The Technology of Orgasm: "Hysteria," the Vibrator, and Women's Sexual Satisfaction (11 page)

If hysteria had its origin in juvenile exposures to sexuality, whether real or imagined, the husbands and male lovers of adult women were entirely exculpated. They need not exert themselves to provide the cure in the marriage bed that Charcot had hinted at, since only a professional
therapist like Freud could “talk out” the disease. This hypothesis proved so appealing that it soon eclipsed all other discourse about hysteria, neurasthenia, and chlorosis. Some mavericks like Wilhelm Reich continued to argue as late as 1927 that neurasthenia and hysterical neuroses in women were caused by lack of sexual gratification, but within a few decades Freud’s became the dominant paradigm.
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His definition was retroactively applied to all supposed cases of hysteria, modern or ancient, couched in terms that made it sound almost like a respectable medical diagnosis. Wesley says, “When the word hysteria is used alone, the reference is to
conversion hysteria
, a term coined by Freud. In this context, it means the appearance of an organic condition with no underlying organic causation.”
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Freud’s view of hysteria redirected not only the attention of his colleagues in the psychological sciences but even that of historians making retrospective studies of the hysteroneurasthenic disorders.

The failure to make sense of hysteria after the Freudian revolution is epitomized in a 1953 article by George Swetlow, a professor of medicolegal jurisprudence at the Brooklyn Law School. Just after the end of hysteria’s 2,500 years of acceptance as a disease paradigm, it is evident that neither Swetlow nor any other physician is quite sure what hysteria was. Swetlow says that it is “a strange disorder in that it takes a position midway between truth and deceit—not only may hysterical symptoms caricature almost any known disability due to actual tissue alteration, but at the same time it presents features hardly distinguishable from fraud.” He goes on to attribute the Freudian etiology: “Forbidden wishes and longings totally unacceptable in a civilized society were never relinquished but merely postponed to a more propitious future.”
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In this model, it would be a marvel if any human being escaped the disease. Clearly, it was a paradigm that explained everything and therefore nothing.

Recent historiography has begun to address the gender issues implicit in the disease paradigm of hysteria. Since 1972 the subject has been taken up by a number of historians, among them Carroll Smith-Rosenberg, Barbara Ehrenreich, Michel Foucault, and Peter Gay. Smith-Rosenberg has postulated that hysteria in nineteenth-century women was a symptom or result of conflict between their hypersexualized role and the social denial of their overtly sexual feelings. This could be interpreted as an intellectually elevated argument for what I am proposing
here in substantially more earthy terms. Whatever Smith-Rosenberg means by “conflict,” she does not explicitly question the post-Freudian definition or symptomatology of hysteria and does not appear to see in the pre-Freudian disease paradigm the normal functioning of women’s sexuality.
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Barbara Ehrenreich and Deirdre English, in
Complaints and Disorders
, discuss the apparent “epidemic” of hysteria in the nineteenth century and describe it as a “new disease,” without an examination of the antiquity of the disease paradigm or its fluid character over time. They do mention, however, that “female sexuality could only be pathological, so it was only natural for some doctors to test for it by stroking the breasts or the clitoris.”
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Michel Foucault superficially addresses what he calls the “hysterization of women’s bodies.” His purpose, of course, is to describe broad social and medical trends, not to document details of how disease paradigms might have masked uncomfortable truths about women’s sexuality:

A
Hysterization of Women’s Bodies
: a threefold process whereby the feminine body was analyzed—qualified and disqualified—as being thoroughly saturated with sexuality; whereby it was integrated into the sphere of medical practice, by reason of a pathology intrinsic to it; whereby, finally, it was placed in organic communication with the social body (whose regulated fecundity it was supposed to ensure), the family space (of which it had to be a substantial and functional element), and the life of children (which it produced and had to guarantee, by virtue of a biologico-moral responsibility lasting through the entire period of the children’s education): the Mother, with her negative image of “nervous woman,” constituted the most visible form of this hysterization.
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Without, again, addressing hysteria’s long history before the nineteenth century, Foucault touches on a significant point: that women’s sexuality was thought to require medical intervention. His discussion does not include the omission of female orgasm from the normative medical model of the nineteenth century, and he has little to say on what this might imply about hysteria. Like many others, he fails to question the disease paradigm itself: Why is this disorder so elastic in its boundaries that it can encompass such a broad spectrum of social goals?

Peter Gay, an unblushing fan of Sigmund Freud’s contributions to
human knowledge, erroneously attributes to him the invention of the idea that these “‘noxae’—hysteria and anxiety neurosis” were caused by “a failure of sexual gratification, whether on the part of the man or the woman.” Gay characterizes Freud’s endorsement of a hypothesis at least as old as Hippocrates as “a radical departure.”
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Freud’s belief that men could be hysterical certainly was a minority opinion in his own and earlier times, but as we have seen, the concept of hysteria as a sequel of sexual deprivation had currency for many centuries before Freud’s time. Oughourlian has a somewhat less sanguine view of Freud’s achievement, pointing out that “we need only replace the word ‘retention’ in the theory of Galen … and in all those who were inspired by it during the next fifteen centuries or so with the term ‘repression’ … and replace ‘purgation’ with ‘catharsis’ to discover in all its supposed originality the Freudian theory of sexual neurosis.”
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Although Gay’s views on sexuality are, as we shall see, substantially androcentric, he does raise a question with real significance for understanding hysteria as a disease paradigm: “To deny women native erotic desires was to safeguard man’s sexual adequacy. However he performed, it would be good enough. She would not—would she?—ask for more.”
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If she did, she could be labeled hysterical and sent to a doctor for treatment, thereby both removing the threat to her sexual partner’s self-esteem and preserving the androcentric norm of penetration to male orgasm. It is to the persistent lure of this model of normal sexuality that we turn in the next chapter.

