[Color bar test pattern sound] [...] [This Audiovisual has been acquired] [for distribution by the National Medical Audiovisual Center] [...] [Instrumental harp music] [Sexuality in the Medical School Curriculum] [From the Center for the Study of Sex Education in Medicine] [University of Pennsylvania School of Medicine] [Produced by Ortho Pharmaceutical CorporationDepartment of Educational Services] Aspects of sexual interviewing] [Copyright 1972 Ortho Pharmaceutical Corp. All rights reserved] [The "Frigid" Wife] [...] [Harold Lief:] This is one of a series of films dealing with sex and marital counseling. The goal of theseprograms is to increase your powers of observationand counseling skills. We are about to observean initial sex counseling session with a young wife. The problem presentedby Mrs. Martin is frequently encountered byphysicians and counselors. As we do in each of thesefilms, following the interview, we will have a replayanalysis of interview tactics and interaction dynamics. [Zoom into televison set] [...] [Therapist:] Now, your name isMrs. Martin, is that right? [Linda Martin:] That's correct. [Therapist:] And yourfirst name is... [Linda Martin:] Linda. [Therapist:] May I call you Linda? [Linda Martin:] Oh,yes, of course. [Therapist:] Right.How old are you, Linda? [Linda Martin:] I'm 26. [Therapist:] And youare married to-- your husband'sfirst name is Bob. [Linda Martin:] Robert,but I call him Bob. [Therapist:] OK, how longhave you been married? [Linda Martin:] Four years. [Therapist:] And do youhave some children? [Linda Martin:] Yes, we have two. Two girls. [Therapist:] What does Bob do? [Linda Martin:] He's a lawyer. [Therapist:] I see. Well, Linda, tell me, how didyou happen to come to see me? What's the difficultyfacing you? [Linda Martin:] [Sighs] Well, it's-- I guess the problem is sexual. When I went to see ourminister for a local church, and he suggested I getsome professional help because I don't quiteknow what to do about it. [Therapist:] How didyou feel coming in today to talk about it? How do you feel being here? [Linda Martin:] Well, I feellike it's really a necessity and I really want toget help and I really want to find out what'scausing these problems. But I have to admit I'm alittle nervous, I guess. [Therapist:] OK. Well, try and tell mefor starters, if you can, what is the current dilemma? What's going onthat troubles you? [Linda Martin:] Well, I'mafraid that I might be frigid. You know, I justdon't seem to be able to respond thesame way I used to. [Therapist:] I see. [Linda Martin:] [Gasp] I'm sorry. [Inhalation] [Therapist:] Well, when didyou first notice this? What...tell me the story. [Linda Martin:]Well, I don't know. It didn't, it didn'thappen all at once. You know, thishappened over time. [Therapist:] And what bringsit to your attention now? [Linda Martin:] Well, quitefrankly, I've just had it. We're fighting a lot now. We're not talking. We don't seem to be able toget to the root of the problem, and I'm frightened. [Therapist:] And did a specificfight occur with you... [Linda Martin:] Well,we've had several, but recently, Bob told methat I've got problems, and I should do somethingabout it, and I agree with him. I feel like I'vereached the point where I've got to have help. [Therapist:] OK, nowtell me, you say it's been goingon for some time. Can you elaborate onthis and exactly tell me what you mean by beingfrigid, as you call it? [Linda Martin:] Well, I don'thave climaxes anymore at all. It seems like wego to bed together, and I feel that he wantsme, or wants the sex, and I feel like I'm justsubmitting now, that I'm not, I'm not giving anythingor getting anything, and it's a veryfrustrating experience. It's like, oh yeah, wewatch television all night or play with the kids. Then we go to bed, andit's like, you know, now it's time for sex. And I don't know. I just want it to be goodlike it used to be or open and, well, romantic, I guess. [Therapist:] Yeah. Well, have you beenfeeling very depressed and upset, guilty aboutit, in some sense? [Linda Martin:] Yeah. Our marriage is a goodmarriage in most ways, and I work very hard to makeour home a special place. You know, different thanmost people's marriages seem to be a little dull. I think women get carelessabout the way they look and I try not to do that. And I want things tobe really nice and-- [Therapist:] Yet you can'trespond when you want to? [Linda