the theaters were regarded as hotbeds of immorality and were periodically shut down entirely on religious grounds.  All the female parts were played by teenage males because the theater was associated with vice and prostitution.  It was commonly thought that many actors were gay.  After the reign of Elizabeth I the theaters were closed altogether following the English Civil War. At the conclusion of Cromwell’s puritanical reign, the theaters would reopen with a ribald vengeance during the Restoration.   This same conflict about representation of the erotic could be seen in Dutch and Flemish painting as the interest in peasant and interior life gave rise to eroticism, and this was alternately exposed, repressed, and restored.  Sex lives mattered during the restoration and Counter-Reformation, but mainly in the context of a contested set of social constructions aimed at demonstrating the superiority of one form of religion over another.

Venus, Cupid, Bacchus, and Ceres (1612-13) by Peter Paul Rubens in the Counter-Reformation's return to eroticism.
Foucault would later criticize the idea that the Western relationship to sexuality was primarily one of Freudian repression.  But in the Renaissance, as society became increasing professionalized by a tiny but rising middle class, there was an initial struggle over repression.  This was not primarily about sex itself.  In the rural Middle Ages and Renaissance, it was hard to come down too hard on reproduction when children were and economic asset and the countryside depopulated by war and disease.  But sex became one more battle ground in the war over belief and the forced decentralization of church authority to dictate what reality was.

© Russell J Stambaugh, October 2015, Ann Arbor, MI.  All Rights Reserved.