The Changing View of Sexual Pathology

SINCE THE SECOND WORLD WAR, several kinds of sexual behavior are no longer considered pathological but are now accepted within the frame of normality. This is not simply because our attitudes have changed. It constitutes, in my opinion, an actual change in pathology. There are signs that a new pathology is developing.

When I listened to my patients before World War II and learned via their anamnesis that they had daily (or nightly) sexual intercourse, I invariably took it to indicate "hypersexuality." I did not consider it a symptom which demanded therapeutic intervention, but I did indeed take it as a clue that I probably would eventually find considerable sexual pathology and anxiety on further investigation. At that time high sexual frequency would suggest that such a person was fighting off feelings of sexual inferiority, doubts about sexual competence, or feelings of general alienation and unrelatedness. Often deeply disturbing homosexual trends could be found which the patient could neither accept nor repress. He had to deny these trends to himself and to his wife by daily sexual activity. If I continued to investigate, my assumption in such situations almost unfailingly was demonstrated as correct. My evaluation and reconstruction of the dynamics would have been accepted by most of my colleagues. Quite generally, satyriasis or nymphomania were considered to be defenses against latent homosexuality. I am not suggesting that these dynamics were incorrect. It is my contention that these dynamics are no longer valid. In previous