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Players: Husband and wife.
Activist: Husband, without wife’s knowledge, or both. Setting: Any bedroom.
Aim: Husband deliberately uses dirty language that wife consciously finds repugnant but unconsciously fantasizes about, thereby making conscious that which was formerly unconscious.
Game Plan: Some evening (or morning or afternoon, as the case may be) while the husband is making love to the wife, he suddenly looks at her and says,
“You slut.”
“You slut. You dirty little slut.”
“Why are you saying that?”
“Because that’s what you are—a dirty little slut.”
“I am not.”
“You are, and you know it. And don’t pretend to be shocked by this language. You know you like it. A dirty little slut like you always likes dirty talk. And dirty sex, too—right?”
*102/196/1*
The success of this game depends on getting both members out of their customary mode of relating, in which the depressed spouse negates both himself and his mate, and the nondepressed spouse continually tries either to soothe him or expresses resentment toward him. In this game, both accept and go along with the depression and the underlying feelings of hopelessness. Further, mirroring the depressed spouse’s hopelessness gives him a glimpse of how he is acting. If they can both accept the depression and allow themselves to have hopeless sex, then they can move on and actually have hopeless sex. Then, ironically, they will find that the sex becomes less hopeless. It may also lead to getting more in touch with the hopelessness and letting go of it.
*77/196/1*
Players: Passive spouse (audience), aggressive spouse (actor), and dummy.
Activist: Aggressive spouse, without the knowledge or cooperation of mate.
Setting: Living room with makeshift stage or room with real stage.
Aim: To shock passive into awareness and allow aggressive to discharge rage.
Game Plan: This game is a take-off on the play within a play from Shakespeare’s Hamlet in which he notes that “The play’s the thing, wherein I’ll catch the conscience of the king.”
The aggressive spouse announces to the passive spouse one night after dinner, “Darling, I have a little surprise. I’ve made up a little play just for you. You like theater, don’t you, darling?”
The aggressive spouse turns the lights down and prepares to act out a scene from their sex life. On the stage is a sofa or bed on which lies a life-size “dummy” (or doll) which will be the surrogate for the passive spouse. The aggressive spouse, having stripped down, enters the scene naked, and lies beside the dummy. (Let’s generally refer to the passive-spouse “dummy” as the dummy, and to the aggressive spouse as simply the spouse.)
*52/196/1*
It is crucial for the wife to never, never give up. She must regard this as a battle—which it is! Her husband has maintained his defenses against spontaneity and intimacy for a good reason (let’s say, for example, he had a very intrusive mother), and he may fight almost to the death to protect himself against vulnerability. The wife must therefore be prepared to fight this battle until he finally gives in, never taking any of his refusals or insults personally, never insulting him back or in any way losing her temper, but always sticking firmly and seductively to the game plan.
Once he gives in to the seduction, the rest of the game is easy. Having lured him out of his defensive posture (of being boring), and herself out of her own defensive posture (of being bored or frustrated), there will most likely be a newfound passion for one another, as well as a newfound interest in sex.
*27/196/1*
“Doc, I don’t understand women today,” he said. “Why not?” “They’re weird.” “What happened?”
“I was at my summer share this weekend and I went out with one of the women in my house, and we had sex—sort of.”
“Sort of?”
“Right. See what you make of this. Doc.” “Go on.”
“I really don’t understand it, but maybe you can.” “I’m listening.”
He paused to find the words, sighing and sitting back in his chair. He was a successful young man in his early thirties who had lived in Manhattan for several years, was buying a condo in the East Thirties, and had just broken up with another woman who had angrily accused him of having a fear of intimacy. He had rented a room in a summer house in the Hamptons, hoping to wash out the bitter taste from this last relationship with a lot of salt air, ocean, and, most important, more noncommittal sex.
*1/196/1*
Prostatitis refers to an inflamed, swollen, and tender prostate. This painful condition can be caused by an infection (by bacteria) or by something else— doctors don’t know what causes nonbacterial prostatitis. In any case, the symptoms may include pain in the joints, muscles, lower back, and area behind the scrotum; aches, fever and chills (in acute cases); urinary trouble, including blood in the urine, pain, or burning; and painful ejaculation.
Bacterial prostatitis manifests itself in both acute (severe and requiring immediate treatment) and chronic (long-term) forms, and may be detected by bacteria in the urine; neither formm contagious, and neither form can be transmitted to a man’s sexual partner. The treatment is to combat the bacteria and thus stop the infection. For nonbacterial prostatitis, the arsenal of treatments includes muscle relaxants. A related condition, called prostatodynia, or painful prostate, may not be an actual prostate disease but may in fact be caused by muscle spasms in the pelvis.
Next we’ll take a look at how the male urinary and reproductive systems work normally, before examining what happens when the prostate—which is involved in both systems—causes trouble.
*4\201\8*
The scrotum is the bag of skin that sits below the penis and contains the testicles, the epididymis, the vas deferens (spermatic cords), and blood vessels that lead to the testicles. The skin is normally loose and wrinkled, and sparsely covered with hair.
