Best Sex Writing 2009

by Rachel Kramer Bussel

  With reference to the husband who decides finally to give up the visual stimulations that fuel his sexual fantasies, Arterburn and Stoeker directly advise wives: “Once he tells you he’s going cold turkey, be like a merciful vial of methadone for him. Increase your availability to him sexually, though this may be difficult for you since your husband might have told you some things that repulse you.”

  Wives are directly told to have sex with their husbands more often, no matter what it feels like for them. (All in the name of his sexual purity.) Having introduced their scientific conclusion that all men need to have their sperm released at least once in any seventy-two-hour cycle, Arterburn and Stoeker approvingly quote the testimony of “Ellen”:In relation to your own husband, understanding the seventy-two-hour cycle can help you keep him satisfied. Ellen said:“his purity is extremely important to me, so I try to meet his needs so that he goes out each day with his cup full. During the earlier years, with much energy going into childcare and with my monthly cycle, it was a lot more difficult for me to do that.There weren’t too many ‘ideal times’ when everything was just right. But that’s life, and I did it anyway.”

  Voice-over interviews:So there’s a place for the quickie.While a long-term diet of drive-by sex is unhealthy, it certainly has a place in defusing the power of the seventy-two-hour temptation cycle. Sometimes you just don’t have the time or energy for the full package, but if you care about his purity, you can find just enough energy to get him by.

  Evangelical women might be unhappy with their men—or with having sex with their men—but Arterburn and Stoeker argue that it is all for a good and godly cause.Take the case of “Andrea,” again quoted by Arterburn and Stoeker: “Even if I’m tired or don’t feel good, I can appreciate his sexual needs, so I do my part to satisfy him. I have to admit, though, I’ve had times that I felt resentful.” Nonetheless, trooper that she is, Andrea soldiers on.

  Sexual Problems: A Common Side Effect of Combat-Related PTSD

  Don Vaughan

  The Warrior did his time in Iraq without complaint. For nine grueling months, he accompanied his buddies on dangerous nighttime raids, dodged IEDs hidden along war-ravaged roads, and engaged in deadly firefights with frightening regularity. He killed enemy fighters and watched, helpless and angry, as the enemy, in turn, killed or maimed many of the men he had come to regard as brothers. At night, in the dark, he prayed that he wouldn’t be next.

  When his commanding officer told him that he was finally going home, the Warrior was ecstatic. The reunion with his family was so joyous that for two full weeks he barely thought about the horrible things he had seen and done during his tour of duty as a United State Marine.

  Then the bright days started to turn gray. About a month after his return, the Warrior developed insomnia and other problems. His mind raced and his thoughts were plagued with the horrible images of combat. Afraid and angry, he started drinking to dull the pain.

  On the increasingly rare occasions when he felt like making love, the Warrior’s body refused to cooperate. After a while, he stopped initiating intimacy with his wife because sex no longer brought him pleasure. The war in Iraq hadn’t just taken the Warrior’s peace of mind, it had robbed him of his sexuality as well.

  Such stories are more common than you might assume among soldiers and Marines returning from Afghanistan and Iraq. In fact, according to Michael Russell, PhD, a noted clinical psychologist in San Antonio, Texas, who has more than twenty years of experience working with veterans and their families, within a year of returning from combat, one-third of all servicemembers will seek mental health assistance around a cluster of problems that include substance abuse, marital problems, depression, and full-blown post-traumatic stress disorder (PTSD).

  “Every single one of these is associated with sexual dysfunction,” Dr. Russell notes. “The best study to date, published in the New England Journal of Medicine, found PTSD rates of almost 20 percent in Marines and 18 percent in Army soldiers returning from combat deployments.That is a lot of people. And the literature suggests that one-third to one-half of those affected with an anxiety disorder like PTSD are going to have a concomitant sexual problem.”

  PTSD-related sexual dysfunction among veterans is nothing new. In fact, the Department of Defense and the Department of Veterans Affairs have been aware of the issue since the Vietnam era.