Martin:] No. [Therapist:] You're nothaving your climax? I see. Now, you're not having a climaxduring intercourse itself, is this your concern? [Linda Martin:] That's right. [Therapist:] Does this meanyou have climax or orgasm outside of intercourse? [Linda Martin:] Yes, sometimes. [Therapist:] You havehad this in the past? [Linda Martin:] Yes. [Therapist:] Roughly howlong ago are we talking? [Linda Martin:]Well, the beginning of our marriage I did with intercourse. [Therapist:] You wereresponsive and satisfied then? [Linda Martin:] Yes. I felt like it was easy givingand, you know, responding. Since then, no. [Therapist:] But somethingmust have happened somewhere along the line. [Linda Martin:] Well,we have two children, and that takes upall day, you know. I'm busy with them going to thepark, and taking them swimming, and of course, hispractice has increased. He's...well, he's home laterand later every night, I guess. [Therapist:] He's a busygo-getting kind of... [Linda Martin:] Oh, yeah. [Therapist:] Lawyer, you said? [Linda Martin:] Very outgoing. Very, very goodin arguments which is which is pretty depressingbecause when we have these fights, you know,he goes point by point where this is my problem and-- [Therapist:] How doyou feel about that? [Linda Martin:] Ican't argue with him. I think he's right. [Therapist:] Oh, youagree with him? [Linda Martin:] Well,I can't disagree or maybe that's just becausehe's a lawyer, he's good at it. I don't know. [Therapist:] Andyou're not quite sure how this makes youfeel at some gut level? [Linda Martin:] Yeah. [Therapist:] Except upset. [Linda Martin:] I mean,we have an argument of any kind before--think before we go to bed. And say it's over a householdmatter or something. He'll put me down, you know,one point after the other and... [Therapist:] What doyou do, kind of grin and bear it orswallow your pride? [Linda Martin:] Sometimes. Most of the time. Sometimes I get angry and thenwe go to bed and I, you know. [Therapist:] OK. Are there any otherstresses on the marriage outside of this particularone at this time? [Linda Martin:] Not really. As I say, on the whole,it's a good marriage and I want to keep it that way. [Therapist:] OK. Now let's go backinto the past a bit. How did you happen to,for example, meet Bob? Tell me about courtingand getting married. [Gasp] [Linda Martin:] We metat a fraternity party. I was a senior in college. He was a junior in law school. And, oh, he was... I was attractedto him right away. [Therapist:] What attracted you? What... [Linda Martin:] Oh, he's sooutgoing, and vivacious, and different, Ifound, than most men. He was sensitive, too. And I was kind ofquiet and reserved, and he sensed thatI was feminine, and he thought Iwas pretty, and then we began to talkabout each other. And I was able to talkto him about myself the way I've never beenable to talk to anybody. [Therapist:] OK. [Linda Martin:] Andthe same for him. [Therapist:] And your sexualpattern during courtship, before you got married,what was it like? What did you do and whatdid you-- how did you react? [Linda Martin:] Well,in the beginning it was kissing, necking. You know, petting and-- [Therapist:] Were you troubledby any of your responses? [Linda Martin:] No, no. I know that I feltmore sexually attracted to him than anyone I ever had. I really wanted tohave sex with Bob. Then after we wereengaged, I did. I felt secure and we did. [Therapist:] You hadintercourse and your response to that before yougot married was what? [Linda Martin:] Was good. I, every now and then Ifelt a little uncomfortable. I mean, we'd be athis apartment and I'd be afraid maybe afriend would come over. I'd feel a little discomfort. You know, I was relievedafter the wedding. [Therapist:] OK. Were there any pressuresto get married that you were going through at that time? [Linda Martin:] Oh,not particularly. I know I wanted to bemarried at that age. [Therapist:] Nothingout of the ordinary? [Linda Martin:] No, no. [Therapist:] OK. And the honeymoon,what was it like? How did you get along? [Linda Martin:] It was very nice. Toward the end of it, there wasa little bit of a feeling of... I guess we wereexhausted and tired. And we'd been togethersolidly like for two weeks. [Therapist:] Yep. [Linda Martin:] Forthe first time. I mean, with schooland other pressures we hadn't been together that much. So a little bit of afeeling of what have I done and where do we go now? But it was