The Myth of Sex Addiction and the Science of Sex with Nicole Prause
One of the hello everyone. Welcome to factually. I'm Adam Khan over and here's a story you've heard before a famous man gets in trouble for cheating on his partner. Of course he doesn't WanNa look like jerk in the press though. So here's what he does. He comes out and says no no no. I'm not I'm not a jerk. I'm a sex addict. See By using the language of addiction. He's able to medical problems. Seek treatment and absolve himself. Rikers is not just an asshole. He had a disease. And here's the thing if you've got cash there's a network of scientifically dodgy sex addiction centers. Who are waiting to help you. Launder your reputation. We have seen this story play out again. Time and time again in the press. Just Take Anthony Weiner today the example of one famous Dick The Truth About Sex Addiction. Though is that it isn't really an actual medical thing that look of course it's possible to have sexual behaviors. That are bad for your personal or professional life right. You can totally fuck up sexually in a way that is damaging and it is quite possible to want to seek help with that but if you look in fact scientifically at the way addiction works in the brain. Sex addiction doesn't really measure up instead of people addicted to say drugs or smoking or gambling. Their brain activates very quickly when they see a picture of what they're addicted to give an addicted brain accuser. It's addiction it. Just lights up but when you show as opposed sex addict or porn addict the thing that they're supposedly addicted to their brain. Reacts Pretty Normally another sign of Addiction? Is Something called? Esscalation for something to be addictive. It needs to be more and more addictive over time so in the case of drugs you start with a little bit and then you need more and more until you work your way up to. What could be a lethal dose? In some cases but in porn studies have shown no evidence for escalation in terms of the time spent looking at it or a slide into more and more extreme content. So it's no wonder then that the American Psychological Association and the World Health Organization have rejected sex addiction as a clinical definition. Six suggestion just does not seem to be a real thing now as a society we are sex obsessed but this misunderstanding about sex addiction is just the sexy tip of our ignorance. Iceberg sex is a foundational part of our humanity but our conversation about it is often shrouded by superstition and pseudoscience and senseless moralism. The fact is that despite its centrality to our lives. We don't know that much about sex at all. Well here today to tell us more about the new frontiers of sex science. Our guest today is an honest to God sex scientists. Her name is Nicole prowse. She's a PhD in currently a scientist with libra. Now I want to say we did our very here to have an inclusive conversation about sex but I want you to be involved in that conversation. 'cause I'm always trying to do better in that regard so please hit me up on twitter. Let us know how we're doing and with that said Hey. I really hope you enjoyed this conversation. It was a really fun. Please welcome Nicole Browsing Nicole. Thank you so much for being here. Thanks for having me on. So you're a SEC. Scientists sure confident about it. I go by many names. That's a good one. Okay what what else are you called? Technical is sexual psycho. Physiologist said. That's an umbrella for the psychology and physiology kind of joining those fields together psycho physiologist cool and you work for a company called Myself Libro. I'm very sorry your company's Got Lieber as and you told me just before we started recording. You do what sexual biotech now. What the Hell is that? That's very intriguing. It's a sexy our way of saying sexual psycho physiology. Okay okay the yeah. Most people don't know that term so kind of sexual biotech nays. Broadly what we're doing and It's maybe less sexy than that makes me. Yeah I mean I just start. My mind starts spinning with like science fictional ideas like like Nanno boss and make you horny or something like really well wait. I made that one of the things we'd worked on is like Patterns of Automated Genital Stimulation for an orgasm steady. We were working on and the question is what is that like. Why does an automated pattern? That would work for men and women to such thing exist and it turns out there no data on that so we had to do some piloting and that involved automating vibrate around the genitals to figure out how to how to stand cheat that response so there are people so i WanNa get the day to day a Sec Science. You got a vibrator and you got control. Group is getting one kind of pattern absorbs and then you're some people are getting. Some people are getting or what? That's what I want you to think. Most of our day programming school analysis but the fund as our yes like piloting bringing in poor friends pilots who are willing to let them up in non-threatening ways to try out different things that were so sex science you. You said you don't have you didn't have data on that particular thing. You were looking for a SEC. Science understanding is it's kind of weirdly undercover topic. Yeah we have all kinds of challenges and getting our work done and so we're a very thin on some areas of development and how to test things especially in the high arousal range so that's kind of anything beyond a few minutes a porn. We don't have a lot of data four in the lab. Now why is there so some of the challenges are political especially in the US? We have Groups that openly oppose us and try and stop our work For example the primary funding group in the US is the National Institutes of Health And there have been five grants brought before Congress in the history of the NIH all five or six grants. That is these grants that were awarded in Congress trying to take them away because they didn't like the H. Was funding anything to do with sexuality so as thin as the funding already is near our grants can be taken away from us just because of the content area that we work on and so those are kind of solid institutional barriers. That obviously if you have no money you can't get work done. And there are lots of protests as well so near the. Us Is a Christian nation and we have lots of religious groups that oppose what we do. And there's a lot of Christians in the nation I wouldn't I wouldn't call it a Christian depending. Yeah how you WANNA slice that But they're certainly very vocal and very influential or you know. We have people who feel very strongly about sexual values and so we're we tried to reduce our bias and Investigate things from a scientific perspective. But it's impossible not to step on someone's toes with almost anything steady in that domain. And so you know we regularly are getting threatened and everyone wants US fired from wherever we are just. It's a tough place to get good scientists to work because you know if you're an excellent neuroscientist and you can go into depression where there's a path and there's funding and it's a known quantity or you can go and have to fight your way for the rest of your career to even be able to do your research. If you're excellent. You have a choice. Where do you go? Do you probably go to less resistant path. Where you're not going to have to fight that fight everyday. It occurs to me that you know of the types of scientists. We've we've had on the show sleep. Scientists all different just trying to think about stuff with the human body often they're university affiliated and and you know but come to think of it. I'm like well it almost tracks for me that you're An independent operator Doing this research opposed to hear from USC. Today is there. Is there also institutional barrier with those big research institutions that like? Maybe don't want people jacking off in the science lab absolutely. I wasn't