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August 30, 2005

Ablow's folly

Salon culture critic Meghan O'Rourke discusses Dr. Keith Ablow's recent New York Times essay about men who are put off sex by childbirth. [Permalink] The blogosphere's heated reaction to Ablow's essay prompted O'Rourke to wonder: "How do we deal with the messy, intractable fact that our desires don't conform to our ideals for an egalitarian society?"

But Ablow's piece isn't about men who don't want to attend births as much as society thinks they should. It isn't even about normal visceral reactions to birth and fatherhood. The article described a few cases of men who developed long-term sexual dysfunction after witnessing childbirth. Ablow didn't spot a trend, he described a rare pathology. His proposed solution? That women and health care professionals coddle the entire male gender to protect the libido of a handful of weak-minded individuals. Now that's male privilege!

O'Rourke writes:

Today's women aren't celebrating pregnancy as a mystical orgasm, but they do see having the father in the delivery room as a necessary component of a healthy marriage, one in which both partners contribute equally to collective partnership. This is an absolutely reasonable request: Childbirth is scary and painful, and it makes sense to have reassurance and help from the person you're closest to (and your child's father). But the belief that men should be on duty no matter what assumes on some level that sex is just like all the other functions that the body performs. What the experience of the men in the therapist's article suggests is that, for at least some, this isn't true; for some, the erotic depends on maintaining a distinction between the sexual and the reproductive.

O'Rourke is urging us to be compassionate towards these poor souls whose libido is no match for biological reality. Fair enough. However, it sounds as if many of the "traumatized" fathers are responsible for their own ongoing discomfort insofar as it arises from modifiable irrational beliefs. Despite what O'Rourke says, the conviction that men should be on duty for their wives and children doesn't assume anything about the ontology of sexual and reproductive functions. Reality, however, establishes that sex is like other bodily functions. If that's not true "in your experience," you need a therapist who will emphasize gross discrepancy between your experience and real life.

Feelings are what they are. But mature adults develop coping strategies to prevent these feelings from derailing their lives. Adults understand that real life isn't always as sexy as fantasy. To borrow a construction from Jaegwon Kim, "That's why real life is real life and fantasy is fantasy." A patient who claims to have permanently lost sexual desire for his wife after seeing her give birth is laboring under some classic irrational expectations: That traumatic experiences necessarily cause permanent emotional damage, that if his wife isn't perfectly sexy she's not desirable at all, that it's intolerable that his real-life responsibilities interferred with his fantasy life, etc.

Appropriately, an interview with Albert Ellis, the father of Rational Emotive Behavior Therapy (REBT) appeared in the Village Voice about the time Ablow's essay came out. I couldn't help but imagine how Ellis would approach a man who was complaining about losing desire for his wife after seeing her give birth.

Patient: I'm alienated from my wife's vagina.
Ellis: Is there something wrong with it?
Patient: No, but I saw it give birth--it was so awful, there was blood and stuff.
Ellis: It still works, right?
Patient: Yes, but now that I've seen it squeeze out a slimy, bloody baby...
Ellis: It's not bloody now, is it?
Patient: No, but every time I look at her I can't help thinking about how awful it looked.
Ellis: Why can't you help it?
Patient: The mystery is gone.
Ellis: What mystery? What part of making babies didn't you understand? [...]

There's plenty of good advice that Ablow could have offered to dads and prospective dads. Practical: Guys, if you're squeamish, park yourself at the head of the bed and don't look under those drapes. Logical: The whole idea of "mystery" is pretty nebulous. You already knew where babies came from. Maybe you saw some gore and maybe that upset you. But why should a fleeting visual sabotage your libido indefinitely? Existential: Yes, parenthood requires major psychological and physical adjustments. No, of course you're not a bad guy for getting squicked. However, if this experience is chronically undermining your sex life, the problem lies with your coping skills, not with the intrinsic horror of the natural process you witnessed. In these cases, the patient's attitude is making his dick limp, it's his therapist's job to help him adjust that attitude. It's not the therapist's job to convince the rest of the world to accomodate the patient's delusions.