good. [Therapist:] And after you gotinto the marriage routine, you had your childrenpretty quick? [Linda Martin:] Yeah. [Therapist:] Or rightaway, I guess. [Linda Martin:] Yes, yes. The first child wasborn about nine months... excuse me, a year later. [Therapist:] OK. And that's some sign of change,as far as you can recall? You were tied up inthe mother scene, and he got tiedup in the career? [Linda Martin:] I knewthat would happen. [Therapist:] Kind of drifting? [Linda Martin:] I expected that. [Therapist:] You did [Linda Martin:] I expectedthat to be difficult. That's why I work pretty hardat keeping the household. And more of anatmosphere of maintaining that feeling of romance. I tried to, but it... [Therapist:] Didn't workout the way you want. [Linda Martin:] No. [Therapist:] OK. Now let's go furtherback into the past, if I can for a moment. Tell me what kind of amarriage do you come from? How did your parents get along? [Linda Martin:] Very well. There were no fights. [Therapist:] Were they... [Linda Martin:] Thatwere obvious, anyway. [Therapist:] Were theydemonstrative in front of you? Did they show affection? [Linda Martin:] Not particularly. My father was a little moredemonstrative than my mother. [Therapist:] Your motherwas pretty reserved? [Linda Martin:] Yes. [Therapist:] Right? [Linda Martin:] Yes, she is. [Therapist:] What, let'scall them vibrations. What vibrationsmight you have got concerning sex as you weregrowing up as a child? What kind of sex educationatmosphere did you go through? [Linda Martin:] Well, as faras education, I had none. My mother wouldn't be ableto talk about sex at all. But as far as dating, shewas pretty rigid about, even when I was veryyoung, she would tell me, you know, youshouldn't kiss boys. They'll think badly of you. [Therapist:] Oh, I see. [Linda Martin:] Don't, don't go out in a car. [Therapist:] A slight putdown. [Linda Martin:] Yeah, yeah. Be careful. It was a cautiousness. [Therapist:] OK. Now when, if you can, whatwas her mother, your mother's reaction, for example, whenyou started your period, beginning menstruation? How did that go? [Linda Martin:] I startedmine very young, before I knew anything about it. And I had called my mother,and I said, mother, I'm dying, I have a terrible disease. And she laughed, and sheexplained the whole thing to me. She gave me some books about it. [Therapist:] I see. [Linda Martin:] Butnothing about... [Therapist:] But thatwas about the extent of her active education? [Linda Martin:]Flowers, pollination. [Therapist:] That kind,birds and the bees, huh? [Linda Martin:] Shewas a gardener. She liked to garden. So she would talk aboutthose things but not people. [Therapist:] Now, as you weregrowing through teenage years, and you developed afigure and all this and became interested inboys, how did you respond to your own growth as a-- growing into a woman? How did you respond to that? [Linda Martin:] Ireally enjoyed it. I was sort of chubby when Iwas younger and kind of plain, I thought, anyway, and Ibegan to slim down about 13. My father noticed and toldme I was getting pretty, and boys liked me. I enjoyed it. [Therapist:] How do yousee yourself these days? [Linda Martin:] Well, I, I know I'm an attractive woman,but I don't feel that way with Bob anymore. [Therapist:] OK. [Linda Martin:] Maybe,maybe that's the problem. I even worry thatmaybe he would be interested in some other woman. I... [Therapist:] Has thisreally come up? [Linda Martin:] No, not really. It's just that I feel like ifI can't respond to him the way I should, that he may getinterested in someone else. [Therapist:] Right. OK, now thus far we understandthat you and Bob got busy, and drifted apart, anddidn't have that much time to get to know each otherintimately in some sense, at some level. Fair enough? And the old days were alittle bit negative about sex. Mother kind of didn'tapprove about... [Linda Martin:] That's right. [Therapist:] Being sexual. It was implied in some way. Is that right? [Linda Martin:] Yeah. [Therapist:] OK. Now take me to present day. What goes on today, thesedays concerning when romance and sex are in the air? What occurs? Paint a word picturefor me, if you can. [Gasp] [Linda Martin:] Nothing. [Therapist:] How's that? [Linda Martin:] Well,as I say, we spend the evening with the kids,after we get the kids to bed he's usually very tired. He watches television. [Therapist:] What'sgoing on in his mind