academic for ten years. Actually and I came here to work at Ucla in psychiatry and that was my kind of a decision to transition out entirely and not to try any more academia was we tried to get a study through to study orgasm in the lab and the Ethics Board will allow us to buzz the genitals we could put a vibrator on them and like Buzzer for a few seconds. But we had to promise they wouldn't need Jackie late and we can try. It doesn't sound like much of an orgasm. Yeah well so if you want to study that process this a no go like. We have to let them do that. Ethics Board wouldn't allow it through and for not giving any good reason that we could discern another university. Science isn't supposed to be this much fun. All right. That was kind of what we can blue balls. This we draw the line. What if you go to the ethics board like Like a jilted fifteen year old boy like oh no come on. It's dangerous if you if you don't comb it could be bad for you like on the myth too late. Sorry guys. That is a myth. You can't use that argument but so you went into the independent world. Yeah and so I still collaborate with universities you know I love scientists and we get along really. Well it's more the Kind of deans. That our hand wringing and worried you know what their donors are. So I. Yeah. We still have oversight Same oversight they of ethics view that any university research has just collaborate with them and I think those universities are happy to have the orgasm. Study AT SOME WEIRD INDEPENDENT LAB IN L. A. That's not us. It's not happening on our campus. There's just the little it's like. The science version of like the little curtain in the back of the video. Rental store is the adults only. It's like just a little bit separate so Mama Deck and still shop in front but like if you want the good stuff you know what function and it gets. The work done. Must go but this other. It's hard to get that research done because sex is like such a fundamental part of human life. I mean we I would. Is it the case that we understand a lot about eating and breathing and sleeping but a lot less about sex in many ways? Yes especially kind of functionality insect so we know a lot more about male anatomy. But they're still questions about female anatomy and functionality. That's where we're like gone like basic stuff. Yeah so kind of Like you know once you've got a cadaver you can cut it up and you can look at stuff but you don't really know how that works when the person is alive. Which seems more? That's not the best way to study. Sex is just. Cut UP A CADAVER. Help you a little bit. But you're like how does this cadaver -actly so if you want to say well how you know when this is an action. What's really happening? We understand that. Yeah so the function as functional aspect. Is I think where we really have big gaps in understanding like how does this work when someone's interacting You know by themselves even as one thing versus with a partner that is infancy. We know very little about two people interacting together sexually really. Yeah this is You may have seen really fun study. I did with a case Ten years ago maybe now they put two people in an MRI tiny people and had them have a vaginal intercourse and just image pelvis. And I go oh. We didn't know that fit that way. Really what did know what to look at this before. What way so they were describing. The penis is more a boomerang shape when it was intra-vaginal at least in this couple and of course we don't have big population samples of this. We don't know how common that is or how much that varies. But we always joke if you have a sexual interaction yet. It's like Oh this is straight as well. It turns straight in. You know it's like there's a lot of curvature and what might that mean in terms of functionality of getting you know if you're trying to become pregnant of expelling the ejaculate and to the vaginal area and you have that can impact a uptake. So those are kind of functional questions that the science looks a little goofy and it made the news around at the time it came out. But they're real functional questions about that you know it matters that it's a boomerang and not a stick goes in so it's kind of striking to me that like you know there's famous Sex researchers right. There's Kinsey Institute number seeing that movie. Trade Yeah Really. Oh you did. I saw that movie with my parents. It was fun Masters Masters in Johnston right there. These are famous. Names are progenitor. Is Yes progenitor. Exactly but that was a long time ago and and I'm not you know other fields have we know Albert Einstein. We also know Stephen Hawking but it seems like with sex. We are sort of stuck in that. Same people are still up Kinsey scale. Yeah that's the most up to date stuff like wait. That was like sixty years ago. Yeah Yeah about. I think like masters and Johnson are a great example because they have this really famous model of sexual response like immune taken a human sex class. Like an intro class in College. You got taught this model. You're still getting taught this model. I think the models wrong and I think we have data to show that part of. It's wrong but it's going to take a while to get it out and I don't know anyone else even working in that area. Yeah so you know it's as we continue to have these kind of repeated over and over again. Yeah it's GonNa take us a while. Correct the record. Update the record. But it's just. We are a tiny tiny field so I would guess like in the. Us There may be twelve us. Doing Sexual Psychopath Geology. Most people have fled from Hanover. People most have left because of the climate in the US and they'll go if they're English speaking probably to Canada And then Europe doesn't have grants that are as big so there are quite a few folks that study it in Europe but they aren't Sometimes able to have as big of projects just because the funding structures are different. Americas falling behind in science absolutely falling behind. And it's an embarrassment. We're losing the SEC. Science Cold War Well what are the big like the thing is? There's so much pseudoscientific language about about sex. I was talking to the intro about sex addiction. You hear people say with porn for example that like they say it quasi scientifically worn is ruining American. Men's sex lives We've had that pitch. Come up in the in the ruins. Everything writers when when writers and researchers are pitching. I I read this about. The porn is like an epidemic. That's ruining American men. Sex Lives and then. I've also heard the all the the the opposite pitch of actually. That's a myth and the fact is we couldn't find enough solid information to do the story we just said we. We actually are not sure what the truth is. So we're not gonNA do this So yeah I mean you you side when I was saying part of that. So yeah please please enlighten me. What is the truth here? Well so there are two things. One is kind of its current status in the diagnostic. Whatever and then there's kind of the science issues and so Naro diagnostically speaking no one recognizes porn addiction so we have the national group which is a diagnostic and statistical manual that does not have porn addiction or sex addiction. Or anything like that. In it. And then We have international the International House classification of disorders and it does not have porn addiction in either has something that looks a little more like sex addiction but is different that they've just introduced called sexual compulsivity which was very controversial about that So no one recognizes porn addiction. That doesn't appear anywhere. You can't diagnose it there's no code for it however In the scientific area you know. We're having lots of debates about clearly. Some people are walking into office. Saying I'm watching too much porn right. Yeah PEOPLE EXIST. Read it and you can find whole communities of. I mean you can find communities of people