  “I have been with the VA for about twenty years and I’ve been doing this kind of work the whole time,” says William Finger, PhD, a clinical psychologist at the Mountain Home VA Medical Center in Mountain Home, Tennessee. “We have been well aware that there are sexual problems [within the veteran population].We recognize this as a problem, we prioritize it as a treatment issue, and we have treatment programs available.”

  Unfortunately, says Dr. Russell, the sexual problems of many veterans often go unaddressed because both the patient and his or her health-care provider are uncomfortable bringing up the issue.

  “I have noticed that sex problems sometimes suffer from ‘don’t ask, don’t tell,’ ” Dr. Russell explains. “Doctors are embarrassed enough that they don’t inquire about it and patients are embarrassed enough that they don’t volunteer the fact that they are having a problem.”

  In addition, the military tends to foster a culture of machismo and a “tough it out” attitude that encourages servicemembers to hide their problems. “Admission of a sexual problem goes to the core of our perception as virile human beings,” Dr. Russell notes. “Not surprisingly, too many veterans suffer in silence.”

  They’re not the only ones, adds Eric Garrison, MAEd, MSc, a Manhattan-based sex counselor who has treated veterans with stress disorders. The issues of PTSD and sexuality also affect Army husbands, long-term partners, and gay, lesbian, and bisexual soldiers and their loved ones as well.

  Indeed, it’s important to note that war-related PTSD does not affect only men.Women have played a larger role in the wars in Iraq and Afghanistan than in any other conflict, and a good percentage of them are coming home with deep emotional wounds. Much of this psychological turmoil is the result of what they witnessed in theater, but some of it is also caused by conflicts with their fellow servicemembers.

  “An important issue to keep in mind is military-related sexual trauma,” observes Linda R. Mona, PhD, a licensed clinical psychologist in Los Angeles who has had experience with the veteran population. “Current research suggests that military sexual trauma is prevalent in both men and women who have served in Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF). Women face unique issues including the need to prove themselves to the men, having conflicts with other women, and experiencing a high rate of harassment, unwanted physical advances, and sexual assault. Not all women experiencing military sexual trauma will have PTSD, but some will.”

  In addition to PTSD, a variety of other issues can contribute to sexual problems among returning soldiers and Marines. One of the most common is the separation that comes with a lengthy deployment, notes Dr. Finger. These extended periods away from family, friends, and career can be especially difficult for National Guard and Reserve soldiers.

  “Quite often, in their absence, their partners have had to step up to fill some of the roles the soldiers were filling before they left,” Dr. Finger explains. “On the veteran’s return, a lot of times those roles have to be renegotiated, which can create stress and result in disagreements and arguments, which in turn can have some impact on emotional intimacy, closeness, and the sexual relationship as well.That may be especially difficult for new relationships because some of those responsibilities haven’t been clarified very well before deployment.”

  Another potential factor is a lack of communication while a soldier or Marine is in theater. Email and social networking sites such as MySpace have made staying in touch with family and friends easier than ever before, but service personnel often still find themselves out of communication for extended periods of time. This can wreak havoc with the emotions of
service personnel and their loved ones back home, and affect sexual relationships upon a servicemember’s return.

  “Stress, anxiety, and other mood disorders can affect communication among couples as well as their ability to connect with each other sexually,” notes Dr. Mona. “Being separated from one’s partner and wondering whether or not you will ever see them again can place a great strain on a relationship. After being exposed to life-threatening trauma, some people may feel withdrawn, depressed, or anxious. These symptoms may prevent someone from engaging in social activities that were once pleasurable, interacting with family and friends, or feeling comfortable being sexual with their spouse or partner.”

  The meaning of sex may also change for individuals who have endured a life-altering experience, Dr. Mona adds. “Feeling guilty about surviving the war while others are still there is difficult,” she explains. “Sexual relationships may become a lower priority.”

  Dr. Russell considers sexuality a barometer of the quality of a marriage. “When providing marital therapy, I always ask about frequency of sexual intercourse and satisfaction,” he says. “The usual response, at best, is once or twice a week but many couples say it has been quite a while since their last encounter.”