if it's going to be sex? What do you, what doyou think he thinks? [Linda Martin:] He givesme a look, you know. Raises his eyebrow. [Therapist:] And your response is? [...] [Linda Martin:] Well,it used to be... it used to be he didn'tjust give me a look. I mean, he would touch me,would tell me I look nice or he would do something tomake me really feel that way. But if it's just going to be... you know. [Therapist:] He gives you a look. He gives you a look andwhat goes on inside? [Linda Martin:] I think,ugh, here it comes. And I want-- you know, I don't-- I want to expressmyself that way. [Therapist:] Yes. [Linda Martin:] And showhim that I feel that way, and I try to when weget to the bedroom. I try to open myselfup that way and relax, and I'm telling myselfto relax, relax. It's not the same. I mean, I don't feel.... [Therapist:] Do you... [Linda Martin:] That heappreciates me, really. [Therapist:] When yousay, here we go again kind of thing with the sexualthing, what do you expect's going to happen? You've got a frown and youlooked a little uncomfortable. Is it--? [Linda Martin:] Well, it's justgoing to be gotten over with and I'm going tobe left feeling... [Therapist:] So you may expect... [Linda Martin:] Unattractiveand unsatisfied. [Therapist:] Yeah. So you're caughtwanting it to be good but expecting it to be bad. Is that right? And what, then you tellyourself, I've got to relax, I've got to relax. Which doesn't work. [Linda Martin:] No. [Therapist:] OK, so then you goahead and get it over with, right? [Linda Martin:] Whichmakes me feel very bad. I sometimes cry myself tosleep, frankly, afterwards. [Therapist:] Where did you getthe impression you were frigid? How did you happento use that lingo? [Linda Martin:] Well,from reading and Bob, I know in one of our arguments,Bob said I was frigid, and he said all myfriends think you're so attractive and so sexy, butyou're not really, which I... [Therapist:] But youhave had climaxes. [Linda Martin:] Yes. [Therapist:] You are orgastic,and you have been in the past in better settings? Correct? [Linda Martin:] That's right. [Therapist:] Well, that doesn'tqualify you for being frigid. [Linda Martin:] Well, it'sbeen a long time, though. You, you can't become frigid? [Therapist:] No, you really can't,not if you're being orgastic. It's a bad term, OK? So leave it in quotes,you know, take it off, wherever you're wearing it,and give it to somebody else, all right? Can you do thatfor yourself, OK? [Linda Martin:] Yes. [Therapist:] So you're not frigid. You do have somesexual dysfunction. You're not respondingas you'd like to. Fair enough. I'll agree to that, butyou're not frigid, OK? Well, let's summarizethe situation and see what we can do onthe whole thing, all right? First of all, I think youhave to appreciate that you've had negative conditioningfrom the past, and this seems toaffect you right now. [Linda Martin:] Yeah, I guessyou could call it that. [Therapist:] You're notentirely comfortable. Secondly, you've got to be ableto explore this communications distance with Bob in some way. We've got to bring him inand see how the two of you can deal with thisthing as a unit and not as just you it's your problem. [Linda Martin:] So youthink it's both of us? Both of our problem? [Therapist:] Sure. [Linda Martin:] That'sreally good to hear. [Therapist:] What do you think? [Linda Martin:] Well, yes. Frankly, it takes two. [Therapist:] Takes two totango or whatever, right? [...] [Linda Martin:] Yes. [Therapist:] So the finalpoint I'd like to make to you is something aboutyour own capacity for communicating in yourselfwhile you're sexual, OK? Seems to me when you getsexual, you know, you're just going through the motions. You know, you expect to relaxand all this, but you don't. Let me ask you a question. Would you ever tell Bobwhat to do in terms of how to help you get more excited? [Linda Martin:] Well, no. I mean, it seems like a manshould know that what you need is tenderness and gentlenessbefore and make you feel pretty and make you feel-- so you can lose yourself. I don't see why I wouldhave to say to Bob, you know, make me feel that way. I mean, that's like-- I don't know. Do this, do that. It's like a trafficcop or something. Because he should feel that! [Therapist:] If he really lovedyou he could read your mind. [Linda Martin:] SometimesI'm not sure he does. [Therapist:] But you feelthat way, do you not? Well, now [Linda Martin:] Yes. [Therapist:] Tell me, do you everask him to scratch your back? [Linda Martin:] Sure. Or rub it. [Therapist:] Why is that-- whyis that legal and you can't ask him how to caress you sexually? [Linda Martin:] Sexually? I don't know, I'd probablybe embarrassed to do that. [Therapist:] And, you'resmiling at the same time. I'll tell you why I bring it up.All right? [Linda Martin:] All right. [Therapist:] I thinkit's important for you to know that spontaneityand, you know, extra special romantic momentsare really matters of luck in most relationshipswhen time goes by, and there are other thingsin life besides just you and your lover. In your marriagewith a busy guy, and you're busy with thekids, perhaps the time for spontaneity hasreally gone by for now. You're too damaged. You're not communicating enough. So how can he possiblyunderstand you clearly unless you tellhim where you are? Certainly, if he had a problem-- if he had theproblem, he would have to tell you somethingabout how to caress him. Wouldn't he? How can you read his mind? Can you? [Linda Martin:] I don'tknow, I thought I could. [Therapist:] But can you really? [Linda Martin:] No, I guess not. [Therapist:] OK. And this is an important area tothink about for you right now. You've got astereotype about sex, that somehow good girlsthink a certain way and pure love is magic andcomes out a certain way. I would suggestthat you're really acting towards yourselflike your mother once did towards you. Shaking your fingers, sayingyou got to be special. Don't dare be bad, OK? How do you feeltalking today about it? [Linda Martin:] Really relieved. [Therapist:] Well, if you cantalk with me, what about the guy out there? Possibility? [Linda Martin:] Oh, I hope so. [Therapist:] All right. Bring him in nextweek, all right? [Linda Martin:] All right. [Therapist:] We'lllook at this matter from all the anglesI've described. Good to see you. [Linda Martin:] Good to see you. [Fade to black the zoom out from TV screen] [Harold Lief in studio set] [Harold Lief:] The interviewthat we have just observed can be divided into three parts. Establishing rapport,making an appraisal, and initiatingtherapeutic responses. Under rapport, we have togive the patient the feeling that we are on thesame wavelength, that we understand the patient. Under appraisal, we haveto pay particular attention to those non-verbalcues which allow us to infer those attitudesand feelings so important in our understandingthe patient. The interaction between thepatient and the counselor or physician is mostimportant because it is through the feelingsgenerated in the interaction that so much progresscan be made in therapy. The strengths andweaknesses of the patient must be understood becauseif the coping patterns are insufficient, if the patient'spsychopathology and liabilities far outweigh thosecoping patterns, referral to a psychiatristmay be necessary. This is a criticalarea of appraisal because every patient mustbe given the appropriate form of therapy. Initiating therapeuticresponse must go on during the very first session. We must educate thepatient, not only because we must have the patientunderstand that we understand, but we must reduce the confusionwhich creates so much anxiety. Tension reduction is alsonecessary to increase communication. Motivation for change mustgo on right from the start. But of course, it is onlythrough motivation for change that we can initiate andmaintain the tempo of therapy. Now let's go to instant replayand examine these three parts of this initial interview. [Zoom in to TV screen] [...] [Therapist:] Well,now, Linda, tell me, how did you happento come to see me? What's the difficultyfacing you? [Linda Martin:] Well, it's um-- [Rapport] I guess the problem is sexual. I went to see our ministerfor our local church, and he suggested I getsome professional help because I don't quiteknow what to do about it. [Therapist:] And howdid you feel coming in today to talk about it?How do you feel being here? [Linda Martin:] Well, I feellike it's really a necessity and I really want toget help and I really want to find out what'scausing these problems. I have to admit I'ma little nervous. [Therapist:] OK. Well try and tell me,for starters, if you can, what is the current dilemma? [Harold Lief:] Toestablish rapport, the counselor mustconvey the sense that he understands thepatient and is compassionately concerned. This reduces