who are doing literally any this. You can find people who are who are jerking off to paper clips and they post pictures of their favorite paperclips deeper than I did. But but yeah I mean that's what that is but yes there are people who feel this problem and they're like God I I need help. Yes so the question is when someone. Yom also licensed psychologist if someone moves into my office and says I'm believe I'm watching too much porn. My first question is where does that. Come from the ideology. Because that's how I know how to help you. So the best predictor of someone identifying as a porn addict is that they were raised with conservative values. Not necessarily religiously but that their family has conservative values and on average they tend not to watch any more than people who are not distressed about their use in other words. These are people who just feel horrible. Like they're very shame based in general and they feel bad about lots of things they do and they may have some perfectionist stick kinds of qualities and their personality. And that kind of a person you know if they present to me and say. I'm watching too much porn. I'm probably going to do education with them. Talk about shame issues and Family of origin issues. Maybe However you know if someone's coming in May I'm watching a lot of porn before I go out at night to the bars and then I keep me. I mean to D- faithful to my partner. Who doesn't want me sleeping around and and I mean to use condoms and I you know I've got all these conflicts and I'm not making tour like okay. There's something else is happening. Could be lots of things. Are you depressed so a lot of people who believe that they have a porn problem? Where SEX PROBLEM Actually have a primary Diagnosis of major depressive disorder. And that's how they cope with it. You know there's a adjust my emotions. Well I'm not treat porn. I'm going to treat your depression because we have excellent treatments for depression. And if you're just using it to cope while that makes sense absolutely or are you doing that because it's a feature of mania and you have bipolar disorder. There are so many things you know that you have to go through before I would even start to think about that. And then the data we do have specifically on people who have like porn issues They just don't fit a lot of the classic of addictions in general so they don't look like other substance addiction models. And something's going on. You know we want to figure out how to best help these men and women and whomever who have these issues but There there's just so much push stamp it with addiction. I think they're some financial reasons for that. Maybe some political reasons for that but not they're not scientific. I don't think we can call it. Addiction ADDICTION THE PROBLEM IS ADDICTION. Itself is also poorly understood and and calm and very complex. Yeah I wouldn't suit winter. Stand a lot about it. But now we're to the nitty gritty of you. Know How you know. To what extent do you think something has to have withdrawal to be called an addiction? And there's speed about that symptom and the and the scientific understanding is very slow to make its way into the public consciousness. And but there's there's all these gray areas with things that we even that we understand better about talk about video game addiction and gambling addiction. You know that my understanding is like slot machines for instance like really do can cause an actual addiction right I do disagree. Yes I that's more compulsive so again there's more Evidence that that looks a little bit more like we understand other substance He's issues but even there exactly like there's debate like okay. It's not an exogenous substances coming from outside the body with a pill is there some supra physio lodge response. So like if I take cocaine I have you know. More broadly say dopaminergic receptors occupied. I can possibly do by myself gamble all day. I can masturbate. I'm never going to do what. Coaching can do and So at what point do I say like there's not enough you know like we need some supra physiological event to be motivated to call something addictive. Well the the comparison I was going to draw is like okay. So you know. Slot machines can be compulsive at at least right and are sort of designed to cause that sort of behaviour and people But like video game addiction is like a thing is often scary. A thing that you know Politicians who don't understand the topic very well bring up to frighten people but at the same time and when you when you talk about depression. It reminded me of that. Because like there've been times in my life I was depressed and I played too many video games because the video games. Give me like a feeling of accomplishment that I'm not able to get in my own life and I don't have to leave the house social at their multi-player. Yeah Yeah exactly. And that could be an unhealthy amount of overuse. That doesn't mean it's an addiction but then there are also games in the middle that are like specifically almost trying to use slot machine mechanics in order to get people hooked right in order to where I play. This and I'm like this is like doing something to me. This is trying to do something to me. And even that is so hazy Where that distinction is drawn and where we should draw that line of how we should talk about those things when you had sex into it which we also don't understand that well. Sex has some nice rate limiting features. That make it a bit different as well so generously. What I'm calling the refractory visit like after you. You're saying you're jerk off and you can't do it again for a little at some point Even if you are a short latency it becomes very difficult so studied this indirectly so there are lots of scientists who I've also I've studied it Kinda directly But please tell me so. Like mostly get studied from fertility perspective. What the content of the ejaculate after the fifth You fifth round in as much time you know twenty four hour period or something and in fact if you're trying to get pregnant you know that Seminal content does reduce over time as well as the total volume so probably not good to just have sex as much as you possibly can drink fertile windows. So that's where we get. This kind of data is exactly like having people masturbate in labs looking at the samples so those kinds of things have been somewhat characterize and then there's but the really good data about Kinda jet the refractory periods are hard. Tang it you know what I'm GonNa say hard to come by to stop it and then I couldn't find a way out of it. No no no. I mean you wouldn't be a very good episode. We didn't take it. The data are very sparse. That I would say very robust helping us understand kind of what? The very ability of that period is got it Well what about a sex addiction? Right I talked about the opening of the show when there's like this so we have these folk pseudoscientific understandings of how sex works right like the public believes that there is such a thing as sex addiction noticed mostly because people go on. Dr Phil and talk about it or they go apologize to Oprah and they say they're getting treatment for it And they go to Some sort of place that claims to treat sex addiction With it's like But is this a and I'm not talking about porn addiction. I'm talking about like having sex with other people. Yeah Is this real. Is that a myth. What's the truth about it? It's a myth but less of a myth and porn so porn is very much easier to study in the lab expose people to porn pretty readily but the Having people actually interact sexually in a laboratory so that we can look the physiology is something very very few labs are doing minor. Mine's doing it but Figuring out what protocols should look like to even study that like two people interacting. When is that abnormal? Yeah when is that? Not a typical sexual response and We know we can't just