3
“MY GOD, WHAT DOES SHE WANT?”

Donald Symons, in his 1979
Evolution of Human Sexuality
, says that female orgasm “inspires interest, debate, polemics, ideology, technical manuals, and scientific and popular literature solely because it is so often absent,” unlike “the male orgasm, which exists with monotonous regularity and for the most part is interesting only to people directly involved in one.”
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As we observed in
chapter 1
, it has been clinically and popularly noted at many times and places that women do not reach orgasm during coitus as readily as men do, and that sustained stimulation of the clitoris is usually required to reliably produce the paroxysm described by Masters and Johnson as “a highly variable peak sexual experience accompanying involuntary, rhythmic contractions of the outer third of the vagina—and frequently of the uterus, rectal sphincter, and urethral sphincter as well—and the concomitant release of vasocongestion and muscular tension associated with intense sexual arousal.”
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This is, of course, a medical definition of orgasm: in this century as in previous ones, physicians are considered the experts on sexuality, and they carry much of the responsibility for establishing sexual norms.

In the second half of this century we have determined that most
women do not have difficulty producing orgasm in themselves through masturbation, as Symons observes when he summarizes Kinsey’s and Hite’s research reporting that most women, like most men, can masturbate to orgasm in a little over four minutes, even though they rarely or never reach orgasm during intercourse. These authors “suggest that many women do not orgasm during intercourse, or do so sporadically, simply because sexual intercourse is an extremely inefficient way to stimulate the clitoris.”
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Empirical studies have shown that women are not slower than men to become aroused and satisfied and that their orgasmic potential is much greater than that of males. In Kinsey’s sample, 45 percent of the female masturbators reached orgasm in less than three minutes. Carol Tavris and Carole Wade pointed out in 1984 that “during masturbation, especially with an electric vibrator, some women can have as many as fifty consecutive orgasms,” a figure that must have raised the ancient specter of female insatiability in more than one male mind.
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The lack of parallel experiences in intercourse for men and women flies in the face of both intuitive reasoning and cherished myth: How can it possibly be adaptive for women to experience orgasm primarily by some means other than the procreative act? How can it be that the act that socially and historically has defined masculinity and to which, to a significant extent, male sexual self-esteem is ultimately linked is not reliably rewarding to women? Why, indeed, do most women desire men at all, when intercourse so often proves a disappointment? Let me assert again that I will not be able to answer all these questions, especially those that relate to the mysteries of reproductive physiology. For example, why should the clitoris not be inside the vagina so as to receive stimulation more efficiently during penetration?
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What is really remarkable about Western history in this context is that the medical norm of penetration to male orgasm as the ultimate sexual thrill for both men and women has survived an indefinite number of individual and collective observations suggesting that for most women this pattern is simply not the case. Clearly there is a strong cultural motivation to deny the contrary evidence. Even when observers have made every effort to be objective and scientific, the androcentric bias has come through in the questions that are asked of the data and in the kind of data that are ruled out of bounds, as when Masters and Johnson selected
their sample of married women to exclude all those who did not reach orgasm during intercourse.
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The failure of traditional medical theory to understand the difference between male and female orgasmic experience has had far-reaching effects. All healthy women, according to the traditional medical view, desire penetration by males and are sexually incomplete and unsatisfied unless so penetrated. Thus a man who penetrates a women can think of himself as doing her a favor, contributing to her mental and physical well-being, especially if he makes her pregnant.
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Women who desire or express sexuality outside this context have been perceived as flawed, sinful, or sick, and men consider themselves justified in imposing social and medical sanctions to get compliance with the normative model of female pleasure during heterosexual intercourse that reinforces male self-esteem.

Since women cannot alter their sexual physiology in order to achieve actual compliance (consistent orgasm during coitus), they have employed a variety of strategies to reconcile reality with the normative model. The intellectually convoluted character of some of these conceptual dodges, a few of which I shall enumerate below, is reminiscent of Ptolemy’s ingenious and, for many centuries, persuasive efforts to explain the apparent motion of heavenly bodies without removing the earth from the center of the universe.
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In both cases removing man (the gender is used advisedly) from the center of things would have required a thoroughgoing reevaluation of the entire framework of belief. To this day most men (and many women) resist reconceptualizing sexuality as something other than a hierarchy in which heterosexual coitus occupies the apex.

PHYSICIANS AND THE FEMALE ORGASM

Since ancient times, physicians have employed five basic strategies to reconcile perceived female sexuality with androcentric norms. The first and least common, of course, was the “emperor’s new clothes” approach: the straightforward acknowledgment that only a minority of women reach orgasm during penetration without clitoral stimulation. Opinions of this kind generally accompany recommendations that such stimulation
be provided during or before coitus, not through masturbation. Second, some physicians (and historians, as we shall see) who wrote about female sexuality confused enjoyment and arousal with orgasm, conflating desire for heterosexual contact and “turgescence” of the female genitalia with orgasmic resolution. Third, as we have seen, the sexual symptoms called “hysterical paroxysm” were observed by doctors who seem to have had little or no experience with the kind of female orgasmic behavior described by Masters and Johnson. Fourth, many physicians of the nineteenth century combined this failure to recognize sexual behavior when they saw it with a conviction that most women lacked sexual feelings and desire. This last was true whether or not the physician in question believed frigidity and anorgasmia were healthy conditions; some felt that an absence of sexual feelings in women was a pathology caused by the stresses of modern life, corsetry, overindulgence in masturbation, or marital incompatibility. Finally, some medical authors omit all mention of female orgasm, even in discussing female sexuality.
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