theembarrassment inevitably present in every patientwith a sexual problem. Allowing the patientto ventilate feelings is a critical stepin this process. [...] Appraisal must includeawareness of non-verbal cues. In addition to words andthe way words are spoken, body language andfacial expressions tell the interviewer many thingsabout the patient's feelings. In this sequence, thepatient opens her hands and reaches outto the therapist, indicating her appealfor understanding. Pounding her fist indicatesthe intensity of her feelings. She is really conveyingmore by her body movements than she is verbally. [Non-verbal] [Interaction] [Therapist:] After you getinto the marriage routine, you had your childrenpretty quick? [Linda Martin:] Yeah. [Therapist:] Right away. [Linda Martin:] The first onewas born about nine months... excuse me, a year later. [Therapist:] OK. [Harold Lief:] Interactionbetween patient and doctor usually provides usefulcues in the appraisal. The obvious slip of thetongue which you just heard indicates the probabilitythat conception occurred before her marriage. This may be highly significant. The interviewer has a choicebetween challenging the patient and letting this slippass without remark. What are the implicationsfor each choice? In making the appraisalin limited time, the doctor has adifficult choice between learning more aboutthe patient's current life or learning more about her past. Often, as in thiscase, the interviewer wants to learn more aboutthe connections between past and present. A response about herbody image in the past naturally leads to a questionabout how she sees herself these days. [Therapist:] How do yousee yourself these days? [Linda Martin:] Well, I-- I know I'm an attractive woman,but I don't feel that way with Bob anymore. Maybe-- maybethat's the problem. I even worry thatmaybe he would be interested in some other woman. [Gasps] [Therapist:] Has thisreally come up? [Linda Martin:] No, not really. It's just that I feel like ifI can't respond to him the way I should, that he may getinterested in someone else. [Therapist:] Right. [Harold Lief:] The therapist'sface reveals his uncertainty about the direction to follow. If he had continuedto explore her past, this is what wouldhave happened. [Therapist:] In terms ofgrowing into a young woman, developing a figure, beginningto be interested in guys, what was your response to that? Did you have any emotional,say, crises about growing? Were you extra heavy orextra thin or-- tell me something about that? [Linda Martin:] Well, I waspudgy as a little girl, and about 12 or 13, Ireally slimmed down and I, it was a good experience. I remember likingto have a figure and I know my father alwaysliked me to look pretty and he commented on it. I enjoyed that. [Therapist:] So you feltpretty good about yourself? Correct? [Linda Martin:] Yeah. [Harold Lief:] In watchingthe following sequence, note the patient'stypical embarrassment. In sexual interviewing,it is usually helpful to ask aboutthe patient's learning about masturbation before askingthe details of actual behavior. [Therapist:] How old were you whenyou first learned about things like masturbation? [Linda Martin:] Oh, um... I can't remember. College, I guess? Reading about it-- well, asfar as learning about it, really knowing aboutit, I guess college. I suppose I knewabout it before. [Therapist:] Did you haveany experience with it when you wereyounger, before that? [Linda Martin:] Um, yeah, I guess. [Therapist:] Now you look alittle anxious at this point? [Linda Martin:] Well, it'sa little embarassing to talk about. [Therapist:] And this is a prettypersonal touchy thing itself. [Linda Martin:] It's just thatit's kind of a funny topic. [Nervous laughter] [Therapist:] How do you mean? [Linda Martin:]Well, I don't know. It's always connectedwith the jokes or humor. I don't know. I suppose it has adistasteful connotation, too. [Therapist:] Have you-- haveyou indulged in at all since you've been married? [Linda Martin:] Rarely. [Therapist:] Does it have, do youhave any feelings about that? [Linda Martin:] I'm sure I stillhave the feeling that it's... not bad. I mean, I realized fromreading that it's not. [Therapist:] Intellectually. [Linda Martin:] Yeah. [Therapist:] But there'sthat quality to it... [Linda Martin:] It's not, it'snot as good as the other thing can be, that's important. [Coping patterns} [Therapist:] Now takeme to the present