go by self report lake sex data. They're places you know where self-reported okay this is not one of them do not accurately report even if they want to. They don't know often what their bodies are even doing. So I can't go. You know to women now and say. Did you have an orgasm? I I don't trust that anymore. I don't even know what they're really like if you're just trying to do on a survey or if you're observing someone. L. Lab and you're just trying to self report on. If they have an orgasm you can't buy what because then I have measures that I'm making sure they did. Yeah part of why I now no longer just self report from women but no seriously. So you're saying you need that that physical you've got a whatever them hooked up to to measure that it happened more objectives and self report is fine at some point. But you've got to verify trust but verify bring them in because even if people want to be honest with you. They can't necessarily do. They have the proper sex education understand what their body is doing in the way that scientists means it right. That's right so it's very hard to study But what it does is it real. I don't think so but I'm using a little more cautious language. They're they're more gaps. God things that we are just not been able to test yet. So is this just like a an excuse. That people are making up for bad behaviour. I mean that's the cynical way to look at it right like. Oh Oh no sorry. I have an addiction. That's like a I'm shifting it from one realm of social understanding where I'm a bad person to a medical is one where oh no I just have a disease like. No one can be held responsible for their disease in order to evade responsibility. How much I mean. Maybe this is outside. You know where you feel Licensed to speak but like how seriously should we take that? Serv attempt to shift their indefinitely. People who are using it for secondary gain that is either they cheated and they'd rather have it framed as a disease than moral failing And then there are people who are may nameless who are sex offenders who would rather be. Yeah oh I'm just so masculine that I'm a sex addict rather than no. I'm like assaulting people between those two labels. They make their choice and within our field. There's been a huge backlash of people who treat sex offenders telling the sex addiction people to knock it off like that dough not treat sex offenders in an addiction model. Are you nuts. So they have good treatments. They know how to help those people and we should let them do that. That's their expertise so enlarge though I don't think most people go for sex addiction treatment. Are Those kind of folks you know. These are people who are really upset. Generally about their own behavior and they don't necessarily understand kind of why they're doing it. They don't get their motivation and so we hope that they are going somewhere where they can gain insight not just be shamed for their sexual behavior. And that's what we're concerned. Some of the sex addiction treatments are doing God. So it's really more of a almost like a therapeutic concern where you've got people. Yeah there's the there's Sex offender or the sort of men behaving badly and trying to get out of the specter. That I'm raising but then there's also the people who are like why do I keep? Why am I having one night stands that make me feel terrible over held beliefs? I don't think these are mostly People who are trying to get away with something that exist in that group. But I think they're a small proportion and so then the question is right like if I'm So of people who are depressed about fifteen percent. Say when I'm in a depressed mood. My sexual interest increases. Well that's not usually how we think of depression depress. You can't get out of bed. You'RE NOT GONNA go hooking up while it turns out. Some people use that to help themselves feel better so maybe we should be looking at the depression as a potential predictor of these quote unquote compulsive sexual behaviors. Because guess what sex feels good. I have noticed that about my studies. My studies have revealed that results so extensive as I'd like but you know so there those kind of more complex ways of thinking about what's going on for those mostly guys is what I would really love to see is. Let's not kind of be stupid about it and say oh you know. The sexes too much. Sex's bad you know we still have a lot of therapists who Call when you have a lot of sex partners. They not not to call them sleds. But they'll say you're acting out you're acting out sexually well okay but sex feels good so yeah. Is that acting out. Do we want to devalue that and say you're dumb or your bad if you're doing this behavior let's understand kind of functionally where it comes from your really revealing. How much our like cultural hangups but also like personal hangups that we may not even know that we have like a about this topic like make all of this so difficult that like people are coming in with maybe some some deep rooted. Shame and so. It's like difficult to tell. Where does the problem begin? And the shame come into it and then and then they're talking to a psychologist Therapist Guy. An an addiction counselor. God knows who really depends who they talk to. And what model is that person using? And then what kind of shame. Based thinking is that person bringing in and all that stuff like how. Do you even begin to unpack that for one person. Really sorry we are so messed up right now and it is not good for you. I I. I want to know how we get our way out of that but I I wanna ask I just going back to porn for one second This idea that I've heard that porn is ruining young men. Sex lies that generation of men porn hub. You know the Internet all that That's now I've heard this as you know. This is a sea change in American sexuality. You've got you know men who were on porn hub every single night and that's giving them a skewed idea of sexuality but now let's say forget like culturally just like hey this is a depiction of sex. That's inaccurate right I. I could agree with that sort of sentiment of like the falseness of porn is should we be concerned but but the claim that I've heard is that literally it's like stopping men from getting erections enormous. They can't have normal sex because they can only get aroused. When they're looking at these like hyper images. Is there any truth to that? We have not been able to find evidence for that so people are calling that porn induced erectile dysfunction a series of laboratory studies including coming out in a couple of months that. I'm dying to talk about and I can't go sneak pre. It's going to be the largest Sexual psychopaths study on the topic today and so there when we have looked the guys who are viewing pornography actually tend not to have those issues and I to me. I think you just have to think about. Why are people looking at porn right? This is not going to the movie theater. You're on well except for you. You're not going to mom and dad to watch porn video. You're going to masturbate. The purpose is to use it to Jack off at the end of the day or Jila for whatever you prefer and so if you think of it like it's just a masturbation it will. Why are you masturbating okay? Well you know. Maybe my partner is annoying me. We're having an argument and so we'RE NOT GONNA have sex. I know they're gonNA have sex with me right now. I'm just GONNA go masturbate on looking at porn while I do that but porn didn't make me unhappy with my relationship like I'm here masturbating settled my usual consensual partner and so again. It's one of these issues. That truth is a lot more complex than if you actually take it into the laboratory and say okay. You said the you're having rectal problems due to porn and I can't see it so these guys just tend to have a higher sex drive. That is yeah. They're saying they have all these problems. Like no like you. Just you masturbate a lot