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I haven't RTFA, but I wonder whether it's not just the "icky stretched-out vagina" that causes the problem for men in this situation, but the Madonna complex itself (not wanting to have sex with her because she's a mother, not a sexual being) being intensified by watching the event take place.

Or maybe it's just that subconsciously, the man is horrified by the ordeal he's just put his wife through and doesn't want to take any chance of causing it again.

None of which implies approval, mind you.

In general, men seem more intent on maintaining the "mystery" of sex than women, using this, for instance, as an objection to the scientific study of sexuality. I think this is because the mystery covers up inequality, and understanding might lead to change.

What I want to know is how people find *time* for sex after they have a few children. Do they cut out blogging?

I was admittedly squeamish, at least the first time, but there was no way I was going to stay out of the delivery room for either of my two children.

Sex afterwards? Well, yes, on those occasions when there was time.

How many men are we talking about here? And did anybody bother to ask them what they thought about sex and the human body before they had the truth graphically illustrated for them? That is, are we talking about a bunch of guys who went into the delivery room already sexually screwed up?

I was there both times. I watched both times. I was very curious, not to mention concerned that the babies made it out, and for the life of me I can't remember the moment. Too much happening too fast and too much following, I guess. Never had any flashbacks later, either.

Just one father's experience, but I think mine's a far more typical one, just based on casual conversations I've had with other fathers.

My opinion's not worth much, except that my experience is the basis of my thinking this sounds like a problem made up to get a byline in the New York Times and a book contract.

Patient: Yes, but now that I've seen it squeeze out a slimy, bloody baby...

Ellis: There's no more blood is there?

Patient: No, but every time I look at her I can't help thinking about how awful it looked.

Are these guys just as put off by the sight of their child (that slimy, bloody baby the wife squeezed out of her vagina) or have they sexualized their child because it in a place previously reserved for their penis? I can understand a guy being squeamish and not wanting to watch the actual birth process. I can even understand the guys weirded out about having sex with their pregnant lovers because their baby is in there. I can not, however, fathom what degree of pathological immaturity it takes to be rendered impotent because his child was delivered vaginally.

Ha ha ha ha!

I'm not sure how a certain subset of men lost so much of their starch, turning into whiny 'victimo sapiens'. Get a grip, man!

While I'm sure there's some level of trauma or horror that would put me off sex, for the life of me I can't imagine what it would be. It certainly wouldn't be the thought that my wife was capable of complete normal biological functioning.

These men should have been born as oysters. Sex is too good for them.

Amy Sohn did one of her NY Mag. columns on this recently. The men offered delightful quips like, "It looks like a papaya," and "If an area that’s zoned for recreation gets rezoned for business, it never gets zoned back." Charmed, I'm sure. (If you're interested, google "amy sohn" and "papaya.")

I don't know what is gained by showing the cross-sectional anatomy of a woman's torso to her lover.

This part really chapped my hide. Anatomy is off-limits? Does this guy think that male OB-GYNs are all impotent? If so, he's off-base, since last time I went to said doctor, his wife was pregnant. I've known men to be with women who suffered terrible gynocological problems that would often put childbirth to shame and they never seemed worse for the wear. I really do think that one can muscle through this sort of thing and in fact, you have to because it's your duty as someone's partner to accept that person is human and has a human body. I agree that it's good these guys are getting help, but this psychologist is way off-base.

Husbands attending childbirth seems to be the nearly universal custom. So if a husband doesn't want to attend, he's got some explaining to do.

I suppose there are periods in most marriages when one spouse feels averse to sex or romance. I don't know if rational thinking can help much with that; but it can help with deciding that acting like a dick is never a good idea.

I don't get it. What is wrong with these guys?

I was there for both of mine. I was at the foot of the bed. I saw the head crown both times. And I admit, I felt a little sick to my stomach the first time around. I think that it was more about the swirl of emotion (and the sudden spell of amniotic fluid) than anything visual.