day. What goes on today, thesedays, concerning when romance and sex are in the air? What occurs? Paint a word picturefor me, if you can. [Linda Martin:] [Deep sigh] Nothing. [Laughter] [Harold Lief:] We oftenunduly emphasize maladaptive responses. It is even more importantto find out the patient's strengths and assets. The patient's responseindicates helplessness. She underplaysher real strengths in an effort to gainthe help of the doctor. [Linda Martin:] Well,as I say, we spend the evening with the kids. After we get the kids tobed, he's usually very tired, he watches television. [Therapist:] What'sgoing on in his mind if it's going to be sex? What do you, what doyou think he thinks? [Linda Martin:] Hegives me a look. You know, raises his eyebrow. [Therapist:] And your response is? [Linda Martin:] Well,it used to be... it used to be he didn'tjust give me a look. I mean, he would touch me,he would tell me I look nice or he would do something tomake me really feel that way. [Therapeutic response] [Harold Lief:] In initiatinga therapeutic response, education is used to buildthe patient's self-esteem and to give her a sense thatthe doctor is able to help. [Therapist:] Well,where did you get the impression you were frigid? How did you happento use that label? [Linda Martin:] Well, fromreading and then Bob-- I know in one of our argumentsBob said I was frigid, and he said, allmy friends think you're so attractive and sosexy, but you're not really. Which I-- [Therapist:] But youhave had climaxes. [Linda Martin:] Yes. [Therapist:] You are orgiastic,and you have been in the past in better settings, correct? [Linda Martin:] That's right. [Therapist:] Well, that doesn'tqualify you for being frigid. [Linda Martin:] Well, it'sbeen a long time, though. You can't, youcan't become frigid? [Therapist:] You really can't. Not if you've been orgiastic. It's a bad term. OK? So leave it in quotes,you know, take it off whenever you're wearing itand give it to someone else, all right? [Reduce tension] [Silent] If he really loved you,he could read your mind. [Linda Martin:] SometimesI'm not sure he doesn't. [Therapist:] But you feelthat way, do you not? Well, now, tell me, do you everask him to scratch your back? [Linda Martin:] Sure. Or rub it. [Therapist:] Why is that, whyis that legal and you can't ask him how to caress you sexually? [Linda Martin:] Sexually? [Laughter] I don't know, probably beembarrassed to do that. [Therapist:] You'resmiling at the same time. [Harold Lief:]Ventilation of feelings and the establishmentof rapport has reduced tension in the patient. The reduction of tension enablesher to learn more effectively. [...] [Motivate for change] In sexual problems, the partneris always involved in some way. Motivation for changeinvolves not only reorientation of herperception about herself and the knowledgethat her partner must be included in theprocess of change, but confidence that the doctoris willing and able to help. [Therapist:] So how can hepossibly understand you clearly unless you tellhim where you are? Certainly, if he had aproblem, if he had the problem, he would have to tellyou something about how to caress him, wouldn't he? How can you read his mind? Can you? [Linda Martin:] I don'tknow, I thought I could. [Therapist:] But can you really? [Linda Martin:] No, I guess not. [Therapist:] OK. This is an important area tothink about for you right now. You've got astereotype about sex, that somehow good girlsthink a certain way and pure love is magic andcomes out a certain way. I would suggestthat you're really acting towards yourselflike your mother once did towards you. Shaking your fingers, sayingyou got to be special. Don't dare be bad. OK? How do you feeltalking today about it? [Linda Martin:] Really relieved. [Therapist:] Well, if you cantalk with me, what about the guy out there? Possibility? [Linda Martin:] Oh, I hope so. [Therapist:] All right. Bring him in nextweek, all right? [Linda Martin:] All right. [Therapist:] We'lllook at this matter from all the anglesI've described. Good to see. [Linda Martin:] Good to see you. [...] [Instrumental harp music] [Harold I. Lief, M.D.: Director of the Center] [David M. Reed, Ph.D., M.P.H.: Asst. Director] [Executive Producer: Charles Galbraith Producer-Director: Stan Carlson] [Video Tape Editor: Bob Howard] [Produced through the facilities of] [of Northwest Mobile Television] [Music fades out] [Tail leader] [...]