in you know you have more porn because your sex drive is higher if that causes more conflict with your partner. Because you're really really trying to get away from these ideas of low sex drive in high trying to say desire discrepancy. It's just a discrepancy of mind. The Menu matches you. You won't be an issue. That's how this works. So you know if you are discrepant with your partner. There's gotta be some balance and some people use masturbation to balance that out and now we're demonizing that. Oh God how could you and thinking about the dynamic like? Why is this person in that relationship in? Let's try to understand that it's like well. They probably have a higher sex drive than they're using that to manage the discrepancy. Is there a concern about porn about the you know the modern version of porn? That you do have Even if it's a nonscientific but you know social one. No I think they're so the one that worries me. The most is kids because they don't have a perception of you know what is normal. And we've got the sex Ed class that we want them to have sex ed in the US especially and even if we give them sex. Ed You know we don't mandate that it be accurate for the most part and get Mike has great stats on that and so really like you want to take it away on both sides. You know we're going to take away all your sex ed and then we're going to give you access to porn and not educate you about that either but the good news is there now. Three empirically supported Porn Literacy Program. So one out of Boston University From Emily Rothman. He was doing a lot of work around. How do we talk to kids and educate them in a way? That's kind of level appropriate. And she's mainly working with adolescents. So not the young young but a little bit advanced and there are programs for that. So you don't need these goofball fly by night websites that are popping up. There's actual science will educate kids on kind of how it understand it at a level it's appropriate for them. That is free that is tested that is available to the public now so I encourage any school Education Person. Who's interested in like? How do I talk to kids about this? I'm concerned there. Things are available now. Available that's stuff is so so important just to just to give kids any level of sex. Ed I this very specific member. I just I don't know if you're familiar with this. Oh it's not that kind of memory. It's when I was when I was a teenager on early. Internet like late late nineties early two thousands. There's this website it's still exists called Jack and world. Have you ever this website? Let's Jack in world like J. A. C. K. If you WANNA look it up. J. A. C. K. I. N. World Dot Com. And like. It's very like nineteen ninety nine looking website. It's just very basic. But it's called the male masturbation resource. It's got like masturbation techniques. There's no porn on the site. It's just like stuff like that and I was reading it and I I remember this website. I looked back at it like you know ten years later and I was like. Oh this was a stealth sex ed site for like young men because what it was was it was like okay. Here's a jerk off technique you could use a cetera but ultimately was like a sex positive site and then the main part of the site was question and answer and it was just like kids write in going like. Hey. Why does my penis big vein on it? Like I'm really worried about this and the answer was always just like you got a normal peanuts like. Don't worry don't worry don't worry about your normal. Pena's it's okay to jerk off and etcetera And I In retrospect was very happy that like I just had some. I read that site you know because it was like straightforward scientic. They were like Thanked Jocelyn elders. The the the surgeon general lost her job because she said that masturbation was healthy. I believe and That was like the overall approach of it and I don't know who the hell made this site and why it's got to be one of mine but just like that. You know that that much is like so valuable and something that we that we don't give kids at all. No I always joke. I say my whole career in summary is everyone does chill the fuck out Mike. Search Yeah. Let's all just calm down. I think that's a great kind of way of walking through exactly like you know. We have these guys who are saying. Oh you know. I'm a porn addict because I have a sore on my penis for masturbating and I'm like that's really really common especially and sometimes even an altered. There's there's a. There's a simple prescription. Let me tell you. It's over the counter. You got to like go to the lotion. I'll yeah it's not a disease like sometimes you masturbate too much. Are you trying new technique? It doesn't work that's fine. It doesn't mean you have a disorder you know. It just means better technique less vigorous. Well we gotta take a quick break but I have so many more questions for you specifically about men and women. We'll be right back with more Nicole. Privacy all guys know that selecting the right razor can actually be a challenge. 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Slash Factually Kentucky Dot Com slash. Factually go today and get. Outta town Folks we've all gotten so comfortable renting instead of buying right. Think about how much stuff you actually rent. Now that you pay for it to us for a little while instead of buying the whole Enchilada all you by yourself right like. How'd you get around the last time you had a big night out? You rented a ride ranger camp or an Uber or lift something like that. What did you do last time? He needed address for that wedding. You rented it didn't you? And Hey even when you stream your music movies or TV shows right you're renting now. You're not buying them. You're just using it for a little bit of time. Well guess what court furniture is. No different court offers furniture rental featuring today's modern home decor trends. You might be thinking. Why would I rent furniture and they would say to you why not? It's the perfect way to get furniture on your terms like dig about you. 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I have heard so much ill-informed pontificating at my workplace about differences between men and women What are some of the myths? And what are some of the things that we know about those differences sexually? I'm sure there's a lot. Yeah so it turns out a lot of things. We attribute within sexuality to gender differences or probably more due to sex drive is on average guys. Fire sex drive in. That's cross cultural. There are very depending who you ask but maybe one culture where women report having a higher sex drive so we hear things like. Oh men are more visual will not if you control for sex drive. It's people who have higher sex drive. Tend to respond more to sexual images like nearly speaking no scientifically And you know it's not that guys have some special receptors in the brain. They're totally different. That pipe porn straight to their penis or something like no that. Of course that doesn't happen It certainly is the case that women orgasm much less consistently than men do very well documented and I back that up in lab physiology so It's very much more difficult. Seems women to get there for what reason we're working on it. These are all these are actually the opposite of misconceptions. These are all sort of like our general cultural beliefs about the sexes that are being held up here in the case of orgasm gaps. Yes but not. The men are more visual. I'd say that's a myth. Oh the idea that men are visual. Because they're hunters and they need to see a lion run and so then they see boob and it's the same as that and they wanNA clunk him on the head with a club I knew. I mean people really believe I listened to some really bad podcast sometimes Where people talk about this. You know so so. It's just that people with higher sex drives were more are more efficient But that's really