But the whole mother and child thing is very sexy. The bond that I felt for both my wife and new child was probably the biggest turn on I have ever known. I was patient, but I must admit that I was glad when the epesiotomy stiches came out and the OB/Gyn gave us the all clear.

Childbirth...the turn off. The former love canal becomes a bloody/mucusy birth canal. Not for me, this biological imperartive.

I think Cranky's on to it... the obvious predicament (which precludes a "postdicament") is that the former Love Canal has experienced something bigger and more grand than these dudes' babymakers- and that's their psychological dilemma, ie "how is this thing EVER gonna satisfy, or even raise some mild interest, again, for my Love object, after All That?" Sometimes, extrapolative powers may be best left unprovoked... ^..^

God knows I was put off sex by childbirth.

Well, not so much "put off" as squeezed back. The screaming and the nurses telling me to piss off didn't help much either.

Okay, I'll shut up now.

To me, Rational Emotive Behavior Therapy has always seemed like a very good mental health intervention for people who don't need mental health interventions.

Over a very long history of mental health problems, I've tried very hard to rework my internal dialog along rational lines. It's been extremely hard work to do so, and the attempt, on the whole, has improved my condition, marginally.

But there's a reason it was so difficult, which is this: I have a very long history of mental health problems. If I didn't have that, being able to reason with myself would be a lot easier.

Now that I'm being medicated effectively, I'm finding my application of REBT is a lot more effective. It would be nice if this regime continued to be effective, but there are no guarantees.

Now, given my background, on this topic I'm a lot more sympathetic to the person with the mental health problem than I am with you, who seem to come from the "this is all your fault, and you should snap out of it" therapeutic school.

Ironically, it's that voice I remember as the one in my head that I spent so much time trying to argue against.

But forgive me if my opinion isn't coherent. It's to be expected: I suffer from mental health problems, so I'm a "weak-minded individual."

And no doubt these delicate flowers are incapable of changing a diaper - because how could they continue to love their children knowing that they aren't always sweet-smelling angels sent down from heaven?

Some people are just hopelessly fucked up. Their wives need to accept that and get on with their lives - and seek out guys who like to fuck living women, not plastic sex dolls.

And those men who think childbirth is so revolting need to get vasectomies - now.


For these people, their relationships and satisfaction in sexual life is degraded to the point where they have sought professional help.

Most people like these who witness childbirth are able to deal with the experience and continue to have normal sexual life.

For whatever reason, these people have not been able to deal with the experience. Maybe the way they process powerful emotional experiences is different than for other people. Maybe they're prone to certain kinds of fixations or obsessions.

Whatever is going on, it's clear that, unlike for the overwhelming majority, their efforts to get past their problem by applying "right thinking" have failed. Given that their discomfort is great enough that they've sought professional help, the failure is, I would guess, not for lack of trying.

Some responses here to this have been frightening and barbaric.

Listen to the name-calling: Lindsay leads the way with "weak-minded." Ol cranky "cannot...fathom" the problem, which would be a good standpoint from which to withhold judgment, except that then a judgment of "pathological immaturity" is offered. To The Great Beast, our sufferers are "whiny," have "lost...their starch," and need to "get a grip."

Nancy takes the broader view. After some snark, she comes directly to her diagnosis: "hopelessly fucked up." She prescribes no therapy for the sufferer (Lindsay would presumably suggest an exercise regime to strengthen the affected weak mind, ol cranky probably presumably would have us off to military school, while The Great Beast prescribes suggest a grip and some starch.) No, Nancy's advice is to the spouse of the sufferer: abandon him.

Amanda stakes out a "liberal" position: "it's good these guys are getting help." But one can "muscle through" this disorder, and one must, as a "duty" owed to one's partner. Sure, the number of entries in the DSM-IV for which the recommended therapy is "tell the patient to suck it up" is a damn short one. And there is currently no Appendix to the DSM-IV listing the disorders that a patient has a moral obligation to recover from. But surely Amanda's extensive CV and clinical experience make such additions a cinch for the DSM-V.

