Multiple Os

For clitoris owners, not being able to orgasm has been called “dysfunctional” by many sexologists. Many factors in one’s ecosystem intersect to continue, preserve, and reinforce this view. An important part is an intersection between the problem-based approaches of modern medicine and the equating of the complex, diverse experience clitoris- and penis-owner orgasms and Master and Johnson (1966) model of human sexual response. A linear model cannot represent complex, variable phenomenon like orgasms well (Check out the r/multipleos post on complexity of orgasm.).

Often featured in college curricula across the globe, the linear Masters and Johnson’s model of sexual response has become equated with the definition of sexual function. Any deviation from their model for clitoris-owners or penis-owners can be seen as dysfunction.

• For clitoris-owners, the model includes vaginal wetness as a part of the trajectory towards orgasms. However, some clitoris-owners may experience multiple orgasms despite vaginal dryness.
• The model places orgasm at top of the cycle, subcommunicating that orgasm is the pinnacle or goal.
• They also include the idea that all clitoris-owners can have multiple orgasms. This is statistically not the case.
• Not being able to have an orgasm has been seen as being dysfunctional, and for some clitoris-owners, some may see inability to experience multiple orgasms as dysfunctional as well.
• It created this false conclusion, which unpins the conceptualization of response for many people: Clitoris-owners have a wide array of responses and types of orgasms; Penis-owners have only one type, the kind that occurs with ejaculation.
• For penis-owners, the model equates ejaculation with orgasm, creating an reductionistic view of the penis-owner sexual response (See our post on reductionistic view on penis-owner sexual response. Orgasm and ejaculation are not the same process. Because the apparent ease to study ejaculatory orgasms, much research has been devoted to ejaculatory orgasms in penis-owners. The array of responses in penis-owners has been reduced to the ejaculatory orgasms. No non-genital orgasms from, say, impact play. No non-ejaculatory orgasms. No prostate orgasms. Et cetera. Prior to Masters and Johnson, and even Kinsey himself, it was suspected that penis-owners could have multiple orgasms before spermarche, and some can retain multiple orgasms later in life (See Kinsey’s work and Kinsey’s review of prior literature.).

For more problems with the model, see here. For a brief history of Master and Johnson’s model, see here. For its intersection with evolutionary science, see the r/multipleos post on bias in evolution theories of the clitoris-owner orgasm.

WHAT IS APPRECIATIVE INQUIRY AND PROBLEM-BASED MODALITY?

Appreciative Inquiry (AI) is a newer modality that is being used in counseling sessions of clients complaining of “sexual dysfunction” and psychological complaints related to orgasm.

It is not used prevalently yet, as many practitioners are not aware of the modality and focus in counseling training is on competency/weakness/deficit/problem-based approaches. The distinguishing factor between AI and problem-based approaches is AI prioritizes strengths, whereas problem-based approaches prioritize weaknesses.

• Using a problem-based approach, counselors “conceptualiz[e] the target individual or group primarily (or even solely) in terms of their perceived deficiencies, dysfunctions, problems, needs, and limitations” (Dunishak, 2016, p. 658) (https://dsq-sds.org/article/view/5236). A deficit approach would begin with a problem query (What problems have you been experiencing?)
• Using AI, first conceptualized by Ph.D. student David Cooperrider and his advisor Suresh Srivastva, consolers “choose the positive as the focus of inquiry, inquire into stories of life-giving forces, locate the themes that appear in the stories and select topics for further inquiry, create shared images for a preferred future, and find innovative ways to create that future” (Watkins, J. M., & Mohr, 2011, p. 39).) AI begins with an asset-based question (What is working right now?), focusing on what the individual does well (https://www.wiley.com/en-us/Appreciative+Inquiry%3A+Change+at+the+Speed+of+Imagination%2C+2nd+Edition-p-9780470527979)

Both the problem-based and AI modalities can be used in harmony. Too much of the problem-based approach, and the client may feel worse off than before therapy and start to see themselves for only their problems. Too much of the AI approach, and critical problems can be overlooked.

ARTICLE HIGHLIGHTS

https://seattle-counseling.com/2013/11/28/sexuality-relationships-therapy/

In response to the research finding from the National Survey of Sexual Attitudes and Lifestyles conducted in Britain, which found that sexual response problems were common, the author of this article (https://seattle-counseling.com/2013/11/28/sexuality-relationships-therapy/) thinks of the idea that sexual dysfunction may, in fact, be normal.

“What some in society call “sexual dysfunction” is statistically much better defined as “normal”. In the most basic sense, normal means reflecting actual norms. Normal symptoms can be both temporary and chronic, occurring at all ages and at high levels. By understanding how common these problems are, we can reduce some of the social and personal anxieties that surround them” (para. 7) The idea that dysfunctions should be seen as more common is not easily acceptable. “Common” can imply a passive acceptance of low levels of sexual health and functioning (or mediocre sex). Therapists could be seen as giving themselves an “out” for not being able to treat these complaints successfully” (para. 7-8)

The author suggests a positive therapy approach called Appreciative Inquiry.

“I work with an idea that the problems are uncomfortable enough to motivate therapy pretty well. It may not be comfortable when therapy looks at the ways that sexual “symptoms” have multiple impacts. Yet this is not a clinical stance that labels people or relationships as “defective.” Rather it’s the struggle to know the widest possible ecology – an “appreciative inquiry” into each relationship I work with. It also comes with an awareness that desire can be expressed and received “ruthlessly”, parallel to existing committed relationships” (para. 9).

“The basic criteria for sexual health and functioning level is not simply behavioral and medical. It’s relational, developmental and existential. Natsal 3 seems to grasp these perspectives, using ideas like the “continuum of experience” and “relevant to everyday life” (Para. 10)

The author believes in adopting an Appreciative Inquiry approach around sexual difficulties relationally.

“I have long worked from the principle that differences in desire are a prime driver of relational change. By defining sexual difficulties relationally, rather than just medically. we can readily integrated developmental (lifespan) perspectives. Common sense tells us that these differences are unavoidable, and therefore not ‘abnormal’” (para. 11)

“The most powerful ‘layer’ of all is the existential, where one’s life meanings, motives, functions and impacts can be more deeply explored and understood through eros and sexuality, and how love has been given and received” (para. 12)

The author, however, does mention a harmony of problem-based and strength-based approaches are essential.

“We know of course that diagnosable medical problems may be playing a role in the difference of desire, but they are only one part of a larger whole. But differences in desire is still the more comprehensive clinical perspective, easily integrating medical information” (para. 13).