interesting that that that that whole one thing that really struck me was. I wonder if any insight on this I was watching a video by Trans woman talking about her transition and one of the things he struck me as I said that was really interesting was after she transitions went on. You know all the various hormone therapies. You said That she felt her sexuality change and she no longer needed to have what she called an obligate daily orgasm that like no longer felt like. I just must have an orgasm wants today and I was like. Oh that's like a way to put it that I've not thought about it before that there's just like Sometimes for many feels like you're just like taking a crap you know it's one of the things you gotta do. You know what I mean that. The research currently on women and drive a lot. There's a lot of interest in something called responsive desires and the idea that we're in the past using the same model for men and women where you're just supposed to be walking on the street and Powell you're hit with sex drive and I must go get off now and it doesn't work that way. It seems as much for women and probably not for lower drive men either and so by responsive desire. What we mean is like you gotTa have a little something. I kind of get the genome is. You can't say I just expect lightning to strike and that's my model like if I don't have lightning striking that I have low sex drive. That's not true. So you know if you need someone kind of coming onto you or touching you and like non sexual regions zones to even start to think sexually. That's normal. That is the common experience and so we don't want people you know believing they're deficient or low drive because they need to be touched. I in some way or solicited in some way we are now trying to transition a call that responsive desire differentiating that from spontaneous desire that walking down the street struck by lightning. Kind of feeling that I think you're describing. How how much do we know about when you know people do transition right or like you know taking how? How much does that change? You know this sort of dichotomy that you're talking about. Yeah so those are interesting because they're exactly supra physiological doses of hormones so in general sex drive is not tightly tied to testosterone. And that's another good myth to us That is an either men or women. The Tigers that are in our bodies at any particular time don't seem too tight or experienced sex drive but that is not true in the case of people who are transitioning. Because they're too strong levels are out of soup out of physiological range. They're going super physiological. You know so. This is I'm getting far more or far less to Saas Stran- than Was in a norm within normal limits. Getting and not that. It's a disease but into disease territory. That is if a doctor saw this and knew you weren't getting testosterone would be worried so those are very different kind of levels and tighter of hormones that they're dealing with but within normal limits. You know those don't generally tie to the experience of drive and in terms of men and women or men and our women and women together when we're talking about we're taught doughnuts or any combinations of folks Like what are the misconceptions? What are we learning? What are the fascinating new things? We're learning about couples or triples trying to trying to like be really how inclusive Arabi woke. Yeah exactly yeah so there are. There's the stuff we're doing. And then some labs generally are interested in this kind of fluidity ideas just briefly. The fluidity idea is women. Tend to be more. Broadly aroused To a variety of different stimulus even a straight woman you show her gay porn of men or women gay porn and she tends to respond to it at least a little bit in terms of her genitals at least but if you show guys things that are outside of their stated preferred range. They tend to be very constrained to respond to just what they say. They're interested in and there are a number of labs that are investigating those kind of sexual fluidity issues differences That they think are their between genders. And I'd say we're kind of in the middle of that we've got some you know fare base of knowledge at this point but we're still trying to suss out kind of what some of the things are due to and then we're actually bringing couples into the laboratory in measuring from both of them at the same time to try and understand really what the physiology of interacting looks like so. We're getting a brain measures from both people interacting for the first time. Ever to understand like when someone is providing stimulation. What is their brain look like? And what is the brain of the prisoners sitting there receiving it look like and then Are Those brain states useful for anything you know. Do they have maybe health applications? That's a strong interest of mine. Can we use being highly sexually arouse to help us in a way like meditation may help us? Yeah so one of the questions like to. What extent do we have that kind of relaxed but awake brain state when we're highly sexually aroused and you know if that was the case with couples? Is there an intervention? There you know can we potentially capitalize on that and use it to even have partners helping each other if you stayed or you know. This is a practice they do regularly together. Looks Meditative. Potentially yeah idea of sexual arousal is like an altered state that's like meditative like really resonates with me. Because I think about the Times where you know I've tried to. You know be aroused and have not been able to. You know what I'm not been able to get into it right and it's like something's running around in my head like I'm thinking about work. I'm angry at somebody or I'm you know you're just like you're making out with your partner and inside your head is just like Volvo. And they're kind of like where are you and you're like I'm not here. I'm sorry and then the times when you're most aroused it's like you're it's like your mind falls away and you're just like in that moment and you're just like in this real and it's like one of the best things about it. Frankly is that you lose yourself and that you you know. Become sort of the thing that you're doing and that's a that's a lot like when people talk about meditating we think these are unique brain states and that's one of the kind of discovery as where we think we've made that were trying to you know trust but verify and so we see. Initially when people start to become sexual you know. The brain is very strongly engaged. You have to have a lot of effort. You have to be able to allocate attention to the stimulus kind of as you're describing but then if we say okay you know that's Nice you've been masturbating now and watching porn for twenty four minutes or we give them. We'd like you to try and have an orgasm now. The brain state at that point completely shifts not orgasm but long before it. And that's when we start to see a kind of a loss of cognitive control or reduction of control and that may be something that looks more meditative so I don't think that kind of earlier arousal stages look very like I have to try to pay attention and I have to be awake but then later on shifts to something that looks very distinct so We also see this in the nervous system that is early on heart rate breathing rate August going up and then we say okay now try and have a climax will masters and Johnson said. Well you just keep getting more and more and more and more arousal. Pow Lamma Orgasm. Yeah you go to bed and Our model doesn't look like that. It's like okay. We get breathing. Hurry up and then we say okay try to have an orgasm and then they just like start going down and we're like wait. We know that happened so now we're trying to figure out what that is. Yeah that is Even if you interrogate your own experiences of sex it's not like Oh yeah just keeps