Indignant moralizing hurts people with mental health problems. It's an common form of victim-blaming by naive non-sufferers when such suffering constitutes a breach of the moral order.

Of all the responses on this thread, only ajg's is reasonable: "I don't get it. What is wrong with these guys?" What ajg says is true of all of you. You don't get it. You don't know what's wrong with these guys. In the future, in discussing mental illness, consider withholding your judgments and your name-calling and your ignorance and your moralizing and your idiotic fucking diagnoses.

"a 'duty' owed to one's partner."

I don't think it's realistic or reasonable to expect anyone to feel sexually attracted to their spouse throughout a marriage. otoh I think it's unreasonable and unrealistic to think that a marriage could last happily if one spouse is withholding sex. So the guy is miserable. I feel sorry for him. But he doesn't have to make his wife miserable too. Anyway, having sex with her is a duty only if there was a specific agreement ("I promise to fuck you 3x weekly"); but it is a good idea in any case.

These guys were traumatized by the experience, and being typical males they wall off their reaction as reflecting something other than personal weakness. Obviously they need help, but their reaction does need to be understood as a form of self-protection.

Some women have a comparable reaction, that is, they are unable to bond with their babies because their experience of childbirth was so traumatic. Being typical females, they blame themselves as being inadequate.

The therapist is wrong for drawing any general conclusions about the suitability of having the dad present, anymore than it would be suitable to assume that because some women are too traumatized to bond with their babies, that women weren't really meant to give birth. Most dads do just fine and wouldn't have missed out on it for the world, but the dads whose experience overwhelmed their coping skills shouldn't be belittled, even if their comments seem crude and silly.

Anyone remember how Amy Richards was belittled for reducing her feelings about having triplets as being required to shop at Costco?

SD, you're assuming that I have no personal history of mental illness. You're wrong.

I don't believe that mental illness itself is weak mindedness. If Ablow's patients have some systematic pathology that prevents them from adjusting their attitudes, then by all means don't blame them at all.

However, Ablow doesn't seem to see it that way. He thinks these guys are experiencing a relatively common reaction to the birth of their children. You can tell he thinks it's pretty common because he suggests that all women consider the male fragility of the male psyche when they decide whether to ask their partners into the delivery room.

Therapists are supposed to provide their clients with unconditional positive regard, but even they don't have to approve of their clients' attitudes. It's quite possible and often therapeutically necessary to say "Your illness is causing you to engage in irrational thought patterns that are undermining your own happiness and hurting people around you."

Ol cranky "cannot...fathom" the problem, which would be a good standpoint from which to withhold judgment, except that then a judgment of "pathological immaturity" is offered.

Social Democrat: they're in need of pretty extensive therapy to treat this condition. . .that would make my comment regarding the pathological nature of their reaction quite appropriate from a clinical perspective.

I would amplify what Lindsay said -- not only is the therapist wrong in asking the woman to "consider" the frail male ego, his approach is likely to compound his patients' problems by normalizing them -- that is, by suggesting that what was a clearly pathological response was normal. How in heaven's name are they going to gain any insight into what happened with that kind of therapist's attitude?

I probably shouldn't be posting this from work, but...

If he's oogied out by the vagina, there's always the pooper. Nothing disgusting about that, is there?

SD, you're assuming that I have no personal history of mental illness. You're wrong.

I made no such assumption. I considered the possibility that your reference to REBT was not merely academic.

I set aside this possibility when posting, though, in order to give you the benefit of the doubt, because if you had experience with mental illness it would make your appalling lack of empathy more culpable.

Lindsay, you're saying your concern is with Ablow.

But in writing about Ablow, you also wrote: "His proposed solution? That women and health care professionals coddle the entire male gender to protect the libido of a handful of weak-minded individuals."

It would take a tortured reading to conclude anything else but that you're calling Ablow's patients as "a handful of weak-minded individuals."

My point is that this sentiment is not consistent with an enlightened understanding of mental illness.

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