  Veterans who have been traumatized during deployment may react to that stress in one of two ways: they either shut down their sexuality as a way of avoiding intimacy, or they develop a hyper-attachment to their partner. Both can have an adverse effect on a relationship, notes Patti Britton, PhD, a board-certified clinical sexologist, sexuality educator, and sex coach in Los Angeles.

  “When someone sees friends blown up in front of them, as soldiers and Marines in Iraq and Afghanistan often do, it’s natural to [pull back from relationships] in an attempt to avoid that kind of loss again,” Dr. Britton explains.“This can occur even among those who are married and in a stable relationship because there’s a perception of, ‘Oh, I could lose him or her.’ That’s the shutdown.

  “On the flip side, someone else may cope by really burrowing into an emotional relationship, an ‘I never want to let her go’ kind of thing, which can be strangulating in an emotional way. Both approaches can have a detrimental effect on relationships and on the formation of relationships.”

  Caregiving also carries certain concerns for both people with physical and psychological impairments and those family members who provide assistance. It is not uncommon for spouses and partners to develop a sense of frustration and helplessness as they try to assist their troubled significant other, who may have difficulty getting the care they now need.

  “Even though an anxiety-based disorder is experienced by an individual, it can affect his or her entire family life,” notes Dr. Mona. “Couples may have decreased communication patterns if the person experiencing PTSD shuts off verbally. However, some couples may actually strengthen their relationship out of this crisis. If the individual experiencing PTSD allows his/her partner in on this emotional experience, both emotional and physical intimacy can be sustained.”

  Another issue facing many returning veterans, and one that can have a formidable impact on sexuality, is that of body image, says Sandor Gardos, PhD, a licensed clinical psychologist and sex therapist in San Francisco. Body armor and improved field medicine save a far higher percentage of lives compared to past wars, but survivors often come home missing one or more limbs, or have extensive scarring, traumatic brain injury, and other aftereffects.

  “These issues can result in dramatic changes in self-perception and self-identity,” Dr. Gardos notes. “Coming home not looking and not feeling the same as you did when you left is going to have a tremendous impact on your sense of who you are sexually and how you interact with others.”

  “It’s very difficult to be free sexually and experience sexual pleasure when you’re hiding something about your body,” agrees Dr. Britton. “Such issues pervade the culture at large but they become heightened and exaggerated when there is scarring, loss of a limb, or injury. More psychological and emotional healing may be required to accept the body as it is.”

  Physical injuries may also affect how an individual has sex, Dr. Britton adds. “For example, if a soldier comes home missing a leg and doggie-style is his and his wife’s favorite position, it could be problematic because he can no longer easily assume that position,” she explains.

  “It becomes a matter of, ‘Can I replicate this behavior and engage my partner in helping me do it, or has this been wiped out of our spectrum of how we can connect sexually?’ ” Dr. Britton notes. “Those are the kinds of important issues that must be faced.”

  The Department of Defense and the Veteran’s Administration are stepping up to help. The wars in Afghanistan and Iraq have brought PTSD and the other debilitating effects of combat to the national forefront, and more is being done than ever before to prevent and treat them.

  For example, servicemembers receive a mental health review prior to deployment, have access to mental health professionals in theater, and receive a mental health assessment within ninety days of their return home. In addition, the VA has greatly increased the number of mental health professionals on staff nationwide, and many VA centers have special OEF/OIF coordinators who look for and help servicemembers who may be struggling with their wartime experiences and/or the transition home.

  “We have a whole team of people who go out and talk to soldiers, family members, and partners prior to deployment,” confirms Dr. Finger. “They talk to them about the types of things they may experience when their family member is deployed and the types of available services that they can access while their family member is away.

  “There is also a much greater emphasis on careful screening upon a soldier’s return in regard to physical and mental health issues. There is much more effort to educate them about the types of services that are available. My understanding is that all returning OEF/OIF veterans have unrestricted access to health care for a minimum of two years to help them deal with anything related to their deployment. So there is a real effort to get them registered, identify their problems, and get them treated much more quickly.”