going up. I think everyone's had the experience of like you know. Yeah Okay let's try to make it happen and then Oh I. It's house not not quite happening. There's something there's something amiss there's like Yeah it's like a really interesting puzzle to try to figure out like what's actually happening in that moment as even in that moment like you said where you're just like all right. Let's you're having all right. Let's finish up. You know what I mean like. What is that difference? And then what actually gets you to the point of finishing up in not everyone where sensors upset. Okay so Yeah it's like the or some people I think are calling this edging here. That term through the heck is that. Isn't that just being aroused? There's another thing well no. It's maintaining that last moment. As long as you can think that edging is maybe not so special. It's maybe just hanging out in that second phase of Arousal Which is Great. You know. It looks like fun by. I don't know that it's anything special to call it edging. And just yeah. Is there any sort of researching that you know? Th this part of this like. Is there any therapeutic advice that you have for folks like hey one thing I've learned that's like here's a tip? You know what I mean that that can help people with their. You know this is a good one so I think you know. People tend to have problems with one or the other. Sometimes they'll say oh. I get turned on just fine but I can't get over the Hump My. I can't have climax and I don't know why I'm just stuck other times. They're like well. Yeah like if I can get turned on. I can climax easily enough but I can't get into it now. It makes better sense because those look like two very distinct brain states and so maybe you're much better at one than another so if you're having trouble kind of getting getting over the Hump so to speak with orgasms. You know that maybe that helping reduce your kind of frontal or cognitive control at that time may be helpful so do not pass yourself out but if you want to experiment with hyperventilating and that that could be something that's helpful to experiment with because that can help reduce frontal control is usually just like breathe a lot yes. I'm not GonNa do it now. I don't know that's why I prefaced. Not Make yourself fast partner. They will call any hyperventilating. Well that's not right. This is not someone else controlling. Its you controlling so if you get out if you get out of hand you pass out so so okay. Let's take some deep breaths and don't go to not spoke but try try. We'll also meditating. Focus on your breath faster. That's what people during meditating. No one's like yes breath fast fast harder harder. One question I have about this is you're talking about a again getting back to hey differences between men and women and you said men sexual fluidity is lower How do you think about the differences that might be biologically based versus you know societal gender role based you know that Like you say to me. Hey man show less sexual fluidity and I'm thinking okay. Is that like a hang up? You know Because as a man I experienced that hang up right Or is that like something about you? Know people with those chromosomes. This there is no nature and nurture right this zone fused together at this point and maybe the best example of that as we used to have guys monitor their erections during the evening as a way of telling if they're erectile dysfunction was due to psychology or due to physiology and then we find out years later decades later that it turns out. Like if you're an anxious guy you also don't get erections at night. We can't really use that test anymore and we don't use it for that purpose but it just tells you like even if you're not in mind so to speak your brain is still you. You're kind of a psychological reaction or your psychology is still impacting your biology. We be duelists here. Yeah that's that's the I understand. You're trying to study people as they are. And so like you know. American men are like living society that creates things and their psychology to some extent and psychology is going to biology in this way. And so we're all one organism but So so you think just a radical that That distinction that I made is that the answer I mean. I think they're just they're together when you address when you're addressing the other So for example there are lots of Physical determines genetic determinants of Female Orgasm Consistency. Like the distance of the clitoris to your ether. Opening it turns out is predictive of how consistent the orgasm during climax. Well we can't change that. So and so. What does that mean right like okay? Well if they're further apart you probably don't even know that because we don't provide it and you know it's also genetically heritable to some extent so ask your mom ladies like how how consistently she climax is probably related to how consistently you climax and it's not that those predictors don't exist it's just like they exist in this context of how aware of that even. Am I do I? If I had conversation about sex with my mom I probably have a pretty open sexuality more generally more open and flexible and accepting and not shameful. So that's GonNa help me. You know in another way that you may impact the genetic impact and you know we. We can push things around from either direction. Either you know from biology psychology. Yeah it's such A. It's such an interesting area to think about. I think again about the transplant. I spoke about earlier. And it's like. How much is that change that she experienced due to you know hormonal treatment versus to like now identifying as a woman with all the societal. You know Different like you know which. Where is that line? Do we even care about where it is or are we just going to say? Hey this I mean this is probably had some expectancy of what would happen to you because I doubt she just decided to have surgery that morning. You should probably write about it a lot if she did that. Probably read about it a lot before started taking hormones and right saw it coming and we're and that just speaks to like how complicated sex is because it's not just I've been asking you a lot of biologically based questions right right but at the same time like sex is not just about us like it's not just about jeans and penises and hormone amounts and things like that it's also about like thoughts and feelings and the things that we generally put in this social box and they're all sort of like marching together in this really complicated bespoke way for every single person. It's like enormously complex. Unfortunately I guess though. Yeah. It's like the best. Predictor of erectile dysfunction has has and continues to be anxiety ninety also manifest in the brain liquid measure. That we can measure and questionnaires. You know so but ultimately is things -iety for the most part and so that's where we intervene try and help folks with that and anxiety is something that like you can take a pill for. You can talk to a therapist about and it's like both things. There are different ways to intervene. That can be helpful. I think what this conversation is doing is helping collapse. The mind body dual ism into one sweet like solved it. Well as a as a person who's been interested in that question it's like it's really cool to yeah. This is like this is all one thing and even half of the questions. I've been asking you. I feel like our almost off base. Because I've been separating them into these two boxes how much is it one of the other and this has reminded me like no. This is one organism that we can talk about a multiple ways but this distinction somewhat of a false one. Now this is why I love psycho physiology. We sometimes call it a hub science because it really brings together these different ideas. Where if you're just psychology ears asking self report and interviews that's limited and you're just a biologist or