Article: Experts Among “SEXperts”

Winter 2001

FRANKLIN & MARSHALL MAGAZINE

Experts Among ‘SEXperts’

by Brenda Murphy-Niederkorn

Sex. The mere mention of the word might still be enough to grab readers’ attention today, but it certainly doesn’t shock them as it did when the world-renowned Masters & Johnson Institute in St. Louis first came to public attention in the early ’60s.

There’s no way it could, says Mark F. Schwartz, Sc.D., ’72, codirector with his co-therapy partner, Lori Galperin, of the Masters and Johnson Clinic in Chesterfield, Mo., a St. Louis suburb. “Since the introduction of the birth control pill [in the early 1960s], the changes have been huge,” says Schwartz.

Schwartz and Galperin are heirs to the Masters and Johnson legacy. They took over the clinic from their predecessors in 1991. A year later, a Vanity Fair writer dubbed Schwartz and Galperin as “the new sexperts.”

Today, says Schwartz, the media bombards us with sex. During the past decade alone, we’ve been introduced to the pharmaceutical benefits of Viagra by former Sen. Bob Dole, and to the extramarital escapades of President Clinton, including details of oral sex, a previously taboo topic. These events may have made society more tolerant to discussions of sex in public, but they haven’t altered our puritanical views about the subject, says Schwartz.

The work of William H. Masters, M.D., and Virginia E. Johnson, Ph.D., was focused on changing society’s attitude about sex to view it as a natural function. Schwartz can chronicle the changes by decade that he’s seen since he began his association with Masters and Johnson in 1975:

  • During the 1970s, Schwartz mostly counseled couples struggling with physiological problems, such as premature ejaculation in men and lack of orgasm in women.
  • In the 1980s, his focus shifted to treating victims of childhood sexual abuse and so-called “sex addicts” — individuals who engage in compulsive and risky behaviors.
  • In the 1990s, his patients’ problems became more complex, compounded by divorces, blended families and step parenting.

We’re now in the cyber-sex age, he says. The Internet is providing sex addicts with a dangerous new medium for encountering multiple, anonymous partners.

In a June 1998 interview with St. Louis magazine, Schwartz said that more than 80 percent of the 3,000 patients he and Galperin had treated at the clinic since 1992 were victims of childhood sexual abuse. An additional 300 to 400 patients have been treated during each of the following two years, according to Schwartz, who says the percentage of patients who were abused as children remains at the same high rate.

Passionate About his Work

No matter how dark his patients’ problems and behaviors might seem to the general public, Schwartz repeatedly uses the term “suffering” to describe their conditions. His personal reward, he says, is seeing his patients’ progress.

“I’m passionate and enthusiastic,” he says. “I listen to what other people [in the field] are doing and creatively apply it in new ways. I love what I do.”

In his sports jacket, khaki pants and shoulder-length hair, Schwartz would blend in well as part of the teaching staff on a college campus. He starts his day at 5 a.m. by spending nearly two hours answering e-mail to his web site (www.mastersandjohnson.com). The media often calls on Schwartz to explain society’s continually changing attitude toward sex. He also receives mail from individuals seeking solutions to sexual problems.

“We have the tools to help these people,” Schwartz says. “It’s remarkable to see how much better they get. I not only help hundreds, I also teach physicians how to help people.”

Schwartz holds teaching appointments at several universities, including Harvard Medical School, St. Louis University, the University of Missouri-St. Louis and Tulane University School of Medicine. He and Galperin also conduct workshops nationwide for health professionals throughout the year.

“Because I watch so much suffering, I really have become much more compassionate,” he says. “One of the things we’ve done in the hospital units where we work is to fight to make sure that people get the best treatment available.”

A Pennsylvania native, Schwartz became interested in the physiological aspects of sexual relationships as an undergraduate psychology student at Franklin & Marshall. He aspired to be either a veterinarian or a psychiatrist.

“Psychology allowed us to work with goldfish, rats, monkeys and chickens,” he says. “I got amazing training in psychology at Franklin & Marshall. I knew as much as many people did in graduate school.”

Schwartz earned his doctor of science degree in 1977 from The Johns Hopkins University Department of Mental Hygiene as part of a joint program in the departments of psychology and mental health and the medical school. For his post-graduate training, he headed for the Masters & Johnson Institute in St. Louis.

“Masters and Johnson are one of a kind,” says Schwartz. “Masters was like a surrogate father to me. They took me in and taught me tons. I had incredible training. I feel obliged to give back because of what they gave to me. I was lucky to be at the right place at the right time.”

Schwartz had the unique opportunity to observe Masters and Johnson in therapy sessions with patients. The pair also personally monitored his early counseling sessions.

“What they taught me wasn’t in their books,” says Schwartz. “They couldn’t really communicate their method in books. Their philosophy was not to treat individuals or symptoms but to treat relationships. If a person presented with a symptom, such as the inability to get an erection or to have an orgasm, they didn’t look at the symptom but at the love relationship. They put the entire relationship under scrutiny. They wanted to know why this person had an inability to communicate his or her vulnerability with another person – and not just in the bedroom. That’s hard to convey in words.”