  Dr. Finger considers sexual issues the same as any other health or medical issue. “If a veteran brings up a sexual issue, it’s going to be evaluated and addressed here,” he notes. “And our providers are doing a much better job of actually making an effort to address those issues, to evaluate them and take care of them.

  “That doesn’t mean that every soldier who has a problem like this is going to report it. It’s a sensitive, sometimes embarrassing topic and one that often is not brought up, even if a health-care provider asks. And if there is a problem, it may be denied. That’s common.”

  When such barriers are broken down, say the experts, treatment for PTSD-related sexual dysfunction is usually quite successful. “If we can just cure the depression, rebuild the relationship a little bit, and keep the patient [from self-medicating with alcohol or drugs], he or she will usually be able to resume normal function,” notes Dr. Russell. “Couples counseling with a good marital or sex therapist can also be very beneficial.”

  Nonetheless, if the Vietnam War is any indication, PTSD and its related side effects, including sexual dysfunction, are issues the Department of Defense and the VA will be struggling with long after the last soldiers return home from Afghanistan and Iraq.

  “In many ways, the infrastructure is not in place right now to handle the sheer volume of disabled veterans coming back,” observes Dr. Gardos. “Unless we make a concerted effort to expand available resources, we are going to have an entire generation of men and women who are scarred, both physically and psychologically, by their experiences. And this is going to have a devastating impact on their spouses and families. We cannot afford to ignore this problem and hope it will go away.”

  Dr. Britton agrees. “What we will discover is that [sexual dysfunction] will be a hidden epidemic that will be part of the fallout of these wars,” she warns. “We will be dealing with this
issue for many years to come.”

  Sources:

  Michael Russell, PhD, a noted clinical psychologist in San Antonio, Texas, who has more than twenty years of experience working with veterans and their families.Tel: 210-221-7989. Email: michael. russell@amedd.army.mil.

  William Finger, PhD, a clinical psychologist at the Mountain Home VA Medical Center in Mountain Home, Tennessee. Tel: 423-979-2934. Email: billfinger@yahoo.com; william.finger@med.va.gov.

  Eric Garrison, MAEd, Msc, a Manhattan-based sex counselor who has treated veterans with stress disorders. Tel: 347-860-0809. Email: eric@ericgarrison.info.

  Linda R. Mona, PhD, a licensed clinical psychologist in Los Angeles, who has had experience with the veteran population. Email: lrmona@aol.com.

  Patti Britton, PhD, a board-certified clinical sexologist, sexuality educator, and sex coach in Los Angeles. Tel: 310-575-8889. Email: drpattixox@aol.com.

  Sandor Gardos, PhD, a licensed clinical psychologist and sex therapist in San Francisco. Tel: 415-749-0942. Email: sgardos@ mypleasure.com.

  Medpagetoday.com: “A Quarter of Iraq and Afghanistan Vets Show Mental Health Problems” by Neil Osterweil, March 12, 2007.

  Penises I Have Known

  Daphne Merkin

  Sidling up to the Matter at Hand

  There are penises so memorable that you never get over them: JC’s for instance, a perfect edition worthy of my rapt contemplation, or so it seemed to me when I lay next to him on his seventies-style platform bed in his bachelor’s pad on an unmemorable Manhattan side street years ago. Others, too, that you would like to recall—the one belonging to your first lover, for instance, the guy who “cracked your geode” (as the man in the red socks, another lover in your not inconsiderable lineup, once put it)—that seem to have eluded your visual grasp, through no fault of their own. Then again there are those that linger in you, like a ghost penis, although they are long gone, such as the impressive piece of equipment that came along with the deceptively slight fellow you met on a Jewish singles weekend at the now-defunct Grossinger’s, a battering ram of a penis that left you raw, a penis so inflexible and obdurate that you could hang a towel on it—which, I might add, he did.