just anatomist and cutting things up that's very limited. She don't know the function so we're trying to get it in the middle. Nba Hub to bring those sites together. So what in this field? Which is I just learned about today and I'm also fascinated by what are the. What are the big questions that you are that remain to be answered? Or what are the frontiers? You're the most excited about. What are we just starting to learn about? I'm very interested in health applications of sex stimulation. So I'm not I don't care too much about sexual endpoints like getting you off more helping your penis. I mean that's great if we hope that but I really want to know how to use orgasm to help you sleep at night. Or how can I use a genital stimulation to improve depression? And so you know. We're in the vein of those applications to the things we're really interested in our The couple's research so actually having to people in the lab at the same time here are interacting sexually and understanding what the dynamic is like. And if it looks like porn is the model we've been using for decades And then also try to understand work as physiology like. We don't know how orgasm is triggered still and it seems like that would be useful. No if we're going to potentially use it as a health application and also just for understanding basic physiology. Some of the questions that are still they are about. Our basic anatomy and physiology have not been answered. I think and again. It's a lot of that functional. Mike I need to see Orgasm in action. I need to see not just the first two minutes of Arousal. Not just afterwards. Did you spoon? Did you cuddle? Did you pillow talk as fine but like what happened in the scientists left the room. We need to get in there like we need to know what's going on and understand what that process is like and are there pieces of that we can pick out. You know to use in health applications and along the way that's kind of how it happens. It's like okay. We've got this end goal. You know they were doing a study. On poster GAZ MIC Illness Syndrome. We're trying to understand that. We poster gives Mcginn illness drew. There are most these are mostly guys. He say they have flu. Like symptoms for two to seven days after every time they climax. Yeah terrible and flew flew like is those are. That's bad? Yeah so they're like knocked out and they have to figure out how sexually active they wanna be baseline having this kind of problems sounds so in the process of trying to figure out how to study this patient sample We realized like Oh. My Gosh. We're GONNA get inflammatory markers and this is going to be the first time we've ever gotten inflammatory markers before. And after climax inflammatory marker so like Interleukin six is one marker and there are inflammation theories of depression for example where some people think major depressive disorder maybe due to Kind of these in inflammation problems throughout the body and so I said well. Gosh if that's true if this continues to be supported for depression And we know the orgasm effects the same kind of inflammatory markers that we think are causing the depression and we've got a new intervention. Wow that's really cool right. That's why I like. I keep thinking you know as much as I hate hitting my head against the brick wall and getting attacked all the time. There's golden there. Mike potential for us to take this so much farther and we just have to fight to be able to do it. What is your what are the prospects for the field getting attacked less right? Those sorta social barriers to doing the research that you were talking about Because I'm convinced that this research is valuable to people and that we need to know as much as possible. Yeah you got me I was obviously a receptive audience. Invited you on the show I'm not I'm not in here going. I'm sorry you study. What now like. Obviously this is not gonna be that interview okay. Well I'm sorry for you. But how do you are there? Are these barriers going down? Are you optimistic in that regard? How do we push that along? In our case the biggest barriers are size where a very tiny field and so when climate scientists get attacked by groups. That have kind of those motivations there. They have groups to advocate for them. They have people working on Capitol Hill. They have attorneys that work with that. We have none of that and so I think part of our challenge is to enjoin with some of these groups that have similar issues to what we do May Be Willing to get sullied with our presence. You know specs researchers and say like you know. We've got similar problems here. Were all scientists. We're trying to get our work done. And we're being stopped in ways that we shouldn't be stopped that are not reasonable and you know. How do we work together? And so there's like a new free speech union that some scientists are joining so that we stopped getting platforms leases. And maybe that's going to be helpful so I'm not sure what the magic bullet is. But I think the particular challenge or my field is just our size. We're very small and we need to be enjoying I think. With other scientific groups that have similar challenges. Where folks go to find out. More about where. Where's the where's this research happening? If THEY WANNA. Where's that study that you talked about that? You really excited about coming out. Oh well that you'll S- I'm sure it will be making the rounds at the time So the my website is libro center dot com and you know so I post things there as they come out. I'm sure the study will be up there that particular study. We're actively recruiting for the poster. Gastric illness syndrome. If you think you have that you know you can come to the website and find out if you WANNA volunteer in Los Angeles. So that's a good repository to or up to and if for folks For folks to home going like man. I got a sex problem. And they didn't talk about US specifically right. Do you have any like? How do you think about those things differently like do you? Do you have a message for for folks at home worrying about? They're worrying about their parts. Were worried about their. We're worried about their beds. Worrying about what goes on at night or in the day you know. Yeah I think in general. It's good to keep in mind that You know the way people make money off of those kinds of things by saying there are problems in your if you go online if you go television shows exactly they're going to be pushing that direction always because that's how they make their money is through patients or if they're coaching or whatever that is and so it's just being a critical consumer information. Yeah and saying like okay. All I've read here is that this is all bad all the time. Is that really true? You know and do I have good. Sources so There's a group of American sex. Educators the acronym Aset A. S. E. C. T. I get you to a group of sex therapists and educators who are science-based and so they tend to have good information You know looking for sites that are just You know as ever. I think we're dealing with a fake news issue. A lot of bad information just thinking. You know what where? What is it that I'm reading? What are the sources? He's contributing to this. And you know being sure you don't just watch that one news channel. Well thank you so much for coming in. Nicole has been a really awesome conversation. I really appreciate it well. Thank you once again. Nicole prowse for being on the show. I had a plastic conversation and I really hope you did too. That is it for us this week on. Factually I wanNA thank our producer. Dana Wiccans our engineer. Brett Morris are researcher. Sam Rodman Andrew W K for our theme song and Hey you hit me up on twitter or anywhere else you have an symbol at Adam. Conover check out my website for my mailing list and tour dates. Adam conover dot net. Until then I'll see you next week on factually. Thanks so much for listening.