Schwartz left Masters & Johnson in 1983 to work in the growing field of childhood sexual abuse treatment. He set up a private practice and his own inpatient sex-trauma unit in New Orleans, and met Galperin when she came to train with him as a Tulane University graduate student.

Together, they now run the St. Louis-area outpatient clinic and inpatient programs at River Oaks Hospital in New Orleans and at Two Rivers Psychiatric Hospital in Kansas City, Mo., as well as the new St. Louis-area inpatient Castlewood Eating Disorders Facility.

“We do the best work together that I’ve ever seen,” he says of his professional relationship with Galperin. “Being married and working together allows us to do unique marital therapy. Often, it’s a case of ‘been there, done that.’ We’ve struggled ourselves in marriage and found solutions. Because we practice what we preach, it’s different than just mouthing words.”

Treatment for Trauma Victims

When Schwartz began seeing patients as a doctoral candidate at Johns Hopkins, counselors knew how to treat people with sexual dysfunction caused by intimacy problems. But they also began to uncover a history of childhood sexual abuse, especially among women. At that time, Schwartz says, “nobody knew how to treat it.”

Schwartz suggests that two-thirds of these individuals forget some or all of the sexual abuse they may have suffered as children. “Memories of the abuse return when they reach their 20s or early 30s – after they get away from their families,” he says. “The brain decides it’s strong enough to handle it. When the memory does come back, the person gets very depressed or develops sexual problems.”

While women have made up the majority of these patients, according to Schwartz, men who have been abused as children continue to surface, he says.

“Most of these men and women have Post-Traumatic Stress Disorder (PTSD) from childhood,” says Schwartz. “They have experienced a traumatic event that is too great for them to assimilate.”

In his therapy with sexual abuse victims, Schwartz incorporates techniques used to treat Vietnam War veterans suffering from PTSD. In some cases, patients display one or more serious symptoms that may indicate that childhood sexual abuse occurred, but they can’t recall the incident. These patients may be hyposexual or hypersexual and are often suicidal. Female patients may display symptoms of bulimia or inflict cuts on their bodies. Male patients may be hooked on cyber-sex.

“These patients participate in reenactments – compulsive behaviors that lead us to believe that something happened in the past,” says Schwartz. “Most know about the abuse, but it’s really hard for them to talk about it.”

Schwartz and Galperin have found hypnotherapy useful in helping these patients to uncover repressed memories. The recovery of memories remains highly controversial. Stories have been published of patients accusing family members of abuse following the use of therapeutic techniques to reveal memories. Some of these patients later recanted their stories and accused their therapists of implanting false memories.

In December 1993, the American Psychiatric Association’s (APA) Board of Trustees issued a public statement on memories of sexual abuse in response to the public debate over the validity of past memories of child sexual abuse and the concerns of many psychiatrists.

“Child sexual abuse is a public health problem that must not be swept under the rug either in the community or in the doctor’s office, but must be dealt with forthrightly and responsibly,” says APA President John S. McIntyre, M.D., in the statement.

Therapists treating patients for whom past sexual abuse may be a factor are advised to maintain an empathic, nonjudgmental, neutral stance towards reported memories of sexual abuse. “All physicians, psychiatrists included, must carefully avoid prejudging the cause of a patient’s difficulties, or the veracity of the patient’s reports,” McIntyre says.

Schwartz insists that hypnotherapy is just a small part of his practice that he uses in combination with other techniques.

“Patients are able to remember in the safety of the therapist’s office. Then they can make some meaning out of their suffering. More important is how to go on with that memory. In many cases, the person causing this suffering is a loved one. They learn that they can be angry with something that someone did to them but still love them.”

Schwartz often gets called to testify as an expert witness in court cases in which victims seek damages for their suffering. He says he testifies on both sides of these cases, depending on who he believes is right.

For example, he served as an expert witness in a case in which a woman who had been molested by her father sued her mother for not interceding to stop the abuse. The plaintiff won the case and was awarded a sum of money from her mother’s homeowner’s insurance policy. In another case, Schwartz testified on behalf of a hospital that was being sued by a boy’s parents when they learned that their son had sex with his hospital roommate while a patient there.

“I was on the hospital’s side because you can’t have kids in a hospital and watch them 24 hours a day,” says Schwartz. “That would create a jail-like atmosphere. I get calls all the time [to be an expert witness]. I only take cases where I feel I can help right a wrong.”

Coping with Change

Schwartz doesn’t see society’s curiosity about sex and relationships lessening.

“Masters and Johnson’s work has always been interesting to people,” says Schwartz. “Relationships are perpetually fascinating, as are different marital and sexual problems. Today, we have to deal with all of the violence in society. The endemic levels of violence by men against women are off the scale.”

Schwartz blames much of this violence on men’s inability to cope with women’s changing role in society.

“This is a very interesting time in history,” he says. “Women have made more changes in the last 25 years than ever before. But men have made very few changes. Women are frustrated. Men don’t have the equipment to make it in a contemporary marriage with two to three stepchildren and all of the problems that arise. Most of my work is to help men adapt to family life. We’re trained to do business and wage war – not to be part of a family. We need to develop a man’s blueprint for intimacy.

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