Testicles
The two testicles, which are located inside the scrotum, are the structures that make sperm and testosterone. (Testosterone is the hormone primarily responsible for the development of male physical characteristics.) The testicles sit away from the body to keep them below body temperature (the lower temperature is required for the production of sperm). The testicles should feel smooth to the touch and have the consistency of a hard-boiled egg. They vary in size, from the size of a large grape to the size of an egg. Normally, most men have one testicle that hangs lower than the other.
When a male infant is in the womb, the testicles start out in the pelvic area and descend into the scrotal sac. Sometimes one or both testicles do not descend; they remain in the pelvis and are not visible from the outside. This condition must be surgically corrected, since an undescended testicle is a risk for developing testicular cancer.
Every month all men should do a self-examination of the testicles, feeling for any bumps or irregularities on them, which can be a sign of testicular cancer. The testicles can be a site of infection, called orchitis, which can be caused by mumps in men who were not adequately immunized or (rarely) by sexually transmitted infections or other viruses.
The area above the testicles feels like cords of string. This area contains the epididymis, which stores sperm; the vas deferens, which carry sperm into the urethra during ejaculation,- and blood vessels going to and from the testicles.
Epididymis
The epididymis is a collection of coiled tubes, the main purpose of which is storing sperm and providing a place for the sperm to mature. The tubes also carry sperm from the testicles to the vas deferens, which carry the sperm into the urethra. Sperm move slowly and mature as they travel through the epididymis. The epididymis can become infected with sexually transmitted bacteria (such as gonorrhea and chlamydia) or nonsexually transmitted bacteria. Infection of the epididymis is called epididymitis.
Vas Deferens
The vas deferens are straight, hollow tubes that carry the sperm from each epididymis to the urethra as it travels though the prostate. These are the tubes that are cut in the sterilization procedure for men called vasectomy.
*3\213\8*
Although prostate “trouble” does seem to be a normal part of aging, prostate cancer is not just an old man’s disease. In 1994, the American Cancer Society’s
Department of Epidemiology and Statistics estimated that two hundred thousand new cases of prostate cancer would be diagnosed in the United States, and that more than thirty-eight thousand men would die of the disease. It is now the second-leading kind of cancer in men (second only to skin cancer); and, of all cancers, prostate cancer is the one whose prevalence increases most rapidly with age.
Again, there is good news: Caught early, before it has spread, prostate cancer is curable with surgery or radiotherapy. Better surgery has drastically reduced the operation’s worst side effects, impotence and incontinence. And new research is laying careful groundwork for understanding prostate cancer and improving the hope for curative treatment even after the disease has spread.
If prostate cancer is detected early, men can be cured; they can also have a normal life. This critical message needs to be heard by doctors as well as patients. Men need to have themselves tested, and doctors need to start checking for prostate cancer earlier, and more vigilantly.
*3\201\8*
The penis is the organ through which men both urinate and produce semen. There are no muscles or bones in the penis, which is composed of three tubes of tissue. The top two tubes are called the corpora cavernosa. These tubes are composed of spongy tissue and blood vessels that, during sexual excitement, become full of blood and thus cause an erection. When not erect, the penis is soft and limp (flaccid). The bottom tube of tissue is called the corpus spongiosum, and through it runs the urethra, the hollow tube that carries both urine and semen.
At the end of the penis is the glans or head. The corpus spongiosum is connected to the glans, and the urethra opens at the tip of it. The glans of the penis has more nerve endings than any other part of the penis, which is why it is so sensitive. Stimulation of the glans is important in sexual arousal and orgasm: it is analogous to the clitoris in women. All men are born with a retractable layer of skin, called the foreskin, which covers the head of the penis. Many males have the foreskin surgically removed at birth in a procedure called circumcision. In some men, small, shiny, painless bumps called pearly penile papules are present around the edge of the head of the penis. Although they are sometimes confused with warts by both patients and health care providers, they are a normal part of male anatomy.
James was sick with worry that he had contracted a sexually transmitted disease. When he noticed small, painless bumps along the ridge of the head of his penis, he did some research in the library, and now he was convinced that he had genital warts.
After several weeks of worrying, James finally went to a local STD clinic, where he was ecstatic to learn that the bumps weren’t warts after all, but pearly penile papules, a normal part of male anatomy. While he was there, he and the physician discussed safe sex practices and how to prevent becoming infected with an STD in the future. James learned so much and was so relieved that he wished he had gone earlier to be checked out.
*2\213\8*
For most men, during the first forty years or so of life, the prostate is on its best behavior. But after age 40, many men—an estimated 80 percent by age 80— develop benign prostatic hyperplasia (BPH), an irritating condition that causes the prostate to swell and interfere with urine flow. BPH may trigger frequent urination (several times an hour); a sense of urgency; a long wait for urine to flow; frequent awakening in the night to urinate; interruption of the urine stream (starting and stopping); and a constant feeling of fullness in the bladder. Sometimes, BPH leads to urinary tract infections; in rare cases, it can cause damage to the bladder or kidneys.
BPH develops from the inside outward, as the prostate’s inner tissue starts to crowd the urethra, which runs through the encircling prostate like a straw held in someone’s fist. As the inner prostate cells grow, they begin squeezing the urethra; the fist tightens. For most men with BPH, this tightening causes an irritating but still tolerable change in quality of life. However, when it progresses beyond the nuisance point—when it hinders the urinary tract, for example, or causes kidney or bladder problems—it needs to be treated.
*2\2101\8*